This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 02 VILNIUS 001447 
 
SIPDIS 
 
STATE FOR EUR/NB, EUR/PGI:BPOMAINVILLE, 
IO/T/HTTP:ABLACKWOOD, M/R:APONCE, OES/IHA, 
S/ES/SWO:KMAYFIELD, AND USAID:LMORSE 
 
HHS FOR WSTEIGER 
 
E.O. 12958: N/A 
TAGS: TBIO KHIV PREL LH
SUBJECT: AIDS IN LITHUANIA 
 
REF: A) VILNIUS 540, B)  VILNIUS 880, 
 
     C) VILNIUS 1180 
 
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SUMMARY 
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¶1.  As it prepares to celebrate World AIDS Day, Lithuania's 
incidence of HIV/AIDS is the lowest in Central and Eastern 
Europe. The GOL is working to keep it that way, despite 
pressures of rapid social change.  Lithuania has a National 
HIV/AIDS prevention strategy, but poorly monitors its 
implementation.  The Embassy continues to reinforce GOL 
efforts to combat HIV/AIDS by encouraging discussion at the 
policy-making level and funding professional training and 
cross-border collaboration.  End Summary. 
 
HIV/AIDS demographics in Lithuania 
---------------------------------- 
 
¶2.  Lithuania has to date registered 928 HIV positive 
patients since its first case in 1998 -- the vast majority 
in the last three years.  Transmission of more than 80 
percent of cases occurred through shared needles.  Some 241 
cases are located in Lithuania's third-largest (port) city 
of Klaipeda, 148 in Vilnius, and 34 in the nation's second 
largest city of Kaunas.  Approximately 76 persons carry the 
diagnosis of AIDS and 34 persons have died from the 
disease. 
 
¶3.  The European HIV Monitoring Center lists Lithuania as a 
country with a low rate of HIV infection.  Lithuania's HIV 
rate per 100,000 people was 24.4 in 2003, in contrast to 
470 in Russia's Kaliningrad region, 272.2 in Estonia, 169.6 
in Russia as a whole, 112.9 in Latvia, and 49.7 in Belarus. 
 
Trends point to a probable increase 
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¶4.  Health Minister Juozas Olekas recently stated that 
although the number of HIV cases in Lithuania is low, the 
country may face new threats arising from increased 
exposure to surrounding countries with a higher number of 
infected people.  For instance, exposure to disease in the 
Kaliningrad region has increased due to recent growth in 
business and leisure travel (including sex tourism). 
Likewise, greater exposure to Latvia's higher rate has 
followed the easing of travel restrictions across the two 
new EU member-states' common border.  Mazeikiai, a 
Lithuanian transit point for truck drivers on the border 
with Latvia, has one of the highest rates in the country. 
 
¶5.  Dr. Saulius Caplinskas, Director of the Lithuanian AIDS 
Center, told us that the GOL must step up its surveillance 
of high-risk "bridge populations," such as drug abusers, 
prisoners, and their sexual partners, to prevent them from 
infecting the general population.  He said that free 
movement of persons within the EU, new kinds of injectable 
drugs, and immigration may introduce new avenues for the 
spread of HIV/AIDS.  Already, twelve refugees in Lithuania 
have been found to be HIV positive.  Caplinskas predicted 
that absent increased prevention, HIV/AIDS would rapidly 
spread.  He observed that Russia had an epidemiological 
profile similar to Lithuania's before a lack of early 
controls permitted the disease to progress unchecked.  A 
recent UNDP report also recommends that Lithuania rapidly 
undertake appropriate actions to prevent the rate of new 
HIV infections from increasing. 
 
¶6.  Other HIV/AIDS experts endorse Caplinskas' views.  Dr. 
Alvydas Laiskonas, Director of the Kaunas Medical 
University Infectious Diseases Clinic, said that 
Lithuania's low rate reflects a lack of active surveillance 
by public health authorities.  Rather than the current 
practice of testing only risk groups in the capital, he 
recommended free testing of all volunteers throughout the 
country, as is the practice in Estonia and Latvia. 
Laiskonas suggested that the government undertake a strong 
education campaign stressing prevention among youth. 
 
Good national strategy, poor implementation 
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¶7.  The Lithuanian government approved in 2003 the National 
HIV/AIDS Prevention and Control Strategy for 2003-2008. 
The Strategy emphasizes education and treatment of high- 
risk groups (e.g., intravenous injections users, 
prostitutes, etc.) and includes program-specific budgeting. 
The GOL had also constituted a National Coordinating 
Committee to oversee implementation of this plan. 
 
¶8.  The Strategy identifies priorities, implementing 
structures, activities and timelines, but the Ministry of 
Health does not monitor its implementation on an ongoing 
basis.  MOH Public Health Division Head Romualdas 
Sabaliauskas told us that the GOL and the AIDS Center had 
no information on the actual funds various institutions had 
allocated to date, the measures they had implemented, and 
the results they had achieved.  Sabaliauskas observed, 
however, that the Ministry plans to prepare a one-year 
review report soon. 
 
¶9.  A recent United Nations report, evaluating Lithuania's 
implementation of the Millennium Development Goals, 
indicated that implementation of the National Strategy 
lacks sufficient resources.  The report urges the GOL to 
prioritize activities and allocate sufficient funding to 
support the Strategy's wide range of activities and ensure 
its implementation. 
 
Embassy efforts 
--------------- 
 
¶10.  The Mission is a key contributor to Lithuania's fight 
against AIDS.  We are funding professional training and NGO 
AIDS advocacy programs here.  Embassy programs in 2004, 
which total $160K, will: 
 
-- enhance knowledge in HIV prevention in 10 districts of 
Lithuania, by training up to 200 health specialists; 
 
-- facilitate provision of necessary services to HIV 
infected persons though an NGO coalition; and 
 
-- conduct Lithuanian/Kaliningrad cross-border HIV/AIDS 
training to promote sharing of Lithuania's experiences with 
Russian medical professionals. 
 
We are also hosting a number of events here during World 
AIDS Day, including a roundtable discussion inaugurated by 
the Ambassador that will assemble Lithuania's top 
authorities on the disease. 
 
Comment 
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¶11.  The GOL has a good plan to tackle HIV/AIDS.  Its 
actions, however, must match its words.  Therefore, we will 
continue to encourage the GOL to ensure effective 
implementation and funding of its national strategy, by 
involving all relevant ministries and stakeholders.  In 
particular, we will encourage the GOL to decentralize 
HIV/AIDS services, and modify provisions of its health law 
that establish a right of free treatment only for AIDS 
patients, but not for the HIV infected. 
 
¶12.  We will also seek to help the GOL to strengthen 
capacity at the district level in order to complement 
efforts at the national level.  For this, we will use our 
training programs to impart to professionals in Lithuania's 
regions much-needed knowledge on how to improve 
surveillance of HIV positive individuals and reduce high- 
risk groups' vulnerability. 
 
MULL