VZCZCXRO6931
RR RUEHAST
DE RUEHVB #0952/01 2221332
ZNR UUUUU ZZH
R 101332Z AUG 06
FM AMEMBASSY ZAGREB
TO RUEHC/SECSTATE WASHDC 6502
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE

UNCLAS SECTION 01 OF 03 ZAGREB 000952 
 
SIPDIS 
 
 
SIPDIS 
 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: SENV KHIV PHUM PGOV HR
 
SUBJECT: CROATIA SEEKS FUNDING TO CONTINUE AIDS- 
RELATED ACTIVITIES 
 
 
ZAGREB 00000952  001.2 OF 003 
 
 
1.(SBU) Summary: As Global Fund support for 
Croatia's AIDS programs ends this year, health 
officials are scrambling to continue funding for 
testing and treatment as well as education and 
prevention programs which have been successful in 
changing preconceptions toward HIV/AIDS patients in 
this conservative country. Croatia cannot reapply 
for funding because its GDP exceeds the Global Fund 
limit. While the number of documented HIV/AIDS cases 
remains low, Croatia believes it is crucial to 
continue these programs as the country draws more 
tourists and transient workers, one possible link to 
the spread of the disease. HIV/AIDS workers are also 
seeking to strengthen legislation to end 
discrimination against those who test positive for 
HIV. End summary. 
 
-------------- 
Infection rate 
-------------- 
 
¶2. (U) There are 512 officially documented cases of 
HIV in Croatia, about .01 percent of the total 
population (5 million). Of those, 234 have developed 
into AIDS. People with HIV in Croatia are almost 
exclusively members of high-risk groups - primarily 
homo/bisexual men and heterosexual men who have 
frequent contact with commercial sex workers (these 
two populations overlap). There are currently nine9 
children who were infected by their mothers and 52 
known cases of intravenous drug users. 
 
¶3. (U) Currently the number of people voluntarily 
seeking testing is five out of every 10,000, 
according to Iva Jovovic, National HIV/AIDS Advisor 
of the UN Theme Group on HIV/AIDS in Croatia. 
Jovovic said that number needs to be 10 out of 
10,000 to get a true picture of the number of 
HIV/AIDS affected people in Croatia. Jovovic added 
that Croatia has moved into the second generation of 
HIV surveillance, analyzing behavior and biological 
research to determine who is at risk for HIV 
infection. 
 
¶4. (U) In 2005, 12 new cases of HIV were reported. 
Dr. Josip Begovac, head of the AIDS unit of the 
University Hospital for Infectious Diseases, 
attributes the increase to more voluntary testing, 
rather than the spread of the disease. However, 
health officials fear a larger increase is possible 
as more transient workers, merchant sailors and 
tourists travel to Croatia. 
 
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Funding 
------- 
 
¶5. (SBU) Croatia's health officials and NGOs have 
been working under a three-year, $4.5 million grant 
from the Global Fund to establish testing centers 
and clinics, treatment, counseling, education and 
prevention programs. Dr. Dunja Skoko-Poljak, senior 
advisor in the Ministry of Health, said 10 million 
Kuna per year ($1.76 million) is needed to continue 
all of the programs. She expects the Ministry of 
Health to maintain at least the 10 clinics 
established throughout Croatia and the treatment 
center in Zagreb, but hopes the NGOs will secure 
their own funding to continue counseling, education 
and prevention. 
 
¶6. (SBU) A representative from the NGO HUHIV was 
surprised to hear there was a chance HIV/AIDS NGOs 
wouldn't be included in future government funding. 
However, they have also begun looking for outside 
funds without much luck. One spokesman said the Bill 
and Melinda Gates Foundation turned down HUHIV's 
grant application, saying, "Croatia is not a 
priority." 
 
-------------------------- 
Centralized care in Zagreb 
-------------------------- 
 
¶7. (U) Treatment has been available in Zagreb since 
¶1996. Currently there are 220 patients seeking 
treatment. The 10 testing centers operate in Zagreb 
(2), Osijek, Zadar, Rijeka, Split, Slavonski Brod, 
 
ZAGREB 00000952  002.2 OF 003 
 
 
Dubrovnik and Korcula. Once diagnosed, patients are 
referred to Dr. Begovac in Zagreb for further 
testing, treatment and medicine. Dr. Begovac keeps a 
record of all HIV/AIDS cases to be reported to the 
National Health Insurance, which pays for treatment 
and medicine. Patients travel up to four times a 
year for exams and prescriptions. Seventeen of 20 
existing drugs are available in Croatia. Health 
officials said this is adequate.  The centralized 
treatment center helps HIV patients maintain their 
privacy, Dr. Begovac said, because they don't have 
to visit neighborhood clinics regularly. 
 
------------------ 
Changing attitudes 
------------------ 
 
¶8. (SBU) Begovac said it's not as easy for AIDS 
patients to find dentists and doctors to treat them 
for other ailments because of lingering fear among 
medical practitioners. Begovac said he is working 
within the University Hospital and medical community 
to educate physicians, nurses and dentists about 
HIV/AIDS. He said the problem remains with older 
medical professionals and expects it to lessen with 
time. 
 
¶9. (U) Croatia's attitude has somewhat improved 
since 2002 when the public and press scandalized Ela 
and Ina, two girls who were nearly barred from 
attending public primary school when it became known 
they were HIV positive. Health officials attribute 
the positive change to the numerous education and 
prevention programs run by five NGOs and backing 
from the Ministry of Public Health. They said 
testing and treatment is not enough without 
community outreach. Since a team of medical experts 
went to Kutina to explain that Ela's and Ina's 
classmates wouldn't be in danger of contracting the 
disease through casual contact, they and a handful 
of other HIV infected children have been able to 
attend public schools. 
 
¶10. (U) Educational programs were introduced into 
middle and high schools nationwide, targeting the 
age group most likely to become sexually active. 
School officials resisted at first, mainly due to 
the influence of the Roman Catholic Church, HUHIV's 
spokesman said, but now 70 percent allow NGOs to 
provide HIV/AIDS education programs and materials. 
The most resistant areas tend to be in Dalmatia 
where the population is most conservative, HUHIV 
reports. But even some of those schools have signed 
on to the Church's own HIV/AIDS education program. 
 
------------------------------- 
Anti-discrimination legislation 
------------------------------- 
 
¶11. (U) The UN Theme Group on HIV/AIDS analyzed 
Croatia's legislation regarding AIDS and anti- 
discrimination and published a report in June. 
The analysts said Croatia essentially follows 
international recommendations regarding testing and 
privacy but needs to strengthen its regulations in 
those areas as well as in protecting people with 
HIV/AIDS and their families from discrimination. 
 
¶12. (U) Although testing is voluntary by law, there 
are exceptions. Testing is mandatory for blood, 
organ and tissue donors. It's also mandatory for 
those seeking positions as crew on aircraft and 
ships and military and civilian bodyguards. The 
report also notes that there is discrimination in 
the workplace in hiring, promoting and treatment of 
employees who are discovered to have HIV/AIDS. 
 
---------------------- 
Working with the Media 
---------------------- 
 
¶13. (U) Jovovic said the HIV/AIDS community is 
making efforts to work with rather than battle the 
media. People discovered with HIV/AIDS are still big 
news, but Jovovic said she and her colleagues 
respond quickly to media inquiries, when 
appropriate, with factual information. Jovovic said 
the UN Theme Group has assembled a group of 
 
ZAGREB 00000952  003.2 OF 003 
 
 
journalists and lawyers to review media coverage of 
HIV/AIDS in Croatia, with a report to be released in 
September. They also are sponsoring a journalism 
competition with an award for the most responsible 
coverage of HIV/AIDS to be announced in December. 
 
-------------------- 
More success stories 
-------------------- 
 
¶14. (U) HIV/AIDS workers point to the AIDS tram, 
painted on the outside with contact information for 
testing and counseling, as one of their most 
successful innovations. The tram has been running 
for a year in Zagreb. HUHIV also publishes a 
quarterly information bulletin, with a circulation 
of 10,000 nationwide, including hospitals, clinics 
and testing centers. The NGOs also organize the 
annual World AIDS Day on December 1. 
 
¶15. (U) Dr. Skoko-Poljak noted the inroads made into 
the communities of sex workers and intravenous drug 
users. She said many are voluntarily going for 
testing, accepting condoms and participating in 
needle exchange programs through outreach workers at 
churches, local governments, NGOs, and police. 
She said they are also offering tests in prisons. 
 
DELAWIE