WEBVTT

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Previously in life… Globalization
means diseases travel,

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crime travels, drug travel, terrorism
travels, so we are in this altogether.

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(inaudible) and precondition for any effort

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to make a development. The big health
tragedy is like TB and malaria

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have to be beaten back
if (inaudible) for use.

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A 42 million people around the world
are now thought to be infected by HIV,

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the virus that causes AIDS.
Many are sick or dying.

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Nine out of ten people with AIDS live
in Africa, Asia, or Latin America.

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Countries like Zambia being battling against
the AIDS epidemic for over 20 years,

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but new regions are now facing
an aids crisis of their own.

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Eastern Europe is at the frontier of the
epidemic. The former soviet republic of Ukraine

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is one of the fastest growing
HIV/AIDS in the world.

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It is estimated that one in a hundred
people are now infected by HIV.

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While the number of people actually dying from AIDS is
still low, the virus is spreading with alarming speed.

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[music]

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We don\'t have a road map for what\'s going to happen in (inaudible)
more then we had a road map for what\'s going to happen in Zambia.

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But the big difference is that
Ukraine crosses 20 years on

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from where Zambia was when its epidemic
started and more over there would be

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some new ideas around, so new responses.

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But what will those new responses be by drawing on
experience and knowledge from other parts of the world,

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will countries like Ukraine take the
necessary steps to contain the epidemic

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before falling into HIV/AIDS of this.

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[music]

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One in five people in Zambia are
infected with the HIV virus.

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From it\'s densely populated cities
to distant rural communities,

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the country has suffered
staggering human loses.

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Lusaka, Zambia\'s capital
city is no exception.

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[music]

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If you just walk on the streets of Lusaka, you\'ll see there\'ll
(inaudible) you… you actually miss the whole picture,

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I mean, you don\'t… you don\'t get a sense
that HIV/AIDS is… is that serious.

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They must vulnerable in age
group (inaudible) from 20 to 49

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and if you go to… to any average, any
graveyards, there is a (inaudible)

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I mean, you… you can go to our graveyard
here in Lusaka, there is always a queue,

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what on daily basis of people being buried.

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Survey show Zambia faces more than
200 age related deaths every day.

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With HIV infection rates at 27% in
urban areas and 13% in rural areas.

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The coffin industries booming.

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[music]

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Zambia already has over 600,000 orphans

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and the streets of Lusaka are becoming home to more
and more children who have no where else to turn

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[sil.]

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Kids on the streets, a lot of
them, their parents died of AIDS.

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When both parents die then there is no one to
commit themselves to take care of these children,

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so because of that kind of situation they… they
rush to the streets because in the streets

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there are so many of them, so they feel comfortable
though they can\'t understand it too much,

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but it devastates them even mentally some of
them because they\'re on blue, they\'re on drugs,

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they\'re on alcohol (inaudible) say that they\'re just
depressed. You can stay with one may be for two months,

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can\'t talk to anyone, so you need to take
some time to redefine out then they explain,

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no, what happened, is this is this is that, I don\'t
know if I\'ll be ever be out of this situation.

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(inaudible) centre in Lusaka provides food,

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education, and accommodation for some
of the cities most vulnerable children.

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Many of the children fall victim to abuse

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and are often drawn into criminal
behavior on the streets.

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When they lost their
mother to AIDS brothers

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Emanuel and Mikey drifted into town.

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The big boys on the streets tried to take our money
and if we didn\'t give it to them they beat us

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and so we often have to keep
running away from them.

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I like it here because I\'m sure of food
here. I\'m sure of sleeping comfortably.

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I\'m sure of playing football and
I\'m sure of seeing tomorrow.

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[sil.]

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But the fear now is how the situation in Zambia
will deteriorate still for as more people die,

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it\'s becoming increasingly hard for the
devastated population to support itself.

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[sil.]

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What we\'re seeing now is that HIV is going to be the economic
impact because again if you look at the age group that are dying

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is 22 to like… 22 to 49, now these are the…

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the ones who are supposed to be the engine of the
economy. Some of the recent studies have shown that

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in fact we cannot train enough teachers
to fill out those who\'ve died,

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so eventually we have a shortage of teachers and
already we have.. I think we are experiencing that,

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the number of nurses and those in the medical position
who are dying and the number of engineers and so on,

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now all those have economic in professions
because who is going to run these things.

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[sil.]

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In the small town of Kalomo, south of Lusaka
residents can find out their HIV status

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at their local Voluntary
Counselling and Testing

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or VCT centre. The rapid development
of these centres across Zambia

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is a key part of its prevention
strategy against HIV and AIDS.

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[sil.]

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Patricia Habeenzu is the district
VCT coordinator at Kalomo Hospital.

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Come in. Good afternoon. Good afternoon.
How are you? (inaudible).

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Fine, thank you. You can. In the HIV,
if you look up to yourself very well.

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If you follow the do\'s the don\'ts,

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you definitely live for a long time. I\'m Patricia
Habeenzu. Knowing your HIV status is very, very good

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because you know how to look after yourself
whether positive or negative. Clemmit,

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were you once robbed in some risky

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behavior (inaudible) out.

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Yeah, I thought that I
would see girlfriend,

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but (inaudible), so he
says now look at you,

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two days ago your girlfriend passed away,

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so you have to go for HIV test. So
I\'ll just get a bit of blood from you

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and then you give me about 5 minutes.
I\'ll come back with your results. Okay.

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[music]

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Outreach program was like this,
introduce the stigma of HIV and AIDS

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and so help to decrease HIV prevalence rates
that confronting the secrecy surrounding it.

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[music]

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For… for this one, (inaudible) tell that the result is negative,
because there is no red line showing on the bottom part,

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so it\'s negative.

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[sil.]

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For removed villages often hundreds
of miles from the nearest small town

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traveling VCT units of the accessed
HIV testing and counseling

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for those who needed.

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The residents of Nabwalya

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are visited monthly by
their nearest VCT team.

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Most of the people in the rural
areas are not able to access VCT,

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reasons being the distance
from the areas to town,

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the drivers spent their money on food than
travel to have their blood tested for HIV.

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[sil.]

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If people don\'t know the HIV status, they
could be infected and if they don\'t know

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they would pass on the infection. We believe
that (inaudible) for us, if people know

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that they are HIV negative, that they have
done the test and they know that HIV negative,

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I think that gives them the motivation
for them to try to maintain that status.

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At that moment, we\'re also
talking about coming in of ARVs,

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I mean, how does somebody get on the
ARVs unless the HIV have been tested,

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so unless we know then I think you cannot make a rationale
decision in terms of what to do about most of these things.

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[music]

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So far tested 48 and 6 of this 48
are positive. It\'s not too bad,

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it\'s better than one out of five.

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Nabwalya may be fairing better than others,
but lack of funds and battles of drug patents

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have stopped antiretroviral drugs,
ARVs reaching those who need the most,

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the world\'s poor.

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After the recently announced collaboration between the Clinton
foundation, the World Bank UNICEF and the global fund,

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this looks up to change.

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Encouraging science point to significant
reduction in the cost of generic AIDS medicines.

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But a wide scale expansion of cheaper ARVs,

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is just a small part of the larger
prevention and treatment strategy

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needed in the fight against HIV and AIDS. The antiretrovirals
are not an answer to the problem of the HIV/AIDS epidemic.

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There\'s something we have to absolutely clear
about. But in the case of countries like Zambia,

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which have got very elevated epidemics

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then the antiretrovirals will offer a window,
a window of opportunity during which

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you can keep people alive, you can able them
to parents, you can able them to be producers

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and that is hope for the future. In Zambia,
there are now a few faint flickers of hope.

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In the 15 to 29 age range,

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incidences of new HIV infections are leveling
out even declining in some urban areas.

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In the general adult population though over a
numbers of infection are still increasing.

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Here in Zambia, there is no family
that you can to (inaudible).

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Personally, I have lost two of my

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young siblings (inaudible) who
have dead of HIV and AIDS.

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I\'m keeping a number of orphans in my
own home. So that\'s the reality of it.

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I wouldn\'t say that fighting is ended, is over yet,
it\'s not. We still have new people getting infected.

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We still have people who are ignoring
know whatever we have been talking about

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that I think it\'s the efforts that we\'re putting in which
we needed to sustain them. If we\'re going to reduce

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the providence that was because really
(inaudible) sexually active population,

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we are still talking about 16% in terms of
HIV is prevented and that\'s incredibly high.

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While Zambia continues its 20-year battle

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against HIV virus, many
countries in Eastern Europe

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are just beginning the fight.

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But new regions oppose
serious new problems.

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(inaudible) countries like Zambia
will new crisis countries Ukraine

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acts to contain the epidemic
before it spirals out of control.

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[sil.]

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And this epidemic is about
drugs and is about sex

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and it was all those things that every society
wants to keep the most (inaudible) most secret

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and if we then confirm those things,
we can confirm the epidemic.

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[sil.]

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Because I understand it,
AID, it\'s a big task

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not only for a person who lives on street,

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but it also a test for society
as a whole, a test of tolerance,

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understanding, openness, sincerity.

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Those qualities which make a person human.

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Worst case scenario of Ukraine

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means that was in a million people
will die from AIDS in 2016,

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so it\'s a very dangerous situation

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and currently Ukraine go
to a lot of opportunist

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to avoid this situation.

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Studies in Eastern Europe showed no other
country has the spread of the virus

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has been drug fueled. Since the
fall of communism in 1991,

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Ukraine has suffered increasing
social economic problems

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including a dramatic increase in unemployment. Today,
there are estimated 30000 injecting drug uses in Kyiv

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Ukraine\'s capital.

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(inaudible) is an
organization run by people

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who\'ve experienced the problem of drug
abuse. They work as pure educators

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holding self help support groups like
this one and offer a place of refuge.

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[non-English narration]

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Ivan Shekker is a social
worker and a former drug user

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involved in outreach (inaudible) projects
with drug addicts and sex workers in Kyiv.

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[sil.]

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When I started using drugs,
it wasn\'t very common,

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just certain closed groups.

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Now we have as many drug users as we had
young pioneers or counselor members

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and that number is increasing. Young people
are interested in dwelling into (inaudible).

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[sil.]

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The sea poverty, the sea problems
and they want to get high now.

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[non-English narration]

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They look at pensioners and ask
what sort of life they\'ll have.

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$10 a month that\'s in poverty,
so they want to get a high now.

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This is the way as is

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to try to grab all of the pleasures
of life the drugs give you.

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[sil.]

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Almost three quarters of HIV
infected adults in Ukraine

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are injecting drug users.

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A major objective now is to contain
virus before its spreads further

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into the wider population.

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[sil.]

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Ivan Shekker\'s outreach work takes
him out on to the streets of Kyiv

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where he distributes condoms and
clean needles to sex workers.

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Many are also intravenous drug users.

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[non-English narration]

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In the absence of medication against HIV and
AIDS, the only way to stop the HIV infection

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is to provide clean syringes and
condoms to as many sex workers

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and drug users as possible.

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Growing poverty and the deteriorating
social and economic conditions in Ukraine,

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a fueled not unleaded huge rise in drug abuse,
but also a rapid increase in prostitution

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as a way of making money.

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The nation\'s health is in their
hands of the sex workers

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and they think this is very true because a
significant part of our male population

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use their services. This
is the nation\'s health.

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[non-English narration]

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If the sex worker is healthy, if she
is aware of HIV and takes precautions,

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I think this fear will prove itself.

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[sil.]

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Somehow we can break the pscho.

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We need to break at least
one link in the chain.

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Ivan also makes House Schools.

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[sil.]

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Today, he is visiting two women in
one of the highest risk groups.

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[sil.]

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Vlada and her daughter Julie take drugs.
Both are HIV positive.

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Julie sell sex for money.

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[non-English narration]

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Ivan has persuaded Vlada and Julie to provide
a needle exchange for local sex workers.

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[non-English narration]

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The flat is very conveniently located.
It\'s right in the city of ring road.

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It\'s good to work here because
most of the sex workers

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are working on the roads near by and this is
an ideal place to give out clean syringes.

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Most of the girls want to exchange needles

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from the street in case they gets stopped by
the police and ask unnecessary questions.

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This is a neighborhood
famous for its drugs,

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so people are coming here to get the drugs

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before he came along, we were giving and provided the
same old syringes even though we washed them out before.

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[music]

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Problem is that AIDS is still considered
as a specifically health issue here.

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No one sink in more
broadly in broad context,

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sink in about consequences for demography

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for connecting AIDS with social conditions
with it\'s economic consequences etc.

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[sil.]

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It\'s very important that the people of Ukraine and the
Ukraine government of civil society organizations

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address this issue right now.

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Ukraine has handicapped by an inability of politicians
and policy makers to look outside of the region

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and see what is happened elsewhere

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and that is a very serious
failing in many respects.

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Of course, it is important to overcome this

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or it will be left with nothing.

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Sick children, sick (inaudible) touch,
nobody capable of working, nothing.

00:21:25.000 --> 00:21:33.000
[sil.]

00:21:40.000 --> 00:21:44.999
I hope for nothing in the future.
I\'m just waiting for my time

00:21:45.000 --> 00:21:49.999
to go to the better world.
But the good lord

00:21:50.000 --> 00:21:54.999
doesn\'t want me yet.

00:21:55.000 --> 00:21:59.999
Drugs break your sense of aspirations.
It\'s not life. It\'s mere existence

00:22:00.000 --> 00:22:04.999
from injection to injection.

00:22:05.000 --> 00:22:09.999
It\'s impossible to explain.

00:22:10.000 --> 00:22:14.999
I seem to respond to AIDS.

00:22:15.000 --> 00:22:19.999
We need to make this problem more human

00:22:20.000 --> 00:22:24.999
to cut Stigma and discrimination

00:22:25.000 --> 00:22:29.999
to link it with… with all society.
Ukraine has just received a grant

00:22:30.000 --> 00:22:34.999
of 92 million dollars from the global
fund for it\'s HIV/AIDS program.

00:22:35.000 --> 00:22:39.999
It\'s part of a world wide strategy

00:22:40.000 --> 00:22:44.999
to tackle the epidemic as it unfolds.

00:22:45.000 --> 00:22:49.999
I\'m an optimist and HIV positive
people that I work with

00:22:50.000 --> 00:22:54.999
they inflicted this optimism.

00:22:55.000 --> 00:22:59.999
I think that may be this will be the point from
which our society, our psychology will be changing.

00:23:00.000 --> 00:23:04.999
It\'s when these people who
looked into no where.

00:23:05.000 --> 00:23:09.999
Can now be able to change

00:23:10.000 --> 00:23:14.999
and to help others to change as well.

00:23:15.000 --> 00:23:19.999
[music]

00:23:20.000 --> 00:23:24.999
The world health
organization has set targets

00:23:25.000 --> 00:23:29.999
for implementing HIV prevention
programs in many developing countries

00:23:30.000 --> 00:23:34.999
but lack of funding is
hampering how well they work.

00:23:35.000 --> 00:23:39.999
More money helps, certainly
more money helps.

00:23:40.000 --> 00:23:44.999
But more than that is to remove other peoples moral
agendas from the support of these organizations.

00:23:45.000 --> 00:23:49.999
If people want to distribute condemns,
we should support them in that.

00:23:50.000 --> 00:23:54.999
If people wanted to give sex education,
we should support them in that.

00:23:55.000 --> 00:23:59.999
If people want to distribute and control
antiretrovirals, we should support them in that.

00:24:00.000 --> 00:24:04.999
But we should not tie the money to
the moral agendas of rich societies

00:24:05.000 --> 00:24:09.999
whose politicians often have no conception
of what is happening in poorer countries.

00:24:10.000 --> 00:24:14.999
Recent cause to expand in generic ALV
treatments could plan important role

00:24:15.000 --> 00:24:19.999
in the global fight against HIV and AIDS, but world
is be enough for the world health organization

00:24:20.000 --> 00:24:24.999
to achieve its three by five goal

00:24:25.000 --> 00:24:29.999
getting three million HIV infected
people on treatment by 2005.

00:24:30.000 --> 00:24:34.999
The world health organization
three by five plan is (inaudible)

00:24:35.000 --> 00:24:39.999
is one of the best things that
happened, but it is a vision

00:24:40.000 --> 00:24:44.999
and it is the most extraordinary challenge,
but its not going to be the answer.

00:24:45.000 --> 00:24:49.999
This is a long term epidemic, it\'s going
to be with all of us throughout our lives

00:24:50.000 --> 00:24:54.999
and through the life of our children and grandchildren
and this is one beginning, one symbolic beginning

00:24:55.000 --> 00:24:59.999
of when the world came together to try
and confirmed human infectious disease,

00:25:00.000 --> 00:25:04.999
but we have to find other
ways for this as well.

00:25:05.000 --> 00:25:10.000
[music]

00:25:45.000 --> 00:25:53.000
[sil.]