US embassy cable - 04ZAGREB2171

UNCLAS  ZAGREB 002171 
 
SIPDIS 
 
 
PLEASE PASS ESTH OFFICER 
DEPARTMENT FOR S/GAC AND EUR/PGI/BRETT POMAINVILLE 
BUDAPEST FOR KARYN POSNER-MULLEN 
 
E.O. 12958: N/A 
TAGS: KHIV, PHUM, PGOV, HR 
SUBJECT: HIV/AIDS IN CROATIA: LOW PREVALENCE AND LOW 
AWARENESS 
 
SUMMARY AND COMMENT 
------------------- 
 
1.  Croatia's few registered cases of HIV/AIDS and low 
knowledge about the disease and how it spreads translate into 
an HIV/AIDS strategy focused on prevention and education. 
Stigmatization continues be an obstacle, as alarmist press 
accounts beat out a small cadre of dedicated health 
professionals in dictating the terms of the HIV/AIDS 
discussion.  A long-overdue updated National Action Plan and 
proposed anti-discrimination law are encouraging signs that 
Croatia is getting serious about dealing with HIV/AIDS before 
it becomes a major problem. 
 
2.  This is the first in a series of three cables looking at 
HIV/AIDS in Croatia.  Reports on Global Fund efforts to 
expand free, anonymous testing and efforts to combat high 
antiretroviral drug prices will follow septel.  END SUMMARY 
AND COMMENT 
 
PREVALENCE 
---------- 
 
3.  With just 470 registered cases in a population of 4.4 
million, Croatia's HIV/AIDS prevalence is low.  Two hundred 
eighteen individuals currently receive drug treatment for 
AIDS.  Four out of five infected are men.  Transmission since 
1985 has occurred primarily by sexual contact within the 
homosexual (38%) and heterosexual (27%) communities; 
intravenous drug users account for 10% of all HIV infections. 
Two cases of transmission occurred via blood transfusion in 
2004.  Most reported cases come from large cities; however, 
large cities also have the best mechanisms for reporting new 
cases. 
 
4.  Official statistics likely underestimate the true extent 
of the problem owing to complicated (but improving) 
bureaucratic procedures to get confirmed test results and to 
register a case with the national health system.   Whereas 
patients until recently were given a choice of paying cash 
for an HIV test or presenting their national insurance card 
-- with identifying details -- to their care provider, 
Croatia's health system now allows for free and anonymous 
testing.  Official GoC HIV/AIDS statistics come from drug 
treatment centers (including needle exchange centers), 
hospitals, HIV testing centers, and blood transfusion centers. 
 
JOURNALISTS AND POLITICIANS FAIL TO SHAKE PUBLIC APATHY 
--------------------------------------------- ---------- 
 
5.  Croatia's low prevalence of HIV/AIDS coexists with 
sensationalist journalism, silence from political leaders, 
and indifference from most of the public.  Media coverage 
surrounding a trafficking victim in Mostar (reftel) and a man 
in Split publicly accused of intentionally spreading HIV 
brought HIV/AIDS to the headlines just ahead of World AIDS 
Day 2004.  A large daily recently ran a headline announcing 
that a Split-based herbologist had 'cured' 5 patients of 
AIDS.  A number of NGO-sponsored group discussions and film 
festivals included speeches specifically criticizing 
journalists for creating anxieties about AIDS rather than 
promoting a serious discussion on how HIV is transmitted and 
how Croatians can protect themselves.  Yet whereas alarmism 
characterizes the reporting on HIV, silence seems more the 
rule in the political class, as politicians frequently go to 
great lengths to avoid speaking up on HIV/AIDS for fear of 
alienating voters.  The Church has likewise shied away from 
speaking out about HIV/AIDS, though some in the NGO community 
have expressed frustration with the Church's obstructionism 
in expanding peer education.  Tabloid journalism and 
political silence in general, however, have done little to 
shake public indifference. 
 
REASONS FOR OPTIMISM -- A NEW NATIONAL PLAN AND 
ANTIDISCRIMINATION LAW 
--------------------------------------------- - 
 
6.  On the occasion of World AIDS Day, Croatia's reconfigured 
National AIDS Committee convened for the first time all year 
on December 1 to adopt an updated National Action Plan on 
combating the spread of HIV/AIDS.  The plan, drafted by the 
Ministry of Health to replace the previous 1993 version, 
emphasizes assistance to people living with HIV/AIDS, 
targeted interventions into at-risk populations, expanded 
peer education, upping test numbers through voluntary 
counseling and testing centers, and improved surveillance of 
how HIV/AIDS spreads in Croatia.  The Committee's membership 
includes a mix of Ministry of Health politicians, 
immunologists, NGOs, doctors, the UNDP Resident 
Representative, and a Catholic priest.  NGOs and GoC 
 
 
representatives were united in supporting the updated plan as 
a positive step towards de-stigmatization and prevention, 
while stressing that its implementation -- with Global Fund 
assistance -- had been ongoing since 2003. 
 
7.  Croatia has no law banning discrimination against 
individuals with HIV/AIDS; however, the Labor Law provides 
some protection from discrimination in hiring and firing. 
Several HIV-themed NGOs recently teamed up with a professor 
from the Zagreb Faculty of Law to draft a comprehensive 
anti-discrimination law that would incorporate HIV/AIDS 
discrimination into a larger disabilities movement.  The 
proposed law would address discrimination in employment, 
education, welfare payments, and access to legal services 
while criminalizing mandatory HIV testing and hate speed 
associated with HIV/AIDS.  The law will also ban 
discrimination based on membership in a risk group or 
personal connections to an infected person.  The NGO 
consortium believes they have support in the Parliamentary 
Committee on Human Rights and hopes to have the bill ready 
for debate by March. 
FRANK 
 
 
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