US embassy cable - 03ANKARA4177

UNCLAS SECTION 01 OF 02 ANKARA 004177 
 
SIPDIS 
 
 
STATE FOR EUR/SE, EUR/PGI, OES/PCI, OES/IHA (GALLAGHER, 
DILDAY) 
PLEASE PASS EPA (BFREEMAN, HHUYNH), HHS (FIC) 
 
 
E.O.12958: N/A 
TAGS: SENV, TBIO, PGOV, ECON, TU 
SUBJECT:  STATUS OF HIV/AIDS: LOW PREVALENCE, LOW PRIOIRTY 
 
REF:  SECSTATE 14643 
 
 
1.  Post used the delivery of Ref A materials on the 
President's Emergency Plan for AIDS Relief to obtain updated 
information on HIV/AIDS in Turkey from the Ministry of 
Health (MOH), Ministry of Foreign Affairs and UN Population 
Fund.  The institutions appreciated receiving the materials, 
acknowledged U.S. leadership in HIV/AIDS programming, and 
agree that developed nations need to provide support for 
AIDS prevention.  The MOH requested that Turkey be 
considered for participation in any worldwide training that 
might be offered. 
 
 
Incidence of HIV/AIDS is low 
---------------------------- 
 
 
2.  The MOH General Directorate of Primary Health Care 
reports that at the end of 2002, there were 1,515 HIV/AIDS 
cases in Turkey: 1,063 HIV and 452 AIDS.  Since 1992, those 
numbers have been relatively stable, with fewer than 50 new 
AIDS cases reported each year.  The incidence of new HIV 
cases have been low but steady since 1997, with the greatest 
increase in 2001 of 144 new cases.  There were 142 new HIV 
cases in 2002. 
 
 
3.  Seventy (70) percent of HIV/AIDS patients are male. 
Most are between the ages of 20 and 39.  The source of about 
half the cases is heterosexual contact. Drug use accounts 
for about 6.5 percent of the cases and blood transfusions 
for less than three (3) percent. The source of about a third 
of the cases is considered unknown. Istanbul has the highest 
prevalence of HIV/AIDS cases. 
 
 
4.  Healthcare professionals acknowledge that there are 
insufficient mechanisms for tracking HIV/AIDS patients and 
that an inadequate legislative base leads to under 
reporting.  In 2002, a representative from the CDC office of 
Public Health and Practice found that Turkey has literally 
no system for monitoring any infectious disease, let alone 
HIV.  The World Health Organization estimates that Turkey's 
HIV/AIDS incidence estimates are likely to be off by a 
factor of 50. 
 
 
Key Milestones, Programs 
------------------------ 
 
 
5.  MOH became active in AIDS prevention upon detecting the 
first case in Turkey in 1985.  AIDS testing began back then 
and is now offered free of charge.  Over the years, outreach 
expanded to include establishing a National Advisory 
Committee, supporting sexual health education in schools, 
distributing free condoms, providing disposable syringes, 
covering health care costs for patients, and instituting a 
telephone information line. Provincial health managers have 
received training in sexually transmitted diseases.  (Note: 
Some programs offered are costly, yet MOH officials could 
not provide a budget estimate for HIV/AIDS prevention, 
treatment or testing.  End note.) Turkey also works 
cooperatively with international organizations such as WHO, 
UNFPA, UNICEF, and UNAIDS. 
 
 
6.  In 1996, GOT formed a multi-sectoral National AIDS 
Committee (NAC).  The Prime Minister leads it, MOH supports 
it, and 32 ministries, institutions, professional 
associations, and NGOs are represented on it.  The NAC 
adopted the country's first National Strategic Action Plan 
last year.  Its primary goals are to educate the public, 
ensure safe blood supply, standardize testing, provide 
counseling, ensure legislation is respectful to individuals, 
and improve monitoring.  The NAC will monitor these targets. 
 
 
Low Prevalence, Low Priority 
---------------------------- 
 
 
7.  Despite these efforts, Turkey's HIV/AIDS infrastructure 
operates at a minimal level.  Post's healthcare provider 
finds that Turkey has demonstrated minimal commitment to 
following accepted epidemiological procedures. 
Professionals are insufficiently trained, data are 
unreliable and public awareness is low.  Mission employees 
rarely see any of the public educational materials 
purportedly disseminated on the media and in schools.  Even 
with the Prime Minister heading the NAC, most professionals 
agree that policy-makers rate HIV/AIDS a low priority. 
Turkey did not participate in the XIV International AIDS 
conference in Barcelona in July 2002. 
 
 
8.  That said, MOH has submitted a $6.5 million proposal to 
the Global AIDS Fund.  Winning such a grant would provide 
the boost needed to fully implement Turkey's national 
strategic action plan and invigorate education, prevention 
and treatment programs. 
 
 
Comment 
------ 
 
 
9.  Thus far, Turkey seems to have dodged the HIV/AIDS 
bullet.  Some attribute this to conservative family values, 
others to geographic luck.  But this luck might not 
continue.  The inability to track the sex-trade industry, 
prevent heroin trafficking from Afghanistan, and stem the 
tide of a potentially exponentially increasing epidemic over 
time requires vigilance, support, and a higher priority than 
HIV/AIDS now receives. 
PEARSON