conic welcome to worlds apart the russians a big believer is that in having that own special way to deal with universal problems including eighty eight here is public health officials found skeptically on hunger induction programs instead of counting on traditional values to sound the growl of infections but with the number of cases reportedly costing one million last year has the time come to change tack well to discuss that i'm now joined by louis lawrence deputy executive director of u.n. aid dr laura since great to talk to you thank you very much for your time but i

will now one of your colleagues an aids recently announced that if russia's interests if your agency can help with negotiate better access to cheaper drugs potentially at reducing the annual cost of therapy to last than seventy five dollars per person and i was really surprised by the if for position is there any doubt if russia is interested in something like that and clowns are off there from wyoming gauging misery is there. was always very high do they had. to be way too fussy to date access to drugs and to treatment and do you any age of course were you spout off your joy be off your response ability to make sure that the experience you are there pots off there would they may be used up lied to you know that but that's the case he had refused to europe as a whole but as far as i understand the securing cheaper prices is more challenging for a richer countries that. for poorer countries and or middle income countries and particularly

here it is to europe where some of the countries including russia are considered to be a relatively well off to be offer at the assistance of hammer adoption or cheaper prices what needs to be done tension or a universal access for this part of that well off that is a clear and is a trial and to spatially eastern europe today spain the highest prices globality in general for access to aids drugs and why is that. good that i'm in that they may not spray you know and a lot experience shows they had that's not the impossible situation to change it seems like a book procurement to buy twenty it's some dime museum going to be by may or may well that has some experience seems to me up to the roof if that's possible you was a recent theme bella who has. been allowed to say yes negotiate for for flood

don't depart i saw feeling to help provide a spur. it is a problem dangerous to be face and you need the system much couple but just how man to stand because one would think that when countries especially when they join forces they they should have known difficulty negotiating with the big pharma and yet it seems that they have to figure that out i mentioned that your colleague mentioned before seventy five dollars per person for an annual course of treatment that's like a fraction then very very small fraction of what they say countries having right now so what's the problem why this free you off your go what's happening death going to these ideals so penalize be thought be meeting come home to fear being up the meeting go we have a different perspective on the scene could describe does not take into consideration on the people because he stabbed to death and maybe when you had to talk about the dark from the mouth of the bald people of that very few unable

because the food they have difficult work says every scene you know it's your duty to meet for aids and so they had to most wouldn't have been so sides and their way that seems to work today jim is off the international deck to get them out allies the disco days and who exactly is in charge of that international architecture who decides that this country should be given a discount on on prices or you know assistance for harm reduction and that particular country does not qualify who decides that we'll talk about pricing and the dutch is a policy shill. but if we talk about pricing in the baltic hall do war disorganize to be been a feeding off of prices and so international should two shows define who they are but to defy my seawitch was they have the their freedom to apply your norwich and your no i have a difficult to stand to stand away a pharmaceutical company or fair

a lower price for. people use a dizzying offering good to excess and not to pull weeds aids eastern europe dark says the day ends you had to talk about a global epidemic in my view the right to excess better prices should be to everyone independent who had to leave but that's not the whole scene and guessing the governments themselves slow be hard enough to ensure this accessible pricing because so one could imagine that for example corruption comes into place here and sometimes maybe in some of those countries that you mention eastern europe central asia corruption is also very high and you can you cannot exclude certain people perhaps driving a personal benefit from keeping the prices up is that a factor i don't have the knowledge for this to my usual. i mean not to the international no but that affects the epidemic about golf course affects every

scene but he spoke i seethed at the end goal of him in that esteemed in him he have access not doing to drugs to take in all the ads and so and make the deaths possible to the largest number possible if you see it since. i never saw and i've seen it used to be on expect that the government has a position against fasi that they don't say as in there that is a right but perhaps not putting enough of an effort to ensure universal access because you know that the universal access in russia for example is. still a bit of a challenge only a third of people who have the virus nature of a virus receive the therapy do you think that's mainly because of the pricing or are there other concerns i see pricing is definitely are you sure and you were adding do or do it or you had it being used in europe spain does a job which is difficult for me you do understand this divide we are dark about people you've got that israel believe they should have access to. you have provided

drugs that's to me is a right is a human right. to me and to end this crisis i was so high. that these become a major challenge but is not too hard the scene where i see the spot you are a few days strategists to facilitate the excess body cell so use vetting wotton now there is a hard to beat here in russia about how serious the hiv aids isha is here and they out. that it's a full list latched epidemic especially in siberia and the here also the government says it is concerning but the activists are being i'm julie alarmist where do you come out on this eastern europe today has defied us to growing epidemic in general . demeanor you'd see. some extensional if you it to be fair to say that eastern europe today is the face off the global reads epidemic it

is no question about it but it's a very good on the lawsuit. if the democrats they vary a lot inside this same to you may have a very different situation than you do use decays ever to add into what they can give an example if i do use this see it seems to be that thing some bit this would seem is that are going there right direction. infections are you going belle but that's not de arledge everywhere well everywhere would be i assume some of the siberia and talents and some of a citizen they hear elsewhere there is a very high number of injecting drug users as well as ah they're at risk groups what a oh want to ask you about is there is also. i debate about how that what is the main mode of transmission in russia because. the epidemic any epidemic would be far more difficult to contain once it moves from beatrice gross to the

general population at large has that rubicon been crossed and russia from dirty needles into unprotected sex but it's a very dynamic epidemic as are you seen knowing in eastern europe as a whole the. definite the. people death injecting drugs they steal. in my view unexceptable he skipped off to getting h. i.v. induced resume. but it's not he wanted to you know that a place is india's regional home without a. czar for the future off they put them in. they have to bring you special costs and to me you know areas where we had stuff to get that. data is that you skewed the top to five percent or. or familiar in the general

population not people that injecting drugs may be infected is h r u v does extend. to me as it's a big head for leg. off diffusion of cool soft is epidemic into swedish now. having been following this issue for quite some time. what the russian officials would say to that is that in many of these regions at the mansion they also have wider availability of the testing so do you at this moment understand what is actually driving the numbers of the better testing or indeed the rise in the in the number of infections the rise in the number of infections definite three years did do the fucked up because seven habits because this is what defined the three and. death pointed out i areas east new york often middle australia because it. rates on the rise of the global in scope to do we are to start to see often degrees in the

number of our from fiction. what made you look as a part of dorks mainly that you had to biggest in sub-saharan africa outside africa we had seen in many regions in many places in many communities if the dems on their right slow because sub-saharan africa has long been the center of attention and as you pointed out that they also received a somewhat privileged access to both drugs and they attention of global public health policymakers one that explained that you had to be sort of the right oh down now is that we did and i did so recent on that is on the conclude if you follow forty's to add the money goes international money that is a. elation she between the investment and disappear and of course most off their money or in debt in a right to do so in should continue sub-saharan africa if you do and if the flow of money gordon did it did then if you had bones we have experienced the scenes of.

hiv. it would be only stable handy to finish the money should continue to be there but the problem is it's a global epidemic we need to find a new balance. for his sauces all so fluid into epidemics but he's this seen it used in europe india's reaction i've heard you make the point earlier that hiv aids has turned into a syndrome of social exclusion discrimination they have the tools or have the drugs to deal with it by the apparent they know the heart of the brain to use those tools fully as somebody who is credited for designing the program for universal access in brazil to the access to therapy in brazil i wonder if you have some of the whys and how to break through that how to make at least on the policymaking level to see the stigma as not just the social concept but also something that prevents effective

policy to port spears again. grew as you did his driving days if a democrat today is basically had the the concommitant to pay demick off discrimination your body not to get on treat them in because it that idea shows like price we discussed but is not to primary actual people are not getting access because they don't have to do did they are not profitable come to a health center because they may be discriminated they are not comfortable because you lost and allies it because they are funny. they have sex who is the same sex today is a gay male so are you not going through desists is is by law forbidding these is to up to speed fooling does it damage but event to people death to people discriminate they go on to their own they don't but you speak on prevention they don't have access to drugs my second point you we have three decades of experience we have

usually and we know what sort is a combination of four factors one sport usually the ship that's clear that you needed to sayas that we saw that were a. button issue. mainly. on the people including the most when able we solve discrimination. and of course money these are there for factors that must work if we want to bring this epidemic well dr laura's for i have to take a very short break now but we'll be back in just a few moments states and. what politicians do something to do. to put themselves on the line to get accepted or

rejected. so when you want to be president and she. want. you to going to be this is what the three of them or can't be good. i'm interested always in the audience in the. first. welcome back to worlds apart from the least the worst deputy executive director of the hearing aids dr laura's russian generally received very negative press for the way deals with hiv aids but i think there's

a few positive stories and one of them being how russia managed to contain the mother to child transmission in two thousand and sixteen the russian authorities report and ninety eight percent success rate and i wonder how do you explain this because to me it seems like a positive discriminate. going on they specifically decided that on that particular group we're going to put all those factors that you mentioned before in place so do you think positive discrimination and that kind of work. do not go. screaming issues so bad to death they don't sink in seeing blows to the sink is misleading to call discrimination ok well let me say on the whole forcing on the one particular group of death i understand there are. definite today. there are actual fitted a shot to do. schools to eliminate want to shut down as we show out some major major step to do is offer burning desire to do good though there is no question but of course is the epidemic is moved by man. is very dynamic if you want

to read you want to throw you through a new read the take the journey to the end the feature i.v. you need to take seem a lot of attention to all groups that the risk to everybody that's been able to reach i.v. that one of such groups would be if the community you mentioned before the. male on male sex is bad in russia it's not bad but what is bad is the propaganda of what is referred to as nontraditional sexual orientation and i think it's also evidently clear that the pretty community in many countries is more vulnerable to this disease than in others i wonder how many you know caught they say media venue for themselves do you think the russian officials the russian public sector public health sector out there can use any other what other means it can use to reach that group specifically because since media and television programs on data frowned upon

the you still need to have some tools to say we specifically to that group definitely. did did the epidemic come along. mandate to have sex or is male game it is one day kreis ever had in their words in the development in the developing war and to end to end it will go to date is epidemics out on the rise why has very few exceptions because do it left behind even in their western developed countries i asked definitely a death some issue additional today you know about the off cos you have some recent developments maybe off that perhaps became evader book that to me very recent case shown that in some places it's tough to hear. but in most of the place today we have seen does epidemics on their rights i see. that i'm in to waste on our lies death to one off their ways that i see. we weep but are going to seem wait

on bio med school and science you know but we didn't the progress in the same way fight the system being discrimination don't. you see it that tomorrow that's the cultists today some sex relationship is penalize that by law you know them india is watch food in there put them you know is sick and this is the end to end is this becoming mahdi a martyr from the mental challenge death display venting us to move the bin duffey hiv so sites that do not think that being a homosexual min being allowed to have been is a pass on that injecting drugs a migrant that but he is on there did the caustic with that they cannot but he does if a democrat don't does not work then that is a sure you know exclusion and they try. they come to get in of indigo if you want you grew. up harming just that particular group but

why society as well because a i don't think anyone can actually solve that. sooner or later the way that the disease always spreads from one group to the general population you know let me just tell you i have a view on the head that's not my primary concern you know my primary concern is diffusion of office site a site is due to the index of growing up you know there was shown that you have you used to grow up you know enough so side that to be not includes if. and they received death yourself. and you'll be exploded too in the future it's a very interesting film norman to when we speak about discrimination to the gay male this same dimension in this same way the mention race is beliefs general far be it police in seems they do it in them. is not the show is not the response to

the general population that the show they usually use is we each kind of society to want to devolve but i agree with you i think there are many ways to approach it and one thing that i noticed and they russia passed its own strategy of dealing with hiv aids last year and while in in a couple of parts it actually comments on the effectiveness of peer to peer intervention and i know that there have been actually some projects made came out for example in st petersburg which involved peer to peer intervention so i wonder if it really fresh or has this law that made some describe discriminatory when it comes to the distribution of information about same sex for relations i wonder if you see any scientific public health interest from the russian officials to work specifically on the group because it is one thing to pass moral judgments but it's another thing to do your job as a doctor and as as an official responsible for public health you still have have to

address as they can't right i think is what something this will give us from deformation that. you know you need some level of pragya much as me and we. we can not to wait to fossil sites to be ideal. to bring dave hiv epidemic you don't you need to have to be but argue much now russia is a very peculiar country when it comes to values and their fact on public health if you actually look at the service it's pretty progressive on many social issues but there is a drive to promote this traditional values and partially bad drive is motivated by public health concerns that idea here is that the year you can drive the number of children being born you can decrease the disease so it's a very interesting combination and irony because on one have you're trying to contribute to public health but on the other hand you are sort of undermining your ability to implement some of the liberal policies like carbon reduction for example

you come from brazil i think brazil has also a very interesting mix of liberal versus conservative values how do you balance the two for a for pay for the benefit of all well i left to brazil twenty years ago and them again my myin go the way that i see the scenes today is very much international. but. from my experience in different parts of their would they seek the stench will always exist in some place off course. is a much stronger emphasis on on on open policies on crucial and so in some basis goes in there with a ritual. and you. brought this. to h. i.v. when come to save your life. we need to find a way for what they see in these regions. in the us so much

driving dems are a few international started that it's you off include joy or being good people together. i think we need to focus more on deists too and its simplicity of aspects and up but i believe that the but they cannot there be more who is who discrimination on exclusion on you wish visited them forward but the you know discrimination exclusion works not only on the national all public health level but also geo politically russia is now in a somewhat challenging geopolitical situation with the west with ukraine and there is also a drive to exclude it from a number of international fora but i think the age issue of the hiv aids issue is a little bit different because i heard you say that you actually want to encourage as many russians to be present that they all start on conference next year as possible or why is that because it seems to me that the a chevy ates is a very issue very rare issue when russia is actually not being pushed out of the

international community. c h r u v u and they sponsor stage i.v. maine as a best buy them from india seems that we can do better in the future. these h. i.v. us defaced opportunities he's starting to study where to. the global society we face a challenge and to proportion about the j.v. minded that at this time from the begin to a no at the least thirty five you know people they die because it's really talking about the measure of jobs and to measure if you did but. have been asking some police we've got stuck to change the deuced the school since some places in the us fundamentally because we are pollution a different way. we brought people to the sense that people leave these h r u v people and the people who knew they would to each of you and to us deists welcome a does this sponsor so

a step children don't see it does the best find it if you are you are to have really a need to be. will be helping us to move forward their agenda stu why rush who the real tough the tough questions well but who know that is a that is there are many aspects is dynamic aspects that to meet need to change that is no question we spoke about but you we need the russian federation to go to it to bring does know is a group of them well it is good to hear because there are lots and lots of very consequential issues like for example the arctic protection or counterterrorism where such cooperation is actually lacking that and as i said i think the h.b. eight is one of the very few exceptions and i think they in their role of the netherlands is very interesting here because now the alliance is very interesting. well it's very much connected to the whole situation around crimea because of the plane because of the war there and yet. there is still an effort to bring the

russians together with the ukrainians and together with other people from other countries in you said that you hold that base could be sort of spread to other areas but why do you think the people of the west a different on that because they they're usually you know don't make exceptions. i see a moderate there i've fallen into a national saw your daddy. from off point of view as un aids as the united nations the new is aids we've invested heavily on debt the primary job is to convene it's to bring people together to being good nations and going to still get at the bidding does epidemic and we have a more than sufficient david gest that does this possible to do why you had these moments you did take god to fact just the chain dick will cinquanta are off debts i mean looking for did the russian federation did the ship in modern never to bring us through to help us to bring visited them

a good deal i mean looking for their russian federation on expect. their recent as debt deal having to ems off if they meet them softly he says she and sophie. be looking for the russian federation to shoot. that sponsible to two brigades a vote and sellers are have to leave it there i really appreciate you being with us today and tara here is please share your comments on our twitter facebook pages and i hope to say again same place same time here in the wilds of.

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