An abridged version of this op-ed appeared in the December 1, 2004, edition of Postimees

Estonia and the United States - Partners in Fighting HIV/AIDS

Ambassador Aldona Wos, M.D.

Today is World AIDS Day. As an Ambassador and as a medical doctor, I mourn the lives that have been lost to HIV/AIDS - in Estonia, in the United States, and all over the world. With international cooperation, though, we can slow the spread of this virus and provide some relief to those who carry it. Estonia and the United States are working together in this spirit, including carrying out elements of President George W. Bush's worldwide Emergency Plan for AIDS Relief.

Eight thousand lives are lost to AIDS every day worldwide. The total number of people living with HIV is 38 million – over 25 times the number of people living in Estonia. In 2003, three million people died from this relentless killer – and five million became infected. In Estonia, I'm told that there are 4356 cases of HIV. Estonia has one of the fastest growing HIV infection rates in Europe; about ten times higher than in Western Europe. Fortunately, Estonia has recognized the problem and is addressing it.

This year's World AIDS Day observance focuses on women and girls. Worldwide, almost 50 percent of HIV-positive people are women. Practices such as infidelity, prostitution, and sex trafficking fuel the spread of the virus. Rape and sexual violence also put women in grave danger of infection. Tragically, HIV-positive women may also pass the virus on to their children through pregnancy and childbirth.

The challenges facing women and girls today are difficult ones. Under the U.S. 177 billion EEK ($15 billion) Emergency Plan for AIDS Relief, the American people are helping the world meet these challenges, including providing over half a million dollars in HIV/AIDS assistance to Estonia in recent years.

The U.S. global plan focuses on preventing new infections, bringing lifesaving treatment to people with HIV, and caring for those infected and affected by the disease, including orphans and vulnerable children. The American people have invested 28 billion EEK's ($2.4 billion) in the worldwide fight this year, making it the leading donor among the nations that are funding this fight.

One key initiative is drug therapy and counseling to prevent mother-to-child transmission of HIV. Worldwide, the U.S. trained 14,700 health workers and built capacity at over 900 different health care sites to prevent mother-to-child transmission in just the first 18 months of the program. A manifestation of that in Estonia was our 685,000 EEK grant to the Ida Virumaa County Government to expand access to services to HIV positive pregnant women and their newborn children.

The U.S. Government's worldwide Emergency Plan supports locally designed behavior change strategies that direct tailored messages to appropriate groups, including education for girls that builds self–esteem, allows for informed choices, and fosters the communication skills to say “no” to sex. The U.S. Government's global efforts to fight sex trafficking, including grants to Estonian non-governmental organizations, address the tragic relationship between trafficking and the spread of HIV/AIDS.

Our Embassy has funded many other projects in Estonia to fight HIV/AIDS. These efforts have included the rehabilitation of former intravenous drug abusers and the improvement of the lives of those living with the disease in Estonia. We have worked with the Ministry of Justice to deal with AIDS in prison populations, and we have cooperated with the AIDS center in Tapa to support their vital work. Our efforts even extend to the cultural front, including partial sponsorship of the Merle Karusoo production of the play "HIV" and the Estonian production of the musical "Rent," which opened just last night.

There are many fronts in the fight against HIV/AIDS - the laboratory, the clinic, the halls of government, the classroom, the theater stage, and throughout all of society. Estonians, Americans, and people all over the world who have recognized the problem and are doing something about it can work together to turn the tide against HIV/AIDS.