Health experts in Moscow say that more than a million Russians are living with HIV as of December 2016. But despite this benchmark number, The New York Times reports, the government is not likely to commit resources to fighting the epidemic.

 

Russia has a population of 143 million, and about 100,000 new HIV infections were expected in 2016. In comparison, in the United States, the Centers for Disease Control and Prevention (CDC) estimates that 1.3 million people are living with HIV out of a total population of nearly 319 million.

 

Unlike the United States, where most new HIV cases are among men who have sex with men, in Russia, heterosexual sex will likely top injection drug use as the main route of transmission.

 

According to UNAIDS statistics, Russia is one of five countries that account for nearly half of global HIV infections. The other four are South Africa, Nigeria, India and Uganda. As the Times reports, in Russia only about 37 percent of people with an HIV diagnosis receive treatment. (To end the world’s AIDS epidemic, the World Health Organization’s 90-90-90 campaign sets a goal of 90 percent of people living with HIV knowing their status by 2020, and 90 percent of those people being on treatment and 90 percent of those on treatment maintaining viral suppression.)

 

In Russia, little money is spent on prevention and sex education, which is not likely to change at a time when the Russian Orthodox Church and many politicians promote conservative values. Stigma against those with the virus is also pervasive, the Times reports.

 

In fact, Russian President Vladimir Putin has remained largely silent about the epidemic—not that the government would even define the problem as an epidemic. “Calling it an epidemic would be akin to admitting that the government let the problem get out of control over the past 30 years,” a doctor told the Times. “This is Russia, so everything has to be top down to get anything done.”