Categories
Health HIV Medicine Russia State

Communicating Disease: The Silenced Epidemic in Russia

Photo by Klaus Nielsen from Pexels

By Ksenia Kogler, BA

HIV/AIDS represents a major global health issue. According to the World Health Organization (WHO) about 38 million people in the world were diagnosed with HIV at the end of 2019. By June 2020, already 26 million of them had access to the antiretroviral therapy (ART), but unfortunately due to the COVID-19 pandemic there is a decrease in the progress of providing the therapy to people.[1]

In the Russian Federation, the number of infections is increasing since the beginning of the epidemic. By the end of 2019, the total number of Russians living with HIV reached 1.1 million according to the statistical data provided by the Federal Research and Methodological Centre for AIDS Prevention and Control. The HIV prevalence in the population increased accordingly, approaching 0.75% of the general population and 1.42% of the population aged 15-49 years[2], the highest number in Eurasia.

Mass media often uses the term “silenced epidemic.” The problem of communicating the disease lies also in the statistics. Officially, the term epidemic is used only when the amount of infected people is over 1% of the population, but in Russia, only in 13 regions more than 1% of residents are infected and in general in 35 regions HIV prevalence is above 0.5%, which makes it more difficult to use this term. However, in official documents the term epidemic has been used more often over the past years.

There is no doubt that one of the main steps for defeating the disease is to inform the population. In Russia, not only public awareness is insufficient, but also the state is reluctant to include the issue on the national agenda. Mass media, on the other hand, frequently uses misleading clichés, such as “plague of the 20th (21st) century” and “at-risk groups,” as well as discriminatory labels such as “homosexuals,” “drug addicts,” etc.

This negative framing has a history. In the second half of the 1980s and early 1990s, the common stereotype was that AIDS was a threat coming from the United States and Western countries as “a focus of the evils of the capitalist system.” In the headlines of articles from 1986 to 1994, the expressions “American syndrome,” “AIDS truck” and “plague from the West” were used. This representation of the disease has formed the opinion in the society that people with HIV/AIDS are very contagious, dangerous and dirty, which has entailed a certain “AIDSophobia,” as well as discrimination against people at risk and people living with HIV as well as their isolation. There is still a lack of awareness in the population about what HIV is, how the latter is different from AIDS and how the HIV virus can be transmitted. Furthermore, it is still little known that it is not a problem limited to homosexuals, drug users or sex workers.

In 2016 the Government of the Russian Federation approved the “State Strategy 2016: Countering the spread of HIV in the Russian Federation for the period until 2020 and beyond”[3], which declared HIV outreach a priority for primary HIV prevention. This strategy contained a specialized federal information resource to counteract the spread of HIV, which included large-scale communication campaigns, comprehensive communication projects, nationwide events, annual specialist forums, and the operation of a specialized information online portal on HIV and AIDS. Unfortunately, there is still no official data available about the results.

Vadim Pokrovsky, head of the Federal Research and Methodological Centre for AIDS Prevention and Control, commented in an interview in 2019 on another important problem that makes government officials reluctant to conduct extensive information campaigns. He explained: “The bet is on the religiosity of the population. The rules of behaviour should be in line with Christian traditions, which in itself, as some believe, should reduce the spread of HIV infection. But, as we can see, the epidemic does not depend on the fact that the so-called spirituality and ideology are promoted in Russia. Not a single official in our country has yet uttered the word “condom” in public. And condoms, by the way, are unaffordable for many in Russia. If it costs the same as a bottle of beer, then there is no telling what people will be more willing to buy with that money. It is necessary to lower the price and increase their availability to low-income people.”[4] The lack of sex education in Russia is one of the reasons why it is difficult to discuss the issue. Even within families, parents often avoid talking to their children about sex, hoping that the child will somehow find out on his or her own.

An excellent example to see the strong difference in discourse across different media platforms were two films on HIV released in 2020. The first film was released on 11 February on the YouTube channel of the well-known Russian journalist Yury Dud, who has become popular with his interviews with celebrities from various fields. The film features the stories of real people, explores the problem of stigmatization, and discusses not only preventive measures, but also testing and treatment methods. In addition, the contact details of the responsible centres and a strategy for dealing with a positive test result are given. In the documentary, accessible, simple, precise, and open vocabulary is used. The film went viral and has been watched by almost 20 million people. What is more, the film inspired a panel discussion on HIV prevention and treatment in Russia that was held in the State Duma on 21 February.

The second example is the HIV/AIDS prevention film, “AGAINST AIDS: The View of Two Generations. A value-based navigation” produced by the Moscow City Health Department on 1 December 2020. This film is aimed more at parents as it calls on them to talk more to their children about the issue in question. However, although the usual stereotypes are explained in the film, they still remain a focus. It also remains unclear, which role the state structures will play in providing this information to more parents, as this film was shown for discussion within universities.

Overall, a positive development can be seen in the provision of reliable information about HIV in Russia. Unfortunately, so far only outbreaks of public outcry have forced representatives of the authorities to pay more attention to the problem. In the meantime, much of the outreach work is done by NGOs in the Russian Federation, which actively use Instagram accounts as well as other social media to educate young people about the disease and its prevention, and to inform them about news and upcoming events related to the topic.

Bibliography:

AGAINST AIDS: The View of Two Generations. A value-based navigation. 2020 URL: https://youtu.be/_vcXKC0KJvA [Accessed: 07.02.2021]

Barysheva. E., Deutsche Welle. Why HIV-related deaths are on the rise in Russia. 2019. URL: https://p.dw.com/p/3NG65 [Accessed: 29.01.2021]

Federal Scientific and Methodological Centre for AIDS Prevention and Control., (2020) “HIV-INFECTION.” Information bulletin No 45. Moscow.

Government of the Russian Federation (2016). No 2203-r, Moscow. “State Strategy 2016: Countering the spread of HIV in the Russian Federation for the period until 2020 and beyond”

HIV in Russia (Eng & Rus subtitles). 2020. URL: https://youtu.be/GTRAEpllGZo [Accessed: 07.02.2021]

World Health Organization. HIV/AIDS. 2020. URL: https://www.who.int/news-room/fact-sheets/detail/hiv-aids [Accessed: 28.01.2021]

Yasaveev I.G., (2006) “The media and the HIV/AIDS situation in Russia.” Sociological Studies no. 12, pp. 89-94


[1] World Health Organization. HIV/AIDS. 2020. URL: https://www.who.int/news-room/factsheets/detail/hiv-aids [Accessed: 28.01.2021]

[2] Federal Scientific and Methodological Centre for AIDS Prevention and Control., (2020) “HIV-INFECTION.” Information bulletin No 45. Moscow.

[3] Government of the Russian Federation (2016). No 2203-r, Moscow. “State Strategy 2016: Countering the spread of HIV in the Russian Federation for the period until 2020 and beyond”

[4] Barysheva. E., Deutsche Welle. Why HIV-related deaths are on the rise in Russia. 2019. URL: https://p.dw.com/p/3NG65 [Accessed: 29.01.2021]

Categories
COVID-19 Health Medicine Security State Surveillance

Podcast: COVID-19 in the history of biopolitics

By Nicolas Friden BA & Carlos Solsona Ribes BA & Camilla Wallner BA

This podcast episode discusses COVID-19 and the vaccination debate in the context of the history of biopolitics.

Categories
Diplomacy Geopolitics Medicine Security State Surveillance

Podcast: The Practice of Quarantine in History

A 1883 cartoon depicting members of the New York Board of Health trying to contain immigrants suffering from Cholera. © Corbis Images

By Anna Dyshlevaya BA, Viviana Espinosa BA & Ksenia Shibaeva BA

The podcast discusses the emergence of quarantine as a historical practice.

Categories
Security State

The reflexive securitization as an inevitable part of state-imposed quarantinism

Security and Health

By Jonathan Schmidt, BA

Facing the current corona pandemic most European countries have decided to impose profound restrictions of their citizens’ everyday life, social contact and mobility. Despite the medical appropriateness and necessity of quarantine in epidemic outbreaks, it becomes a whole new discussion as it is to be imposed on a national or even global level. It is difficult to maintain acceptance of such highly restrictive measures, so governments are increasingly using their legislative and executive powers to ensure the success of their quarantine strategies. As society attempts to combat the pandemic and mitigate its many impacts, the debate is slowly shifting away from medical issues towards homeland security. This blog post is intended to show how closely the medical approach of quarantine to contain the further spread of a virus is intertwined with the authoritarian use of state violence.

What does the Covid-19 epidemic tell us about the political system in which we live?

Dealing with epidemics is not only a question of medical and technological concerns, but also strongly influenced by political convictions and prevailing ideologies, as Erwin Ackerknecht already formulated in the 1940s. He argued, that the way governments react to epidemics could be read as an expression of the dominant political regime. In his text, Ackerknecht (1948) distinguishes between autocratic, or at least more authoritarian, conservative systems that prefer the use of a restrictive approach to disease in the form of compulsory vaccinations or quarantine and more liberal, democratic political systems that favor less intrusive strategies but instead structural developments in the sense of expanding preventive measures (cf. Ackerknecht, 1948). His argumentation is probably based on the experience of totalitarianism, which was widespread in Europe in the inter-war period and culminated in the Second World War. Ackerknecht (1948) follows a binary argumentation, contrasting quarantinism and sanitationism, authoritarianism and liberalism, individual freedom and mandatory community spirit (cf. Ackerknecht, 1948). Although this might appear like a convenient simplification of things, there is some interesting observation in the correlation between political regimes and their handling of epidemics, which can be traced in todays “fight” against the Covid-19 pandemic.

Looking at the paradigm of the policies to manage pandemics that prevails in most parts of the Western states, it becomes clear that they base their strategies on the enforcement of quarantine, social distancing, and the sealing off of large sections of public and cultural life, “giving priority to the interests of the community and the state” (Ackerknecht, 1948: 156). As many of the measures for this kind of reactionary strategy inevitably come with a high degree of renunciation and loss of personal freedom, the term “enforcement” is the key word to focus on.  In particular, quarantine and night curfews, as first imposed by the Austrian government under Sebastian Kurz on December 2 and further tightened after December 26, can certainly be seen as a kind of deprivation of liberty that not all people are willing to accept without further ado (cf. Der Standard, 2020).

Imposed quarantine regulations become law

Most European nation states attach great importance to reassuring communication tactics and appeal to reason and morality in the first place, but they do not hesitate to impose highly restrictive regulations that have to be followed under the rule of law. What can be observed during the current second lockdown is a further tactical escalation as part of the strategy to handle the Covid-19 pandemic. The German government has introduced a specific corona-related catalogue of fines that implies fines starting from 200 euros for the disregard of contact regulations, up to 25.000 euros for failure to comply with the notification obligation, and, in addition, prison sentences for disregarding the ban on assembly (cf. Bußgeldkatalog, 2020). This is just an example for the partly drastic sanctions that have been imposed in almost every European state. What I would like to emphasize is the fact that many governments have already adopted a strategy for dealing with the Covid-19 epidemic that will inevitably lead to increased use of executive forces. There are new rules and orders that have been imposed, and now governments must use their executive powers to ensure compliance with the law. With reference to the analytical concept of Ole Weaver (1998), one could speak of a reflex-like defense attitude, which manifests itself in increased securitization.

The Austrian Ministry of Interior regularly publishes numbers to demonstrate its effort to combat the Covid-19 pandemic. A successful fight against the pandemic thereby seems to be closely linked to tight police controls in public places and at the external borders. Within just one weekend in September 2020, the Austrian border patrol controlled about 230,000 people. In addition, more than 90,000 checks were carried out within the country’s borders in a so-called “Schwerpunktaktion”, where 1.000 offences were reported and fined (cf. Bundesministerium Inneres, 2020). Those numbers just give an indication about how resources intensive and bureaucratic such restrictive handling of an epidemic can be and how heavily the chosen strategy of quarantinism relies on an assertive security apparatus that disciplines the population on unpopular rules. To strive for the ideal of a disciplined social body of this kind can be found in an authoritarian, military context – a reference that is also used these days.

The global Covid-19 pandemic is indeed a deadly threat to a large part of society, especially the elderly and people with pre-existing conditions – so there is a necessity for governments to fulfill their constitutive duty and ensure the safety of their citizens. Most people would agree on that, but nevertheless the chosen “lockdown”-strategy is perceived as a dramatic incision into personal freedom. So how to legitimize the quarantinism, restrictive regulations, fines and the increased use of executive power?

War rhetoric to prove the need.

“Nous sommes en guerre”, we are at war – this is what the French President Emmanuel Macron repeated six times during a television address (Pietralunga & Lemarié, 2020). He also pleaded for the mobilization against an invisible enemy, using vocabulary that Donald Trump also used. After long hesitation to acknowledge the presence of such a virus, the US president mobilized thousands of national guard soldiers, recruited reservists, rapidly established military field hospitals and made use of a 1934 law allowing the government to manage the private sector to uplift the production of ventilators (cf. FAZ, 2020). But not only the controversial US president commits to the establishment of a war economy – Pedro Sanchez, the Spanish president also adopted this strategy.

It is this war rhetoric that is used to swear the people in, to appeal to their discipline, their sense of community, their sense of duty and their trust in the government and its decisions. Unpopular arrangements, the loss of civil liberties, the need for an excessive increase in the use of law enforcement agencies – all this is to be justified by the degree of urgency and severity of a war-like situation (cf. Straehler-Pohl, 2020). The proclamation of war brings people closer together – closer to each other and closer to the one who calls. Even though this sounds cynical these days, metaphorically spoken, this is what the war rhetoric is meant to achieve.

It has long ceased to be a medical debate

Regarding this approach to handle the Covid-19 pandemic, it seems that governments, which choose the quarantism strategy inevitably have to resort to authoritarian measures. In order to achieve presentable results this whole approach relies heavily on restrictive laws violating civil liberties, which are understandably only respected if the executive enforces them. What can be observed is that this strategy shifts the whole debate from a health-related issue to a security issue that is strongly linked to the state monopoly on the use of force. Today, it is more about how to control, how to enforce rules, how to discipline people, how to get used to circumstances. We have lost sight of the fact that there must be structural changes in order to find real long-term solutions. Unfortunately Covid-19 has not yet been understood to the extent that structural solutions could be found, and that is totally fine. But it cannot be helpful to reflexively persist in war-like defensive attitudes and debate the enforcement of laws, instead of focussing on medical solutions. The experience of the first lockdown and the meager results of the current lockdown during the Christmas season have proven that the strategy of quarantinism can only be a short-time and provisional solution that carries many risks on a political level.

Sources

Ackerknecht, E. (2020) Anticontagionism Between 1821and 1867. BHM,(March–April 1948).

Bundesministerium Inneres (2020). Nehammer: Zusätzliche 215 Millionen Euro für Sicherheit der Menschen. BMI. 13.11.2020. https://bmi.gv.at/news.aspx?id=526835414F7941514F32413D

Bundesministerium Inneres (2020). Nehammer: Kontrollen werden auch am Wochenende fortgesetzt. BMI. 13.11.2020. https://bmi.gv.at/news.aspx?id=386C41733649573173724D3D

Bundesministerium Inneres (2020). Verstärkte Kontrollen am kommenden Wochenende bei Einreise nach Österreich. BMI. 13.11.2020. https://bmi.gv.at/news.aspx?id=37634B33714A3649304D633D

Bußgeldkatalog (2020). Corona-Bußgeldkatalog: Das kosten Verstöße. bußgeldkatalog.org. 13.11.2020. https://www.bussgeldkatalog.org/corona/

Bußgeldkatalog (2020). Polizei in der Corona-Krise: Welche Befugnisse haben die Beamten?. bußgeldkatalog.org. 13.11.2020. https://www.bussgeldkatalog.org/polizei-corona/

Buzan, B., Waever, O., & Wildede, J. (1998). Security : A new framework for analysis. Boulder, Colo. [u.a.]: Rienner.

Der Standard (2020). Österreich vor zweitem Lockdown: Welche Maßnahmen nun kommen könnten. 13.11.2020. https://www.derstandard.at/story/2000121301025/rotes-oesterreich-welche-vorbereitungen-jetzt-fuer-verschaerfte-corona-regeln-getroffen

FAZ (2020). Gegen „unsichtbaren Feind“ : Trump „im Krieg“ gegen das Coronavirus.

Frankfurter Allgemeine Zeitung Online. 13.11.2020. https://www.faz.net/aktuell/politik/ausland/trump-im-krieg-gegen-corona-mehr-als-100-000-infizierte-in-usa-16700550.html

Hanke, T. (2020). Macron sieht Frankreich „im Krieg“ und schränkt Bewegungsfreiheit ein. Handelsblatt. 13.11.2020. https://www.handelsblatt.com/politik/international/kampf-gegen-coronavirus-macron-sieht-frankreich-im-krieg-und-schraenkt-bewegungsfreiheit-ein/25651200.html

Pietralunga, C. & Lemarié, A. (2020).« Nous sommes en guerre » : face au coronavirus, Emmanuel Macron sonne la « mobilisation générale ». Le Monde. 13.11.2020. https://www.lemonde.fr/politique/article/2020/03/17/nous-sommes-en-guerre-face-au-coronavirus-emmanuel-macron-sonne-la-mobilisation-generale_6033338_823448.html

Strahler-Pohl, L. (2020). Die Welt befindet sich im Kampf gegen ein Virus – aber nicht im Krieg. Der Tagesspiegel. 13.11.2020. https://www.tagesspiegel.de/politik/corona-und-rhetorik-die-welt-befindet-sich-im-kampf-gegen-ein-virus-aber-nicht-im-krieg/25725856.html