Last week, Richard Feachem, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, visited Moscow to announce two major grants that can dramatically improve Russia's ability to fight its surging AIDS epidemic.. The first, which totals some $89 million, focuses on education and prevention and is ready for disbursement now. The second, which totals over $120 million and is in the final stages of negotiation, is largely intended to provide critical care, treatment and support for young Russians living with AIDS. Together, these grants represent the single largest investment in HIV/AIDS in Russia, and will provide critical stimulus to government agencies and civil society organizations who have been working for years with limited funds pieced together from a meager federal budget and generous international donors.

The Global Fund grants will supplement important investments in Russia's AIDS war by USAID, the European Commission's TACIS program, DFID and other governmental and private sector donors. The World Bank and Russia have recently agreed on a loan for $150 million, $50 million of which is reserved for fighting HIV/AIDS. These resources are desperately needed. While enormously important, however, these should not substitute for domestic investments by the Russian government to fight the country's HIV epidemic, which has now become the fastest-growing in the world. In order to be effective, international support must be met by serious investments in political and financial support by the Russian government to slow the rate of infection, care for those who already have the virus, and support programs that aim to reduce stigma and discrimination.

The AIDS epidemic in Russia has entered a dangerous and decisive stage. Most experts agree that about 1 million Russians are living with HIV today, and there are strong signs that Russia's AIDS epidemic is moving into the general population. The number of HIV-positive mothers is skyrocketing along with the number of HIV-positive babies, many of whom are abandoned by at birth. The growth rate of other sexually transmitted infections (STIs) is accelerating among young heterosexuals, a sure sign that they are putting themselves at risk for HIV. Most HIV-positive Russians have no idea they are living with HIV.

If these trends continue, Russia's HIV epidemic will quickly spin out of control; within 2 years the total number of HIV positive Russians could reach approximately 1.5 million-over 2 percent of the adult population, a level generally regarded as a tipping point for the epidemic. (NOTE: We suggest in our report that the level is already 1.5 million. Anyone who visits our website as a results of this op-ed will see this.)

Because most new infections occur among young people just entering the work force, the medium and longer term impact on Russia's economy could be severe. Russian businesses can do much more to implement worker education programs that will help employees stay healthy, protect the rights of HIV-positive employees and help parents talk with their kids about safe sex.

The strength of Russia's armed forces, already struggling with conscription, retention and readiness problems, will also be jeopardized because HIV-positive conscripts are prohibited from serving, and active duty soldiers who become HIV positive and who are discovered are discharged. As a result, long and already porous borders will become even less secure than they are today, prodiving traffickers of people and drugs will easier access to Russian markets. Russia's ability to participate in international peacekeeping efforts could be put at risk if it lacks the human resources to maintain stability and security inside its own borders.

To be successful, a new strategy to fight AIDS in Russia must include the following elements. First, recent investments by the Global Fund, the World Bank and other donors must be joined by a meaningful increase in spending from the Russian federal budget. Spurred by high economic growth, the general level of federal expenditure is on the rise. This means that more than ever, Russia can now afford to channel more resources into fighting AIDS. Yet the Ministry of Health and Social Services' HIV/AIDS department remains woefully under funded and under staffed.

Second, Russia's federal AIDS law should be implemented fully, especially those articles that ensure the human rights of HIV-positive citizens. Experience elsewhere has shown unequivocally that repressive policies only drive the virus underground where it spreads undetected and with impunity.

Third, Russia must immediately begin negotiations to reduce the price of anti-retroviral medicines. Today, the annual cost for treatment in Russia is at least $10,000; this figure can be reduced by 70% or more. Reliable, sustained access to treatment is not only the only way we know to extend the lives of HIV-positive people today, but by keeping viral loads suppressed these medications also reduce the chance of HIV spreading from one person to another. My discussions with leaders in the pharmaceutical industry confirm that price reductions are entirely realistic now. There is no need-or excuse-for delay.

Fourth, Russia must engage in a massive education campaign so that today's young people stay healthy. A recent study suggests that over half of Moscow-city residents have incorrect views about HIV transmission. Even more striking, over 45 percent of Muscovites would support programs to isolate HIV-infected persons from the rest of society. Fighting misinformation and prejudice requires straightforward talk about safe sex and harm reduction methods, all of which challenge traditional Russian precepts about social behavior. For the sake of the next generation of Russians, however, honesty and openness about risks and ways to minimize them are simply not optional.

Fighting AIDS is a long-term prospect. A vaccine is still 25 years away according to experts from the U.S. National Institutes of Health. The Russian government thus will need to include an integrated strategy of prevention, treatment, care and support into its longer term plans for economic and social development. Increased political leadership is essential; a recent initiative to create a special working group in the State Duma is a step in the right direction. A presidentially-appointed AIDS Czar with real authority would be a welcome addition to the policy community. International actors, most importantly the Global Fund, must remain engaged as well, and must be given the resources to do their jobs effectively.

AIDS in Russia presents special challenges. Yet, to date, the Russian government has failed to publicly recognize these challenges or present an adequate response strategy. Given the growing security, economic, and human implications of this virus for Russia, denial is no longer a viable option. International support, though substantial, will never be enough. It is time for the Russian government to meet its AIDS challenge with its own serious commitment to improve the lives of those already infected and prevent the further spread of the disease.

John Tedstrom is President of Transatlantic Partners Against AIDS (TPAA). Prior to founding TPAA in 2003, he served as Director for Russian, Ukrainian and Eurasian Affairs at the US National Security Council and then as Vice-President at the EastWest Institute.