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You could also send an email to the <a href="https://meta.wikimedia.org/wiki/Special:MyLanguage/Stewards" class="extiw" title="m:Special:MyLanguage/Stewards">stewards</a> <a href="https://meta.wikimedia.org/wiki/Special:MyLanguage/VRT" class="extiw" title="m:Special:MyLanguage/VRT">VRT</a> queue at <kbd>stewards@wikimedia.org</kbd> including all above details. </p> </div> <p>Other useful links: <a href="https://meta.wikimedia.org/wiki/Global_blocks" class="extiw" title="m:Global blocks">Global blocks</a> · <a href="/wiki/Help:I_have_been_blocked" title="Help:I have been blocked">Help:I have been blocked</a> </p> </div></li></ul><hr /> <div id="viewsourcetext">You can view and copy the source of this page:</div><textarea readonly="" accesskey="," id="wpTextbox1" cols="80" rows="25" style="" class="mw-editfont-monospace" lang="en" dir="ltr" name="wpTextbox1">== Antiretroviral therapy in Russia == === Specifics of therapy in Russia === [[Highly active antiretroviral therapy|Antiretroviral therapy]] (ART) does not eliminate HIV, but inhibits its reproduction. This allows the carrier to live in an [[Asymptomatic carrier|asymptomatic stage]], the development of secondary diseases is slowed down. At the same time the therapy serves as a preventive measure and reduces the contagiousness of people with HIV. ART is a continuous combined etiotropic therapy. It is treated and monitored at [[Acquired Immune Deficiency Syndrome|AIDS]] centers in all [[Federal subjects of Russia]].<ref name=rgsanpin>{{cite web |url = https://rg.ru/2011/04/15/sp-spid-dok.html |title = Resolution of the Chief State Sanitary Doctor of the Russian Federation of January 11, 2011 |date = 2011-04-15 |publisher = Rossiyskaya Gazeta |accessdate = 2020-03-02 |archive-date = 2020-09-29 |archive-url = https://web.archive.org/web/20200929085816/https://rg.ru/2011/04/15/sp-spid-dok.html |language = ru }}</ref> Antiretroviral therapy for HIV and AIDS was first used in 1987 in the [[United States|USA]]. It was based on the nucleotide drug [[Zidovudine]]. Academician Vadim Pokrovsky reported that "patient zero" in the USSR also received this medication. But there was no full-fledged ART system in the country at the time, and not all infected people had their viral load checked.<ref name=kommersant/><ref name=spiddosichporjywy/> Since the end of 1995, physicians have been using [[Protease inhibitor (pharmacology)|inhibitors]], which formed the basis of combined ART. It implies simultaneous use of two nucleoside analogues of reverse transcriptase and one [[HIV-1 protease]]. In 1999 academician {{ill|Alexander Kraevsky|ru|Краевский, Александр Антонович}} invented and registered the first Russian AVRT drug — {{ill|Fosfazid|ru|Фосфазид}}. It is a substance that is formed by [[phosphorylation]] of Azidothymidine in the human organism. Clinical studies showed that 89% of patients tolerated the drug well, which made it possible to increase its dosage in ART systems. In the following decade, other drugs were developed, allowing more than 200 treatment regimens to be composed.<ref name=svpressa/>{{sfn|Vorobyova|Ivanova|2013|p=46—49}}{{sfn|Pronina|2014|p=7-15}} International practice is to treat HIV-infected people as soon as antibodies to the virus are detected, when the immune system is not weakened yet.<ref>{{cite web |url = https://www.bbc.com/russian/other-news-39882747 |title = Почему сейчас люди с ВИЧ живут столько же, сколько и здоровые |trans-title=Why do now people with HIV live as long as healthy people |language=ru |author = Roxby, F. |date = 2017-05-11 |publisher = BBC |accessdate = 2019-01-06 |archive-date = 2019-04-13 |archive-url = https://web.archive.org/web/20190413215843/https://www.bbc.com/russian/other-news-39882747 }}</ref> In Russia, medication is prescribed when the level of immune [[CD4| CD4 cells]] falls to the count of 350. In 2019, Evgeny Vornin, an HIV specialist at the Ministry of Health, reported that officially 90% of HIV carriers with such a score received treatment. But some epidemiologists and activists report that to save money, doctors delayed treatment, persuading patients to refuse it voluntarily. Often no therapy was prescribed until the count reached 200 units, which could lead to the patient's death from AIDS. In some regions, drugs are prescribed only after special training. Such an approach makes it difficult to obtain life-saving medications: not all newly diagnosed HIV carriers are able to pass the training course for their health condition. Also, according to activists, doctors can prescribe the initial regimen of treatment without taking into account the analyses and personal intolerance of patients. Only if the standard courses are not suitable for the patient, healthcare providers conduct special testing.<ref name=novayametadon/><ref name=dissedentmeduza/> Treatment interruptions and discontinuation lead to the development of virus resistance.<ref name=metoda/>{{sfn|Pronina|2014|p=7-15}} Russia has a complex patient profile, particularly IDUs, who often refuse regular medication.<ref name=spidcentr2019pokrov/> Thus, in 2019 alone, about 36,000 people interrupted their ART course.<ref name=spravka2019/> In addition, the virus is constantly mutating and developing new strains, resistant to all classes of ARV drugs. In 2015-2019, 5.2% of patients who were not previously on therapy were found to be drug resistant to HIV.<ref name=interfaxrospotrebriski/> Despite side effects and the need to follow a strict treatment plan, ART is the most effective means of keeping HIV-positive people alive.{{sfn|Shaldina|Pirogova|2017|p=1-4}} The development of the ART system made it possible to increase the average life expectancy of HIV-positive people in the United States and [[Europe]] to 78 years by 2017. In 85% of carriers taking ART, the viral load was undetectable.<ref name=unaids/> This result is only possible with regular medication from the early stages of infection. Nevertheless, the results of the studies do not reflect the situation in Russia, although they help eliminate stereotypes and stigmatization of carriers.<ref>{{cite web |url = https://www.gazeta.ru/science/2017/05/11_a_10668647.shtml |title = ВИЧ больше не убивает |trans-title=HIV doesn't kill anymore |language=ru |author =Saltykova, A. |date = 2017-05-11 |publisher = Gazeta.ru |accessdate = 2019-01-06 |archive-date = 2019-04-13 |archive-url = https://web.archive.org/web/20190413214334/https://www.gazeta.ru/science/2017/05/11_a_10668647.shtml }}</ref> Vadim Pokrovsky also noted the need for comprehensive measures: {{blockquote|If a person is infected with HIV once, he or she will remain infected for life. [The population of our country is not growing, so the percentage of infected people is increasing. This will continue until new infections are reduced, until there are fewer HIV-infected people who die. The main focus of the Department of Health now is to provide as many HIV-infected people as possible with antiviral drugs. And those who get treatment are less infectious. But the data from [[HIV/AIDS in Africa]] show that even though treatment coverage there reaches 90 %, the figure that the Ministry of Health is aiming for here, it still only reduces the number of new cases by 10-30 %. Of course, it is necessary to treat everyone who is HIV-positive, no one disputes that, but we also need to educate people on how not to get infected with HIV.<ref name=nsmdostupnye> {{cite web |url = https://nsn.fm/society/dostupnye-prezervativy-i-lekarstva-gomoseksualistam-kak-borotsya-s-epidemiei-vich-v-rossii |title = "Людей нужно учить!" Как бороться с эпидемией ВИЧ в России |trans-title = "People need to be educated!" HIV epidemic in Russia |language=ru |date = 2019-07-03 |publisher = National News Service |accessdate = 2019-01-06 }}</ref>}}In 2020, Patients' Control conducted this survey to find out how much money Russian citizens have to spend to receive medical care for HIV infection, including transportation costs, purchase of medications, paid diagnostics, and/or visits to paid specialists. According to the survey results, 12% of HIV-positive Russians buy antiviral therapy at their own expense.<ref>{{Cite web|url=https://pereboi.ru/2020/12/25/rezultaty-oprosa-sredstva-kotorye-zatrachivayut-lzhv/ |title=Результаты опроса "Средства, которые затрачивают люди, живущие с ВИЧ, для получения медицинского наблюдения в России" |trans-title=Results of the survey "Money spent by people living with HIV to get medical care in Russia" |language=ru |date=2020-12-25 |accessdate=2021-01-03 |archive-date=2021-01-20 |archive-url=https://web.archive.org/web/20210120092101/https://pereboi.ru/2020/12/25/rezultaty-oprosa-sredstva-kotorye-zatrachivayut-lzhv/}}</ref> === State support === In 2005, the cost of antiretroviral therapy was more than $7,000 per person per year.<ref name = vsemirnyjbank/> Effective and affordable drugs only appeared in Russia a year later, when the government began to sponsor the Global AIDS Fund to join the G7. The international organization participated in the pricing of major manufacturers, which reduced the cost of drugs.<ref name=fominanovaya/> After 2007, the situation with the supply of drugs worsened. By 2016, the state negotiated with pharmaceutical companies on its own. In order to reduce the cost, a number of drugs were included in the list of vital drugs. For example, this halved the cost of "[[Emtricitabine/rilpivirine/tenofovir|Evipler]]" from 50 to 25 thousand rubles.<ref name=dissedentmeduza/> Before 2013, antiretroviral therapy drugs were purchased by the Ministry of Health of the Russian Federation and distributed among the regions. The system did not take into account regional distinctions, different patient populations, and the specifics of the drugs. Later, drugs began to be supplied on the basis of regional tenders, financed from the [[Federal budget of Russia|federal budget]]. As a result, the cost of a course of treatment differed in the regions, the difference could be as much as 20 times (according to some reports, 76 times). AIDS Centers were unable to procure the necessary amount of drugs, and HIV-positive people were assigned to centers in the regions where they were registered. Thus, {{comment|in Moscow, doctors illegally denied therapy to people without residence registration|The press service of the Ministry of Health called the reported cases "unverified" and did not comment on the situation.<ref name=novaya-volnameduza/><ref name=novaya-volna/>}}. Since January 2014, the requirements for the execution of state orders have been tightened. Regional officials were not introduced to regulations for tender documentation preparation. The timeframe for local auctions was delayed, for example, in [[Perm, Russia|Perm]] they were held only in the summer, when suppliers sold out their stocks. Some regions lacked [[didanosine]], [[ritonavir]], and other drugs.<ref name=novaya-volnameduza/><ref name=novaya-volna/><ref>{{cite web |url = https://www.gazeta.ru/social/2015/03/03/6434513.shtml |title = Вирус отправляют по прописке |trans-title=Virus sent to residence location |date = 2015-03-05 |publisher = Gazeta.ru |accessdate = 2019-01-06 |archive-date = 2020-08-05 |archive-url = https://web.archive.org/web/20200805082101/https://www.gazeta.ru/social/2015/03/03/6434513.shtml |language = ru }}</ref> During this period, the [[Russian financial crisis (2014–2016)|currency crisis]] and import substitution led to changes in the Russian antiretroviral therapy system. Because of the fall in the national currency, suppliers inflated prices by 20-30%. Doctors switched patients from foreign drugs to Russian less effective analogues. Of the 1,845 contracts, 614 were for generic forms of drugs, and the rest were for branded medications. At the same time, the cost of generics could be much higher than the market price, as officials indicated the cost of original medicines in the initial maximum contract price. As a result, in 2016 the cost of drugs in Russia and India, where companies regulated pricing under the influence of international funds, differed by more than 6 times.<ref name=dissedentmeduza/> There was virtually no competition between suppliers. Thus, in [[Chechnya]] the company "Medtehfarm" won in more than half of the cases due to the lack of competitors, in [[Ingushetia]] the same was with "ArchiMed". As a solution to the problem, the general director of [[Rostec]] [[Sergey Chemezov]] suggested officially securing the status of antiretroviral therapy provider to the corporation {{ill|Natsimbio|ru|Национальная иммунобиологическая компания}}. Although Nikolai Bespalov, development director of the analytical firm RNC Pharma, emphasized that Natsimbio was unable to supply the required number of the drugs.<ref name=novaya-volnameduza>{{cite web |url = https://meduza.io/feature/2015/09/04/vich-novaya-volna |title = ВИЧ. Новая волна Как кризис и импортозамещение возвращают вирус в Россию |trans-title=HIV. A New Wave How the Crisis and Import Substitution are Bringing the Virus Back to Russia |author = Rozhdestvensky, I. |date = 2015-09-04 |publisher = [[Meduza]] |accessdate = 2019-01-06 |archive-date = 2019-04-08 |archive-url = https://web.archive.org/web/20190408141716/https://meduza.io/feature/2015/09/04/vich-novaya-volna |language = ru }}</ref> The regional director of the [[Joint United Nations Programme on HIV/AIDS|UNAIDS]] Vinay Saldan pointed out that by 2014, therapy coverage in Russia was only about 40%.<ref name=hsesoolevskaya/> According to Anton Krasovsky, director of the [[AIDS.Center]], after two years, only about 20% of people with HIV were receiving medication.<ref name=dissedentmeduza/> In January 2017 it was 35%. By comparison, during the same period in [[Botswana]] the figure reached 90%, in [[Angola]], [[South Africa]], and [[Mozambique]] — 100%. In order to increase coverage and reduce the cost of treatment, the government reintroduced a system of centralized procurement by the Ministry of Health at the expense of the federal budget and subsidies of the subjects. Due to this the average cost of treatment per patient was more than halved — from 169,400 rubles to 84,000 rubles. Treatment coverage of HIV-infected people increased from 39.5% to 50.1% without raising additional funds.<ref name=kommersant/><ref name=izvestiya2019/><ref name=unaids/><ref name=dw/> The [[BBC News Russian|BBC Russian Service]] reported other figures: almost half of the patients received an annual course of ART at a cost of 11.4-23 thousand rubles, 34% received a course of 63-88.6 thousand rubles, 10% received more than 130 thousand rubles, and for 6.4% the cost of treatment was unknown.<ref name=kommersantidi/> Despite a significant reduction in procurement prices, the situation remained problematic in a number of subjects. Of the 24 billion rubles allocated for ARV procurement, most were centralized costs of the Ministry of Health. Regions did not allocate enough money, despite instructions from the authorities. The International Treatment Preparedness Coalition noted that 21 regions did not announce their own tenders. As a result, in 2017 the portal "Pereboi.ru" registered a record 509 reports of drug shortages in 45 subjects (according to other data, there were 700).<ref>{{cite web |url = https://www.kommersant.ru/doc/3482778?from=doc_vrez |title = Пациенты с ВИЧ продолжают жаловаться на нехватку лекарств |trans-title= Drug shortages for HIV infected people still raises concerns |author =Mishina, V. |date = 2017-12-01 |publisher = Kommersant |accessdate = 2019-01-06 |archive-date = 2018-04-19 |archive-url = https://web.archive.org/web/20180419091427/https://www.kommersant.ru/doc/3482778?from=doc_vrez |language = ru }}</ref> In 2018, Academician Vadim Pokrovsky reported that about half of registered infected people did not receive medication. According to other data, ART coverage was only 25%, with an overall increase in the number of infected.<ref name=novaya-volna>{{cite web |url = https://iz.ru/769929/elina-khetagurova/uzhe-ne-prigovor-chetvert-rossiian-s-vich-prakticheski-ne-zarazny |title = Уже не приговор: Четверть россиян с ВИЧ практически не заразны |trans-title=No longer a death sentence: A quarter of Russians with HIV are practically not contagious |author = Khetagurova, E. |date = 2018-08-03 |publisher = Izvestiya |accessdate = 2019-01-06 |archive-date = 2018-12-28 |archive-url = https://web.archive.org/web/20181228070632/https://iz.ru/769929/elina-khetagurova/uzhe-ne-prigovor-chetvert-rossiian-s-vich-prakticheski-ne-zarazny |language = ru }}</ref> The press secretary of [[President of the Russian Federation]] [[Dmitry Peskov]] denied problems with the provision of medicines to citizens. Nevertheless, Yulia Vereshchagina, a representative of the "Patients' Control" movement, testified about the critical situation: {{blockquote|In the regions there is a shortage of a number of ARV drugs, due to which they change treatment regimens without medical indications. There are reports of short-term, monthly dispensations, so patients have to travel every month to pick them up, which is difficult for those who live in remote areas. Some medications are reported to be denied, forcing patients to switch to an incomplete regimen or remain without therapy altogether.<ref>{{cite web |url = https://www.rosbalt.ru/russia/2019/05/22/1782525.html |title = Эксперт: Перебои с обеспечением ВИЧ-инфицированных препаратами и средствами диагностики продолжаются |trans-title =Expert: Shortages in the supply of drugs and diagnostics to HIV-infected people continue |date = 2019-05-22 |publisher = Rosbalt |accessdate = 2019-01-06 |archive-date = 2019-05-22 |archive-url = https://web.archive.org/web/20190522181348/http://www.rosbalt.ru/russia/2019/05/22/1782525.html |language = ru }}</ref>}} According to the WHO HIV strategy for 2016-2021, to end the epidemic it is necessary to identify at least 90% of all HIV-infected people and provide at least 90% of them with therapy.<ref name=interfaks2016/> Despite Russia's commitment to achieve such targets, government programs determined the real number of HIV-positive people to be covered by therapy to be at least 60%. This would almost halve the rate of increase of the disease and prevent up to 40,000 new cases of infection annually. But in practice, in 2019, only 32 regions reached 70% ART coverage.<ref name=spidcentr2019pokrov/><ref name=metoda/><ref name=ministr/> Nationwide, it was 48.5% of the total number of carriers and 68.9% of those on dispensary care.<ref name=bbcnevidimajaepidemia/><ref name=nsmdostupnye/> The situation was worsened by the fact that the main work on combating HIV was concentrated in the 10-15 regions with the highest rate of spread of the virus.<ref name=izvestiya2019/> In 2019, 19.3 billion rubles were allocated for the purchase of drugs for people with HIV.<ref name =ministr/> The cost of an annual course of antiretroviral therapy could reach 200-300 thousand rubles per person. At the same time the use of generics allowed the Ministry of Health to reduce the cost of several treatment options to 12 thousand rubles per year. Within the framework of import substitution programs, 27 antiretroviral drugs were produced in the country.<ref name=unaids/> By this time, more than 200 possible combinations of antiretroviral therapy drugs from Russian and foreign manufacturers had been used in Russia. But none of them was universal, which complicated the work of epidemiologists. At the same time, there was a severe shortage of qualified personnel in Russia familiar with the side effects and various combinations of ART with [[cardiac glycosides]], [[Diabetes|synthetic antidiabetic agents]], and other drugs. Vadim Pokrovsky estimated that about five hundred infectious disease specialists needed to be trained for the full operation of AIDS centers. But the federal budget provided funds only for the purchase of drugs.<ref name=izvestiya2019/> Despite an increase in funding, the situation with drugs in the regions remained difficult. Errors in calculations in the formation of centralized procurement led to crises across the country. For example, in the summer of 2019, the Ministry of Health set a low price for "[[Lamivudine]]," and pharmaceutical companies refused to supply it.<ref name=izvestiya2019/><ref name=dw>{{cite web |url = https://www.dw.com/ru/почему-в-рф-пациенты-с-вич-могут-остаться-без-главного-лекарства/a-48983579 |title = Почему в РФ пациенты с ВИЧ могут остаться без главного лекарства |trans-title=Why in Russia patients with HIV may be left without their main medicine |date = 2019 |publisher = Deutsche Welle |accessdate = 2019-01-06 |archive-date = 2019-06-01 |archive-url = https://web.archive.org/web/20190601132409/https://www.dw.com/ru/%D0%BF%D0%BE%D1%87%D0%B5%D0%BC%D1%83-%D0%B2-%D1%80%D1%84-%D0%BF%D0%B0%D1%86%D0%B8%D0%B5%D0%BD%D1%82%D1%8B-%D1%81-%D0%B2%D0%B8%D1%87-%D0%BC%D0%BE%D0%B3%D1%83%D1%82-%D0%BE%D1%81%D1%82%D0%B0%D1%82%D1%8C%D1%81%D1%8F-%D0%B1%D0%B5%D0%B7-%D0%B3%D0%BB%D0%B0%D0%B2%D0%BD%D0%BE%D0%B3%D0%BE-%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2%D0%B0/a-48983579 |language = ru }}</ref><ref>{{cite web |url = https://www.kommersant.ru/doc/3606295 |title = "При существующем подходе региональных властей мы не остановим эпидемию" |trans-title="With the current approach of regional authorities, we will not stop the epidemic." |author = Mishina, V. |date = 2018-04-18 |publisher = Kommersant |accessdate = 2019-01-06 |archive-date = 2018-05-30 |archive-url = https://web.archive.org/web/20180530035837/https://www.kommersant.ru/doc/3606295 |language = ru }}</ref> In particular, HIV-positive inmates in prisons of the [[Federal Penitentiary Service]] did not receive the drug. Since March, the Ministry of Health refused to consider their needs in targeted procurement, and the Federal Penitentiary Service had to conduct auctions on its own. But the supplier company "Natsimbio" did not receive a request for the drug.<ref>{{cite web |url = https://www.kommersant.ru/doc/4087149 |title = Схема лечения ВИЧ дала сбой в неволе. Из учреждений ФСИН жалуются на перебои с препаратами для ВИЧ-инфицированных |trans-title=The HIV treatment scheme has failed in prisons. Federal Penitentiary Service institutions complain about interruptions in the supply of drugs for HIV-infected people |author = Mishina, V. |date = 2019-09-09 |publisher = Kommersant |accessdate = 2019-01-06 |archive-date = 2019-09-10 |archive-url = https://web.archive.org/web/20190910174452/https://www.kommersant.ru/doc/4087149 |language = ru }}</ref> In 2020, the government allocated 29 billion rubles for ART procurement. The number of HIV-infected people was constantly increasing, and according to experts, in a year the amount of subsidies for the full-fledged operation of AIDS centers should have been at least 100 billion rubles.<ref name= izvestia2019/><ref name=bbcnevidimajaepidemia/> In addition, medical institutions did not have enough specialists to work properly. At least 500 infectious disease specialists needed to be trained in 2020.<ref name=spidcentr2019pokrov/><ref name=metoda/><ref name=ministr/> === Methadone therapy === One of the most effective HIV prevention programs for IDUs is substitution therapy. In many European countries, instead of full treatment for addiction, drug users are offered alternative ways of using drugs under the supervision of medical personnel.<ref>{{cite web |url = https://novayagazeta.ru/articles/2019/07/04/81121-nado-esche-300-tysyach-zarazhennyh-dobavit |title = "Надо ещё 300 тысяч заражённых добавить" |trans-title= ‘We have to add 300,000 more infected’ |author1 = Torop, A. |author2=Dokshin, V. |date = 2019-07-04 |publisher =Novaya Gazeta |accessdate = 2019-01-06 |archive-date = 2019-07-04 |archive-url = https://web.archive.org/web/20190704151911/https://www.novayagazeta.ru/articles/2019/07/04/81121-nado-esche-300-tysyach-zarazhennyh-dobavit |language = ru }}</ref> HIV-positive IDUs are offered [[Methadone maintenance]] to help them more easily give up [[opiates]]. Critics of the method insist that the therapy does not fight drug addiction. Thus, the deputy chairman of the [[State Duma]] Sergey Zheleznyak believed that methadone therapy cannot be called therapy because it "does not treat".<ref>{{cite web |url = https://tass.ru/obschestvo/2002455 |title = Зампред Госдумы: Москве не подходят программы замещения наркотиков и раздачи шприцов |trans-title=Deputy Duma Speaker: drug substitution and syringe distribution programs are not suitable for Moscow |date = 2015-05-28 |publisher =TASS |accessdate = 2019-01-06 |archive-date = 2015-08-03 |archive-url = https://web.archive.org/web/20150803075815/http://tass.ru/obschestvo/2002455 |language = ru }}</ref> Advocates of the method believe that slowing down the spread of the virus is more important than fully curing a potential carrier of drug addiction. Experts named insufficient prevention efforts, the ban on drug therapy for opioid addiction, and the "law against [[gay propaganda|propaganda of homosexuality]]" passed in 2013 as the main reasons for the deteriorating situation with HIV in the country.<ref name=vichchernova/><ref name=fominanovaya/> As a result, by 2015, Russia remained the only country in the world where parenteral drug use remained the predominant way of spreading HIV.<ref name=novayametadon/> === Developing vaccines in Russia === The development of the first Russian HIV vaccines began in 1997 at the Institute of Immunology of Russia, the GosNIICHB, and the [[State Research Center of Virology and Biotechnology VECTOR|Vector scientific center]].{{sfn|Onishenko|2010|p=42}} Scientists developed three candidate vaccines against the virus, which were preclinically tested in Moscow, St. Petersburg, and Novosibirsk. In 2004, the Institute of Immunology began clinical trials of the drug HIVREPOL. It was a conjugate of recombinant [[Protein]], replicating the internal protein and part of the HIV envelope protein, with the immunomodulator polyoxidonium.<ref>{{cite web |url = https://www.dissercat.com/content/pervaya-otechestvennaya-kandidatnaya-anti-vichspid-vaktsina-immunologicheskii-monitoring-i-i |title = Первая отечественная кандидатная анти — ВИЧ/СПИД — вакцина: иммунологический мониторинг и испытания |trans-title=The First Domestic Candidate Anti-HIV/AIDS Vaccine: Immunological Monitoring and Testing |author =Gudima G. O. |date = 2009 |publisher = Federal State Budgetary Institution "State Research Center Institute of Immunology" FMBA of Russia |accessdate = 2019-01-06 |archive-date = 2018-12-07 |archive-url = https://web.archive.org/web/20181207120934/http://www.dissercat.com/content/pervaya-otechestvennaya-kandidatnaya-anti-vichspid-vaktsina-immunologicheskii-monitoring-i-i |language = ru }}</ref> But in 2005, the development was phased out. A year later, during the [[G7]] summit, the President of the Russian Federation recognized the need to develop the vaccine. In 2008-2010, with the patronage of [[Vladimir Putin]], a trial program was launched again. For example, during this period, the Vector Medical Center was developing the KombiVICHvac vaccine against HIV-1. It combined B- and T-cell immunogens in a single design, which ensured formation of [[Humoral immunity|humoral]] and [[Cellular immunity|cellular]] immune responses.<ref>{{cite web |url = http://www.vector.nsc.ru/news/391/ |title = ФГУН ГНЦ ВБ "Вектор": испытания новой вакцины! |trans-title=FGUN SSC Vektor: New Vaccine Tests! |date = 2010-07-23 |publisher = Rospotrebnadzor |accessdate = 2019-01-06 |archive-date = 2019-04-29 |archive-url = https://web.archive.org/web/20190429022311/http://www.vector.nsc.ru/news/391/ |language = ru }}</ref> When all three vaccines passed the first phase of clinical trials, government funding stopped again. The teams of scientists broke up. In 2013, a grant from the Ministry of Industry and Trade under the Pharma 2020 program was won by a research team from St. Petersburg, but three years after the clinical trials, the funding was also terminated.<ref name=vichchernova/><ref name= riakaramov/>{{sfn|Onishenko|2010|p=42-52}} The main problems in vaccine development are the variability of the virus genome, the unique molecular and epidemiological composition of different territories, and the lack of a universal formula that affects several [[strain (biology)|strains]]. Epidemiologists estimate that an effective drug will be available worldwide by 2028. But foreign drugs will not be effective for Russian HIV-infected people. In order to stop the spread of the virus within the country, it is necessary to develop our own vaccine focused on the country's dominant strain. Despite this, [[Joint United Nations Programme on HIV/AIDS|UNAIDS]] expert Eduard Karamov reported in 2018 that the majority of Russian research programs were terminated.<ref name= riakaramov>{{cite web |url = https://ria.ru/20180720/1524995025.html |title = Эксперт ООН по СПИДу Эдуард Карамов: вакцина от ВИЧ появится через 10 лет |trans-title=Eduard Karamov, UN AIDS Expert: HIV Vaccine Will Be Ready in 10 Years |date = 2018-07-20 |publisher =RIA |accessdate = 2019-01-06 |archive-date = 2021-06-18 |archive-url = https://web.archive.org/web/20210618004014/https://ria.ru/20180720/1524995025.html |language = ru }}</ref> A year later, only the scientists from the St. Petersburg State Research Institute for HIV and the Biomedical Center were still working on the research. They conducted their studies of the DNA-4 vaccine which consisted of four [[plasmid]] DNA, encoding proteins.<ref>{{cite web |url = http://innovaplus.ru/uvelichenie-spontannyx-viral-blips-skachkov-virusnoj-nagruzki-u-nekotoryx-uchastnikov-ii-fazy-klinicheskogo-ispytaniya-terapevticheskoj-dnk-vakciny-protiv-vich/ |title = Увеличение спонтанных "viral blips" (скачков вирусной нагрузки) у некоторых участников II фазы клинического исследования терапевтической ДНК вакцины против ВИЧ |trans-title=Increased spontaneous "viral blips" (viral load spikes) in some participants in a phase II clinical trial of a therapeutic HIV DNA vaccine |date = 2019-10-16 |publisher = Innova Plus |accessdate = 2019-01-06 |archive-date = 2020-11-27 |archive-url = https://web.archive.org/web/20201127051126/https://innovaplus.ru/uvelichenie-spontannyx-viral-blips-skachkov-virusnoj-nagruzki-u-nekotoryx-uchastnikov-ii-fazy-klinicheskogo-ispytaniya-terapevticheskoj-dnk-vakciny-protiv-vich/ |language = ru }}</ref> In 2019, the Moscow City Center for AIDS Prevention and Control began testing a therapeutic HIV vaccine, which allegedly would allow a carrier to live for a long time without therapy.<ref name= riakaramov/><ref>{{cite web |url = https://www.interfax.ru/russia/638670 |title = Терапевтическую вакцину против ВИЧ начнут испытывать в Москве в 2019 году |trans-title=Therapeutic HIV vaccine to be tested in Moscow in 2019 |date = 2008-11-20 |publisher = Interfax |accessdate = 2019-01-06 |archive-date = 2019-01-21 |archive-url = https://web.archive.org/web/20190121115654/https://www.interfax.ru/russia/638670 |language = ru }}</ref>{{sfn|Onishenko|2010|p=42-52}} </textarea><div class="templatesUsed"></div><p id="mw-returnto">Return to <a href="/wiki/HIV/AIDS_in_Russia" title="HIV/AIDS in Russia">HIV/AIDS in Russia</a>.</p> <noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; 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