News Release from the Canadian HIV/AIDS Legal Network; Eurasian Harm Reduction Network; Harm Reduction International;
Russian Drug Policy can lead to an additional 5 million people becoming infected with HIV in the near future.
MOSCOW, October 7, 2011 — On October 10–12, 2011, in Moscow, the Russian Government has organized the International Forum “Millennium Development Goal 6 in Eastern Europe and Central Asia”. Representatives from the scientific community, civil society and government will participate in the Forum. Millennium Development Goals are the targets that 193 UN member states, as well as over 20 international organizations, have pledged to reach by 2015. The Millennium Development Goal 6 (MDG 6) aims to slow down and begin to reverse the HIV/AIDS epidemic by the year 2015, including in Russia.
However, today the growth of HIV incidence has not been contained, and in fact HIV incidence continues to grow. By December 31, 2010, 589,581 people with HIV were registered in the Russian Federation, compared to 529,828 people with HIV registered in 2009. Sharing of non-sterile syringes by injecting drug users remains the main route of HIV transmission – over 59.2% of all registered HIV cases, according to the Federal Scientific and Methodological Center for AIDS Prevention and Control. According to the Federal Agency for Drug Control (FSKN), there are estimated 5 million drug users in Russia. Thus, today 5 million people are under threat of contracting HIV, and in the future the epidemic in Russia could take catastrophic proportions.
“Clearly, in this situation HIV prevention among drug users must be a priority for Russia”, says Alexandra Volgina, activist, person living with HIV; Chair of the charity foundation Svecha. “In many countries that had to face drug dependence long before Russia and had similar epidemic situations, it was possible to significantly reduce HIV spread among drug users by implementing harm reduction programs. These programs include methadone substitution therapy and needle and syringe exchange. But the current Russian policy denies these methods that are accepted worldwide and recommended by the UN. This denial is not based on evidence.”
The emphasis of the fight against HIV in Russia is on using ineffective prevention measures in the background of repression against drug users and creation of an atmosphere of public intolerance towards people who use drugs. However, global experience shows that the spread of HIV in this group can be reduced also through changing drug policies to ensure their conformity with public health and human rights principles, and abandoning the repressions.
“There is an obvious connection between the spread of HIV among drug users and human rights”, says Mikhail Golichenko, Senior Policy Analyst at the Canadian HIV/AIDS Legal Network. “However, currently the Russian policy reflects quite the opposite of the developed countries’ experience.
Repressive Russian drug policy deprives people who use drugs of the right to health and the right to life itself. Harsh law enforcement measures result in drug users going “underground”, contracting infectious diseases, using prescription drugs and mixes and dying from overdoses; enforcement measures also result in the growth of the prison population. Together with a tuberculosis epidemic – at the end of the year 2009 there were 262,718 people with active tuberculosis registered at the Russian TB treatment facilities, – this makes achieving MDG 6 by 2015 absolutely impossible for Russia.”
Here are just some practical examples: the Russian government‘s estimated annual expenditures related to drug law enforcement (Articles 228-233 of the Russian Criminal Code) equal 2 billion 878 million 750 thousand rubles, or about 100 million US dollars. This amount does not include the money spent on detention and imprisonment.
To compare, only 20 million US dollars was allocated to HIV and hepatitis B and C revention among all population groups in 2011. The same amount will be allocated to HIV and hepatitis B and C prevention among all population groups in 2012 and three times less will be allocated in 2013. Considering the context and tendencies in the development of the HIV epidemic in Russia, clearly such policies are not leading to any positive results.
“No money at all is allocated towards HIV prevention among injecting drug users”, says Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice. “However, at the Moscow Forum on October 10-12 the Russian Government is planning to take on a leadership role in combating the HIV/AIDS epidemic in Eastern Europe and Central Asia. If Russia is acknowledged as the regional leader for reaching MDG 6 and its drug policy will continue to be based on repressive measures,then undoubtedly the region will become involved in a new round of mass human rights violations. This would lead to an HIV outbreak, new AIDS-related deaths, overdoses, denial of medical help based on discrimination. At the same time, economic and financial expenses necessary for effective prevention and for reaching MDG-6 will keep growing. Currently, a few days prior to the MDG 6 Forum, Russian and international nongovernmental organizations (NGOs) are appealing en masse to the Russian Government. One of these appeals says that the Moscow MDG 6 Forum, is a magnifying glass, allowing us to see these problems and Russia’s neglect of its own HIV epidemic and of the people who are at the highest risk.”
“To change the situation, the Russian Government must radically change the useless and expensive methods of combating HIV and the repressive policy towards drug users”, says Ivan Varentsov from the Eurasian Harm Reduction Network. “Before the opening of the MDG 6 Forum we want to call upon the Russian Government to support the necessary prevention programs for those at the highest risk of HIV, including substitution therapy and needle exchange programs. Otherwise, tackling the HIV epidemic and reaching the MDG by 2015 will be impossible.
Overwhelmingly, women who use drugs do not have access to basic medical care on a regular basis, although they are at a high risk of HIV and other life-threatening illnesses. Drug treatment options are also extremely limited, since drug treatment programs inRussia rarely— if ever— accommodate women with children or pregnant women. Another frequent barrier to care is the requirement that patients present a full set of legal documents— their passport, residence registration, and proof of medical insurance— to receive treatment at AIDS centers. Women and men who use drugs often lack some or all of these papers and thus are denied care. Again, much needed harm reduction programs offer help with residency registration and other documents through legal advocacy. This is the first post in a series that will lead up to World Aids day, and will follow in the footsteps of Russian drug users who took up a protest in Russia on International Drug User Day November 1st 2009, where they attempted to lay flowers and white slippers (a symbol that is put of the coffins of the dead in Russia) on the steps of their embassy. Immediately police rushed out of the building and chased the peaceful demonstrators arresting 5 of them. 
