To: Mr. Michel Sidibe
UNAIDS Executive Director
Cc: Dr. Jean-Elie Malkin
Director, UNAIDS Regional Support Team for Eastern Europe and Central Asia
Date: 24 April 2014
We, representatives of civil society organizations involved in the HIV response in Russia and other countries, are addressing you in relation to the Fourth Conference on HIV/AIDS in Eastern Europe and Central Asia (EECAAC) to be held in Moscow in May, where UNAIDS acts as co-organizer and donor.
UNAIDS’s mission is to coordinate the global HIV response and support the best practices of governments’ and civil society’s involvement. Unfortunately, we have to repeat our view  that in the past few years, UNAIDS has ceased its leadership role in Eastern Europe and Central Asia (EECA) and in Russia in particular, and does the Russian government’s bidding by supporting its inefficient HIV policies. UNAIDS’s continuing role of EECAAC co-organizer and donor is one more proof of that.
The Russian government openly emphasizes its opposition to the effective evidence-based approaches to HIV prevention among key affected populations (KAPs), replacing public health approaches with repressions and criminalization, and creating an atmosphere of intolerance and discrimination against KAPs, such as people who use drugs (PUD), sex workers, men who have sex with men, and migrants.
Because of the murderous governmental policies, Russia remains one of the world’s few countries where the HIV epidemic continues to grow rapidly: 77,896 new HIV cases were diagnosed in 2013 – a 10.1% increase from the previous year, and 798,866 HIV cases have been registered in total. The main route of HIV transmission, 57% of cases, remains sharing of non-sterile syringes among PUD  – the same as 18 years ago when the HIV epidemic drastically started rising in Russia. Despite the declaredly universal access to HIV treatment in Russia, 22,387 people with HIV have died in 2013 alone  – yet another, 9.1% increase over the previous year. HIV is the main cause of death among all Russians aged 25-44 and the second important cause in the age group 45-49. 
According to the Russian Federal Drug Control Service, 8.5 million people use drugs in Russia, of which a million and a half are opiate users.  Yet, while PUD account for the biggest share of all HIV cases, and HIV prevalence in PUD reaches 60% in many Russian cities, the Russian government does not allocate a single ruble to the effective evidence-based programs of HIV prevention among PUD, as well as other KAPs, and blocks not only implementation but the mere discussion of opioid substitution therapy programs.
Russia continues enforcing a harsh drug policy where “the war on drugs” stands for the war on drug users. Other KAPs are equally harassed and humiliated. Last year, Russia adopted a number of homophobic laws that further provoke hatred and violence against LGBTs and impede HIV prevention efforts in this group. In December 2013, the only Russian association of sex workers has been denied registration on discriminatory grounds.
The Russian government not only jeopardizes the lives of its own citizens but aims to extend its “approach to HIV prevention” among KAPs to other countries in EECA, undermining their achievements in HIV prevention, incl. harm reduction programs effectively implemented elsewhere. A striking example of these policies and of disregard to the patients’ needs is the humanitarian crisis in the Crimea where 800 substitution therapy clients have literally lost access to essential drugs, methadone and buprenorphine. According to Viktor Ivanov, director of the Russian Drug Control Service, “the first thing [we have] to do in the Crimea is to abolish the practice of treating drug addiction with methadone”.  The EECAAC organizers are hoping that this official will speak at the conference opening. 
The EECAAC Organizing Committee includes a Deputy Chairman of the Russian State Duma Sergey Zheleznyak, a co-author of several repressive laws incl. the “Law on foreign agents” that jeopardized NGOs work and limited their access to international funding for HIV programs that are not supported by the national budget, such as harm reduction programs. This politician is also invited with a speech to the EECAAC opening. 
Holding a regional HIV conference in Russia makes it impossible for KAPs to participate. Drug user activists from other countries will be unable to obtain substitution therapy during the conference and, moreover, will be at risk of prosecution. Presentations by LGBT representatives may fall within the scope of the homophobic law “On the prohibition of propaganda of non-traditional sexual relations among minors”.
According to its mandate, UNAIDS should play a leading role in the HIV response and protection of human rights of people living with, and affected by HIV. However, once again you choose the path of
collaborationism, allowing the Russian authorities to impede the access to HIV prevention, treatment, care and support for KAPs in their own country and endorsing the promotion of similar policies in neighboring countries.
Russian officials repeatedly make public statements about the ineffectiveness of harm reduction and substitution therapy. By not refuting these allegations and continuing the role of EECAAC’s co-organizer and donor, UNAIDS in fact agrees with the HIV policies of the Russian government.
We express our solidarity with all those who suffer from repressions and the murderous policies within Russia and who are not able to participate in EECAAC, and we join the boycott of the conference.
We understand that UNAIDS will not refuse to participate and support this conference. But we want to openly re-state our position and to express disrespect to, and disagreement with UNAIDS’s work in the region and in Russia in particular, which manifests in the inability and refusal to protect the interests and rights of KAPs at high level.
Andrey Rylkov Foundation for Health and Social Justice (Moscow, Russia)
International HIV/AIDS Alliance
|Dr. Eliot Ross Albers
International Network of People who Use Drugs (INPUD) Secretariat
On behalf of the ENPUD Steering Committee
Eurasian Network of People Who Use Drugs (ENPUD)
Harm Reduction International
Secretariat of the Eurasian Harm Reduction Network (EHRN)
International Drug Policy Consortium
|Anke van Dam
AIDS Foundation East-West (AFEW)
International HIV/AIDS Alliance in Ukraine
Canadian HIV/AIDS Legal Network
Georgian Harm Reduction Network
Romanian Harm Reduction Network
Drug Policy Program Director
Hungarian Civil Liberties Union
Chair of the Board
All-Ukrainian Charitable Organization “Positive women”
Head of Board
Association of Substitution Treatment Advocates of Ukraine
|Jean-Paul C. Grund, PhD
CVO – Addiction Research Center (Netherlands)
Head of the Board
Charity organization “Svitanok Club”, Donetsk, Ukraine
NGO “Chance Plus” (Yekaterinburg, Russia)
HOPS-Healthy Options Project Skopje, Macedonia
NGO “Real People Real Vision”, Georgia
Categories: ARF international advocacy | Tags: advocacy, EECA, HIV, OST, Russia, UNAIDS | 2 comments »