Andrey Rylkov Foundation
for Health and Social Justice
Русский

Global Fail of Harm Reduction in Russia

This speech was given by Ivan Varentsov, the representative of the Andrey Rylkov Foundation for Health and Social Justice on 16th November 2016 in House of Commons, London (UK) at the launch of the ‘”Global State of Harm Reduction 2016” report – the flagship publication of the ‘Harm Reduction International’.

This launch was chaired by the Right Honourable Ann Clwyd MP and  jointly hosted by Harm Reduction International and The All-Party Parliamentary Human Rights Group, who continue to work together to raise greater awareness of how current drug policy can result in serious human rights violations and to bring about redress and reform.

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Dear colleagues,

First of all would like to say that it is an honor for me as a representative of a small local Russian NGO to speak here today in the British Parliament on the situation with harm reduction in my country and support the presentation of the 5th edition of the Global State of Harm Reduction.

I represent the Andrey Rylkov Foundation for Health and Social Justice – a community based NGO working since 2010 on the streets of Moscow among people who use drugs to decrease the rate of HIV, HCV infections and overdoses among them and to provide a legal and social help to those who are in need and can’t receive such support from the government.

It is not a secret that Russian drug policy is known as one of the most conservative and repressive among those around the world. If to list the main features of the Russian drug policy they could be the next:

- It declares a zero tolerance towards drug use inflaming the stigma and discrimination towards people who use drugs because of their drug dependence and primarily they are considered not as patients who need proper treatment and support but as criminals. Russia totally supports the concept of War on Drugs but it even goes further and it de facto introduced the war on drug users – there are more then 150 000 imprisoned people in Russia sentenced for drug related crimes – mostly for the possession of certain amount of illegal substances for personal – use which is a bit less than one fourth of all prison population in Russia

- It restricts the access for drug users to vitally important for them information on health issues and to the health services needed such as opioid substitution treatment, naloxone and harm reduction programs by providing zero support for the secondary HIV prevention and psycho-social work with this key HIV-affected population: in 2009 there were 75 projects reaching out to 135.000 clients (coverage of less than 5% of conservatively estimated 2.5 mln PWID). In 2016 – only 16 projects reaching 13.800 people (90% decrease!) coverage = 0,5% of PWID.

- It overemphasize drug control at the expense of drug demand reduction and even creates the obstacles in the access to drug demand reduction programs: OST programs are strictly prohibited in Russia and we all remember what happened in Crimea in 2014 when Russia introduced ban on OST treatment and in one month closed all OST programs working there for 8 years restricting access for 800 people to vitally needed for them treatment. This forced many people to return to the use of the illegal drugs, all of them became criminals and some of them already died

As a result of such drug policy Russia has one of the fastest growing HIV epidemics in the world with over 1 023 000 officially registered HIV cases. About 70% of all HIV cases in Russia are associated with the use of injecting drugs and still the main way of HIV transmission is parenteral. There are nearly 5 million people use illegal drugs in Russia, about half of them are estimated to be the injection drug users. On average, 37.2% of the injecting drug users live with HIV and in some cities, up to 90% of people who use injecting drugs are infected with hepatitis C. Tuberculosis has reached epidemic proportions in Russia, now the primary cause of death among people with HIV, and 78% of men with both TB and HIV are injecting drug users. The total number of people with HCV who also inject drugs is estimated to be over one million.

As a community based organization which tries to support people who use drugs and help them to protect their rights we experience the influence of repressive national drug policy on ourselves. In 2012 Federal Drug Control Service closed our website for publishing UN recommendation on the use of OST treatment as it was considered as promotion of the illegal drugs. Our outreach workers are constantly facing the police attention while working on the streets with drug users. Just last week our outreach team was approached by policeman and told that if he see them and out outreach mobile unit once again in this area – they will be taken to the police and accused of promoting the drug use because people living in the area complain on this our work with IDUs as they don’t want to see it. But we will keep trying to continue to work helping drug dependent people on the streets of Moscow, and trying to promote the drug policy based on humaneness, tolerance, public health, human rights and dignity.

I also would like to give you the understanding of the political context in which NGOs especially those working in the field of HIV prevention are operating in Russia nowadays. In July 2012 Russian government introduced a new version of a law regulating NGOs’ activities: now all NGOs receiving foreign funding and implementing “political activities” should be registered as “foreign agents” which is equal of being given an official stamp of a traitor and which could imply certain sanctions including financial. Needless to say that definition of the “political activity” could be interpreted very broad. After the law was introduced more than 1000 NGOs undergone unexpected inspections by prosecution offices in 2013, few of them were labeled as “foreign agents” and experienced sanctions, few were closed. In June 2014 Ministry of Justice got the right to decide itself which NGO is a “foreign agent” and the recommendation was issued for all governmental structures to avoid dealing with those NGOs named as foreign agent. And a month later the Ministry of Justice of RF issued an order to start unscheduled audit and inspections of all NGOs in country dealing with HIV prevention although without any major consequences for such NGOs. Starting from 2016 we see a tendency for NGO working in a sphere of HIV prevention to become included into this list – since January 6 of such NGO was labeled as foreign agent. And my organization is one of this six. The political activity which was incriminated to us is our advocacy for introduction of opioid substitution treatment in Russia. Now we are constantly under a threat of being fined for any minor violation of the “foreign agent” law which could lead to the closure of the organization.

Yes, we do carry out our work using foreign funding, donations from private foundations and crowdfunding. But this is not because we want to work this way. Over the last few years, we applied for President’s grants few times so that our work could be funded from Russian sources but our projects were never financed. For a long time already, HIV prevention is not funded from public funds and at seems like nothing will change in next few years as the new HIV strategy till 2020 adopted this October doesn’t support harm reduction programs. The main source of funding which now allows us to continue our work is the last Global Fund HIV grant allocated to Russia – actually the major source of funding for harm reduction and community mobilization programs in Russia nowadays. But it is coming to an end next year and no continuation is expected as now Global Fund has the policy of transition from MIC which will have a huge impact on those countries with concentrated epidemics among KAPs as Russia which unwilling to sustain adequate HIV response from national sources.

At the end I would like to thank colleagues from HRI for their continuous and adherent work on harm reduction advocacy worldwide and particularly for the very important work they do for many years on the Global State of Harm Reduction – a report which on one hand allows to capture and show the inability, unpreparedness and lack of willingness of the governments in countries like Russia to ensure an adequate response to concentrated HIV epidemic among people who use drugs but on the other hand – to show the expedience of other countries who base their drug policies on the evidence based approaches focused on tolerance, protection of health, dignity and human rights. And I really hope that UK will always base its drug policy on these principles but will never take the same track in it as Russia.

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