Andrey Rylkov Foundation
for Health and Social Justice

Human rights, drug policy and HIV

The 2nd World Forum on Human Rights, held under the patronage of King Mohammed VI, took place on 27 – 30 of November in Marrakesh (Morocco). The Forum brought together 7,000 participants from 95 countries. Over 100 themes have been discussed during the four-day forum, and 160 association, sports, cultural and training activities have been organized all over the city.

Anya Sarang, the President of the Andrey Rylkov Foundation, also took part in a Forum and gave a speech on the issues of human rights, drug policy and HIV. Please find the text of her speech below.


Good afternoon, dear colleagues and friends.

I’m honored to speak at this forum as I believe it is very important that we keep reframing our public health discussions with more focus on human rights. I’m very glad that in todays debates on HIV we have finally moved away from the behavioral science discourse and from fixing on peoples condom and syringe use, to taking a wider perspective and assessing structural factors, including economic and social conditions as well as the laws and policies that influence peoples lives and health.

I came from Russia – one of a few, if not the only country in the world, where HIV epidemic is still fast growing. The reason for this public health disaster is the Russian governments refusal to implement effective prevention programs for the most vulnerable group affected by HIV in the country – people who inject drugs. Today the world knows very well which simple public health interventions work most effectively to stop the spread of HIV among this group. These are so called ‘harm reduction’ programs: provision of sterile needles and syringes, low threshold counseling, opioid substitution therapy which helps to stabilize drug use and take care of ones health, prevent infection or better adhere to treatments; as well as timely provision of antiretroviral therapy in the settings that reflect patients special needs.

What drives the Russian government in blocking these interventions is the same political fear that in lesser extent paralyzes other governments in advancing their public health policies – the stigma of drugs and drug users. This stigma grows out of repressive policy and discourse framed by the International Drug Conventions that were accepted in the middle of the last century. While inception of these conventions was justified by public health and public safety rhetoric, it is clear today, that not only have they not reached their stated goal to eradicate drugs and drug use, the results of their implementations are in fact counterproductive – drugs availability grows all over the world, and more dangerous drugs arrive on the black market. At the same time, the war on drugs has aggravated health epidemics that are direct consequences of criminalization of drug users – the epidemics of HIV, hepatitis, overdose and tuberculosis.

For many governments, repressive drug policies have also become a tool to punish people for their poverty or race. Instead of protecting people economic and social rights and fighting poverty and economic segregation that represent an underlying cause of drug abuse and involvements into the black markets, its easier for the governments to put people who use drugs out of sight of the society and place them to prisons or labor camps. The world three larger economic and political powers – USA, China and Russia also happen to host three largest prison populations with huge proportions of prisoners serving time for poverty and drug addiction. The drug laws became an easy tool for the governments to mask economic and social problems and put the blame on the victims.

The last year was an important milestone in moving forward the drug policy debate all over the world. An important step forward was legalization of marijuana in Uruguay as well as in several US states – a crucial shift that showed that some countries are ready to take on more realistic and public health oriented approach to drug policy.

Another important step was a new report by the Global Commission on drug policy released in September this year that called for immediate decriminalization of drug users and revision of International drug conventions in order for the governments to take control over the currently illegal drug markets. The Commissions report calls the governments and civil society actors to take serious steps in preparation of the UN General Assembly on drugs that will take place in 2016 and will provide an important opportunity to introduce changes to the current ineffective drug policies.

We hope that the more advanced governments will take these recommendations with full seriousness and will start working on reforms aimed at drug decriminalization in their countries, alongside with suggestions for improvement of the international treaties.

It is also important that the UN system, including the multiple human rights bodies should improve their capacities in addressing criminalization, discrimination and enormous stigma towards drug users. While working on HIV and drug policy in Russia we face opposition form the government and try to use every opportunity to utilize UN human rights mechanisms to make the government fulfill its obligations under multiple human rights conventions. Through this experience we’ve learned that the UN system is not well prepared to act upon appalling human rights violations, and is not immune to stigma around drug use. Several committees and agencies have preferred to dismiss evidence of severe rights violations including systemic torture and inhumane treatment of people who use drugs and we have missed several important opportunities to influence the Russian policy through the reviews by the Committee against torture, Universal Periodic Review by the Human Rights Council and several UN agencies due to these bodies shortsightedness on the issues of drug policy.

The whole UN system should reassess the stigma attached to drug use and ally with human rights defenders who call for a major drug policy reform including full decriminalization of drug use and further redesign of the global drug control system. Without this reform, it will be impossible to move too much further on tackling global epidemics of HIV, hepatitis C and tuberculosis.

While giving more attention to the wider drug policy reform we should also keep pressure to sustain harm reduction programs as we witness setback in some countries, and lack of progress in others. Despite many years of advocacy and gaining scientific evidence, access to HIV treatment for drug users still remains problematic as they face discrimination and lack of flexibility of clinical programs that fail to meet their special needs. While hepatitis C treatment quickly develops and new more effective medications emerge, they remain inaccessible to drug users due to high cost and discrimination. Naloxone, which saves hundreds of thousands from lethal overdose, is available only through a handful of harm reduction programs throughout the world. Today we know of many simple and effective interventions that can save peoples lives and health, but remain inaccessible due to lack of diligent and fair public health systems.

Concluding my speech I would like to emphasize the main recommendations this forum could suggest:

First of all, we should call the world’s governments to repeal the laws and policies that criminalize people who use drugs. These laws do not stop people from using, but they stop them from addressing health services, including HIV prevention and treatment.

Second, meanwhile, the civil society and human rights activists, should keep pressure on governments, pharmaceutical companies and medical specialists in order to provide equal access to treatment programs for people who use currently illegal drugs – including equal access to antiretroviral treatments, new treatments for hepatitis C, as well as naloxone to prevent overdose deaths.

Third, The UN human rights bodies and agencies should reassess their stigma and bias in relation to drug users. They should fully commit to fighting oppression, stigma and human rights violations faced by one of the most vulnerable groups in the modern society – people who use drugs.

Fourth, between the progressive governments, civil society activists and UN systems, we should join forces to act at the UNGASS 2016 and push for a major review of the international drug conventions – in order to put the governments and not criminals in control of the global drug markets.

And fifth, on the national level, in countries where HIV epidemic hits people who inject drugs, we need to keep pushing for sustaining and increasing harm reduction services including needle and syringe programs, opioid substitution treatment, peer education and outreach, but also strengthen advocacy, human rights protection and legal support and activism of people who use drugs.

Thank you very much for your attention.


Category Categories: Voices from Russia | Tag Tags: , , , , , , | Comments No comments »

Leave a comment: