Andrey Rylkov Foundation
for Health and Social Justice

A speech of Irina Teplinskaya at the 29th meeting of UNAIDS PCB

Established in 1994 by a resolution of the UN Economic and Social Council and launched in January 1996, UNAIDS is guided by a Programme Coordinating Board (PCB) with representatives of 22 governments from all geographic regions, the UNAIDS Cosponsors, and five representatives of non-governmental organizations (NGOs), including associations of people living with HIV.

The 29th meeting of the UNAIDS Programme Coordinating Board took place 13-15 December 2011 in Geneva, Switzerland.



Dear ladies and gentlemen,

Initially I prepared a totally different speech for today’s presentation; it was a more formal, ideologically sustained speech with references to statistics and official documents. However, having studied the agenda and participant list, I realized that all of you who have gathered here are experts of the highest caliber and that you are aware of the Russian drug policy and statistics much better than I am. I, on the contrary, am listed as a representative of the affected populations, and that obliges me to speak not with a language of cold mind and faceless figures, but with a language of the heart – because the affected population comprises 5 million Russian drug users, which makes up half of the total population of the majority of European countries. Imagine for a moment that over half of the people who live in Switzerland are living with constant fear, humiliation, diseases and torture, outside the Constitution and Law, denied the most important inalienable human rights: the right to life and the right to health. It is difficult, isn’t it? Nevertheless, you see in front of you a person who has spent two-thirds of her life like that!

My life is like a small mirror showing a bigger general picture; it gives an example of what’s happening to millions of people using drugs in Russia and most other countries of the former Soviet Union. I am 44, and for the past 30 years I have been suffering from a chronic opioid drug addiction. According to the definitions of the World Health Organisation and the United Nations Organisation, drug addiction is a chronic recurrent disease. However in my country, people suffering from drug addiction are outcast by default, they are socially isolated and deprived of their civic rights! I was born in the Soviet Union in a high-rank family. I could have had great prospects and a brightest future, I could have done something good for my country. But this future has never come. When I was 14, I had my first experience with opium, and since then I have been living in my country as an outlaw, persona non-grata. I had multiple unsuccessful attempts to treat drug addiction in different clinics, but they all failed, and every time I got back to drugs. I spent 16 years in prisons, sentenced to jail for purchasing and possessing drugs for personal use, which means, for behaviours directly caused by and symptomatic to my disease! My family abandoned me, I became homeless and for 2 years lived literally in the street. Whatever happened to me, I continued using drugs, I lost my battle with the disease. Through contaminated syringes, I have acquired hepatitis C and HIV. Last time I was in prison, in 2007, I developed AIDS and had tuberculosis. At this moment I, for the first time in my life, have undertaken efforts, though not quite deliberately, to protect my major right, the right to life. The HIV therapy in Russia is guaranteed by the government, but to get the vital and essential medicines for HIV treatment in prison, I had to go on hunger strikes and to open veins. As a result, I almost killed myself, my life was in danger, and before it was too late I was sent from prison to a tuberculosis hospital. God knows why I did not die, I survived just despite everything, even though nobody actually cared for me: neither my family, nor friends, nor my country. I had no place to go. Two years I have lived in the tuberculosis hospital, working as an aid-woman in the HIV-TB coinfection department. In this two-year period, I witnessed deaths of more than 100 friends of mine and people who I knew – all young people, quite talented and promising. Almost all of them died for one common reason – they were opioid-addicted, and they came for treatment on last stages of the disease, when it was already too late to help them. Drug-addicted people have little opportunity to receive an adequate HIV and TB treatment, as they just cannot stop being addicted, and their addiction force them into never-ending hunts for illegal drugs and money for the drugs, involving criminal activities. Needle and syringe programs have recently been banned in Russia, too – although according to the General Assembly of the United Nations Organisation, these are a major component of comprehensive HIV prevention programs among people who inject drugs. Even scientific discussions of issues related to the use of methadone – one of the essential medicines recommended by the World Health Organisation – is considered illegal and can be classified as “propaganda of drug use” in Russia. Pregnant women are not given any specialised narcological assistance; they have either to terminate pregnancy or to continue using illegal drugs till they have their babies. In the countries where substitution therapy is available, drug-addicted women, like any other women, can have babies, nurse and raise them without risking their health or lives. In our country, there is no specialised crisis center for drug addicted women with children who wants treatment to stop using drugs.

Prison sentences that we are getting for insignificant drug-related offences are disproportionate to the severity of those offences. For many of us prison conditions equal death sentence because of the absence of substitution therapy and the drugs to treat HIV, tuberculosis and viral hepatitis. As of next year, Russia will reintroduce a law according to which drug use will be punished by incarceration; I have been sentenced three times in accordance with to that law. And yet, our country leaves no choice for us: substitution therapy is prohibited, and state-supported drug treatment is absent. To enter detox, you must spend a month waiting for your turn, which is difficult for an active drug user who must be able to find drugs during that month and may die any time. There are no state rehab centers in our country; each year only 400 free spaces are made available to 5 million people. Prison, discrimination and death are the three whales – and the Russian drug policy turtle rests on them!

Thirty years have passed since the discovery of HIV; exactly the same time as I have been using drugs. During those years the disease took the lives of millions of people all over the world. Human life lost its value in the face of the epidemic. The only way to return the value of human life is to express respect, tolerance, solidarity, compassion, care and love for each other. The whole world has united to stop human deaths and pain, to help those who were the first to face the disease, those whose lives are in the risk zone, and to do all it can to say: “We have stopped it!”

We have overcome many things already. We have moved racial, religious and cultural prejudice in the background. Sexual orientation has become a personal matter. We have enabled prevention to protect people from infection in the most difficult situations. It is now possible to control drug use. It is possible for key communities to participate in vital decisions. Doctors and patients have united. Finally, antiretroviral therapy to treat HIV appeared! This has largely been possible due to some simple (as it seems at first) and, at the same time, complex (as shown in practice) things. I am referring to harm reduction programs. I am referring to decriminalization of drug use, to observing human rights and WHO protocols. To my great regret, those changes took many years and many lives. But to my despair I live in a country where the goals do not justify the means, where it is easier to destroy ill people to save healthy people’s lives. Where ethics and humanism have turned into contempt and cruelty. Where prevention is evaluated not by methods and results, but by money and popularity. Where science and practice has been replaced by lies and repressions. The fact that the Russian anti-drug strategy until 2020 mentions HIV only once and the words “human rights” are not mentioned at all speaks for itself: we, the Russian drug users, although citizens of our country, are denied inalienable human rights: the right to health and the right to life. I am not even mentioning other rights.

I can’t understand the rationale behind the actions of my country’s government which is persistently unwilling to implement harm reduction programs. Here are just some figures: before the MDG6 Forum that took place in Moscow last October, the Eurasian Harm Reduction Network researched the costs involved in the Russian drug policy; it turns out Russia is spending about $100 million annually on drug-related law enforcement. This doesn’t include the money being spent on keeping people in prison for drug related offences. And only $20 million was allocated in 2011 for the prevention of HIV, hepatitis B and C in all the groups! Similarly to 2012. And three times less will be allocated in 2013; I’ll specify again that the government is not spending a penny on needle/syringe exchange programs, so I’m referring to primary prevention in the broader population. Where is the logic and common sense from an economic point of view? In the past 10 years Russia’s population has decreased by 9 million people, and it keeps decreasing. Each year over 100,000 people of a reproductive age are dying of overdoses, AIDS and tuberculosis: where is the logic from a demographic point of view? Finally, I believe that harm reduction programs are related not only to healthcare; they are also part of a legal framework. Because I consider Russia to be a great country with immense resources, a country that won the Second World War, that sent the first man into space – a superstate where human rights must be at the basis of society. And if drugs that can alleviate our suffering from drug dependency have been invented, if methods that reduce drug related harm exist, we must have access to those drugs and methods because our right to health is guaranteed by the Constitution, and while those drugs exist denial of medical assistance equates to torture.

This past year I have repeatedly addressed various UN structures asking them to influence Russia so as to obligate the country to introduce needle/syringe exchange and OST programs. I made an official complaint to the Special Rapporteur Anand Grover; I made a statement for the High Commissioner for Human Rights when she visited Russia in February of 2011; before the MDG6 Forum I met Mr. Sidibe in St. Petersburg and told him about ubiquitous violations of our rights. Ms. Pillay and Mr. Sidibe made clear to the Russian government the position of the UN and the international community, stating that discrimination, humiliation, destruction and violation of rights of 5 million Russian citizens who live with drug dependency contradict the norms of civilized society, WHO and UN recommendations, and facilitate the spread of HIV/AIDS. What they got in response was silence and even tougher punishments for drug use. This in spite of the fact that the whole world has recognized the futility and ineffectiveness of the 60 years of the war on drugs! The Russian government calls upon the whole world to address the Afghan threat, seeing in it the root of all problems, and doesn’t want to see that because of inaccessibility and high costs of heroin our whole country has switched to more dangerous legal drugs: desomorphine (crocodile) and methedrone (bath salts). In the 30 years I spent using pure opiates I did not have to face such irreversible consequences that the modern generation of drug dependent people face; people are rotting alive, their tissues, bones and brains are decomposing, their kidneys are failing and irreversible changes are happening in their mental condition. Pharmacy drugs are special in that they are used by large groups in closed spaces, and they are injected 25-100 times more often than heroin. Considering that needle/syringe exchange programs are prohibited in Russia, in a couple of years we will enter a new round of the HIV epidemic at a scale that will threaten our national security. How many tears, suffering, deaths and broken lives does the leadership of my country need to finally realize that there is no other way to fight the HIV and drug epidemics besides the one used by the whole civilized world?!? When will my country finally realize that it should fight the virus and not the people?

My case against the Russian Federation has passed all domestic authorities; currently it rests with the European Court on Human Rights. I have nothing to lose; I have lost it all: my bright future, the best years of my life, my health, family and home. The only thing I have left is my dignity that nobody can take away from me. Three months ago as I was crossing the Russian border, intelligence services planted a methadone pill on me, having searched me and my things for no reason. They opened a criminal case against me for “drug smuggling”, and I risked going to jail for seven years. Thanks to the whole world that stood up to defend me, my case was closed in 5 days. This was our common victory, the triumph of justice and the proof that together we can make this world a better place. But I am not feeling safe, because I believe that this provocation was how the government reacted to my active citizenship and to my fight for the rights of drug dependent people without discrimination. In Russia, drugs have become an instrument of intimidation and political repression against those who disagree with the government’s policy. This is scary. We are returning into the age of Stalin and nationalism, and judging by the latest events the country is possibly facing a new civil war to protect democracy. My friends and I do not want a war. Having a chronic disease, we are striving to enforce our right to health, which is guaranteed by the Constitution of the Russian Federation, as well as the rights of 5 million people who use drugs in Russia! I want to have access to sterile syringes, to prevent thousands of young people annually from getting infected with HIV and HVC through contaminated injections. I want my friends to have access to treatment of HIV, tuberculosis and hepatitis – the diseases few people dying of nowadays in the developed world. I want my female friends to have no need to sell sex for drugs, I want them to be protected against violence and be able to have healthy babies and raise their children. I do not want hundreds of thousands lives to be broken every year in prisons for minor drug-related offences. I want the health officials to give us treatment, not throwing us away from life! Russia’s refusal to use opioid substitution treatment programs is absolutely ungrounded and not based on evidence; more over, it results in the violation of human rights. In October 2010, UN Secretary-General Ban Ki-moon visited a methadone clinic in Cambodia, demonstrating to the world that methadone maintenance therapy programs are legal, important and should be available to people with drug-related problems. UN Secretary-General himself handed methadone to patients at Cambodia’s methadone clinic. In Russia, we are also humans with universal human rights, and we also have the right to live!

In conclusion I would like to thank the International Network of People Who Use Drugs that organized the protest action in our support, held on December 1 outside the Russian embassies in the 12 largest capitals of the world. Also, I would like to thank you for the opportunity to ask you for help to save our lives.

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