Andrey Rylkov Foundation
for Health and Social Justice

Unholy Alliance: How a US-Russian Partnership Undermines Good Drug Policy



June 7, 2012

Huffington Post

by Daniel Wolfe

Foreign policy makes unsavory bedfellows, but few instances of bedsharing are more disheartening than that of the U.S. and Russia on the issue of illicit drugs. U.S. drug czar R. Gil Kerlikowske and his Russian counterpart, Victor Ivanov, recently joined in a statement from the World Forum Against Drugs condemning drug legalization and urging commitment to policies based on “evidence and research.” For the Russians, this hypocritical posturing is business as usual. For the U.S. to put its name next to the Russians in such a statement is a credibility-threatening step, and shows how easily international politics bend the aims of public servants who know better.

Invocation of the evidence-base by Russian drug control officials would be absurd if the results were not so tragic. Russia has one of the fastest growing HIV epidemics in the world, with infections concentrated among people who inject drugs. Nonetheless, the government has steadfastly refused to approve methadone or buprenorphine treatment, despite multiple studies showing the effectiveness of those medicines in reducing HIV risk behavior and cravings for opioids. Even providing information about methadone and buprenorphine — which are on the World Health Organization’s list of essential medicines — is a high-risk activity in Russia. Physicians and nongovernmental organizations have been threatened with prosecution or had their websites summarily closed by Ivanov’s Federal Drug Control Service. Programs that provide clean needles to drug users, operating effectively in Russia with international funds, have received no support at all from the Russian government. Instead, the Federal Drug Control Service has identified needle exchange and other harm reduction efforts as a “threat” in its national strategic plan.

Ivanov is also working to make Russian ideology into the regional standard, traveling to Ukraine to condemn methadone and buprenorphine use there, and using Russia’s new position as an international donor to fund drug control in Central Asia. Alarmingly, Russian influence is also manifesting itself in the U.N. system, where the appointment of a Russian career diplomat, Yuri Fedotov, as head of the U.N. Office on Drugs and Crime (UNODC) has been followed by substantial contributions from Russia to the cash-starved agency and UNODC retreat from previous commitments to harm reduction. At a meeting in March, Fedotov — disingenuously suggesting that he spoke as an individual rather than the head of the U.N. entity leading the world’s response to drugs — made the astonishing statement that he did not regard methadone as a medicine. So much for the evidence base.

In the U.S., Kerlikowske’s Office of National Drug Control Policy (ONDCP) has publicly stepped away from the old “war on drugs” approach, instead launching a “drug policy for the 21st century” that emphasizes a public health orientation. When the U.S. Congress returned the federal ban on needle exchange last year, ONDCP did the right thing, pointing out in a statement that multiple studies, including those funded by the U.S. government, had shown the approach to be important in protecting the health of people who inject drugs. ONDCP’s drug strategy has also included more attention to treatment and prevention of overdose. As a police chief, Kerlikowske helped pioneer some of the more innovative and effective responses to drug offenses in his own jurisdiction, including diversion to services rather than to jail at point of arrest.

Why would drug czars who see the world so differently be forced into public partnership? The blame likely rests higher than Kerlikowske, with a massive, multi-million-dollar, bilateral “presidential commission” that promotes U.S.-Russia collaboration on everything from agriculture, emergency response, space exploration, high-tech industry and drug control. Since the launching of the initiative in 2009, Kerlikowske and Ivanov (as well as U.S. Secretary of State Clinton and Russian foreign minister Lavrov) have been shaking hands and sharing the dais at multiple international fora. Whatever the intentions of the effort, American silence has clearly been one outcome. Ivanov’s multiple misstatements of fact about methadone, including blatant misrepresentations of treatment in the U.S., have brought no public response from ONDCP. The U.S. has not expressed public concern about the hijacking of UNODC with Russian funds. While Ivanov travels the world suggesting that opium production in Afghanistan is the root of all drug problems, there has been no public effort by the U.S. to urge the Russians to get their own drug treatment policies in order. If ONDCP believes that private conversations are sufficient, the facts suggest otherwise: the Russian position has hardened, rather than improved, during the partnership.

“Resetting” U.S.-Russian relations has been an explicit priority of the Obama administration. But government officials such as Kerlikowske should also be able to hit the eject button when the truth is so blatantly sacrificed for political ends. ONDCP’s recent interest in looking abroad for creative approaches to drug treatment — and attention to decriminalization and expanded treatment approaches through programs like those visited recently by ONDCP in Portugal — is a better approach than letting fear of legalization drive the U.S. publicly into the arms of the Russians. It is bad enough that the approach of the Russian drug control service has fueled mass incarceration and HIV infection in their country. Now they are also threatening the credibility of drug control in Washington, D.C.

Daniel Wolfe is director of the International Harm Reduction Development Program at the Open Society Foundations and an advocate whose work has included community organizing and public media campaigns to repeal discriminatory legislation, boost AIDS funding, and raise the public profile of people with HIV.

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