FIGHT HIV/AIDS NOT PEOPLE WITH HIV/AIDS
Day of protest scheduled at Russian Embassies throughout the world

On the 1^st of December, International AIDS Day, the International Network of People who Use Drugs (INPUD), and local organisations of people who use drugs in several countries will lead protests and a Day of Commemoration for the millions of Russian people who use drugs. The latter are brutalized by the vicious nature of Russian drug policies which directly lead to tens of thousands of unnecessary deaths every year. By refusing to legalise the provision of opiate substitution programmes or provide needle and syringe exchange, the Russian government has the blood of millions on its hands, as the denial of these services, which are intrinsic parts of the inalienable right to the highest attainable standard of health, defies and ignores the international scientific consensus as to their effectiveness in reducing the spread of HIV amongst people who inject drugs. In addition to being a health catastrophe it is also an abrogation of the basic human rights of people who use drugs on a massive scale. Since 2005 both methadone and buprenorphine, the two major drugs used in opiate substitution programmes, have been part of the WHO list of essential medicines, and so their provision is a basic human right[i]. As such, we echo the clarion call issued in the recently published series of papers on HIV in people who use drugs published in The Lancet, in their words, “we want to see inappropriately aggressive, state-sponsored hostility to drug users replaced by enlightened, scientifically driven attitudes and more equitable societal responses. We recognise that the barriers to these hopes are many and deeply rooted across continents and cultures. But we also know that science can catalyse unprecedented social change, and unprecedented social change is what is needed for the millions of marginalised people infected with HIV who use drugs.”[ii]

Russia is a country devastated by a rapidly escalating HIV/AIDS epidemic and one with an estimated 5 million people who use drugs, 1.7 million of whom are estimated to be injecting opiate users, 37.2% of the latter are estimated to be living with HIV (although in some regions prevalence rates are up to 75%)[iii]. Everyday, over 150 individuals are newly infected with HIV, and the majority of these cases are due to a lack of access to clean syringes and needles. Whilst OST remains illegal, the few NSPs that do exist are run by NGOs with limited resources in a legal grey area and operate under constant harassment from the authorities. This total lack of evidence-based strategies such as opiate substitution programmes and the poor provision of other key harm reduction measures to the drug using community have lead numerous international bodies to call upon Russia to provide opiate substitutions[iv]. These services are universally recognized as being the most effective measures in stemming the spread of HIV amongst injecting drug users. According to official Russian data, approximately “80% of HIV cases from 1987 till 2008 were related to injecting drug use”[v]. Furthermore in “59.2% of HIV positive people identified in 2010, drug use with non-sterile equipment was named the main risk factor”[vi]. The number of those dying from HIV/AIDS related causes is almost matched by the number lost to overdoses. Families continue to lose their relatives and loved ones.

Effective, safe, evidence-based harm reduction interventions remain illegal in Russia, and those individuals and organizations that promote the implementation of such interventions in the hope of saving lives are officially considered to be, and condemned as, criminals. According to the Russian Minister of Health “distribution of sterile needles and syringes stimulates society to tolerate drug dependent persons and violates the Russian Criminal Code”[vii].

Russian officials claim that the effectiveness of opiate substitution therapy has not been adequately demonstrated, in spite of the scientific consensus to the contrary, and insist on refusing to implement it. Likewise, harm reduction programs, including needle exchange, are officially accused of propagandizing drug use and have an uncertain legal status.

The consumption of any illegal substance in Russia is a criminal offence, and lawmakers are currently considering the introduction of new, stricter legislation that will lead to the criminal prosecution of any individual convicted of using drugs. This criminalisation of the drug using community is driving them further underground, and the HIV/AIDS crisis is being further compounded by the appalling results of the use of desomorphine, often called krokodil, a crudely produced injectable opiate made by cooking up over-the-counter pain relief tablets with a hell’s kitchen of noxious substances. The use of krokodil is growing because it is cheap to produce and powerful in its effect, and rather than face the risks of buying heroin which is being sold at prohibitive prices, injecting opiate users are choosing to cook up this alternative, so named because it literally eats up the skin, producing horrific injuries, rotten flesh and gaping wounds. According to one Russian opiate user “You can feel how disgusting it is when you're doing it [i.e. krokodil]," he recalls. "You're dreaming of heroin, of something that feels clean and not like poison. But you can't afford it, so you keep doing the krokodil. Until you die”[viii]. Disturbingly, reports are coming in of the appearance of this substance in Germany, thus making this a matter of European wide and not just Russian significance.

On November 1st, 2009, Russian activists placed flowers and white slippers (a common symbol of death in Russian culture) at the entrance to the building of the Federal Drug Control Service of Russia in Moscow. This served as a sign of protest against the brutal practices employed against people who use drugs and signified the need to start providing these much needed services to Russian drug users, to begin to stem the tide of HIV/AIDS.

Five participants in the demonstration were subsequently arrested, and in 2010 official drug policy became even more repressive and unjust.

Activities that draw public attention to the problems faced by people who use drugs in Russia have serious consequences. As one Russian activist put it:

“the indifference of officials to our needs continues to destroy our lives and the lives of our families.  We are now turning to the global community and requesting that you support us by showing up at the Russian Embassy in your own cities […] We will honor the countless casualties of the War on Drugs with flowers. We will express our protest of Russia’s inhumane drug policies. Lastly, we will demand that the leaders of this country answer one question:

What do you offer the citizens of Russia who […] cannot stop using drugs?

As of now the answer to that question is unequivocal: prison or death!”

We are therefore calling upon the Russian government to:

·       Begin providing the needed programming for those most at risk of contracting HIV/AIDS, this includes OST and NSP for people who inject drugs.

·       Cease criminalizing the use of illicit drugs, which is in and of itself a major barrier dissuading people who use drugs from accessing the few services that are available.

·       Begin providing ART to people who use drugs.

·       Replace the current punitive, coercive, discriminatory approach to people who use drugs with a human rights and science based one, this includes the right to liberty and security, the right to health, the right not to be subjected to torture, cruel, inhumane or degrading treatment and punishment, and the right to freedom from discrimination[ix].

·       Cease persecuting those Russian activists and organisations that are calling for change and the introduction of harm reduction, human rights based measures.

·       Recognise that people who use drugs must be in the forefront of designing programmes and policies aimed at improving our lives.

Nothing About Us Without Us!  www.inpud.net

Protests will be held on December 1st at Russian Embassies in London, Stockholm, Berlin, Bucharest, New York, Sydney/Canberra, Barcelona, and Toronto. For times and locations follow updates at http://russianembassyprotest.wordpress.com