Researchers, Public Health Experts Urge Russia to Expand HIV Prevention Programmes for People Who Inject Drugs As Regional AIDS Conference Opens in Moscow
Evidence-based Programmes in Ukraine and Kyrgyzstan and Russian Scale-up of HIV Treatment Highlight Potential for Action
28 October 2009 (Moscow, Russian Federation) - As Moscow prepares to host the 3rd Eastern Europe and Central Asia AIDS
Conference (EECAAC) on 28-30 October, the Eurasian Harm Reduction Network, the International AIDS Society and the International Harm Reduction
Association issued a joint call to the Russian Government to dramatically expand access to HIV prevention programmes for people who inject drugs.
Citing deep concerns over recent reports that the government's new strategic health plan will not support such programmes, the
organizations called for increased financial resources, widespread availability of confidential and free drug treatment services, and the
removal of legal and regulatory barriers that inhibit evidence-based HIV prevention and drug treatment programmes. The groups
specifically urged the repeal of laws that limit or prohibit opioid substitution therapy (OST) and access to clean needles and syringes.
Of particular concern, a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria supporting HIV prevention programmes
for people who inject drugs, sex workers and men who have sex with men ended August 2009. The Russian Government has not upheld a promise made
during EECAAC in 2008 to finance the continuation of the services started by this grant. The funding crisis leaves projects in ten regions
subject to staff layoffs and closures, despite the fact that they have averted an estimated 37,000 HIV infections.
"Russia's financial commitment to scaling up HIV treatment over the past five years has led to greatly expanded AIDS
treatment access. It's time for the nation's leaders to make the same commitment to deliver universal access to services to prevent HIV
infections," said Robin Gorna, Executive Director of the International AIDS Society (IAS) and Co-Chair of EECAAC. "The response
to injecting drug use in Russia is driven by criminalization, but evidence tells us that criminalization is counterproductive to both
effective drug treatment and HIV prevention. In order to stem the tide of infections, Russia must embrace proven HIV prevention
programmes driven by public health principles."
An estimated one million people are living with HIV in Russia, 80 percent of whom are under 30. An estimated1.85 million Russians,
two percent of the adult population, inject drugs, one of the highest rates in the world. In 2007, 64.5 percent of new HIV infections in Russia
were the result of injecting drug use.
"The HIV epidemic amongst drug users in Russia could easily have been avoided if not for the negligence of past and present
administrations," said Professor Gerry Stimson, Executive Director of the International Harm Reduction Association (IHRA). "Years of government
inaction and obstruction have brought us to these staggering numbers. This is nothing short of a public health policy disgrace and government must recognize
that controlling HIV depends on controlling HIV among people who inject drugs."
Despite considerable external funding, needle and syringe programmes remain very limited in the Russian Federation and there is no state
funding for these programmes. Effective drug treatment is inaccessible and there are no confidential and free drug treatment services. Rehabilitation
programs are rare and OST programmes are prohibited under the Federal Law on Drugs
"In some regions in Russia, harm reduction services have been proven to slow the epidemic and are supported by local authorities. To cut
off funding to these programmes is to waste years of investment, training, and expertise," said Shona Schonning, Program Director, Eurasian Harm Reduction
Network. "If these lifesaving programmes are not continued and funded properly, the cost will be thousands more HIV infections and lives lost."
Neighbouring nations have demonstrated the effectiveness of drug treatment and harm reduction programmes. Ukraine is making major efforts to scale
up OST to reach 20,000 people by 2013 and Kyrgyzstan has one of the most comprehensive approaches to harm reduction in the region. In Kyrgyzstan, nationwide
scale up of OST is underway, including pilot OST in prisons. Needle and syringe exchange programmes are already available in most prisons.
"The evidence in support of these strategies is clear and denying the validity of existing research is an unacceptable response to this
growing crisis," said Gorna. "If Russian leaders believe, as some have stated, that more regional evidence is necessary, then we must look to the
Russian Government to support and fund this additional research."
The effectiveness of OST and access to clean needles and syringes is well-documented. According to the World Health Organization (WHO), OST
reduces HIV prevalence and risk of HIV transmission and infection, while also reducing the proportion of users who inject drugs and the frequency of infection.
For those infected with HIV, OST increases access and adherence to antiretroviral therapy. WHO also concluded that there is compelling evidence that increasing
the availability and utilization of sterile injecting equipment by people who inject drugs reduces substantially the spread of HIV. The programmes are
cost-effective, have no convincing evidence of unintended negative consequences, and show evidence of increasing recruitment into drug treatment.
The Eurasian Harm Reduction Network (EHRN) is a regional network with a mission to support, develop, and advocate for harm reduction approaches
in the field of drugs, HIV, public health, and social exclusion though: documentation and advocacy activities; provision of high quality technical assistance
and training; and through networking and information activities. Founded in 1997, EHRN today unites more than 300 individuals and organizations from 29
countries of Central and Eastern Europe and Central Asia that come both from public and non-governmental sectors.
The International AIDS Society (IAS) is the world's leading independent association of HIV professionals, with 14,000 members from 190 countries
working at all levels of the global response to AIDS. Our members include researchers from all disciplines, clinicians, public health and community practitioners
on the frontlines of the epidemic, as well as policy and programme planners. The IAS is the custodian of the biennial International AIDS Conference, which will next
be held in Vienna, Austria in July 2010. The conference's close proximity to Eastern Europe and Central Asia is an opportunity to examine that region's AIDS response.
IAS Executive Director Robin Gorna is Co-Chair of the 3rd Eastern Europe and Central Asia AIDS Conference (EECAAC), which will be held in Moscow from 28-30 October 2009.
Professor Gerry Stimson is Executive Director of the International Harm Reduction Association (IHRA). The International Harm Reduction Association (IHRA) is
the leading organisation promoting a harm reduction approach to all psychoactive substances on a global basis. IHRA exists to prevent the negative social, health, economic and
criminal impacts of illicit drugs, alcohol and tobacco for individuals, communities and society. IHRA supports the engagement of people and communities affected by drugs and alcohol
around the world and works to promote harm reduction and human rights issues within national, regional and international bodies (such as the UN). IHRA organizes the annual harm reduction
conferences. Harm Reduction 2010: IHRA's 21st International Conference will be held in Liverpool, United Kingdom, 25-29 April 2010.
For more information, contact:
IAS: Michael Kessler: firstname.lastname@example.org; +7 (8) 915 265 0198; +34 655 792 699
IHRA: Gerry Stimson: email@example.com; +44 207 953 7412; Mobile +44 7872 600 908
EHRN: Shona Schonning, firstname.lastname@example.org; +370 685 51553
Reproduced with permission - "International AIDS Society (IAS)"
International AIDS Society (IAS)