An Interview with Igor Kuzmenko & Ambassador Lambert Grijns for IHRC2015

Lambert Grijns - Since 2012, I am Director of the Social Development Department and Special Ambassador for Sexual and Reproductive Health and Rights (SRHR) & HIV/AIDS at the Ministry of Foreign Affairs of the Netherlands. 

Igor Kuzmenko - I was born in Sevastopol, the big naval base in Crimea. In a past life, I studied shipbuilding and tried to become an engineer. But I never worked as engineer, ultimately.

I've used drugs for more than 20 years. Since 2008 I'm a client of an opioid substitution treatment program in Ukraine and in the same year I started to work at harm reduction programs as a social worker. Since 2010, after the training in Budapest, I started to make a short video advocacy movies. I hope my work helps other people to understand that addiction is not a crime.

What is the importance of this conference and harm reduction more generally to your work?

LG - Ending HIV/AIDS is a prioritry for the Netherlands. Over the years the Netherlands has made substantial contributions to the AIDS response. Our focus is on key populations; sexual minorities, drug users, and sex workers. The Netherlands is a staunch supporter of improving the position of these groups. Harm reduction is the most effective approach to reduce the spread of HIV among drug users. Given our 35 years of experience with harm reduction, with its failures and successes, we believe the Netherlands can have an added value by supporting harm reduction programmes internationally. As the Dutch AIDS Ambassador it is my job to share Dutch experiences in multilateral fora as well as bilaterally.

This conference has a long-standing history. It provides an excellent opportunity to learn about the state of harm reduction globally and – at this edition – in the Southeast Asian region. In Kuala Lumpur you have the chance to meet your partners, grassroot experts, scientists and activists; people I can learn from and people that can and should make the difference.  

IK - In my opinion most importantly of all this conference provides the possibility to share your thoughts, meet colleagues and friends and tell everyone about the most important points. The most painful point for me is the Crimean and South East Ukraine crisis. I'll speak about it. As loud as possible. 

What is the most pressing challenge in terms of harm reduction that you face in your work?

IK - For me the most pressing challenge is the problem with former OST clients in Crimea. When someone dies almost every month and when you know that someone it's very painful. I'm permanently trying to tell as wide an audience as possible about these people, about Crimea, about how it can be scary when someone takes away your treatment.

LG - We advocate for harm reduction services to reduce the spread of HIV. We also advocate for more respect for the rights of drug users. Many drug users suffer from stigmatisation and discrimination and therefore lack access to information and/or healthcare. Respect for the human rights of drug users is key to removing barriers to essential HIV services. Last month, the United Nations High Commissioner for Human Rights underlined the importance of rights-based approaches in drug policy. Generally speaking people are quite receptive to the “health argument”,  but reluctant to accept a “rights–based approach”. We should acknowledge that criminalizing drug users has detrimental health and social consequences. Helping governments and societies understand that upholding the human rights of drugs users is an essential element of the AIDS reponse, is a pressing challenge.  

What is the biggest issue you face when it comes to financing for harm reduction?

IK - In my country, in Ukraine, as you know the Global Fund is still a leader in funding harm reduction. But, as you know the Fund is going to leave our region. We're preparing for tough times.

What do you see the Dutch government’s role as being in tackling the funding crisis for harm reduction in the future?

LG - We will uphold our current level of funding for harm reduction services. Although the Netherlands is one of the largest bilateral donors in harm reduction, our contribution is just a drop in the ocean. We will lobby for more investments and we support civil society financially and otherwise  to do the same. Currently, most international funding is going to the poorest countries. That seems logical: that’s where the money is needed most. But at the same time, more and more people with HIV live in middle-income countries. We must shift our focus from countries in need to people in need. We have to look beyond country lists and GDP lists. What matters is ensuring that people who need access to information and treatment get it. Whether they’re in Rwanda, Russia or Romania. It is important  to call on public authorities in middle-income countries to invest more in health care for all. The UN’s slogan for the new Sustainable Development Goals is ‘Leave no one behind’. That must certainly include the 35 million people living with HIV. Let’s not leave them behind!

What change in the field of harm reduction (or drug policy) do you expect to see in the near future? 

LG - Next year’s UNGASS on drugs will be a landmark. It will be a challenge to include the words “harm reduction” in the declaration. I’m hopeful that there will be more focus on the public health approach in general, on access to controlled medicines, on proportionality of sentencing, on human rights and on the UN code phrase for harm reduction: “reducing the adverse consequences of drug abuse for individuals and society as a whole”. I expect and hope for a significant step forward.

IK - Ideally I want to see a global legalization of drugs in the near future, though as a first step for Ukraine I'd like to see full decriminalization. I'd like to see good changes in Russia but unfortunately in the near future this is extremely unlikely. I'm not optimistic and the Global Fund is going to leave us. But we have to be strong. We should be clever. We have to be persistent and patient, and everything sould be ok.

What is one key message you would like to share with everyone?

IK - Former OST clients is still die in Crimea.There are no human rights. There's no treatment. There's no life for them. They won't survive there. Let's help them!

LG - At this conference we talk a lot about the funding crises for harm reduction, UNGASS, the Global Fund, etc. That is important, but not the essence what harm reduction is about. Harm reduction is a bottom-up approach. Innovations come from civil society organizations. In the end it is about the hard work of grass-root organizations and about their efforts to lobby for sustainable domestic funding.