Russia's drug policy merely increases HIV infections

Russia has been in the grip of an HIV epidemic for years now with many organisations believing that it will not reach the millennium development goal 6. This is partly due to Russia’s inability to tackle the prevalence of HIV amongst IDU’s which are most likely caused by a Russian government abysmal drug reduction strategy which involves denying any use for harm reduction.

The millennium development goal 6 involves a number of targets around the decreasing of the spread of HIV and increasing access to HIV treatments. All of which Russia seems to be failing at despite Russia increasing its HIV/AIDS budget to $445 million annually. Russia seems to spend this on measures such the promotion of “healthy lifestyles” with the preaching of abstinence from drugs and providing HIV treatments (though HIV treatment is only reaching a quarter of those needing treatment).

The funding of HIV treatments has meant that Russia has managed to become one of the worldwide leaders in reducing mother to baby transmission. That does not mean that the rate of infection is not going up. Due to poor preventative measures within vulnerable groups such as IDU’s (injecting drug users) who are thought to make up the majority of HIV cases it has meant that HIV rates have been steadily increasing. According to the Federal Scientific and Methodological Center for AIDS Prevention and Control, injecting drug users make up 59.2% of all HIV cases in Russia.

Historically Russia has always had a firm opposition to substitution programs and even needle exchanges to a certain degree with Russia’s chief public health officer claiming that needle exchange programs may promote illicit drug sales and HIV transmission. The limited needle exchange programs in Russia which were funded mainly through grants from the Global Fund to fight HIV, TB and malaria. These grants have now stopped though as Russia is now seen as being too rich to need these grants.

The International AIDS society paints a grim picture when it comes to needle exchanges in Russia saying that there are now just 53 needle exchange programs in Russia all of which are mainly funded by foreign donors. 22 needle exchange programs have shut down since the grant from the Global Fund has stopped. As It shows the ineptitude of the Russian government in realising that preventative methods within vulnerable social groups is the only way to stop Russia’s HIV epidemic something which the Russian government is in denial about. As Anya Sarang from the Andrey  Rylkov  Foundation  for  Health  and  Social  Justice  says “No money at all is allocated towards HIV prevention among injecting drug users”. This the fundamental flaw in the Russian government’s policy, the fact that no money whatsoever is given to harm reduction.

The Russian government instead of realising that prevention is the best way of decreasing HIV rates have gone on a propaganda campaign of scapegoating, blaming everyone but the true instigator of increased HIV rates, the Russian government. For instance the Russian Foreign Minister has recently blamed America for not eradicating opium crops as a reason to why the HIV rates are increasing in Russia. Hypothetically If America was more successful in eradicating opium crops it would lead most likely to a heroin price increase.

This may sound like vindication for the Russians view after all it would mean less people using heroin due to the price but in actual fact it just migrates the problem to other drugs often more deadly that heroin. For instance a drug which has increasingly been featured in the news is a drug called Krokodil it is cheaper than heroin due to the fact that it is a homemade drug with the ingredients easily available. It therefore is thought of as an alternative to heroin and is thought to be used by those who can’t afford heroin.

The effects of Krokodil are considered far worse than those of heroin with the press naming it the “flesh eating drug” neither does it decrease HIV prevalence amongst drug users as Krokodil is a drug which the user injects into themselves. That means the HIV prevalence is just as high as heroin will the Russian government therefore start blaming the pharmacies for the countries HIV rates?  The Russian government is deluded if it thinks the destruction of opium is the answer to all its problem it is an excuse that is being used as a bizarre way to justify Russia’s bizarre and ineffective policies.

One of these bizarre policies is the fact the Russia still bans substitution therapy the reason is because the Russian government thinks that all it does is replacing one drug with another. This apparent ‘moral’ line of thought does not take into account the fact that not only does it prevent disease in drug users but it also prevents HIV infections in those who are not drug users. When two thirds of the HIV infections are coming from drug users you have to take steps to decrease that and the evidence is on the side of substitution therapy.

Millennium development goal 6 will never be reached by Russia with the current strategy employed. We could wait till next millennium and Russia would still be in the same place it is now with the same epidemic like HIV rates and blaming anyone it can. The only way to decrease HIV in Russia is for the Russian government to come to the realisation that harm reduction policies are the most effective way to decrease IDU HIV infection rates which in turn will help decrease the HIV infection rates overall. It is time for Russia to start implementing harm reduction policies instead of the harm maximization policies it currently employs.