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GFO Issue 245



Tinatin Zardiashvili

Article Type:

Article Number: 3

While dozens of activist groups withdrew, others met to try and develop a regional strategy to counter Russian influence over opioid substitution therapies

ABSTRACT Russia's increasingly hostile attitude towards harm reduction and outreach among injected drug users and men who have sex with men was cited by dozens of NGOs that publicly boycotted a recent conference co-hosted by UNAIDS in Moscow.

Dozens of groups from across the region boycotted the Conference on HIV/AIDS in Eastern Europe and Central Asia (EECAAC) for what they claim  is Russia’s increasingly hostile position towards harm reduction and outreach among injected drug users and men who have sex with men.

The fourth EECAAC was held in Moscow in May. Co-sponsored by the Russian government and UNAIDS,  it sought to bring together academics, activists, technical partners and other stakeholders to trade ideas on best practice for prevention and treatment of the growing regional HIV epidemic. EECA is the only region in the world where HIV infections are continuously growing, due in large part to high transmission rates among injected drug users and other key populations.

But in decrying UNAIDS support for Russia’s “murderous policies” and its work doing “the Russian government’s bidding,” many of the activist groups on the front line of the HIV response opted out in “solidarity with all those who suffer from repressions… and are not able to participate”, and urged UNAIDS executive director Michel Sidibé to do the same.

“We want to openly re-state our position and to express disrespect to, and disagreement with UNAIDS’s work in the region and in Russia in particular, which manifests in the inability and refusal to protect the interests and rights of KAPs at high level,” said the open letter signed by some 20 regional and international organizations, among them both principal and sub-recipients of Global Fund grants.

Sidibé, in response, demurred on the request not to attend, instead considering that he feared his absence “would only exacerbate a polarized debate on HIV in EECA at a pivotal time, and risk to undermine UNAIDS’ ability to advocate for people affected by the HIV epidemic in this region, including, most significantly, people who inject drugs”.

From those who did attend the meeting, Aidspan understands that the boycott, while hanging over the event, did not, ultimately derail good meetings between activists and government representatives about finding common ground to deal with the threat posed by HIV.

Tatiana Evlampieva, deputy director of Russia’s  Social Development and Healthcare Fund ‘ Focus-Media’, a Round 4 Global Fund sub-recipient, said it was important to develop a data-driven evidence base for harm reduction in order to prevent the wrong approach from being adopted at the regional level. Russian and regional stakeholders must collaborate in this research, she said, in order to develop the most effective strategy to respond to the needs of all affected populations.

Evlampieva noted further that Russian bans on LGBT propaganda as well as a law about foreign agents that has restricted NGOs appear to have had the opposite effect, helping to strengthen and mobilize civil society and affected communities in the country to raise awareness, albeit covertly, about how to prevent infection by HIV.

The conference also provided an opportunity for the Global Fund’s principal recipient in Russia to convene a side meeting of some 100 local organizations. Russia disbanded its country coordination mechanism (CCM) in 2013, leaving its remaining two HIV grants in the hands of independent non-governmental organizations including the Open Health Institute (OHI) and non-profit partnership ESVERO, previously known as the Russian Harm Reduction Network.

Now working under the NGO rule, which allows for proposals for Global Fund grants to be submitted by entities other than the CCM,  the Russian NGO community is preparing a concept note to access some of the $15.7 million allocated to Russia under the new funding model (NFM).

Russia’s influence in the region also shadowed tough conversations on how to improve domestic spending across the region on activities that have been the traditional purview of the Global Fund, as many EECA countries may from 2017 no longer be eligible for Global Fund support. Nicolas Cantau, the Fund’s EECA regional manager, noted that now was the time for stakeholders  working on harm reduction to establish enabling policies and dedicated budget lines at the national level in order to ensure that those activities are safeguarded when financial responsibility for them shifts to the state.

“Russia is an important player in EECA, and influences the region politically and economically and becoming a donor for international development, so it is important to work with the government and advocate to promote appropriate harm reduction strategies,” he told Aidspan. “This conference should be seen as a beginning of a renewed process to demonstrate that evidence-based approaches such as OST should be seen as public health strategy to reduce the epidemic in the region.”

Yet already, Russian influence is being felt; there was no official discussion of harm reduction on the agenda, and Russian government officials and scientists used the conference as a platform to express highly negative opinions about OST, using terms like “street Methadone” and describing OST as highly addictive and harmful.

Proponents of OST as a substitutive therapy for injected drug users to wean themselves off heroin and other narcotics consider the treatment to have a highly positive impact on reducing HIV transmission rates, improving adherence to anti-retroviral therapies and reducing criminality spawned by drug use.

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