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Unintended consequences: drug policies fuel the HIV epidemic in Russia and Ukraine. A policy report prepared for the UN Commission on Narcotic Drugs and national governments.
New York, New York, Open Society Institute, International Harm Reduction Development program, 2003. 16 p.Taking action now to reduce HIV transmission rates and treat those already infected is critical. With the goal of avoiding adverse effects on social welfare and public health, the Russian and Ukrainian governments should reconsider how they interpret international treaties. Policy changes should be made in the following areas: Harm reduction. The governments should play an active role in establishing and supporting a large, strategically located network of harm reduction programs that provide services for IDUs, including needle exchange, HIV transmission education, condom distribution, and access to viable treatment programs such as methadone substitution. Similar services should be available in all prisons. Education. Simple, direct, and dear information about HIV transmission should be made available to all citizens-especially those most at risk. Similarly, society at large should be educated about the realities of drug use and addiction as part of an effort to reduce stigma. Discrimination and law enforcement abuse. Public health and law enforcement authorities should take the lead in eliminating discrimination, official and de facto, toward people with HIV and marginalized risk groups such as drug users. Authorities must no longer condone or ignore harassing and abusive behavior, including physical attacks, arrest quotas, arbitrary searches, detainment without charges, and other violations of due process. HIV-positive people, including IDUs, should be included in all policy discussions related to them in the public health and legal spheres. Legislation. Laws that violate the human rights of people with HIV and at-risk groups should be repealed or restructured to better reflect public health concerns. Moving forward with the above strategies may make it appear that the governments are backing away from the goals and guidelines of the UN drug conventions. They may be criti- cized severely by those who are unable or unwilling to understand that meeting the goals of the conventions, some of which were promulgated more than 40 years ago, is far too great a price to bear for countries in the midst of drug use and HIV epidemics. Governments ultimately have no choice, though, if they hope to maintain any semblance of moral legitimacy among their own people. (excerpt)