The Charitable Fund Humanitarian Action in Saint Petersburg is fighting back against the crackdown on harm reduction organisations: a court recently annulled the government decision to include them in the infamous foreign agent list. We interviewed Alexei Lahov, Director of Development of the NGO.    

Drugreporter: Your organisation was created more than 20 years ago to support people living with HIV, people who use drugs, and sex workers. How many clients do you have and what kind of services do you provide to them?

Alexei Lahov: Every year, we have more than 5,000 clients. We provide them with the whole HIV prevention package approved by World Health Organisation (apart from opiate substitution treatment (OST), of course, as it’s prohibited in Russia) – needle and syringes distribution, access to ART, viral hepatitis, Tuberculosis and sexually transmitted diseases (STI) prevention, rapid testing for HIV, Hepatitis B, Hepatitis C, and syphilis, referral to drug treatment centres, overdose prevention with Naloxone, and even mobile X-ray for people who use drugs (PWUD).

What is the current situation with HIV infections and overdoses among people who use drugs in Russia? Is the situation getting any better?

According to the official data, in the year 2020, 18,013 people overdosed on illicit drugs and 7,366 died as a consequence. This is a 16.1 percent increase compared to 2019, so the overdose situation is getting worse. There are fewer people (381,505) who are officially registered as drug dependent, and the estimated number of people (165,184) who inject drugs has decreased as well. It seems that the number of people dependent on opioid drugs has decreased but stimulant use is on the rise. The prevalence of HIV among people who inject drugs is still very high but it continues to decrease, from 56.1 percent in 2012 to 31.1 percent in 2020.

Drugreporter produced an animated movie about one of your former clients, Kostya Proletarsky. How did you and your colleagues like the film?

Kostya was not only our client but our colleague too, he worked for the Fund. It’s a powerful movie that accurately depicts the state of drug treatment services and attitudes toward people who use drugs in the 2000s.

Is there any change in the situation in prisons compared to what we see in the film?

A lot has been done since that time, and though people who use drugs keep dying from HIV and TB in prisons the situation is not as dire as it used to be back then. At least in terms of the number of deaths. But disruptions in treatment still occur, as well as other problems related to medical help provision. To put it bluntly: quite a lot still needs to be done.