Censorship and dirty needles fuel HIV/AIDS epidemic in Russia

IPS, 17 February 2012, By Kester Kenn Klomegah

A recent government crackdown on Russian media, particularly online information portals specialising in health tips and harm reduction methods for drug users, has sparked widespread public opposition, with critics claiming that the "draconian silencing" of public health advocates could worsen an already perilous health situation in the country.

The crackdown is "over methadone, plain and simple," Anya Sarang, president of the Andrey Rylkov Foundation (ARF) - an organisation dedicated to providing health information to intravenous drug users, which had its website shut down in early February – told IPS.

The order to shut down ARF’s website came from the Federal Drug Control Service (FSK) of the Moscow Department on Feb. 3, supposedly to prevent the "placement of materials that propagandise the use of drugs, information about distribution and purchasing of drugs and inciting the use of drugs."

Far from these allegations, ARF advocates harm reduction strategies and has been a vocal critic of the Russian government's ban on methadone. Its website (www.rylkov-fond.org) often carried extensive international and local research proving that methadone reduces the risk of HIV among users of heroin and other opiates, as well as helps people stay on AIDS and TB treatments.

According to the World Health Organisation (WHO), methadone is an essential substance for treating heroin dependence and preventing HIV transmission by reducing the practice of injecting, but the Russian government’s ‘zero tolerance’ approach to illicit drugs has stalled the use of methadone across the country.

Given that Russia currently has one of the largest populations of injecting drug users in the world as well as one of the fastest growing HIV epidemics, the dissemination of such information is essential to keep the spread of the virus under control.

Some experts estimate that as many as 1.65 million people could be HIV-positive by 2015 if current trends persist unabated. Others believe that even these official statistics are conservative.

An estimated 980,000 people are living with HIV in Russia; in some regions as many as 80 percent of those with HIV contracted the virus through contaminated needles, Eka Iakobishvili, human rights analyst at the London based Harm Reduction International told IPS.

"For years, human rights advocates like ARF have argued that Russia's colossal failure to provide vital services to (drug users) is a breach of its obligations under international law to respect, protect and fulfill the right to health," Sarang told IPS.

"The government's latest crackdown against public health activists has now turned the matter into a (violation of our) freedom of expression as well," she said.

The fact that the United Nations listed universal treatment for people living with HIV/AIDS as one of its most urgent millennium development goals (MDGs) – with a deadline of achieving universal treatment by 2015 - human rights and health advocates contend that Russia's failure to allow information or services helpful to drug users breaches international human rights and public health laws.

"We are very concerned about the closure of the website, which is one of very few Russian language websites with accurate information about drug treatment, particularly drug treatment using methadone," Diederik Lohman, a senior researcher from the health and human rights division at Human Rights Watch (HRW), told IPS.

According to Lohman, although the WHO, UNAIDS, and the U.N. Office on Drugs and Crime have all recommended the use of methadone as the most effective method for treating opioid drug dependence and as a highly successful means of preventing HIV transmission, the Russian government routinely misinforms the public about the treatment, claiming it to be futile and dangerous.

Since ARF is a grassroots organisation, responding directly to the needs of local people, "the shutdown of (its) website would likely have a double impact on Russian society," Iakobishvili told IPS.

"The first would be to (silence) the democratic voice that opposes current government policies in health and social justice; and the second would be to deprive thousands of people of (vital) information on health issues, which the website provides on daily basis."

In fact, Lohman believes that the Russian government has exacerbated its country’s HIV/AIDS epidemic by cracking down on public discussion on key health interventions. Thousands of people who have perished over the last few years could have been saved if only the government had allowed proper treatment and prevention programmes, he added.

Academics, too, are deeply concerned about these disturbing developments in Russia.

For instance, Evan Wood, director of the urban health research initiative and centre for excellence in HIV/AIDS and professor of medicine at the University of British Columbia in Vancouver, told IPS that it is now estimated that nearly one in 100 adults in the country is HIV-positive, largely because scientifically proven HIV prevention interventions, such as methadone, are illegal.

"This is despite the fact that methadone is on the WHO's list of essential medicines and has been proven in clinical trials to reduce HIV risk and be among the most effective treatments for heroin addiction," Wood told IPS.

Wood strongly believes that the Russian authorities’ move to censor the site was a clear infringement on freedom of information and is another "horrifying example" of why the HIV epidemic has such a strong foothold in the Soviet region.

According to several reports, Eastern Europe and Central Asia have the fastest growth rates of HIV in the world, with Russia accounting for between 60 – 70 percent of the epidemic.

By shutting down a site dedicated to promoting and developing drug policies based on tolerance, health protection, dignity and human rights, Russian authorities have shown, to their own nation as well as to the international community, an utter disregard for the constitution, citizens’ rights and Russia’s international human rights obligations, Iakobishvili told IPS.

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