I dreamed of coming to Washington to speak at AIDS 2012. I had a message to deliver to those who have the financial and political means to turn the tide of the epidemic. I wanted to speak up because Eastern Europe and Central Asia (EECA)—the region where I live—is the only region in the world where HIV rates continue to rise while available resources for HIV prevention continue to shrink. Yet it’s not just an issue of funding or lack thereof. There is another reason—for millions of us, repressive drug policies and the stigma associated with drug use stand in the way of accessing HIV treatment and prevention. Russia’s drug users, second-class citizens in their own country, are denied basic human rights—the right to health and the right to life. The fact that Russia’s new national drug strategy through the year 2020 mentions HIV only once, while making no mention of human rights at all, is a case in point.
The World Health Organization defines drug dependency as a chronic relapsing condition, but in my country, people who struggle with drug dependency automatically become outcasts stripped of basic human rights. My life resembles the lives of millions of others who use drugs in Russia and other countries of the Former Soviet Union. I am 45 years old. For 30 of them I’ve been dependent on drugs. I was infected with hepatitis C 25 years ago through a dirty needle. I’ve been living with HIV for the past 13 years for the same reason—needle and syringe exchange programs are not legally sanctioned in Russia and are equivalent to “drug propaganda.” Russia also put a ban on opiate substitution therapy (OST). With no other treatment options available to me, I spent a total of 16 years in prison for possession of drugs for personal use. During my last stint in prison in 2007 I developed AIDS and contracted tuberculosis. In order to get life-saving HIV treatment I resorted to extreme measures—I went on hunger strikes and slashed my wrists. That was my first attempt to stand up for what was rightfully mine, to defend my right to life and health. I had nothing to lose. I’d lost everything—a promising future, the best years of my life, my health, my family, my home. The only thing I have left is my dignity. No one can take that away from me.
When I got out of prison I met like-minded people and from then on, dedicated my life to defending the rights of people who use drugs and to advocating for the introduction of opiate substitution treatment in Russia. In 2010 I submitted a complaint to Anand Grover, the UN Special Rapporteur on the right to health, an appeal to push Russia to remove the ban on OST. In February of 2011, on behalf of five million Russian drug users, I addressed Navi Pillay, the UN High Commissioner for Human Rights, during her official visit to Russia –once again asking that she urge Russia to comply with its international obligations and lift the ban on evidence-based methods of HIV prevention: OST and needle exchange.
The Russian government responded with silence and more repressive measures against drug users. All this despite a growing international consensus that the war on drugs has failed.
In August 2011, as I was crossing the border into Russia from Ukraine, Russia’s Federal Security Service planted a methadone tablet on me. I was charged with drug trafficking and faced the possibility of another seven years in prison. The whole world came to my rescue and the charges were dropped 5 days later. It was our joint victory, a triumph of justice. It showed us that together we can make this world a better place.
But I also understood that the government had sent me a message. I no longer felt safe because I knew this was their way of getting back at me for my outspoken position on OST and drug users’ rights. In Russia drugs have become an instrument of political repression against those who contradict the party line. It was also clear that the new law, which had made drug use a criminal offense, has rendered me extremely vulnerable. So I made the decision to leave Russia and move to Ukraine, where I am writing this letter today.
In June a wish I had finally came true—I became a methadone patient. But it breaks my heart that millions of Russians who, like me, struggle with addiction, won’t have a chance to lead a normal life, to do the work they love, to take care of their health, to raise their children and, quite simply, to enjoy their lives. How many more lives, shattered and lost, will it take for the government to recognize that it’s time to join the rest of the world in addressing HIV from an evidence-based perspective? When will they stop targeting people and start facing the epidemic?
In October 2011 Moscow hosted the MDG-6 Forum where Russia was praised for its leadership in responding to the HIV epidemic in the region. Russia is a leader, all right. In 2010, 60 Russians were being diagnosed with HIV every day. In 2011 that number rose to 172—clearly, that signifies “progress and leadership.” Every year Russia spends roughly 100 million dollars prosecuting drug crimes, not including the money spent on keeping people in prison on drug-related charges. Yet last year only 20 million dollars went to prevention of HIV, hepatitis B and C among the general population. That amount is set to decrease by two thirds in 2013. Again, I am talking about primary prevention, meaning vulnerable groups won’t get a penny. Now consider the extent of Russia’s political and economic influence in Eastern Europe and Central Asia–it’s evident that such “leadership” has the potential to jeopardize harm reduction and OST programs throughout the region.
This was my message to the delegates in Washington, DC. Imagine my surprise when I learned that drug users and sex workers are denied entry into the United States. To host a major conference on AIDS in a country which turns away those most exposed to the virus, is to show contempt and disrespect to the millions of people whose lives were lost to AIDS. HIV will claim more lives next year, because this year we won’t be heard and we won’t be helped. There is an ethical principle that states that people should be involved in making the decisions that directly affect their lives and their health. I was sure the organizers of AIDS 2012 shared this belief. Now the words “human rights,” “stigma,” “discrimination,” and “tolerance” have been rendered meaningless to me. Do they still mean anything to those who will be gathering in Washington, DC at the end of July?