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VI. CONCLUSION

On World AIDS Day 2003, people with AIDS and their supporters courageously spoke out on the streets of Saint Petersburg, the home city of Vladimir Putin, to demand an end to the discrimination and abuse that they face. In one of the media reports of this event, a member of the city Duma and the city health committee of Saint Petersburg, Alexander Redko, told reporters that it made no sense to have a program just for HIV/AIDS because there were many other diseases that were also a problem. “Do we need a special program for hemorrhoids or for dental caries?” he said.236 In the priority it accords to HIV/AIDS, the Russian government has for too long been acting as though HIV/AIDS is little worse than hemorrhoids. It has also been dangerously dismissive of the rights of people at high risk of HIV and those already living with it.

President Putin addressed the Russian nation in January 2002 on the subject of the country’s ailing health system, but he did not mention HIV/AIDS.237 His first notable mention of AIDS in a national address in June 2003 was described this way by a reporter for The Economist: “He flicked out the word [AIDS] as if expelling a tiny, irritating hair, so unobtrusively that many listeners did not hear it.”238 In September 2003, following a visit by Putin to the United States, the U.S. and Russian governments announced a “cooperation initiative” on HIV/AIDS that would include technical cooperation in research and surveillance of the disease.239 This partnership, while bringing welcome attention to HIV/AIDS in Russia, is unlikely to help Russia to move forward in the area of HIV prevention services for drug users as the United States government will not support needle exchange services, for example, either at home or abroad.240

In 2002, President Putin publicly committed Russia to a contribution of U.S.$20 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria.241 It did not escape the notice of international observers that, as his own federal government limped along with a U.S.$5 million annual budget for HIV/AIDS, this gift to the Global Fund gave the impression that Putin believed AIDS to be a problem for other countries but not for Russia.242 Soon after, Putin allocated U.S. $1.3 billion in federal monies to the celebration of the three hundredth anniversary of Saint Petersburg.243

With his post-election mandate, President Putin should speak out forcefully about the importance of HIV/AIDS in Russia. Even more importantly, the federal government must ensure appropriate follow-up in resource allocation, effective policy development, and incorporation of lessons from the best experiences of countries with more mature epidemics. While some of Russia’s neighbors and countries around the world are vying with urgency for discounts on ARV drugs and for resources from bilateral and multilateral resources, Russia has acted as though it has all the time in the world to get its HIV/AIDS programs in order.

It is clear that in spite of a lack of commitment to proven HIV/AIDS strategies on the part of some Russian authorities, there is a corps of health professionals in Russia who are convinced of the need for a better funded and more rational set of HIV/AIDS policies than the state has so far developed. In addition to proposing retrogressive regulations, the narcotics control authorities have suggested that harm reduction programs, many of which are operated by government health officials, are marred by their lack of professionalism.244 In our interactions with people providing HIV prevention services for drug users in Saint Petersburg, Human Rights Watch was struck by their dedication to enabling every person at risk of HIV to do everything possible to prevent getting the disease and their courage and persistence in difficult circumstances. The work of these professionals and others to move Russia into the twenty-first century on HIV/AIDS policy must not be drowned out by those who cling to failed strategies of repression and abuse.



236 Videotape of local news broadcast of December 1, 2003 of file at Human Rights Watch.

237 Badkhen, “Russia on brink…”.

238 “Russia is running out of time to curb AIDS before it devastates the country,” Economist, June 21, 2003, p.43.

239 United States Government, The White House, “Fact sheet HIV/AIDS: U.S.-Russian HIV/AIDS Cooperation Initiative,” September 27, 2003, available at www.whitehouse.gov/news/releases/2003/09/20030927-9.html (retrieved March 10, 2004).

240 See review of U.S. policy on syringe exchange in Human Rights Watch, Injecting Reason, pp. 14-18.

241 “Russian AIDS official asks government to match domestic AIDS funding with U.N. Fund donation,” Kaiser Daily HIV/AIDS Report, July 25, 2001.

242 Paula J. Dobriansky, “The emerging security threat of HIV/AIDS: Russia,” presentation at East-West Institute Conference, Washington, D.C., February 28, 2003.

243 Irina Titova, “Kremlin Pair Puts Spin on Jubilee,” Saint Petersburg Times, May 23, 2003, p. 1.

244 Interfax interview with Alexander Miklhailov, February 16, 2004.


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