The human immunodeficiency virus (HIV) is in retreat almost universally – but not in Russia. As infection rates drop globally, Russia has seen increases of 8 to 10 percent annually over the last decade. The number of Russians living with HIV surpassed 1 million, according to official data release in January, but experts believe the real number to be closer to 1.5 million. The head of Russia’s Federal AIDS Center recently described the situation as a “national catastrophe.”

Used needles being returned to a needle exchange point in St. Petersburg, Russia. © 2007 Lorena Ros

One of the main reasons behind the spread of the virus is the Russian government’s obstinate refusal to implement HIV prevention measures, such as needle exchange, that have helped other countries drastically reduce – and in some cases almost eliminate – transmission of HIV among injecting drug users. Sixty percent of HIV infections in Russia occur through injections.

Yet, two weeks ago, Russia’s top drug official said he strongly opposes harm reduction programs in the country, such as distribution of free syringes to limit drug injectors’ risk of HIV infection. Russia also bans methadone replacement therapy for drug users dependent on opioids such as heroin. Despite overwhelming evidence from numerous countries of their effectiveness, the Russian drug agency calls harm reduction programs ineffective and dangerous to the general population.

During negotiations in preparation for the April United Nations General Assembly session on drugs, Russia has even blocked inclusion of the term “harm reduction” in the document, even though UN agencies, such as the UNAIDS, the UN Office for Drugs and Crime, and the World Health Organization, have all endorsed the approach.

Ironically, a week after Russia vetoed mention of harm reduction in the UN document, Moscow hosted the Fifth Eastern Europe and Central Asia AIDS Conference. At the conference, the Russian government pledged to help combat the HIV epidemic worldwide but failed to announce any measures to counteract the sharing of needles among drug users, the driving force behind its own epidemic. Meanwhile, 20 regions in Russian are now considered to have “generalized epidemics,” meaning that more than 1 percent of the general population is infected. UNAIDS considers this to be the threshold where an epidemic concentrated in a high risk group, such as injecting drug users, can start spilling over into the general population – and spread rapidly through sexual contact.

It is high time for the Russian government to start acting in a manner consistent with the right to health, and abandon its opposition to evidence-based HIV prevention strategies. Its own citizens – and not just those who use drugs – are paying the high price.