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- End discrimination in health care services to people
living with HIV/AIDS. Monitor efforts to provide
antiretroviral treatment to people living with HIV/AIDS to ensure that
access to such treatment is provided on a nondiscriminatory basis.
- Respect the rights of people in Ukraine to complete, accurate information about HIV/AIDS and to obtain HIV/AIDS information and
services without fear of punishment or discrimination. Ensure
that large-scale, sufficiently resourced information campaigns provide
complete, factual, and unbiased information about HIV/AIDS, including the
facts of transmission, the importance of reducing stigma related to
HIV/AIDS, and the role of harm reduction measures in HIV prevention.
Ensure that information campaigns are tailored to meet the needs of drug
users and their sex partners, street children, sex workers, and other
marginalized persons at high risk of HIV. Enhance government support for
peer education among young people, drug users, sex workers, and others at
risk, building on the lessons of government and nongovernmental experts in
Ukraine and in other countries.
- Take a leadership role in educational campaigns
focusing on improving human rights protections and reducing stigma and
discrimination against people living with and at high risk of HIV/AIDS,
including drug users and sex workers. Government officials
at all levels, including the president and cabinet officials, should
engage in a concerted educational campaign including by using public
events and media contacts to condemn police persecution and other human
rights abuses against high-risk groups and HIV/AIDS outreach workers, and
to reiterate the crucial importance of HIV prevention services for persons
at high risk.
- Ensure that the national HIV/AIDS program, in
consultation with the Ministry of the Interior, develops and implements a
formal plan for a budgeted program of monitoring of and regular police
reporting on violence and abuse against marginalized groups at risk of
HIV/AIDS.
- Provide training on HIV/AIDS, harm reduction, and
drug use to all personnel in health care facilities. This should
include instruction on the right to privacy and protection of confidential
information about HIV status, and specific guidance on how to guard
against negligent and intentional disclosure. Ensure that legal remedies
are accessible to individuals whose privacy has been infringed or who have
experienced discrimination or harassment in the health system based on
their HIV status.
- Reform the health care system infrastructure to
ensure better coordination among health care facilities managing related
diseases, including HIV/AIDS, tuberculosis and drug addiction, and to
ensure further integration of HIV treatment into the overall health care system.
Collaborate with peer-based care projects, harm reduction
organizations, HIV/AIDS organizations, and the community of people living
with HIV/AIDS to prepare health care workers to coordinate and support
services to link HIV/AIDS, tuberculosis, and drug treatment services.
- Protect the sexual and reproductive health rights of
women living with HIV/AIDS. Ensure that HIV-positive women are
provided complete, unbiased information about pregnancy and the prevention
of mother-to-child HIV transmission, and that health care providers and
women recognize that all women, regardless of HIV status, have the right
to independently decide on number, timing, and spacing of children, and
information and means for doing that.
- Expand and enhance the scope of humane treatment
services for drug addiction, including in prison, according to
international standards, which would include the prompt implementation of
substitution therapy with methadone and buprenorphine. These
measures arein accordance with Ukraine’s commitment as a state
party to the Single Convention on Narcotic Drugs of 1961 and its
additional protocol of 1972, the Convention on Psychotropic Substances of
1971, and the United Nations (U.N.) Convention against Illicit Traffic in
Narcotic Drugs and Psychotropic Substances of 1988.
- Reject the proposal by the Ministry of Health
Committee on Narcotic Drugs Control to amend Ukraine’s drug classification
tables to criminalize possession of very small amounts of certain
narcotics, which would exacerbate the problem of HIV/AIDS among drug
users. Repeal mandatory imprisonment for possession of small
amounts of illicit drugs, which also serves to accelerate HIV infection.
- Ensure that implementation of a full-scale
substitution treatment program, including with methadone and
buprenorphine, has the full support of the Ministry of Interior, the
Committee on Narcotic Drugs Control, and the Security Services of Ukraine.
- Ensure that substitution therapy is available to all
opiate drug users, regardless of HIV status or previous enrollment
in state-sponsored drug treatment programs, on a confidential and
anonymous basis.
- Increase government support for all harm reduction
services for drug users. Ensure that the Ministry of Interior, the
Committee on Narcotic Drugs Control, and the Security Services of Ukraine
give full support to these efforts. Establish and increase support for
harm reduction services for all at-risk populations, including sex workers
and men who have sex with men. Evaluate the existence of any legal
barriers to harm reduction services, such as criminalization of very small
amounts of narcotic drugs, or the use of syringe possession as evidence to
arrest drug suspects, and eliminate these barriers.
- Discontinue the registration of drug users by
government offices, and any other practice that violates an
individual’s right to privacy about his or her use of drugs, including the
sharing with law enforcement and other government agencies of information
gained through provision of medical care about HIV status or drug use.
- Cease and publicly repudiate the unlawful use of
force and other ill-treatment by police and other agents of the state
against drug users and sex workers. Ukrainian law enforcement
officers must conduct arrests of criminal suspects with the minimum force
necessary, as called for in the U.N. Code of Conduct for Law Enforcement
Officials and U.N. Basic Principles on the Use of Force and Firearms by
Law Enforcement Officials. The Ukrainian government should ensure that Ukraine’s parliamentary ombudsperson on human rights has the necessary resources and
authority to fully investigate torture and other serious offenses
committed in the context of the government’s antidrug efforts.
- Cease and publicly repudiate interference by police
and other agents of the state with efforts to provide harm reduction
services. Establish and maintain appropriate training programs
for police at all levels on HIV/AIDS, harm reduction services, and related
human rights issues. All new officers should be trained, and a refresher
course should be provided for veteran officers. As part of the training,
reinforce harm reduction services’ role as a legal and central part of Ukraine’s efforts to fight HIV/AIDS, and include information on referring drug users to
appropriate drug treatment, HIV prevention, and other related health
services.
- Cease arbitrary arrests and due process violations
by Ukrainian law enforcement officers. Cease all practices of false
arrest, planting of narcotics on drug suspects, and use of threats or
physical or psychological force or intimidation to coerce testimony
regarding drug or other criminal activity. Cease harassment and arrest of
persons on the sole basis of known or suspected history of prior drug
use.
- Conduct independent, impartial investigations of
allegations of unlawful use of force, extortion, and other abuses by
Ukrainian law enforcement officers. Discipline, discharge, or
prosecute officers who engage in or condone unlawful use of force,
extortion, torture, and other abuses.
- Reform evaluation of police performance, so
that the evaluation standard for effectiveness is not a simple counting of
criminal cases including those connected to ordinary drug possession for
personal use, but is based on impact of law enforcement activities on
combating major crimes. Repeal any policy that encourages officers to stop
or arrest suspected drug users or sex workers without legal basis in order
to meet arrest, detention, or crime disclosure targets.
- Ensure due process protections for people arrested
or held in detention including by ensuring full and unimpeded
access to counsel at all phases of investigation; that the practice of
mistreatment of people arrested or in detention is stopped; and that
confessions coerced under duress cease to be admitted as evidence in any
law enforcement proceedings, except against a person accused of causing
such duress.
- Take concrete steps to reduce drug users’ fear of
seeking health services. Immediately and publicly declare that
drug users seeking health services will not be reported to police or
forced into drug treatment based solely on their status as drug users.
- Reaffirm the Ukrainian government’s commitment to
human rights by extending a standing invitation to all thematic special
procedures, in particular to the U.N. Special Rapporteur on
Torture, the U.N. Special Rapporteur on the Right to Health, and the U.N.
Working Group on Arbitrary Detention.
- Implement fully the recommendations of the European
Committee for the Prevention of Torture in its 2004 report on protections
against torture and other forms of ill-treatment by law enforcement
officials.
- Relevant United Nations Officials and offices—such as
the Joint United Nations Programme on HIV/AIDS (UNAIDS), the U.N. Special
Rapporteur on the Right to Health, United Nations Office on Drugs and
Crime (UNODC), and the Commission on Narcotic Drugs (CND)—should affirm
the right of all individuals, including drug users, to the full range of
HIV prevention services, including access to harm reduction
measures without fear of arrest or punishment, as part of the right to the
highest attainable standard of health.
- The United Nations Commission on Narcotic Drugs
(CND), in cooperation with the United Nations Office on Drugs and Crime
(UNODC), should support the amendment of international drug conventions to
call explicitly for the legalization and promotion of the full range of
strategies to reduce drug-related harm. These amendments
should state that harm reduction measures, including syringe exchange
services, substitution therapy, and peer outreach and education are
compatible with drug demand reduction and essential to HIV prevention.
- The World Health Organization and the Joint United
Nations Programme on HIV/AIDS (UNAIDS) should work with the CND and the UNODC
to include in international drug conventions guarantees of access to the
full range of harm reduction services. These organizations
should, with active input from public health experts and nongovernmental
organizations, issue specific recommendations on the deregulation of
syringes, including the legalization of syringe exchange services, the
legalization of nonprescription pharmacy sales of syringes, the repeal of
drug paraphernalia laws, and the development of safe syringe disposal
policies and protocols.
- UNAIDS and its co-sponsor organizations, in
particular the United Nations Office on Drugs and Crime (UNODC) and the
World Health Organization, and UN bodies charged with issues related to
illicit drug use, should support measures in Ukraine that contribute to an
evidence-based public health approach to HIV and related health care
services for drug users, especially by strengthening syringe
exchange, substitution therapy, and other harm reduction measures.
- UNAIDS and its co-sponsor organizations, in
particular the United Nations Office on Drugs and Crime (UNODC) and the
World Health Organization, and UN bodies charged with issues related to
illicit drug use, should encourage Ukraine to provide alternatives to
incarceration for individual possession of very small amounts of narcotic
and other illicit drugs, and to reject proposals to amend Ukraine’s drug
classification tables to criminalize possession of very small amounts of
certain narcotics.
- Support amendment of the international drug
conventions to encourage states parties to adopt public health approaches
to drug use, including expanded access to sterile syringe
interventions and substitution therapy with methadone.
- Adopt domestic public health approaches that affirm
the right of drug users to the full range of HIV prevention services,
including access to harm reduction measures without fear of arrest or
punishment, as part of the right to the highest attainable standard of
health.
- Use the Partnership and Cooperation Agreement (PCA),
the framework that regulates the European Union’s relationship with Ukraine, and contains a human rights clause, to urge the government of Ukraine to bring its laws and
practices into compliance with international standards, with
particular attention to the violations documented in this report. Make a
public statement about Ukraine’s compliance with international standards
and make clear that continuation of the PCA is contingent on specific and
measurable progress in observation of these standards.
- Further develop the European Neighbourhood Policy
Action Plan for Ukraine to ensure that protection and promotion of human
rights is a central part of its response to HIV/AIDS, with
particular attention to the violations documented in this report. Urge Ukraine to elaborate specific benchmarks to address these violations, and clear timelines
for their implementation.
To the Council of Europe Secretary General, Committee
of Ministers and Parliamentary Assembly (PACE)
- Use all available means to ensure that Ukraine, as a member state, fulfills its obligations to guarantee the full protection of
all human rights to all individuals within its jurisdiction, including
drug users and people living with HIV/AIDS. To this end, continue
to assist the Ukrainian government in its efforts to reform and develop legislation
to conform with human rights standards.
- In ongoing initiatives on HIV/AIDS and promotion of
public health policy on drug control, take into account the concerns
raised in this report, and formulate specific recommendations for measures
to address these concerns in Ukraine and other member states as relevant.
- Make human rights abuses against people living with
and at high risk of HIV/AIDS, including drug users and sex workers, an
integral part of the overall work of the OSCE Project Coordinator in
Ukraine on the promotion and protection of human rights in Ukraine.
- Include people with HIV/AIDS as a category of
persons explicitly and actively covered by the work of the Tolerance and
Non-Discrimination Programme of the OSCE Office for Democratic
Institutions and Human Rights.
To the United States Government
- Make HIV/AIDS-related concerns discussed in this
report an integral part of bilateral dialogues with the Ukrainian
government on human rights concerns. Press for the Ukrainian
government to enact and enforce sanctions for human rights violations
against people living with and at high-risk of HIV/AIDS.
- In pursuing its project on tuberculosis and HIV/AIDS
control in Ukraine, the World Bank should take into account the concerns
raised in this report, and promote elimination of human rights abuses
against drug users and people living with HIV/AIDS as a key component of Ukraine’s HIV/AIDS prevention, treatment, and care efforts.
- The European Bank for Reconstruction and Development
should incorporate language reflecting the concerns expressed in this
report in its next country strategy for Ukraine, and overall encourage the
Ukrainian authorities to pursue a human rights-friendly HIV/AIDS policy as
part of its engagement with Ukraine.
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