MOSCOW (Reuters) - In 2010, President Dmitry Medvedev pronounced heroin was a hazard to Russia's inhabitant security. This year, Russia affianced to financial programs to revoke a mistreat finished by drug use, including an HIV predicament that is one of a many serious in a world.
But even nonetheless a series of new HIV infections in Russia jumped 10 percent over 2011, health workers and tellurian HIV authorities contend Moscow has not respected that promise.
This is not due to a miss of income - Russia is doubling a bill for HIV in 2012 from 2010 levels. At emanate is how it will use a funds. From subsequent year, no income will go to such internationally famous efforts as needle exchanges. None has ever left to heroin substitution: a Russian authorities conflict it. Moscow doesn't trust these approaches assistance delayed a widespread of HIV/AIDS.
"Working on drug dependency is some-more effective than needle sell and methadone programs," pronounced Alexei Mazus, who heads a Moscow Centre for HIV/AIDS Prevention, one of around 100 such venues opposite a nation run by a health ministry.
In areas where needle exchanges have taken place, he pronounced a health method had seen new HIV cases increase, not fall. Russia's health method pronounced final year it had justification that HIV rates have tripled in areas where foreign-run needle sell programs were running.
The United Nations says supposed "harm reduction" programs - needle exchanges, and regulating methadone as a surrogate for heroin - are effective in negligence a widespread of HIV. Methadone reduces a risk of infection by unwashed needles since it can be swallowed, rather than injected.
A vital WHO investigate found HIV rates fell some-more than 18 percent in cities with needle exchanges, while they rose 8 percent in areas that did not have them. The British and U.S. governments both authorized needle exchanges in new drug policies drafted to fight HIV. But in Russia's drug plan for 2010-20, heroin substitutes are banned.
Projects such as giving drug users and sex workers purify needles, HIV recognition training and remedy have been saved by a United Nations in Russia for a final 7 years. Next year that appropriation comes to an finish and with it, so will many of these schemes.
Some health workers and tellurian HIV authorities are hurt and confused by Russia's approach, that they contend will usually irritate a problem.
"When a few programs were saved and regulating it was afterwards formidable to see how things could get worse. Now we know," Damon Barrett, a comparison tellurian rights researcher during Harm Reduction International in London, told Reuters.
RICH RUSSIA
Separated from universe no. 1 drug writer Afghanistan by former Soviet Central Asia, whose borders are porous, Russia has some-more heroin users than any other country. Moscow puts a sum during dual million, nonetheless a United Nations says there are half a million more, and internal non-governmental organizations (NGOs) contend there could be as many as 3 million.
This year, Russian health officials guess 62,000 people were newly putrescent with HIV, a 10 percent boost on 2010 and a top extent of a prophecy finished final year by a International AIDS Society. Officially, Russia has had roughly 637,000 cases, including over 100,000 deaths in a year to November.
The UN puts a series of people vital with HIV currently in Russia during over a million.
Since 2004, NGOs in Russia have perceived a extend from a UN's Global Fund to Fight AIDS, Tuberculosis and Malaria. The Fund says a $351 million it has supposing has reached half a million Russians. It has upheld over 70 mistreat rebate programs opposite a country. The 20 or so that sojourn will stop receiving UN income during a finish of this month.
This is for dual reasons, says Nicolas Cantau, account portfolio manager for Russia during a Global Fund. First, Russia has turn richer, and a Fund's resources can be given to bankrupt countries. For abounding countries to be authorised for Global Fund resources, 10 percent of a race contingency be infected: South Africa is a usually nation in a Group of 20 richest nations to qualify.
Russia has been a donor as good as a recipient, and has given a Fund $265 million adult to date. But a Fund now wants something in return: It says Russia should start financing a possess mistreat rebate programs.
BROKEN PROMISE
At a United Nations assembly in New York in June, Russia affianced to do usually that from this year. Its emissary health apportion Veronika Skvortsova pronounced Moscow also gave "general support" to a stipulation for "Zero new infections, 0 discrimination, and 0 AIDS-related deaths".
A orator for a health method pronounced Russia has put aside income for giveaway HIV testing, for a initial time ever. But he declined to criticism in fact on because mistreat rebate programs have nonetheless to materialize. "They are not deliberate useful in fighting this disease," he said.
Some health workers are incensed.
"As it turns out, they were tricking us," pronounced Anya Sarang, who heads a Andrey Rylkov Foundation for Health and Social Justice, a tiny Russian NGO. "Now we are in a final month of a year. Have they indeed finished anything? No," Sarang said.
The Global Fund's Cantau is dismayed. "All a things that we have finished will be mislaid though serve funding," he says. "It is disappointing".
PREVENTION BY COUNSEL
Russia has put aside around $600 million for HIV in 2012 - double what it had in 2010 - though usually 3 percent of this will go towards prevention. Some income will go to HIV tests, and Moscow says it also provides giveaway anti-retroviral drugs for all sufferers of a disease, nonetheless a UN says usually a entertain of those in need indeed accept them.
No supports will go to needle exchanges. Instead, Russia's HIV/AIDS Prevention Centres will try forestall HIV with anti-drug adverts, and provide HIV with psychological counseling.
Mazus, a conduct of a Moscow Centre, pronounced HIV sufferers need to suffer by counseling, that will also forestall them from flitting on a illness to others.
"HIV is a behavioral disease. It's not being eliminated in bland life. It is not dangerous," he told Reuters.
Such views are neglected by unfamiliar health bodies.
Instead of creation good a Jun promise, Russia has "ramped adult odious measures famous to fuel HIV", pronounced Harm Reduction International's Barrett. He forked to a anathema on soporific transformation therapy.
"AGGRESSION"
Concerns have widespread over health workers. On World AIDS Day, Dec 1, a drug-users' network orderly protests during 12 Russian embassies from New York to Stockholm to Canberra.
Hundreds of protesters rallied and hold candles, some holding signs accusing a state of murder for a refusal to legalize methadone, while others hold vast red banners heaping contrition on Russia.
The protests' coordinator, Erin O'Mara, also editor of "Black Poppy", a British repository for drug users, pronounced "the spotlight was on Russia and a ashamed miss of response and indeed inappropriately aggressive, state-sponsored charge towards... people who use drugs".
In Moscow, protesters played wake song and hold adult coffins as they paraded past a health ministry. The method declined comment.
Some unfamiliar health workers in Russia fear a autochthonous crime could make it tough for them to entrance what supports are accessible for HIV prevention.
"It will be really tough to find money. We fear that a state's appropriation for HIV will be pre-awarded," pronounced Yelena Agapova, from a AIDS Foundation East-West (AFEW), a Dutch classification set adult in Russia 10 years ago.
Like dozens of NGOs in Russia combating HIV, her classification has perceived a bulk of a support from a Global Fund. It runs mother-to-child HIV impediment programs, jail HIV impediment and protected sex campaigns.
Though a Moscow bureau will stay in place with a fundamental staff, it says it will "significantly" downsize a projects from subsequent year. Only a handful of identical organizations will continue operative once flows from a Global Fund stop over entrance weeks. They will be financed from Western awards and George Soros' Open Society Foundation.
Harm Reduction International's Barrett says a impact will be catastrophic: "It is a tellurian disaster that Russian authorities are peaceful to watch unfold," he said.
(Additional stating by Catherine Koppel; Editing by Sara Ledwith)
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