Why have effective, “simple tools such as Medication Assisted Therapy (methadone, buprenorphine) and clean needle-exchange services” — methods that are “very effective in decreasing drug abuse and reducing risk of infection with HIV, hepatitis C and other diseases” – “had so little impact on the policies and programs of the Russian Federation?” Bertrand Audoin, executive director of the International AIDS Society, and Chris Beyrer, a professor at the Johns Hopkins Bloomberg School of Public Health, write in this New York Times opinion piece. With an “estimated number of injecting drug users [at] 1.8 million, and the estimated number of opiate users exceed[ing] 1.6 million,” and more than one million people living with HIV, “Russia now accounts for two thirds of the Eastern Europe and Central Asian HIV epidemic, the fastest growing in the world,” they write.

Russia’s “‘zero-tolerance’ approach to drug use … fuel[s] poor treatment, discrimination and vulnerability to disease among drug users” and goes against WHO and U.N. recommendations, and several international declarations signed by the Russian Federation, they write. “Turning the tide on the HIV epidemic in Russia, as in so many other countries, is first and foremost a matter of politics — of political will, of evidence-based decisions, of a wise middle — and long-term allocation of funds, of a recognition of human rights for all, of making the end of stigma a political vision,” Audoin and Beyrer state, concluding, “Russia has the means to enshrine health as a human right” and should “urgently endorse these proven harm-reduction strategies, and … show their citizens and the world that they are embarking on safe, wise and sound public health policies” (3/2).