News (Updated January 8, 2012)

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Insight: Russia says no to West's way with HIV

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Wed, Dec 21 2011

By Amie Ferris-Rotman

MOSCOW (Reuters) - In 2010, President Dmitry Medvedev said heroin was a threat to Russia 's national security. This year, Russia pledged to finance programs to reduce the harm done by drug use, including an HIV crisis that is one of the most severe in the world.

But even though the number of new HIV infections in Russia jumped 10 percent over 2011, health workers and global HIV authorities say Moscow has not honored that promise.

This is not due to a lack of cash - Russia is doubling its budget for HIV in 2012 from 2010 levels. At issue is how it will use the funds. From next year, no money will go to such internationally recognized efforts as needle exchanges. None has ever gone to heroin substitution: the Russian authorities oppose it. Moscow doesn't believe these approaches help slow the spread of HIV/AIDS.

"Working on drug dependency is more effective than needle exchange and methadone programs," said Alexei Mazus, who heads the Moscow Centre for HIV/AIDS Prevention, one of around 100 such venues across the country run by the health ministry.

In areas where needle exchanges have taken place, he said the health ministry had seen new HIV cases increase, not fall. Russia 's health ministry said last year it had evidence that HIV rates have tripled in areas where foreign-run needle exchange programs were running.

The United Nations says so-called "harm reduction" programs - needle exchanges, and using methadone as a substitute for heroin - are effective in slowing the spread of HIV. Methadone reduces the risk of infection by dirty needles because it can be swallowed, rather than injected.

A major WHO study found HIV rates fell 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 approved needle exchanges in recent drug policies drafted to combat HIV. But in Russia 's drug strategy for 2010-20, heroin substitutes are banned.

Projects such as giving drug users and sex workers clean needles, HIV awareness training and medication have been funded by the United Nations in Russia for the last seven years. Next year that funding comes to an end and with it, so will most of these schemes.

Some health workers and global HIV authorities are angered and baffled by Russia 's approach, which they say will only aggravate the problem.

"When a few programs were funded and running it was then difficult to see how things could get worse. Now we know," Damon Barrett, a senior human rights analyst at Harm Reduction International in London , told Reuters.

RICH RUSSIA

Separated from world no. 1 opium producer Afghanistan by former Soviet Central Asia, whose borders are porous, Russia has more heroin users than any other country. Moscow puts the total at two million, although the United Nations says there are half a million more, and local non-governmental organizations (NGOs) say there could be as many as three million.

This year, Russian health officials estimate 62,000 people were newly infected with HIV, a 10 percent increase on 2010 and the upper limit of a prediction made last year by the International AIDS Society. Officially, Russia has had almost 637,000 cases, including over 100,000 deaths in the year to November.

The UN puts the number of people living with HIV today in Russia at over a million.

Since 2004, NGOs in Russia have received a grant from the UN's Global Fund to Fight AIDS, Tuberculosis and Malaria. The Fund says the $351 million it has provided has reached half a million Russians. It has supported over 70 harm reduction programs across the country. The 20 or so that remain will stop receiving UN money at the end of this month.

This is for two reasons, says Nicolas Cantau, fund portfolio manager for Russia at the Global Fund. First, Russia has become richer, and the Fund's resources can be given to impoverished countries. For rich countries to be eligible for Global Fund resources, 10 percent of the population must be infected: South Africa is the only country in the Group of 20 richest nations to qualify.

Russia has been a donor as well as a recipient, and has given the Fund $265 million up to date. But the Fund now wants something in return: It says Russia should begin financing its own harm reduction programs.

BROKEN PROMISE

At a United Nations meeting in New York in June, Russia pledged to do just that from this year. Its deputy health minister Veronika Skvortsova said Moscow also gave "general support" to a declaration for "Zero new infections, zero discrimination, and zero AIDS-related deaths".

A spokesman for the health ministry said Russia has put aside money for free HIV testing, for the first time ever. But he declined to comment in detail on why harm reduction programs have yet to materialize. "They are not considered useful in fighting this disease," he said.

Some health workers are incensed.

"As it turns out, they were tricking us," said Anya Sarang, who heads the Andrey Rylkov Foundation for Health and Social Justice, a small Russian NGO. "Now we are in the final month of the year. Have they actually done anything? No," Sarang said.

The Global Fund's Cantau is dismayed. "All the things that we have done will be lost without further 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 - but only 3 percent of this will go towards prevention. Some money will go to HIV tests, and Moscow says it also provides free anti-retroviral drugs for all sufferers of the disease, although the UN says only a quarter of those in need actually receive them.

No funds will go to needle exchanges. Instead, Russia 's HIV/AIDS Prevention Centres will try prevent HIV with anti-drug adverts, and treat HIV with psychological counseling.

Mazus, the head of the Moscow Centre, said HIV sufferers need to grieve through counseling, which will also prevent them from passing on the disease to others.

"HIV is a behavioral disease. It's not being transferred in everyday life. It is not dangerous," he told Reuters.

Such views are scorned by foreign health bodies.

Instead of making good its June promise, Russia has "ramped up repressive measures known to fuel HIV", said Harm Reduction International's Barrett. He pointed to the ban on opiate substitution therapy.

"AGGRESSION"

Concerns have spread beyond health workers. On World AIDS Day, December 1, a drug-users' network organized protests at 12 Russian embassies from New York to Stockholm to Canberra .

Hundreds of protesters rallied and held candles, some holding signs accusing the state of murder for its refusal to legalize methadone, while others held large red banners heaping shame on Russia .

The protests' coordinator, Erin O'Mara, also editor of "Black Poppy", a British magazine for drug users, said "the spotlight was on Russia and its shameful lack of response and indeed inappropriately aggressive, state-sponsored aggression towards... people who use drugs".

In Moscow , protesters played funeral music and held up coffins as they paraded past the health ministry. The ministry declined comment.

Some foreign health workers in Russia fear its endemic corruption could make it hard for them to access what funds are available for HIV prevention.

"It will be very tough to find money. We fear that the state's funding for HIV will be pre-awarded," said Yelena Agapova, from the AIDS Foundation East-West (AFEW), a Dutch organization set up in Russia 10 years ago.

Like dozens of NGOs in Russia combating HIV, her organization has received the bulk of its support from the Global Fund. It runs mother-to-child HIV prevention programs, prison HIV prevention and safe sex campaigns.

Though its Moscow office will stay in place with a skeletal staff, it says it will "significantly" downsize its projects from next year. Only a handful of similar organizations will continue working once flows from the Global Fund stop over coming weeks. They will be financed from Western awards and George Soros' Open Society Foundation.

Harm Reduction International's Barrett says the impact will be catastrophic: "It is a human disaster that Russian authorities are willing to watch unfold," he said.

(Additional reporting by Catherine Koppel; Editing by Sara Ledwith)

 

 

AIDS group rejects allegations against France 's Bruni

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Fri, Jan 6 2012

PARIS (Reuters) - The Global Fund, a wealthy medical charity, on Friday dismissed as "inexact and misleading" a magazine report of alleged financial misconduct implicating French first lady Carla Bruni, who is one of its ambassadors.

The Geneva-based fund issued the statement after the French magazine Marianne said in an article the fund had awarded $3.5 million of contracts to companies controlled by a musician friend of Bruni, the wife of President Nicolas Sarkozy, at her request.

The multi-billion-dollar fund, set up 10 years ago to combat AIDS, malaria and tuberculosis, issued the money without a public tender, Marianne said.

"The article makes several allegations that are groundless regarding a campaign that the Fund launched in 2010 with the backing of Mme Bruni-Sarkozy," its statement said.

Sarkozy's office declined to comment, saying it had nothing to add to the statement from the Global Fund.

The focus of the story is an AIDS awareness campaign called Born HIV Free which the fund said cost a total of $2.8 million and which allowed it to leverage further support worth $20.4 million in the form of free advertising and creative work by media partners.

A Global Fund official said Bruni had asked a friend, Julien Civange, to represent her and develop a concept of how entertainment could be used to publicise the AIDS fight.

Based on Civange's idea, the Fund agreed to pay him and four employees 580,000 euros over 18 months to develop a campaign, in accordance with the fund's rules which allow non-competitive contracting when an individual has a proprietary idea.

"As part of this process, Mr Civange brought in pro-bono contributions worth $20.4 million through free media placements, advertising and creative work," said the official.

Bruni, a singer and former supermodel who married Sarkozy in early 2008, was appointed "first ambassador" in the same year of the Global Fund. Her husband was elected in 2007 and is widely expected to run for a second term in an election less than four months from now.

The Global Fund, a public-private partnership, was set up in 2002 and says it has saved 7.7 million lives with funding for AIDS treatment and programmes worldwide to fight malaria and tuberculosis.

(Reporting By Brian Love and Patrick Vignal; Editing by Jon Boyle)

 

200 million use illegal drugs: Lancet estimate

(AFP) – 5 Jan., 2012

PARIS — About 200 million people around the world use illicit drugs, according to a study published on Friday in The Lancet.

It estimates that in 2009 between 149 and 271 million people used an illegal drug.

Cannabis users comprised between 125 and 203 million; users of opioids (heroin and morphine), amphetamines or cocaine totalled 15 to 39 million; and those who injected drugs numbered between 11 and 21 million.

Drug use is more prevalent in rich economies and in drug-producing regions of poor countries and is often a major health burden, the paper adds.

"Cannabis use is associated with dependence and mental disorders, including psychoses, but does not seem to substantially increase mortality," it says.

"Illicit opioid use is a major cause of mortality from fatal overdose and dependence," it says, adding that injecting drug users faced specific threats of catching HIV and hepatitis by sharing needles.

All three types of drugs seem to be associated with higher rates of mental disorders, road accidents and violence, although information about this is often sketchy.

The estimate is based on data from the UN Office on Drugs and Crime (UNODC), from national surveys and peer-reviewed studies into the impact of drug use.

Ecstasy, LSD, non-medical use of prescription drugs and anabolic steroids are not included in the estimate.

Copyright © 2012

 


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