The Charitable Fund Humanitarian Action in Saint Petersburg is fighting back against the crackdown on harm reduction organisations: a court recently annulled the government decision to include them in the infamous foreign agent list. We interviewed Alexei Lahov, Director of Development of the NGO.
Drugreporter: Your organisation was created more than 20 years ago to support people living with HIV, people who use drugs, and sex workers. How many clients do you have and what kind of services do you provide to them?
Alexei Lahov: Every year, we have more than 5,000 clients. We provide them with the whole HIV prevention package approved by World Health Organisation (apart from opiate substitution treatment (OST), of course, as it’s prohibited in Russia) – needle and syringes distribution, access to ART, viral hepatitis, Tuberculosis and sexually transmitted diseases (STI) prevention, rapid testing for HIV, Hepatitis B, Hepatitis C, and syphilis, referral to drug treatment centres, overdose prevention with Naloxone, and even mobile X-ray for people who use drugs (PWUD).
What is the current situation with HIV infections and overdoses among people who use drugs in Russia? Is the situation getting any better?
According to the official data, in the year 2020, 18,013 people overdosed on illicit drugs and 7,366 died as a consequence. This is a 16.1 percent increase compared to 2019, so the overdose situation is getting worse. There are fewer people (381,505) who are officially registered as drug dependent, and the estimated number of people (165,184) who inject drugs has decreased as well. It seems that the number of people dependent on opioid drugs has decreased but stimulant use is on the rise. The prevalence of HIV among people who inject drugs is still very high but it continues to decrease, from 56.1 percent in 2012 to 31.1 percent in 2020.
Drugreporter produced an animated movie about one of your former clients, Kostya Proletarsky. How did you and your colleagues like the film?
Kostya was not only our client but our colleague too, he worked for the Fund. It’s a powerful movie that accurately depicts the state of drug treatment services and attitudes toward people who use drugs in the 2000s.
Is there any change in the situation in prisons compared to what we see in the film?
A lot has been done since that time, and though people who use drugs keep dying from HIV and TB in prisons the situation is not as dire as it used to be back then. At least in terms of the number of deaths. But disruptions in treatment still occur, as well as other problems related to medical help provision. To put it bluntly: quite a lot still needs to be done.
Can you explain to us who the so called “foreign agents” are, according to Russian law?
According to the Russian law on non-governmental organisations (NGOs), an NGO receiving funding from abroad and engaging in political activities can be put into the register of foreign agents. But the criteria of a political activity is so vague that, basically, any mass media interview, or a presentation at a round table with officials, or a petition related to healthcare issues may be deemed as such. In the English language, it’s rather more about policy than politics.
In 2020 the Ministry of Justice added you to the list of “foreign agents”. Why does the government think that an organisation helping marginalised people is so dangerous to society?
The main reason for our inclusion in this list was our harm reduction advocacy work. We supported our colleagues from the Forum of People Who Use Drugs in their appeal to the government on the issue of providing unrestricted access to naloxone, we spoke out for OST, we sent our feedback to the Ministry of Justice on the amendments to the law on HIV infection, and even my personal story on treating HCV in which I encouraged people to sign a petition to the President so that a National Viral Hepatitis Strategy could appear in our country – all these things served as a basis for our inclusion into this list.
What were the consequences to your organisation when it was added to the list?
We were participating in the SOS multi-country project as a primary recipient for Russia and several NGOs that were our sub-recipients decided to terminate their relationships with us out of fear that they would be put on the register of foreign agents as well. The same shit happened when we became the PR for a Global Fund grant for Russia. Also, access to government funding in the form of Presidential grants has become much more restricted. And, of course, we needed to mark all our external communication materials as “produced by a foreign agent”.
It seems the St. Petersburg City Court agrees with you and it cancelled the Ministry’s decision to include you in the register of foreign agents. Congratulations! How do you feel about this decision?
Thanks! We still can’t believe it really happened. Moreover it sets a precedent because before that courts had de-listed NGOs only if they gave up funding from abroad for a year. And we managed to do it without giving it up. But I’m afraid that our situation is unique because we have medical and pharmaceutical licenses, that’s why the court decided that we’re working in the field of healthcare provision rather than influencing policies. Unfortunately, not every NGO working in the field of HIV prevention and deemed a foreign agent has such licenses and, thus, can prove without doubt that it provides health-related services.
How do you see the future of your organisation and the future of harm reduction in Russia?
As for our organisation, in 2021, we celebrated 20 years since our official registration and this year it will be 25 years since the launch of our legendary mobile harm reduction unit – the Blue Bus, one of a kind in Russia. Also in 2021, we became the first community-based NGO in Russia to have been granted a status of a Primary Recipient of a Global Fund grant. Therefore, until at least 2024, Saint Petersburg, Moscow and Chelyabinsk will be implementing harm reduction services within this grant.
As for the state of harm reduction in Russia overall, the situation has been deteriorating since 2008. Then, there were 100 such projects in the country. Nowadays, it’s fewer than 15. Certainly, it isn’t enough to address all the issues pertaining to PWUD, apart from HIV prevention. By this, I mean the issues of drug decriminalisation, safe supply, protection of PWUD rights, launch of safe injection rooms, etc. But if you work in the field of HIV prevention for PWUD and distribute sterile injection equipment, condoms, information materials, provide services of case managers and peer counsellors, carry out rapid testing, then you’re protected (partially, at least) by the National Strategy on HIV. In my opinion, the situation will stay the same in the next 3-5 years.
Interview by Peter Sarosi