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‘When I started to use heroin I
was only 18,’ Irena Yermolayeva
told delegates in
Evidence is not
enough
. ‘There is a moment
when all drug users want to
quit, but in my country of
Kyrgyzstan there was no
accessible, free detox or rehab
available. So I had to wait.’
Several years later she had met
other drug users involved in harm
reduction services and was inspired
to help people in a similar position to
herself, one of whom was a 15-year-
old girl. ‘She had syphilis but it
wasn’t possible to treat STIs without
parental approval. Her partner was
also beating her and forcing her to
provide sexual services. She needed
shelter, but the laws in our country
meant that she couldn’t get it.’
If she could make three
recommendations to policy makers,
she said, they would be
accessibility of reproductive health
services for teenagers without
having to get the permission of their
parents, the need to develop
services and approaches designed
specifically for young drug users,
and rehab and crisis centres for
young drug users and vulnerable
groups.
‘Young drug users must have
the chance not to be imprisoned
and not to become inmates,’ she
said. ‘In Kyrgyzstan, there are no
rehab centres available for young
people and teenagers.’
Young drug users were also
experiencing violence from the
police, she said, while Inspector
Abdallah Kirungu of the Tanzanian
police also described how drug
users in Tanzania were being
criminalised.
Forty-two per cent of injecting
drug users in Dar es Salaam were
HIV positive, he said, and the
Tanzanian AIDS Prevention Project
had initiated meetings with the police
to discuss the impact that arresting
drug users was having on their work.
This prompted him to go incognito to
see the actions of the police for
himself, he told the conference.
‘I found to my shock and dismay
that the police were furthering drug-
related harms,’ he said, with officers
ambushing drug users to confiscate
and sell their drugs, harassing clients
at HIV and methadone services, and
extorting money and demanding
sexual favours from sex workers.
‘These practices called for an
integrated harm reduction
intervention for police officers. We
need to educate our police force
about drug harms to individuals and
society, and the police need to be
mandated and supported to take
drug users for treatment rather than
arrest. Police officers who extort sex
workers and sexually violate them
should also be subject to
disciplinary action and prosecution,
and we must also empower drug
users and sex workers to protect
their human rights.’
The Tanzanian police were not
able to do this alone, however, he
stressed. ‘It needs to be supported
by those already in the field.’
4 –
Daily Update
– Tuesday 11 June 2013
Challenging the status quo
‘There is a
moment when
all drug users
want to quit.’
IRENA YERMOLAYEVA
‘If you break stereotypes,’ Lithuania’s health
minister Vytenis Povilas Anriukaitis told
delegates, ‘you break down walls.’
Human rights included the right to live, to have
opportunities and to acknowledge that people are equal,
he said. ‘We must always remember that. It’s
predetermined positions that destroy people’s lives – we
have to fight for leadership.’
Human rights were
not invalidated by drug
use, former president
of Switzerland Ruth
Dreifuss told the
conference. Lithuania
was playing a
pioneering role in harm
reduction in Eastern
Europe, she said, with
HIV rates ten times
lower than in some
neighbouring
countries. However,
the ‘ticking timebomb’
of hepatitis C meant
that adequate
coverage of services
was vital.
Ensuring that
services were
accessible and
affordable for all was
challenging, she said.
International solidarity
was essential, with
financing from states and NGOs combined and
pharmaceutical companies making their drugs
affordable in poorer countries.
‘HIV was a brutal teacher,’ she told delegates. ‘We
learned that mass incarceration for drug possession – far
from discouraging drug use – was the place where HIV,
hepatitis C and drug use were allowed to flourish. Our
approach has to be more comprehensive.’
It was also vital to consider harms ‘beyond the public
health approach’, she said. These included the increased
power of criminal organisations, which not only challenged
weaker states but had actually come to threaten
democracy and the rule of law in many parts of the world.
‘Mass incarceration is a huge waste of public
resources, and human rights violations are justified by the
war on drugs,’ she said. It also remained vital to fight for
and finance harm reduction measures, and ensure they
were accepted and understood by the public.
‘We are all committed to achieving these aims,’ she
told delegates. ‘And you are saving lives.’
The right to life
‘Mass incarcer-
ation is where
HIV, hepatitis
C and drug
use flourish.’
RUTH DREIFUSS