Read Irina's story: part 1 part 2

World Aids Day on 1 December came and went in Russia, though HIV activists managed to ensure that it was not completely unnoticed by the authorities. A demonstration was organised outside the White House [seat of Russian government ed] to protest against what is at best interrupted treatment and at worst lack of any treatment for people with HIV.  

Activists protest against the lack of HIV medication in Russia. The Ministry of Health continues to deny even the existence of a problem. Photo: Irina Teplinskaya

The 2010 state budget allocation for HIV medication was 10bn roubles, but reports from the regions confirm that in many places stocks are lamentably inadequate. In September 2010, Russian HIV activists promised the Ministry of Health a series of protest meetings at the inability or unwillingness of the authorities to acknowledge the shortages and rectify the situation. They were as good as their word. Throughout September, October and November protest meetings were held in cities in the north, south, east and west of Russia, culminating in the Moscow demonstration on 1 December.

More than twenty people took part in this latest protest. Some were dressed up as nurses and bears, others as weeping Pierrots. Together they held up a 20m black banner with such slogans as “Ministry of Health must work with HIV” and “Ministry of Health – we are fed up with your circus!”  There were funeral wreaths emblazoned with the phrases “Ministry of Funerals” and “Treatment RIP”. 

The meeting was peaceful, but that did not prevent nine people from being arrested and taken to the local Presnya police station in central Moscow. Irina Khrunova, a legal analyst of the AGORA Inter-regional Human Rights Organisation, has since taken up their case.

In 2010 there was medication for 75,000 out of 120,000 who needed it. Stocks of medication have been woefully inadequate for the last 4 years, which has irreversibly affected public health and put the lives of those living with HIV at risk.

Has anything changed? The Ministry of Health continues to deny the existence of any problem. Minister Tatyana Golikova, for example, insists the authorities have already provided regions with medication for HIV, Hep C and B.  But how can this be so when there are still clearly shortages?  By continuing with this intransigent approach, the Ministry ensures that the situation will not change in 2011. The only hope people with HIV have of saving their lives is in street demonstrations and protest meetings. It is surely unsurprising that many people feel  they are entitled to obey only half of the laws given the state offers only half the treatment. 

In 2010, the government laid in stocks of medication for 75,000 people.  Yet the Federal AIDS centre estimates that there are 120,000 people in need of treatment.  The shortfall means that new patients will be denied medication.  This situation is not new: stocks of medication have been woefully inadequate for the last 4 years, which has irreversibly affected public health and put the lives of those living with HIV at risk.

What is it that the protesters want?  They are calling on the Ministry of Health to guarantee that uninterrupted supplied of antiretroviral (ARV) treatment will be available throughout the Russian Federation.  In order to be able to do this the Ministry will need to:

• establish a reserve fund of medication to compensate for the shortfall;
• establish regulations for HIV treatment and make them mandatory for the planning of procurement procedures and the implementation of treatment programmes;
• ensure that ARV therapy procurement and supplies are properly planned;
• include in the List of Essential Medicines all medication approved in Russia for the treatment of HIV;
• organise and hold a session of the Government Commission for HIV Prevention, Diagnostics and Treatment – the last session was in Moscow at the end of 2008;
• institute systematic inspections to monitor the quality of services provided to HIV positive patients and guarantee universal access to treatment.

HIV infections across Russia. Owing to a lack of governmental action, most regions have a serious shortfall in the availability of anti-retroviral medication

The SIMONA+ project has made a study of  the availability of drugs for HIV positive patients in 20 Russian cities.  During the period January – August 2010, 13 of them had documented cases of changes in treatment because the necessary drugs were unavailable or in short supply.  These cities were spread throughout the Russian Federation and included Moscow, St Petersburg, Kaliningrad and Orenburg.  The SIMONA+ figures were backed up by other sources.

The website www.pereboi.ru  [the Russian word means disruption, ed] carries information about drug shortages throughout the country.  18 cities are reported to have experienced disruptions in supplies.  Organisations responsible for the prevention and treatment of HIV use the shortage of life-saving drugs as an excuse for their refusal to give patients the treatment guaranteed by the state.  They use the same excuse for giving them insufficient amounts of the necessary medication:  this both reduces the effectiveness of the treatment and infringes their right to medical help. At the moment of writing court cases related to issues around medication shortages are going on in Moscow, Kazan and Tula.

The Federal Aids Centre estimates that there are currently more than half a million people living with HIV in Russia.  Their successful treatment depends on uninterrupted supplies of medication.  Disruptions lead to the virus mutating and becoming resistant to the drugs.  Treatment is thus rendered ineffective and lives are put at risk.

NO THERAPY means WE DO NOT EXIST!  NO THERAPY means THE EPIDEMIC WILL SPREAD! LACK OF ACTION spells DEATH FOR US!