Battling Aids: Former health secretary claims Russia is causing setback in efforts to defeat the virus

Ignorance and bigotry still kill 30 years on from HIV's discovery, reports Norman Fowler

Norman Fowler
Saturday 12 April 2014 21:23 BST
Aids activists protest in Kiev against Crimea’s ban on methadone therapy
Aids activists protest in Kiev against Crimea’s ban on methadone therapy

In April 1984, the biomedical researcher Robert Gallo filed a United States patent application for the discovery of the HIV virus that causes Aids. By any standards, it was a significant step forward but, unfortunately, the anniversary has coincided with the latest setback in the efforts to defeat the virus he helped discover.

One of the unwelcome first results of the Russian takeover of Crimea has been a radical change in policy on the treatment of injecting drug users. Before then, about 800 drug users in Crimea were treated for their addiction by methadone – or another similar-acting drug called buprenorphine. It is this form of treatment that is now being closed down.

The vast advantage of methadone is that it is taken orally. Transmission of HIV by shared needles is thus eliminated and the drug user is able to hold down a job and reconnect with his family. Some come off drugs altogether.

According to the International Network of People Who Use Drugs, methadone is an essential part of an effective response to HIV. They say denial of access to methadone "defies the internationally accepted scientific consensus and is a fundamental breach of human rights". They have now appealed to international health organisations to urge the Russian government to change its policy.

None of this has ever been enough to persuade the Russians, although drug use there is causing a massive public health problem. It is based around not only the use of heroin, but around a range of home-made drugs which are also injected. Methadone is banned, and the figures for cases of HIV caused from injecting drug use rises remorselessly year by year.

When I was in Moscow recently, health officials told me that their policy was that "you cannot treat narcotics with narcotics". They were deaf to any argument about the success of methadone and determined to continue with their "cold turkey" policy of trying to force users off their addiction by suddenly withdrawing drugs.

It is a process that sees most patients back on drugs within the year. It is also one that can be brutal – in some private clinics, there are stories of drug users being beaten. By any objective standards, Russian policy has been a notable failure. Yet it is precisely this policy that will now be extended to Crimea.

For Crimea's 805 registered methadone users, the future is bleak. Its health ministry confirmed on Thursday the ban on methadone therapy. In the next few weeks, the drug will have run out and the likelihood is that most of the users will be forced back to injecting. From the point of view of HIV prevention, this is disastrous. No one expects the Russians to do what in Britain we started doing in the 1980s, and provide a ready supply of clean needles. Many users will have no other option but to share needles. This is a sure way to spread the HIV virus.

Aids activists rallied in Kiev last week, calling on Crimea's new government to think again. There is little hope it will do so. Andriy Klepikov, the director of the International HIV/Aids Alliance in Ukraine, warned: "The ban will inevitably lead to a drastic increase in both acute illness as well as new infection [and] a slide back towards a criminal environment." The past 30 years have seen so many strides forward in helping those seeking to combat the HIV virus. But in Crimea, a life-saving medical service will no longer be offered and the patients who had been seeking help abandoned.

As Health Secretary (1981-87), Norman Fowler launched Britain's first public HIV awareness campaign. His book 'Aids: Don't Die of Prejudice' is published in June by Biteback Publishing

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