1. Natalya Podogova Chairman of the Board Charitable Foundation for Support of Priority Strategies in Public Health Russia Legislative Barriers for Harm Reduction Programs Implementation in the Russian Federation

2. Charitable Foundation for support of priority strategies in public health – Russian non-governmental organization that aims at joining up the efforts of the three sectors of society – governmental bodies, business structures and NGOs – to strengthen their common abilities in defending national health and promoting healthy lifestyle. The Foundation promotes the best practices and contributes to implementation in Russia of the efficient strategies of public healthcare development in the field of HIV/AIDS, tuberculosis and other socially significant diseases prevention.

3. Charitable Foundation for support of priority strategies in public health – implementing partner of the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) in Russia.

4. Russian State Duma of V Convocation supported the initiative of several deputies to continue working over further improvement of RF National strategy fighting socially significant infectious diseases and strengthening legislative basis, necessary for effective measures support in this sphere. To achieve these goals Interfactional Deputies Working Group on prevention and treatment of HIV/AIDS and other socially significant infectious diseases (Parliamentary Working Group - PWG) has been formed in 2008 and started to function in 2009. Representatives of all 4 fractions in State Duma were invited to join the Group. The Group is chaired by the Deputy Chair of State Duma Nadezhda Gerasimova.

5. Events of PWG 20.03.09: Extended Meeting of the Russian Interfactional Deputies’ Working Group on Prevention and Treatment of HIV/AIDS and Other Socially Significant Infectious Diseases: “Educational Programs as an Effective Way to Improve Inter-Agency Cooperation in the Fight against HIV-Infection and Other Socially Significant Diseases“ 09.04.09: Joint meeting of the Parliamentary Working Group on Prevention and Treatment of HIV/AIDS and Other Socially Significant Infectious Diseases and the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor) “Role of National Project “Health” in advancing national HIV strategy”.

6. Examples of legislative barriers (1)In 2003 the following note to 230 article “Inclination to drugs and mind benders use” of Criminal Code was introduced: «The action of present article doesn’t apply to cases when special instruments and equipments are used for injecting drug-use and for purpose of HIV and other diseases prevention and if these cases are agreed with healthcare bodies of executive power and drug control services”. But till now there are no regulating endorsement documents/rules/agreements.

7. (2) Article 46 of Federal Law «About drugs and mind benders» prohibits any promotion in the sphere of drugs and mind benders circulation, which is identified as «activities of individuals and organizations, aimed at information dissemination on ways and methods of creation and use, places of purchase of drugs and mind benders, as well as production and dissemination of publications, mass media outputs, dissemination of the information in internet or other actions”. This prohibition in practice has brought to limitations of HR programs effectiveness in RF, as it was formulated so widely, that almost any activity or publication, which touch upon issues of non-sharing common instruments for drug use, can be brought to the prohibition.

8. In the present time the legislative order doesn’t favor wide dissemination of Harm Reduction programs in Russia. These programs act in the framework of restrictions, provided by the legislation of RF (Federal Law “on drugs and mind benders” and Criminal Code in the first turn). That’s why in the present time the potential of HR programs can’t be realized in the full volume - due to legislative barriers and lack of necessary funding (Globus project finalization, “0” for HIV prevention national project Health in 2010).

9. 14.07.09: Organizational Expert working group meeting to analyze effectiveness of harm reduction programs implemented in Russia Expert working group was organized in line with recommendations of the joint meeting of the PWG and the Federal Service for Surveillance on Consumers Rights Protection and Social Welfare (Rospotrebnadzor) held on April 9, 2009, which was dedicated to the analysis of prevention measures to be taken in Russia to stop the spread of HIV- infection, including harm reduction (HR) programs.

10. Priority topics (research areas) of the expert group 1. Main principles of HR, international best practices, evidence of the need in and advisability of HR programs in Russia 2. Analysis of HR programs implemented in Russia's regions 3. Analysis of Russian legislation and normative documents which regulate HR programs development and implementation 4. Using evidence-based medicine principles, provide proofs of the effectiveness of HR regarding HIV prevention 5. Cost-effectiveness of HR in Russia 6. Social components of HR programs in Russia

11. Expert working group will prepare evidence base of HR program effectiveness for HIV prevention as well as necessity and reasonability of such programs implementation in regards with epidemic dynamic in the country. Concluding report with the analysis and recommendations of the Expert working group will be developed by end-2009 – early-2010 and will provide information necessary to convince relevant governmental agencies to consider harm reduction as an effective and financially justified intervention in response to the combined epidemic of HIV and injecting drug use. The document will be disseminated among parliamentarians and government officials of federal level and will serve as an effective tool for harm reduction advocacy in Russia's regions. The document will be discussed at PWG meeting.

12. Thanks for the attention! 3 rd floor, 5, Gazetny pereulok 125993, Moscow Russian Federation Tel: +7 (495) 510-53-70 Fax: +7 (495) 510-53-71 E-mail: npodogova@gbcimpact.org www.HIVpolicy.ru, www.TBpolicy.ru © 2009 Charity Foundation to Support Priority Strategies in Public Health