The Russian Federation, a member state of the United Nations since 1945, has committed itself to protecting and promoting human right through its ratification of the Convention against Torture (CAT) and the International Covenant on Economic, Social and Cultural Rights (ICESCR). Yet, some of the most vulnerable populations in Russia are denied the very rights these treaties aim to protect. People living with HIV are among the most vulnerable. They experience high levels of stigmatization and discrimination at the hands of both public and private institutions. And with roughly 70% of people living with HIV in Eastern Europe having contracted the disease through injecting drug use, the stigmatization and discrimination spreads to drug dependent persons as well.
Agents of the state create and perpetuate a hostile environment for people living with HIV and drug dependent persons. Testimonies from detainees, some in jail with no legal justification, detail horror stories from being denied food, water and medical attention, to physical brutality at the hands of detention officers. Such treatment is in direct violation of Russia’s obligations under international human rights law, including prisoners’ and detainees’ right to be free from torture and other cruel, inhuman or degrading treatment or punishment, and their right to health. CAT defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession.” By subjecting detainees to the physical brutality of detention officers, the state and its agents are in clear violation of the right to be free from torture. General Comment No. 14 of the Committee on Economic, Social and Cultural Rights (General Comment No. 14) elaborates on the content of the right to health in Article 12 of ICESCR. It establishes the obligation of States Parties to refrain from denying or limiting prisoners and detainees access to preventive, curative and palliative health services. By denying food, water, and adequate medical attention, the state fails to fulfill this obligation In addition, General Comment 14 provides that health goods and services “must be accessible to all” and within “safe physical reach for all sections of the population, especially vulnerable or marginalized groups, such as . . . persons with HIV/AIDS.” It further explains that the right to health includes the obligation to create conditions that assure the provision of essential drugs, of which antiretrovirals are included.
The Russian Federation has adopted the same view on drug dependency as the WHO, recognizing drug dependence as a chronic illness. Despite this, Russia has banned one of the most successful evidence-based treatments available for drug dependency—opiate substitution therapy (OST). OST has proven to be effective in reducing opiate addiction, including heroin addiction. Instead, Russia employs punitive measures and denies drug dependent persons access to treatment. This, in turn, discourages those suffering from drug dependency, and people living with HIV in particular, from seeking medical assistance, due to the fear of discrimination and mistreatment at the hands of authorities.
Russia needs to change its policies, strategies, and treatments for drug dependent persons and those living with HIV to be in line with its human rights obligations and international medical standards. This includes providing adequate health care for detainees. One way to create this change is to focus efforts on training law enforcement and detention officers. Article 10 of CAT requires that States Parties include “education and information regarding the prohibition against torture . . . in the training of law enforcement personnel.” The High Commissioner for Human Rights has produced a manual for the training of law enforcement personnel. The manual lists the prohibition against torture as an essential principle of police investigations and articulates the human rights obligations of law enforcement personnel. Article 12 of CAT requires that States Parties “ensure that [their] competent authorities proceed to a prompt and impartial investigation, wherever there is reasonable ground to believe that an act of torture has been committed.” By implementing these practices and de-stigmatizing HIV and drug dependency within the prison system, appropriate medical treatment is more likely to be applied in Russia. In addition, State officials must implement proven successful, evidence-based treatment program, such as OST. Without evidence-based treatment, the relapse rate for drug dependent persons is considerably higher and the withdrawal process is painful and degrading. Toward this end, education programs should be implemented to raise awareness about drug dependency in Russia.
As it stands, Russia is in breach of its obligations under CAT and ICESCR. It must act to protect, respect and fulfill the rights of people living with HIV and drug dependent persons in prison and detention.