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Human rights in Ukraine – 2005: XIX. Observance of the rights of people living with HIV or AIDS, and measures to avert an epidemic

   

Against a background of ineffective systems of social support and public health care, Ukraine is experiencing two major epidemics - that of people living with HIV, and that of drug addiction, with the rise in one exacerbating the increase in the other. According to World Health Organization (WHO) estimates, Ukraine is one of the countries with the fastest increase in the number of those infected with HIV.  The complexity of the problem of the spread of HIV / AIDS in Ukraine lies in the fact that a significant number of cases where people are infected are linked with the use of injected drugs.

The number of new HIV cases registered rises each year. In 2004 the figure was 12,491, nearly 25 % higher than in 2003 (10,009 cases) and virtually double the number in the year 2000 (The Ukrainian AIDS Centre, 2005, EuroHIV, 2005). The overall number officially registered as living with HIV at the present time has reached 85,655, this being almost 200 times greater than the equivalent figure ten years ago.

In just 10 months (from January to October) 2005 10,812 people were officially diagnosed with HIV in Ukraine. The number of deaths from AIDS during those 10 months in 2005 was 41% higher than during the same period in 2004.  These figures significantly understate the real extent of the epidemic given that they reflect only those people registered by official Ukrainian Ministry of Health institutions carrying out testing.

Ukraine where, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), the percentage of those living with HIV/AIDS exceeds 1,4 % of the adult population, or more than 360 thousand people between the age of 15 and 49, remains the worst-affected country in Europe as regards the HIV epidemic.

In terms of the number of people living with HIV/AIDS, Ukraine is in second place behind Russia, a country with a population three times larger than that of Ukraine (cf. Table 1).

Table 1. The estimated number of people living with HIV/AIDS in the countries of Western and Eastern Europe and the CIS most vulnerable to the epidemic (according to UNAIDS estimates in absolute figures).

Country

Calculated number of people living with HIV/AIDS in absolute figures

Russia

860 000

Ukraine

360 000

Italy

140 000

France

120 000

Germany

43 000

Portugal

22 000

Kazakhstan

16 500

Poland

14 000

Uzbekistan

11 000

Austria

10 000

Belgium

10 000

Estonia

7 800

Latvia

7 600

Romania

6 500

Republic of Moldova

5 500

Armenia

2 600

Lithuania

1 300

Table  2. The Number of adults living with HIV in some countries of Eastern Europe and Asia[1]

Country

Number of adults living with HIV

Number of adults living with HIV per 100 thousand of the population

Ukraine

360 000

748

Russia

860 000

604

Estonia

7700

589

Kazakhstan

16 400

106

Hungary

2800

28

Slovenia

500

25

Czech republic

2500

24

Romania

2500

11

Poland

3500

9

Bulgaria

500

6

Slovakia

200

4

The epidemic which is spreading as a result of the use of injected drugs and because of unprotected sex shows no sign of abating. The number of people being diagnosed with HIV among injecting drug users is continuing to rise (Ukrainian AIDS centre, 2005a).  Although the majority of these injecting drug users are young men, in 2004 women also formed a significant percentage (23 %) of those diagnosed with HIV[2].  A large percentage of those living with HIV are drug users who were infected by injecting themselves using shared syringes.  This group is largely formed by young people up to the age of 30.  Since any drug user can be infected themselves or pass on HIV through sexual contacts, there is danger in this group of the population being drawn into the epidemic. There has been a recent increase in the number of cases where the partners of drug users, who do not themselves take drugs, have been infected precisely through sexual relations.

As well as injecting drug users, there are other higher risk groups in Ukraine who are being drawn into the HIV epidemic. These are sex workers, men having sex with other men, prisoners and others.  High-risk behaviour can fuel the danger of being infected with or passing on HIV not only to other members of their group, but to the population as a whole. This is leading to a situation where the HIV/AIDS epidemic in Ukraine has the potential for turning into a generalized epidemic which could affect any person in the country.

Harm reduction programs to minimize the dangers from the use of injecting drug use are at the present time being implemented in some regions of Ukraine with a high prevalence of HIV infection.  However the number of people reached by such programs remains very low. In Ukraine such programs, for example, reach only 10 % of all injecting drug users, or an estimated 560,000 people (Balakireva and others, 2003). At the present time, pilot programs are being run which provide alternative treatment for injecting drug users. Such services are, however, extremely limited in the number of people they reach.  Another factor in the spread of the epidemic is connected with the fact that the same people often inject illicit drugs and offer sex for money. In Odessa 67% of workers in the sex industry who are injecting drugs were found to be HIV-positive, while in Donetsk, Lutsk, Poltava and Simferopol the figure varied from 35% to 50%.  Many of these people were infected by a sexual partner who had probably been infected through unsafe ways of injecting drugs.[3]  .

The overwhelming majority of people living with HIV in Ukraine are younger people between 20 and 39, i.e. people at the peak of their physical, creative and intellectual energy.  Experts predict that if the present trends continue, the number of people who are HIV-positive could reach 1,5 million by 2010, with the number of new cases of AIDS reaching 95 thousand and the number of deaths from the disease in that year rising to 90 thousand.  The percentage of deaths from AIDS out of the overall number of deaths by 2010 would be around 10%, with the overwhelming majority of those who die being people up to the age of 40[4].

As well as HIV/AIDS, the high-risk behaviour of drug addicts contributes to the spread of other infectious illnesses such as Hepatitis B and C, and venereal diseases.  This in term causes a number of social consequences with the breakdown of family relations and friendships, the increase in crime connected with drug abuse, huge expenditure on treating drug dependence and infectious illnesses, a large number of young people losing their work capacity, as well as human rights violations and violence towards drug addicts. All of these negative consequences manifest themselves on a daily basis in Ukraine and touch the lives of an ever rising number of our fellow citizens[5].

The HIV/AIDS epidemic is fuelled by social marginalization which then, in turn, exacerbates it.

In Ukraine a repressive approach in state policy was adopted for countering drug addiction. For Ukraine, as indeed for other countries of the post-Soviet area, a tendency is generally evident towards measures to “stop” any social problems which arise, rather than applying methods for preventing their appearance.

Measures taken by the Ukrainian government have been aimed at putting a stop to drug addiction as illegal behaviour presenting a danger to society, and are of a severe and uncompromising nature in their attitude to drug addicts.

However drug addiction which is leading, among other problems, to the spread of HIV infection in Ukraine cannot be viewed in isolation or as a problem which can be eliminated through the use of law enforcement measures.

Any attempt to remove the consequences without taking measures to address their causes is doomed to failure. The causes of drug addiction in our country are of a pronounced social and economic character, being rooted in the lack of opportunity for many young people to find themselves occupations which can satisfy their material and psychological needs, as well as by negligent state policy as regards introducing changes to social structure.   Using drugs is therefore for a great number of drug users not a form of relaxation, but rather a means of psychological adaptation to the reality around them.  Drug addiction is a social ill which indicates the presence of serious social contradictions.

Drug addicts and people who are HIV-positive are subjected to stigmatization and discrimination.  A situation where revealing ones HIV status places the safe existence and interests of the person infected and his or her relatives in jeopardy will objectively lead to the person concealing the illness, so as to not harm himself or herself and family.  This, in turn, leads to the problem being driven underground which significantly increases the risk and runs counter to public interest.  The non-observance of the rights of drug addicts and people living with HIV has a negative impact on the effectiveness of the fight against the spread of both drug addiction and HIV infection in Ukraine[6].

The repressive approach in drug policy, the lack of coordination of measures in drug policy and in prevention of HIV is making it impossible to resolve the problem of HIV in Ukraine.  At present drug users are at once the targets of a policy of fighting drugs and of a policy for preventing HIV. With regard to drug addicts this policy is confined to voluntary or forced treatment, and criminal prosecution.  Such an approach insists on the total eradication of drug addiction.  The possibility that drug addicts could legitimately exist in society is not regarded as conceivable[7].

The victims of the HIV/AIDS epidemic being spread largely through injecting drug use and work in the sex industry are mostly individuals from marginalized groups in society who are at high risk of violence from law enforcement bodies and from lack of any respect in institutions of the healthcare system. If immediate and coordinated measures are not taken, these violations of human rights could nullify the many important steps which Ukraine has already taken in trying to overcome the epidemic[8].

At the state level, Ukraine has taken on the obligation to observe the rights of people who are HIV-positive and drug addicts, and to provide social support.  Most injecting drug users are unemployed, however they do not turn to the employment services nor do they receive any unemployment benefits. They are also unable to arrange concessions on communal charges. Solutions to these problems could significantly decrease the negative consequences of drug addiction; however access to social services for injecting drug users remains problematical.

Access to medical services is also a major problem for injecting drug users.  It is often extremely difficult for an injecting drug user or person who is HIV-positive to receive urgent medical assistance or to have a surgical operation.  The reasons are the stigma they are subjected to, the negative attitude and lack of professionalism of doctors.  Another factor in the way can be the apprehension of the drug users that if they turn for help, their condition will be disclosed or their name will be put on the records.

At the end of 2005 in Ukraine, there were 152.4 thousand drug users on the records of the law enforcement bodies (these figures have increased 1.4 times over the last 5 years, in 2001 the figure being 107.1 thousand), of whom 86 thousand are addicted.  These figures for official records do not however reflect the real situation. Studies have shown that the real number is several times higher.  According to expert assessments, the number of drug users is around 560 thousand. The spread of the epidemic among them requires urgent measures to decrease the losses among injecting drug users.

Of the number of people living with HIV, around 70% are injecting drug users[9].  The statistics suggest that the percentage of such drug users among of new cases of HIV infection is decreasing, however the absolute figure of new cases of HIV continues to grow.

At present in the country the long out-dated practice is still applied of bringing criminal charges against a person under Paragraph 1 of Article 309 of the Criminal Code of Ukraine (CC) for the illegal preparation, obtaining, possession or other actions of a relatively small amount of psychoactive substances without the intention of selling it, and also under Paragraph  2 of Article 308 of the CC, in cases where the substances are particularly dangerous but where there was no intention to sell them.  Thus, according to current legislation, the discovery on a person of more than 5 grams of dried hemp plant or 10 grams of poppy straw is sufficient grounds for punishment in the form of deprivation of liberty for a period up to three years.  The overwhelming majority of people prosecuted under this article are those who suffer from drug addiction, and therefore according to the position taken by the European Community, are themselves the victims of organized drug crime. Such people are not usually able to defend their own rights.

In 2005 the number of drug-related crimes “solved” by the law enforcement bodies in Ukraine came to 65 thousand, this being 13.5 % more than in 2003 -  57,435.  At the same time, the amount of recorded dealing in narcotics decreased for the same period from 17.5 to 17.1 thousand (– 2,3 %) cases of actual drug dealing, meaning that the “increase” in the showings was achieved through bringing criminal charges against average drug users for possession of drugs for their own personal use.

In particular regions the number of criminal cases launched in relation to handling drugs equalled or even exceeded the number of people on the official police registers.  The regions involved were the Kharkiv, Lviv, Poltava, Zhytomyr, Transcarpathian and Cherkasy regions.

As regards the solving by the Ministry of Internal Affairs Department for fighting the illegal circulation of narcotics of crimes classified as drug-related (selling, running dens, making others addicted, stealing drugs, organizing drug laboratories, laundering profits from drug dealing), the percentage of these in relation to the overall number decreased by 0.9 %[10].

Injecting drug users who are addicted to drugs have a permanent psychological and physiological need of psychoactive substances. This means that as a result of their ill state, regardless of the risk of sanctions, they will regularly take narcotic substances or psychotropic means in order to avoid withdrawal symptoms which cause both physical and psychological suffering, even if only the minimum dose needed.

The Ukrainian Criminal Code does not impose criminal responsibility for drug abuse, yet, according to official statistics, around 70% of the criminal cases initiated following the discovery of incidents of illegal handling of drugs fall under Article 309 of the Criminal Code (possession of drugs without the intention to sell them). More than 90% of the people charged in such cases are on the drug abuse register.  In general this involves the possession of a few grams or even some cubic centimetres of drugs regardless of the fact that the substance found is virtually only an individual dose. Cases involving the possession of drugs in particularly large quantities form a tiny part of the overall number of criminal cases.

The prosecution of an individual suffering from drug addiction on such grounds serves no preventive function, and only exacerbates the situation.

Current departmental normative acts contain the requirement to provide police bodies with regular reports on a number of indicators. One of these is the number of criminal cases launched in connection with crimes related to the illegal circulation of drugs.  As a result, police officers have an interest in increasing the number of cases launched.  Investigative bodies wishing to avoid penalties for not fulfilling the necessary quotas quite frequently launch criminal cases without any real justification. Such cases, based on flimsy evidence, are knocked down at the very first court hearings, the guilt of the person accused is declared unproven and he or she is released from custody. That, however, is of no concern already to the investigative bodies of the police since their task to gain the needed showings as regards the efficiency of their activities is considered to have been fulfilled.

The fact that the present system of quotas leading to ordinary drug addicts being prosecuted does not work is also demonstrated by the experience of using particular methods of investigative operations, in particular controlled supplies and special investigative operations involving buying drugs.

According to Ukrainian legislation on fighting drug addiction and world experience in using these two methods for combating the illegal circulation of narcotics, they are usually applied in order to receive documented evidence of the criminal activities of drug-dealing gangs, largely those on an organized scale. Consequently the number of such operations in countries of the EU and in the USA is fairly limited, and is not expressed in the thousands. In Ukraine, on the other hand, these operations are in the main carried out in order to catch and prosecute ordinary illicit drug users for selling or smuggling a few grams of an illicit drug.

One must also note that Ukrainian law enforcement bodies do not keep the relevant statistical records regarding the “quality” of the criminal cases in this category.[11]

In addition to this, police brutality to drug addicts, sometimes descending to the level of actual torture, is a permanent and extremely widespread problem in Ukraine and extends well beyond the framework of the issue of HIV/AIDS alone.  However it is specifically drug users and sex workers who frequently fall victim to such violations since their marginalized position makes them an easy target for a police officer whose aim is to fulfil arrest quotas.  The police use drug addiction as a weapon in order to force drug addicts to give evidence: the prospect of the suffering they will endure from “withdrawal” makes such people especially vulnerable and more inclined to succumb to pressure from the police.  And since a lot of people see drug users and people working in the sex industry as socially undesirable, police officers run little risk of being punished for their actions.[12]

Human Rights Watch also found that discrimination towards people living with HIV/AIDS or towards people at higher risk of infection is extremely widespread among health care employees in Ukraine. People living with HIV/AIDS, as well as injecting drug users had been turned away from hospitals or discharged as soon as it was discovered that they were HIV-positive.  Others received a very low standard of medical care which was exceptionally inhumane and undermined their already weakened state of health. Ambulances had refused to transport drug addicts or people living with HIV/AIDS.  In some cases patients could only arrange medical care for payment although the medical services were supposed to be free.  Fear of arrest over a trivial amount of drugs heightens the danger that the increase in HIV infection will accelerate since those most vulnerable turn down services aimed at preventing HIV, as well as because of the increase in periods of imprisonment for drug users. For these reasons many continue to use illicit drugs while the opportunity to prevent HIV and receive effective treatment for their drug addiction remains limited. This increases the risk of HIV infection, while at the same time susceptibility to other infectious diseases (such as tuberculosis) can exacerbate the development of the infection[13]

These conclusions presented by Human Rights Watch are entirely borne out by the results of national studies carried out from 2003 – 2005. According to the latter, of particular concern is the practice of using legislation in relation to injecting drug users and people living with HIV/AIDS. The results of the studies identified systematic violations of the rights of both groups of people in Ukraine. The analysis showed that violations of the human rights of people living with HIV/AIDS were typical in the medical, social and labour spheres, as well as in their encounters with law enforcement agencies (the latter being typical also in relation to drug addicts and members of other groups at higher risk of HIV/AIDS.

The following were found to be typical violations of the rights of injecting drug users and people living with HIV/AIDS.

1. The nature and specific forms of typical violations of rights in the area of criminal justice:

a) the lack of appropriate documents (resolutions, protocols) during official procedure;

b) the absence of witnesses in the majority of cases during official procedure;

c) advantage taken of a detained drug user’s state of narcotic intoxication, including advantage of those female drug users working in the sex industry when police officers fill in procedural documents.  Signatures are obtained from people detained who are not at the time in a fit state to understand the nature of the documents they are signing, and cannot monitor  their actions or level of responsibility as a consequence of their condition;

d) deliberately making use of people’s state of withdrawal when carrying out investigative operations, taking advantage of their desperate physical condition  to extract confessions to having committed a crime, or to force them to incriminate themselves or make allegations about other people, or for other purposes;

e) pushing people to testify against themselves in violation of Article 63 of the Constitution of Ukraine;

f) not providing an explanation of a person’s rights in accordance with legislation on procedure;

g) refusing to provide  the services of a lawyer, and not informing people that they have the right to a defence lawyer or informing them after some delay;

h) illegal use of physical force and special means in relation to a detained person during the detective inquiry stage (before charges are laid) and pre-trial investigation;

i) coercion by employees of law enforcement agencies to pay bribes;

j) the very widespread practice of torture in relation to injecting drug users by police officers, knowingly unlawful detention or launching of a criminal cases, i.e. committing a crime against these people.

2. The nature and specific forms of typical violations of rights of injecting drug users and people living with HIV/AIDS in the area of health care

a) when there is official information indicating that a person falls into one of these two groups of people, there are frequent cases of refusal by medical staff to provide medical services or the necessary professional assistance with various excuses being given such as, for example, the lack of necessary equipment, medication, the need for registration (based on residential address), to join a queue or other unfounded motives;

b) refusal to admit people who have taken an overdose to hospital or referral for such services to specialized departments of psychiatric hospitals, even where there are no such departments in more isolated district centres;

c) no response to ambulance callouts (the calls are not recorded), or refusal of the ambulance to drive out to the address, or advice to turn to specialized departments of psychiatric hospitals, with such refusal to provide medical help in time sometimes having fatal consequences;

d) in the case of women who are HIV positive or who are injecting drug users giving birth, medical personnel try to discharge this as quickly as they can, justifying this by the need to minimize the risk of possible infection with HIV;

e) the disclosure of confidential information on the results of examinations in the case of people known to be living with HIV/AIDS;

3. The nature and specific forms of typical violations of rights of injecting drug users and people living with HIV/AIDS in the area of social services:

a)   the unwarranted refusal by social workers of local administrations to allocate social aid which is stipulated and guaranteed by the state;

 b)   one of the predominant violations in this area is the illegal eviction of injecting drug users from their accommodation.  This type of violation can be divided into several subcategories:

-  the person is tricked into giving up his or her accommodation through the machinations of criminal gangs;

-  loss of the accommodation on the ruling of a court;

-  illegal eviction from the occupied accommodation by close relatives of the drug user, or guardians;

c)   unwarranted refusal to grant concessions for payment of communal charges;

d)  unjustified termination of parental rights;

e)  refusal to enrol the children of injecting drug users in pre-school institutions.

4. The nature and specific forms of typical violations of rights of injecting drug users and people living with HIV/AIDS in the area of labour relations:

 a) dismissal from ones job after information (official or unofficial) is received about the person belonging to one of the above-mentioned groups.  As a rule, various formal grounds are provided for the dismissal, such as staff redundancies, the restructuring of the business or organization, the employee’s negligent attitude to their duties, or other infringements discovered. The list of “grounds” in each individual case varies lending the semblance of legality;

b) the refusal to employ an injecting drug user or person living with HIV/AIDS;

c) discrimination at work on the basis of the person’s belonging to one of the said groups of people.  For women working in the sex industry the following are also problems: demands from individuals from the criminal world; sexual and physical violence from clients; the restriction of maternal rights; demands for bribes or sexual favours by police officers; harassment from police officers;  discrimination.

From interviews with injecting drug users

Svitlana, 28 (Mykolaiv):  “When I wasn’t home, the cops climbed through the window, opened the door, and walked in. Only my daughter and her friend were in the building. They started saying that your mother is shooting up. And my daughter didn’t know. They showed her a syringe and asked her if she knew what it was. She said, yes, that it was a syringe and that in the kindergarten they gave them injections. The little one began crying and they shut her month. When I arrived home they took me away and kept me there the whole day. My daughter was alone at home, hungry. And there they tortured me, put a gas mask on me, blocked the tube that you breathe through, and breathe what you like. One of them grabbed a mob, put a condom on it. He says: “I’m going to …. you in the arse, take this off and show it to your friends”. 

Volodya, 30 (Cherkasy): „I feel most sorry for young girls who are addicted. A girl I know was raped by a police officer in his office. He told her that if she didn’t provide him with sex, he would call all his staff from the entire floor. They’re constantly subjected to sexual violence. If she uses drugs, then a realistic way of avoiding conflict with the police is to provide them with sex: in the block entrance, in their office and anywhere in the building”.

Oleh, 33 (Cherkasy):  “They have a special device. It’s a box and in it there’s a twisted cable, twisted from one end and the other, with special levers on the left and right.  In the middle there’s a noose, they call it a “balls-squeezer”. They chain you to a stool with handcuffs, pull your pants down, shove your genitals in the contraption, and begin to squeeze and twist.  “Slonik” [“little elephant”], that the whole country knows. They put a gas mask on and block your breathing, and he stands with a stop-watch, knowing that on average a person can stand it for 40 seconds. If you lose consciousness, they pour water over you, you get up, stand up. They wrap you in wet towels, and beat you, no bruises, your kidneys are dislodged, you leave there a cripple. But when you come to him, and confront him with it, you’re a swine, a pig, a sadist. “I’m what?   What are you saying? I’m an officer, how could I possibly have anything to do with such a thing?  Anyway nobody beat him”.  The boss says: “I know his staff, no, we don’t have such lawlessness.  How can you, in my department everything is according to the law. We run lectures, provide psychological support”.

Ihor, 31 (Poltava): “I want to say. When they detain you they launch a criminal case, and they immediately give you something to sign saying that you’ve been made aware of Article 63 of the Constitution of Ukraine – that’s about your rights. What rights there, who the hell knows?  Then they ask questions and if you don’t want to answer, specific actions begin – gas mask, electric shocks, “lastivka” [“swallow”] (they tie your legs and arms together behind your back).  In the end you give up, you crack and sign anything so that they’ll let you go. They torture you for eight hours, after which your tongue is black, and your ears are black from the electric shock. Your psyche can’t endure 8 hours. You turn into a boxer’s punch bag”.

Slava, 37, (Odessa): “In autumn they detained 6 people, here at Mechnikov near the place where the selling takes place. Obviously they had an interest in getting them put away. They tortured them. They killed two of the six, another one had his Adam’s apple crushed, they took him to the hospital on Yevreiska Street, and he died that night.  And it wasn’t even light when the police were at his parents’ place with money; they said he was still alive and offered money for his treatment.  They refused the money and took them to court, the case is still continuing. And another one had internal bleeding; he didn’t live longer than 3 weeks. There his grandmother took money for the treatment and didn’t write anything”,

From interviews with women in the sex industry

Tanya, 24 (Poltava) “The police of course turn up, take us in, threaten that they’ll “close us” if we don’t give them sex, because they can’t prove that the girls are involved in the sex industry.  We do our “subotniks”[14], that’s what It’s called – we provide our sexual services free of charge. And not just for one – for the group”.

Lesya, 21 (Poltava): “I know that they don’t have the right to burst into my flat without any grounds and to carry out a search. How the police turn up and begin to beat us, demand money, and also demand “subotnik”. And how they want us to admit to a theft, or use “slonik”, and whatever else you want. The police get up to a hell of a lot”.

Svitlana, 25 (Cherkasy): “they beat me up behind the kiosk, chained me up with handcuffs. They know I can’t complain to anyone”.

Halyna, 27 (Cherkasy): „And how they stub out their “butts” on our face, that’s normal. They stubbed out their butts on Tanya’s face and mine, she’s still got the scars”.

Inna, 23 (Mykolaiv): “It’s all because of these drugs. And we’ve punished ourselves. Ourselves. And instead of providing at least some kind of support from the authorities, instead they humiliate us. If they wanted, it would be possible to get us out of it. And a good few of us could turn into real people. A lot of us …”

Conclusions

At the present time only the prohibitive aspect of the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances is, in practice, implemented in Ukraine, while the provisions of the Convention on the obligations of signatory states with regard to treatment, rehabilitation and support of drug addicts are effectively ignored.  At the same time, Article 38 of the Single Convention on Narcotic Drugs

(Measures against the abuse of drugs) states: “The Parties shall give special attention to and take all practicable measures for the prevention of abuse of drugs and for the early identification, treatment, education, after-care, rehabilitation and social reintegration of the persons involved and shall co-ordinate their efforts to these ends”.  Article 20 of the 1971 Convention on Psychotropic Substances puts forward the following commitments: “The Parties shall take all practicable measures for …. the early identification, treatment, education, after-care, rehabilitation and social reintegration of the persons involved …”.  In connection with the above, a change is needed to the one-sided, incomplete and ineffective approach to the implementation of the commitments of these UN Conventions.

As the studies carried out show, injecting drug users, people living with HIV/AIDS and women working in the sex industry are subjected to widespread discrimination in Ukraine.  In the treatment by police officers of injecting drug users and partly women in the sex industry, there are not only cases of flagrant violation of their procedural rights, but also the widespread use of torture which is a grave violation not only of such international legal documents as the Universal Declaration of Human Rights, the European Convention for the Protection of Human Rights and Fundamental Freedoms, the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and other international agreements, but also of Ukrainian domestic legislation.

At the same time, due to their vulnerable situation, these people are virtually deprived of the chance to secure the restoration of their violated rights and to bring those responsible to justice. Analyzing the statistical reports of the agencies of the prosecutor’s office, one notes the effective lack in them of criminal cases launched within the framework of their competence on incidents involving illegal activities by police agencies in relation to injecting drug users, or involving the flagrant violation of the rights of drug users, people living with HIV/AIDS and women in the sex industry to receive medical assistance, including cases which had grave consequences.

An analysis of court statistics makes it possible to also conclude that the level of actual court-based protection of the rights and legitimate interests of drug users, people living with HIV/AIDS and women in the sex industry is extremely low[15].

Recommendations

A change is needed to state policy with regard to drug addiction away from the ineffective clear focus on “the aim of stopping it” to a pragmatic preventive approach which takes into consideration the situation as it actually exists in this area, and specifically:

a) measures should be taken to remove the contradictions which lead to an unwarrantedly severe approach to the issue of the actual use of illicit drugs by people suffering from drug addiction.  While in legislative terms this is not defined as a criminal act, in practice, people face prosecution for actions which are objectively linked, such as obtaining or possessing for personal use small amounts of narcotic substances;

b)  a strategy of harm reduction for users of narcotics, which is an international method that has recommended itself and proved highly effective, needs to be made widely;

c) the emphasis should be moved from the present ineffective fight against drug addicts who are, according to the approach adopted by the European Union, victims of organized drug crime, to the fight with the real culprit of  the rising level of drug abuse in Ukrainian society – namely organized drug crime:

d)  it would be expedient to undertake immediate measures aimed at fighting corruption in the law enforcement bodies, in particular those within the system of the Ministry of Internal Affairs, which contributes to the increasing level of drug abuse in Ukrainian society and flagrant violations of the rights of drug addicts:

e) an effective model should be created aimed at educating the upcoming generation (children and young people) with a focus on a healthy way of living which ensures maximum opportunities for their physical, cultural and spiritual development, and affirms universally accepted values, the fostering of creative possibilities, since the existing system for bringing up young people has little effect and does not resolve the issues which they face;

f) a healthy style of life should be declared a state priority, with support being provided by the state;

g) a broad complex of educational and information measures about drug addiction and HIV/AIDS, and the problems connected with them, should be implemented[16].

It is also vital:

1.  to pass a Law on introducing amendments to Paragraph 1 of Article 309 of the Criminal Code of Ukraine which would remove from this Article the sanction in the form of deprivation of liberty, replacing it by a punishment involving participation in socially useful work on the basis of social rehabilitation centres; it would also supplement Paragraph 2 of Article 309 with an alternative sanction envisaging the involvement of those guilty of the acts referred to in the article in alternative liability in the form of socially useful work on the basis of social rehabilitation centres for a period longer than that envisaged by Paragraph 1  of Article 309, with the obligation to voluntarily undergo a medical rehabilitation course against drug addiction, defining drug addicts as those for whom such an alternative sanction would largely be applied.;

2.  to gradually change the system for assessing the effectiveness of the activities of police agencies. At the first stage to exclude from the effectiveness showings of the activities of police agencies in the area of fighting the illegal circulation of drugs such indicators as the launching of criminal cases under Article 309 of the Criminal Code (for illegal actions relating to drugs but not for the purpose of selling them). At the second stage – to draw up and implement a system which meets modern demands;

3  to move the focus towards uncovering crimes related to the circulation of drugs, in particular, those connected with their illegal transportation onto the territory of the state, their production and preparation in order to sell them, and also crimes of involving minors in drug abuse.  We would thus achieve a transfer of the efforts of police agencies towards fighting organized drug crime which is directly responsible for the increased drug abuse in Ukrainian society, and not fighting ordinary illicit drug users;

4.  to introduce amendments in the table of small, large and particularly large amounts of narcotic drugs, psychotropic substances and precursors in illegal circulation, approved by Order No. 188 of the Ministry of Health of Ukraine from 01.08.2000, as regards defining where the borders lie, in particular of doses for personal use by drug addicts, with this being determined by a competent drug abuse commission;

.5. to introduce a comprehensive system of medical and social assistance for those suffering from drug addiction which would unite programs for detoxification, rehabilitation, substitution therapy, psychological and social reintegration;

6.  to ensure that drug addicts are informed as to the presence and available of medical and social services, the provision of services to injecting drug users and people living with HIV/AIDS for protecting their rights and legitimate interests, establishing precedents in bringing those responsible for violating the rights of injecting drug users and people living with HIV/AIDS to answer.



[1]  Estimates from the Joint United Nations Programme on HIV/AIDS: http://www.unaids.org/

[2]  UNAIDS/WHO AIDS Epidemic Update: December 2005.  Eastern Europe and Central Asia

[3]  UNAIDS/WHO AIDS Epidemic Update: December 2005.  Eastern Europe and Central Asia

[4]  O. Balakireva,  Y. Galustyan, O. Yaremenko and others: “Social and Economic Impacts of the HIV?AIDS Epidemic in Ukraine: New Predictions” – Kyiv, 2003

[5]  Priorities in preventing HIV/AIDS – Harm Reduction Strategy.  International Centre for Policy Studies, 2005

[6]  A. Tolopilo. Sotsialno-pravova pidtrymka narkozalezhnykh ta VIL-pozytyvnykh osib [Social and legal support for drug addicts and people who are HIV-positive], 2003

[7]  Priorities in preventing HIV/AIDS – Harm Reduction Strategy.  International Centre for Policy Studies, 2005

[8]  Rhetoric and Risk: Human Rights Abuses Impeding Ukraine’s Fight Against HIV/AIDS, Human Rights Watch Report, 2 March 2006,  Available from their website  http://www.veritas.org.ua

[9]  According to figures from the Ukrainian Centre for preventing and fighting AIDS of the Ministry of Health of Ukraine

[10]  Statistics from the Ukrainian Ministry of Internal Affairs Department for fighting the illegal circulation of narcotics

[11]  Priorities in preventing HIV/AIDS – Harm Reduction Strategy.  International Centre for Policy Studies, 2005

[12]  Rhetoric and Risk: Human Rights Abuses Impeding Ukraine’s Fight Against HIV/AIDS, Human Rights Watch Report, 2 March 2006,  Available from their website  http://www.veritas.org.ua

[13]  Rhetoric and Risk: Human Rights Abuses Impeding Ukraine’s Fight Against HIV/AIDS, Human Rights Watch Report, 2 March 2006, 

[14]  A word from Soviet days where all the employees of institutions, enterprises, etc «voluntarily” gave up a Saturday  to do work for the state (translator’s note)

[15]  Report on the observance of human rights in relation to drug addicts and people living with HIV/AIDS in Ukraine. The Odessa Human Rights Group, “Veritas”, 2005.  Available on their website: http://www.veritas.org.ua

[16]  Priorities in preventing HIV/AIDS – Harm Reduction Strategy.  International Centre for Policy Studies, 2005

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