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Global Call for Solidarity with People who Use Drugs in Ukraine
The International Network of People who Use Drugs (INPUD) stands in solidarity with the Ukranian Network of People who Use Drugs (PUD.UA/VOLNA), the Ukranian Network of Women who Use Drugs (UNWUD/VONA) and all Ukrainian peers, colleagues, and friends against the invasion of their country by Putin’s regime. This is a clear, unequivocal act of aggression against a sovereign country and its’ people that is also against the will of many Russian people, who arevocalising their dissent, despite personal risk.
People who use drugs are particularly vulnerable during times of war and conflict, and never
more so when the threat comes from a President who has actively imposed a zero-tolerance
approach to drug use, harm reduction and people who use drugs. He has ignored all global
guidance concerning evidence-based treatment for people who use drugs, such as
recommendations made in 2017 by the UN Committee on Economic and Social Rights to align
drug policy with human rights, including lifting the blanket ban on opioid agonist treatment
1
(OAT). In2013,druguseractiviststookonthemightoftheRussianstatebylodgingalandmark
case Kurmanayeskiy et al vs Russia with the European Court of Human Rights, that ultimately was 2
rejected . In contrast to Russia, Ukraine has been a harm reduction leader in the region by
demonstrating commitment to the right to health of people who use drugs. Tragically, during
Russia’s unlawful annexation of Crimea in 2014, 800 people were suddenly thrown off OAT
programmes in line with Putin’s extreme views. This led to between 80 and 100 entirely
preventable deaths, all in the name of fearmongering and moralism. Withholding OAT has been
defined by the Special Rapporteur on Torture as a violation of the right to be free from torture
3
History cannot be allowed to repeat itself in Ukraine. Currently there are thousands of Ukrainians who are worried not only about Russian aggression, but how it will impact the supply of methadone and buprenorphine, and broader harm reduction, in their country. We cannot accept that amidst all the costs of war, that access to essential, life-saving medications to be disrupted.
Putin recently took his demonisation of people who use drugs to another level when he referred to the Ukrainian government as a “band of junkies and neo-Nazis”. There should be no misinterpretation or underestimation of Putin’s comments here. In an age where similar
1 Concluding observations on the sixth periodic report of the Russian Federation, CESCR, E/C.12/RUS/CO/6 (2017). Para 51.
2 Memorandum of the Government of the Russian Federation, Kurmanayevskiy et al v Russia, no. 62964/1, ECHR 2015.
3 Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Applying the torture and ill- treatment protection framework in health-care settings, Human Rights Council, A/HRC/22/53, (1 February, 2013). Para. 73.
and ill-treatment.
comments made by heads of state have led to extrajudicial killings and violence against people who use drugs in countries such as the Philippines, equating a community of people who use drugs (in addition to the leadership of a democratic country) with a hate group, should set off loud alarm bells for what may come for people who use drugs under a Putin regime. We all have a responsibility to speak out against hate talk of this kind and prevent further atrocities being committed in its name.
The global community must stand up for the rights of people who use drugs in Ukraine, including the approximately 17,000 people on opiate agonist treatment (OAT) programmes, amidst this crisis. Drug supply on the streets has been interrupted and people, whether remaining in Ukraine or travelling across borders, are in more need of evidence-based treatment than ever. In Ukraine, people who use drugs are bravely fighting for their lives and defending their community; they are creating temporary shelters for those who have fled or lost their homes, sharing limited resources, and plugging the gaps of health systems.
We ask that all UN agencies, the Global Fund, multilateral and bilateral donors and other stakeholders commit to the following actions:
Work to ensure the implementation of the directive from the Ministry of Health, Ukraine No 26-04/538/2-22 dated 25.02.2022 regarding harm reduction programmes, particularly the administration of at least 15 days take home OAT doses, making sure it is implemented across all regions of Ukraine. More recent directives now recommend 30- day take home doses.
Address the immediate risk of stockouts of drug treatment and overdose prevention by actioning the following: -
- create a coordinating body to work on supply and procurement issues, including
resolving blockages related to the purchase and receipt of drugs from state and non-
state manufacturers
- develop a regulatory framework for the purchase, provision and transport – including
cross-border movements - of drugs (methadone, buprenorphine, tramadol) in the
form of humanitarian aid and its delivery to treatment centres
- re-distribute donor funds for setting up and expanding mobile clinics and community-
and peer-led responses in delivering critical services such as needles and syringes, OAT
and naloxone; and for the purchase and delivery of drugs to medical centres
Facilitate ease of access and mobility for people who use drugs by ensuring services are low threshold by removing all barriers for those entering and continuing treatment. People who use drugs must be able to register and receive medications, including
methadone and buprenorphine across different sites, including in pharmacies
Donors must immediately make emergency funding available and ensure maximum flexibility to meet humanitarian needs, such as food, shelter, transport, protection from violence and medical supplies, including projecting their investment towards addressing
post-crisis trauma and issues
Coordinate with neighbouring countries (Poland, Romania, Moldova etc.) to deal
effectively with an increase in refugees who require continuation of OAT, ARV, TB and
viral Hepatitis treatment. This includes ensuring adequate supply of medication and commodities and removing barriers to entry and treatment continuation without discrimination.
The world is struggling to comprehend and deal with the aftermath of the Russian invasion that is undeniably a threat to peace everywhere. People who use drugs have always known how damaging and futile wars are, and that its impacts are felt by the most marginalised and oppressed. We call for global solidarity and action to mitigate the immediate consequences of this act of violence and aggression for peers in Ukraine, who are fighting back against tyranny and further persecution.
