Treatment Issues: Newsletter of Experimental AIDS Therapies - Volume 17, Number 12, December 2003
Vitaly Zhumagaliev

Advocacy is a strange thing in Russia. There is no equivalent term in Russian — and there seems to be no equivalent concept. People have always hoped to solve their problems on a personal level: "The Czar/Party Secretary/Boss/President is fair, he just doesn't know about my trouble. If I can make it clear to him, he will do something, for sure." Yeah, right.

HIV advocacy is even less familiar. Although Russia has one of the world's fastest growing HIV infection rates, HIV is still terra incognita for most Russians. It took President Putin four years to declare that HIV/AIDS is a national problem.

One-on-one lobbying doesn't work. To get things moving, organizations and individuals involved in HIV/AIDS must join forces to strengthen their efforts. This is advocacy. But when there is no history of advocacy or culture in your own country to draw on, you have to look elsewhere for guidance. The success of AIDS activism in the United States is well known. The advocacy fellowship designed by the International Harm Reduction Development (IHRD) Program of the Open Society Institute and Gay Men's Health Crisis (GMHC), enables people from Central and Eastern Europe and the former Soviet Union to learn from the U.S. experience and develop ways of changing AIDS policies at home.

The fellows' program, based at GMHC, was intense. We had meetings every day with new people in different organizations. We visited the Harlem Hospital and talked to the staff of the Callen-Lourde Gay and Lesbian Community Health Center. We went to the Bedford Hills Correctional Facility, and met with pharmaceutical companies. Since the HIV epidemic in the region is largely driven by injection drug use, we had to understand how HIV activism could work with the harm reduction movement. We met harm reduction specialists at the Positive Health Project and the Harm Reduction Coalition, and spoke with experts such as Robert Newman, M.D., and Jay Dobkin, M.D. The heart of advocacy is networking and coalition building, even if sometimes HIV/AIDS activists have to lead the way.

The fellowship helped change my thinking about what needs to be done. I hope the knowledge and skills I gained are not wasted. As the policy program officer at the Open Health Institute (OHI) in Moscow, my goal is to more actively engage HIV advocacy in Russia. I was on the organizing committee of the Russian HIV/AIDS NGO Forum whose inaugural meeting in September 2003 brought together for the first time more than 60 nongovernmental organizations working in HIV/AIDS from all over Russia.

At the AIDS conference of the Ministry of Health of Russia in October, OHI and its Russian and international partners made a strong case for access to treatment for all PLWHAs. Currently, OHI is completing a survey on the needs of Russian harm reduction projects, which will be used for developing a strategy tailored to the needs of our clients.

More than one million, mostly young Russians now live with HIV. They have virtually no access to HIV treatment and limited access to primary health care. Experts believe that 50,000 Russians will need HIV treatment in two years, but the total budget for the 2004 national HIV/AIDS program is $4 million, which is supposed to cover prevention, treatment, testing, monitoring, and anything else. We don't have time for warming-up. We need to push our government to change its HIV policies and save those in the younger generation who still can be saved.

Vitaly Zhumagaliev is a program officer at the Open Health Institute in Moscow.

Reprinted from Harm Reduction News: www.soros.org/harm-reduction

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