Example 8: Encouraging implementation of CESCR recommendations on opioid substitution treatment in Russia

Example 8: Encouraging implementation of CESCR recommendations on opioid substitution treatment in Russia 

Project Type: Advocacy and Litigation

The Organization

Andrey Rylkov Foundation for Health and Social Justice 

E-mail: Rylkov.foundation@gmail.com
Website:  http://en.rylkov-fond.org/  (English)

The Andrey Rylkov Foundation for Health and Social Justice (ARF) is a non-profit organization incorporated in the Russian Federation in September 2009. The aim of ARF is to develop and promote a “humane drug policy based on tolerance, protection of health, dignity and human rights in Russia.” It is a small organization with a minimalist budget that depends on volunteers for most of its program activities.

The Problem

Opioid substitution therapy (OST) is an effective method for reducing the harms associated with injection drug use. Yet, Russia prefers to incarcerate people who use drugs instead of providing them with OST. Indeed, Russia prohibits access to OST, disseminates false or misleading information regarding OST, stifles discussion of OST and promotes a treatment for injection drug use that ignores best practices in science. As a result, Russia now faces the world’s largest and most dramatic rise in HIV/AIDS morbidity within its injecting drug use community.

Actions Taken

ARF has pursued a multifaceted strategy to secure access to OST in Russia, including proceedings before domestic courts, direct appeals to the highest state authorities, and activities to raise public awareness of the need for the measures recommended by the international human rights bodies.

Alleged Violations

Right to the highest attainable standard of physical and mental health (ICESCR, art. 12; UDHR, art. 25; Russian Const., art. 41).

Right to enjoy the benefits of scientific progress and its application (ICESCR, art. 15(b)).

Right to freedom of information (ICCPR, art. 19; UDHR, art. 19; Russian Const., art. 29(4)).

On April 2, 2010, ARF submitted a shadow report to the International Committee on Economic, Social, and Cultural Rights (CESCR) on Russia’s failure to implement the right to health (art. 12) “as it relates to access of people who inject drugs to drug treatment and HIV prevention, care and treatment programs.” Specifically, ARF presented evidence that the government violated the human rights of people who use drugs by banning access to harm reduction services and information, including OST.

On May 20, 2011, the CESCR issued its Concluding Observations to the Russian Federation, recommending that the government “apply a human rights-based approach to drug users so that that they do not forfeit their basic right to health” and “provide clear legal grounds and other support for the internationally recognized measures for HIV prevention among injecting drug users, in particular the opioid substitution therapy (OST) with use of methadone and buprenorphine, as well as needle and syringe programs and overdose prevention programs.” (UN Doc. E/C.12/RUS/CO/5)

On September 2, 2011, ARF submitted a formal request to the Office of the President, as guarantor of the Russian Constitution, asking for implementation of the CESCR Recommendations, including the introduction of OST in Russia. The President’s administration forwarded this request to the Ministry of Health, which responded to ARF with false information on the ineffectiveness of OST. ARF did not request information on the efficacy of OST. ARF submitted a new request to the President asking for an appropriate reply. However, the President’s Administration responded that the initial reply would suffice.

On January 10, 2012, ARF submitted a complaint to the district court against the President’s Administration and the Ministry of Health, claiming that both had violated the right to a reply on the merits and the right to receive objective, accurate information about the affairs of the state bodies. In July 2012, the district court dismissed the complaint based on the constitutional provision of separation of powers. According to the district court, the court cannot pass judgment mandating the President’s Administration to propose certain laws. ARF did not request the court to pass judgment; it requested the court to mandate the Administration to fulfill its obligations to reply to citizens on the merits of their petitions. An appeal was filed in July 2012 to the Moscow City Court and on October 2, 2012, the court of appeal upheld the judgment of the district court. ARF is preparing an application to the UN Human Rights Committee claiming the violation of the right to receive reliable information on the matters related to the implementation of the International Covenants on Human Rights.

Results and Lessons Learned

The work of ARF demonstrates successful advocacy for OST and other harm reduction services on an international level. Nevertheless, Russia continues to void its international treaty obligations and has in fact retaliated against ARF by persecuting its staff for challenging the legal ban on OST. On February 3, 2011, it shut down the entire ARF website. ARF continues its advocacy work at the domestic level through court-based challenges, calls for changes to domestic drug-related legislation and policies, calls for international attention to ARF website closure, and ongoing recommendations on further actions to protect the human rights violations of people who use drugs.