 Hello, everybody. I hope you're enjoying your lunch. I'll be talking a little bit about Consequences of policies because this is broadly what we are talking about Under the banner of estimating the costs of drug policies So I'll briefly focus on a few examples from our region how the drug policies Actually impact the health and the rights of people who use drugs and And it makes fairly easy for me to talk about that because I come from the region We have the highest number of people injecting drugs and We have also the most prevalent HIV epidemic Could you Steve, please? next so In terms of applying the counter-costs ideas to the region what we can do Is ask whether the policies that the countries pursue have any kind of positive or for that matter negative effect So let me start first of all with Russia the country which has the highest population of People that inject drugs and one of the highest HIV prevent prevalence rates among injecting drug users Also hepatitis C Infection is reaching about 90 percent about Among the people that use drugs which in itself is an indication that some something is not working So let me just guide you very briefly on what is the policy response to that? Despite that that there is half a million people living with HIV and most of them up to 80 percent would get HIV Related to unsafe sharing of injecting equipment Right now the budget for HIV in Russia is about 600 650,000 million dollars and This is for the period for each year from 2011 to 2013 and if we see how much of this money goes for the prevention of further health related harms We will see that less than 3% and further in time only 1% would go for HIV prevention We can see clearly that that amount of money won't be enough to provide efficiently even HIV tests Which means that less people will be diagnosed with HIV and therefore enrolled in HIV treatment. So that's sort of to illustrate how the prevention work is done in Russia There is also no federal funds for needle exchange programs all the programs that are Working in countries in the country. They are sustained only on the international funds And this is happening at time when Russia for example provides to UNODC the grant of more than What was it 500 million dollars? and Just basically by the end of 2012 when the global fund leaves the country there will be no harm reduction in the country at all so And the Ministry of Health has a very clear policy message It says that there is no need for needle exchange as there is effective state policy And If we look at the policy At the end of 2010 the new drug strategy was approved in the country and What it does it actually refers only briefly like in two places to such drug-related harms as HIV hepatitis C or TB and it actually Stipulates that the main objective of Russian drug policy is to form negative Approach in the society towards drugs Which means that almost two million people that are injecting drugs and the country are Some more alienated discriminated against and feel and will Feel stigmatized by the official policies Moreover that the drug strategy that is now approved in Russia It concerned it considers harm reduction being a risk to the implementation of The policies of the official policies which as I mentioned has the goal of forming negative attitude towards drugs So here most probably as we gather in Vienna and what we can talk about is how Countries comply with their international commitments We don't need another eight years which will take to evaluate the new political declaration which was adopted in 2009 to see that Russia won't reach the objectives of effectively forming drug demand policies and That's the call that we have to use because none of us since we are not Russian and we don't work for Russian government none of us can Can help Russia accountable for that for the fact that actually drug policies go against The constitution of the country with which sees health health and well-being for all its citizens So as I mentioned the official approach is this zero tolerance towards drugs and Another slide please oh Okay, because I cannot see them from here. Sorry So what in terms of applying county costs ideas or approach We should ask well what kind of positive effect or what kind of effect such Zero tolerance policies can have and already now we can see that the negative attitude towards people that use drugs and towards heroin which is followed by extensive law enforcement Against people that use drugs and also over stress and over stress of Drug supply reduction What we see is right now in the country a lot of people would switch from heroin which is less accessible and which is Expensive and Which is of bad quality a lot of people would switch to the semi legal drugs Meaning the drugs that can be prepared using the substances that they can Get in the pharmacist for example and what we see is that it further increases the risk risks of HIV infection Because usually those people would inject more often that they would inject Heroin and what we see that there is no means to prevent HIV infections because there is no harm reduction in the country No needle exchange that Programs supported by the country so What we see here that? The policies actually have more negative effect and instead of looking at the social economic and cultural Means that that might drive the epidemic of injecting there is Sort of discontent between the means that That the country would imply and the effects that it would have And now moving to another country Yes, Georgia Here let me tell you a little bit about how Georgia approaches the drug policies and here It's most probably worth mentioning that Georgia is one of the Soviet countries that was first to introduce them Registry of drug users during the Soviet times It was one of the countries that had one of the most harsh policies based in fear and punishment so If we can could find one word to define the policies of Georgia, we can call it the policies of fear Because what they do is they think that if they would criminalize use They would prevent young people from further using drugs and that's the official position of the government So how is it expressed in terms of political means? It's put into practice by Testing people on the streets for drug use And random street drug testing which has more than 50,000 people tested Each year Which cost to the country on more than 10 million dollars Um The same amount actually almost ten and a half million dollars is collected in fines from those people that at as that attested positive Um in comparison Home reduction Measures reaches about five to ten percent of people that use drugs meaning that there is much less investment in Health-based services than into law enforcement And more money overall is spent on the forced Testing of people on the streets then all together into drug prevention and HIV prevention together And let me just quote how it's justified The high-level official which I was asked not to disclose Said that if drug users are able to fund their habit why should not we force them to contribute to the state budget as well? Apparently the government thinks that if you contribute to the government you don't necessarily have to get anything in return because there is no Home reduction that could reach most of the people that use drugs But let's say well that's okay. We have this logic The government collects and finds almost the same amount that is spent then on testing So the next question to ask is what is the effect and what is the result of such policies? Does it work does the policy of fear of people fearing to get caught affect their injecting behaviors so what the study done and Georgia found which had like 500 drug users interviewed it found that it actually had no significant influence on their drug related behaviors They were caught in the street and put into prison They would continue with their drug use because even if they are put into prison. There is no health services provided in prison Of course we can talk a lot About more human dimensions such as stigma and discrimination of the people that are put into prisons only for their drug use Of course, it's overburden of the judicial system and The four years that this Random street drug testing was implemented. They estimated 25 percent of Prisoners that serve sentence. They say they say serve sentence for drug Offenses and majority of them are drug users Within the last years the prison population has increased five times and Georgian our second among the former Soviet Union countries second also to Russia for the imprisonment rates More than 1,000 people is imprisoned each year based on this street Drug testing and there is actually no harm reduction services in the prison. So they're left at even increased risk for their health and Talking about very practical thing is we can estimate that patrol policemen that collect truck users in the street would spend more than one day for one per one truck user to Get that person to police to test that test them and to proceed the papers to the court So here we can ask whether it's the most Sort of violent crime that affects the public security and public safety That that we want the police to spend their time on and If we look into it even more then we can see that people that have to pay Fines for their drug use and finds if the person is caught for the first time he has to pay 500 Georgian Larry, which is almost twice of the average salary, so most of the people that will have to pay fines About 85% of those that responded they said that they would go Where that would have to get engaged in the criminal activity to get the money to pay the fine So they wouldn't have to go to prison or they would Sometimes even sell family properties and had to live on the streets as a result of this And last Okay, sorry, I cannot see what's there The last country I think if we talk about them Policy approach is the one that is more or less suitable for most of the countries in Central and Eastern Europe and Central Asia Those countries that sort of have two different policy streams Here I will talk specifically about Ukraine which is had which has the highest HIV prevalence in the region 1.4% of the whole ukrain population is estimated to be living with HIV and most of them get infected through sharing of injecting equipment so The logic here is that on one side the government wants to fight the unintended consequences for health and On one side the government struggles with those health consequences for example if we take Ukraine The budget that is spent on HIV in AIDS is increasing vastly But if we once again look on how much is spent for the prevention measures We'll see that it's less than 1% of all actual Spendings and we have numbers that is actually is either spent from the government from the budget for 2009 and 2010 and the plan number for 2011 we can you can see that there are some funds left It's not like the government doesn't have any more money for prevention for efficient prevention But they just don't ascribe that money for the prevention so At the same time with the help of the global fund There is exceeding services available for drug users such as substitution treatment and harm reduction services you can see that the Number of people that get substitution treatment is increasing as well as the Overall capacity of services to reach the people that use drugs is increasing Next one Then on the other hand There is those structures in the country that would prevent any kind of positive effect of those Spendings and those services paid by the government and by the global fund in this case So that it would reach a positive effect on health So let me just Briefly tell you what's going on in parallel to that in September of 2010 a new concept of drug policy was Approved and it doesn't have any mention about treatment On measures for treatment of drug dependency moreover in October of 2010 will witness the decrease of Amount of drugs for personal possession And Now it means Looking at the digital practice. We can see that even the traces of drugs left in needles Can be used in courts to put people in prisons that means that despite the increasing investment into the fight against the consequences of drug use What's going on that in parallel those people? Won't access the service because they would be put into prisons They would be afraid to go and get help and would be afraid to go and obtain the health services Because they would be afraid to get arrested So Briefly, I think I just wanted to highlight how the logics of different policies work in the region and Last point what I want to say as we talk here on the in Vienna about the international conventions I think for us the rationale behind the 50 years on drugs and why we need to Reconsider whether the truck conventions matches the needs now is very simple for us Who are promoting the rights and health of people who use trucks? It's very simple that they were developed right before the HIV and Hepatitis and other infections and other drug related harms were known to us And now it's there is enough evidence if we use the argument for health impact of the policies we can see why The current international drug regime doesn't work and doesn't respond to those needs anymore. Thank you