Russia is besieged by an HIV epidemic that’s largely invisible to the outside world. Medical professionals blame this public-health crisis on an unchecked outbreak among injecting drug users and President Vladimir Putin’s refusal to accept outside help. Driven by the same anti-Western impulses that have led to the worst political tensions in decades, Putin’s government has turned away international aid while banning methadone, needle exchanges and other proven HIV prevention strategies. As a result, 21 percent of the world’s HIV-positive injecting drug users live in the country and new cases are rising faster there than any nation with a large number of infected people, including South Africa.
The story documents Russia’s health emergency through people living under Putin’s policies – from a Moscow drug user who lost his wife to the virus and can’t get help to stop shooting up a homemade concoction – to addicts confined to a decrepit hospital known as “The Last Way.”
We contrast Russia with Ukraine, which has implemented Western-style prevention strategies that have decreased its new HIV infections. That progress is likely to stop: One of Putin’s first steps in annexing Crimea in February was to discontinue methadone treatments. Ukrainians are returning to street drugs – with the potential for HIV cases to begin rising.