Russia came under fire from international AIDS campaigners on Wednesday for refusing to provide drug users with drug substitution therapy to stem a spreading HIV epidemic.
Russia's chief medical official Gennady Onishchenko told a major AIDS conference that Moscow opposed providing methadone -- a synthetic drug that is not injected -- to heroin users.
He said that Russia preferred to use other methods in fighting the spread of HIV, including calling on the authority of the increasingly powerful Russian Orthodox Church.
"Russia speaks out categorically against this component in prevention programmes," Onishchenko told the Eastern Europe and Central Asia AIDS Conference, adding that methadone is outlawed in Russia.
But in a country where 500,000 people are infected with the HIV virus, international speakers at the conference expressed disappointment that Russia could be ignoring a potentially crucial method to stem the spread of HIV.
Giving methadone to drug users reduces HIV infection among the most vulnerable group and helps those infected lead more stable lives and take live-saving antiretrovirals, international campaigners say.
Michel Sidibe, executive Director of UNAIDS, called methadone provision "an essential element of universal access to HIV prevention" and called for Eastern European countries to introduce the programmes.
"I fear that in this region the legal barrier to harm reduction programmes also makes injected drug users a target for harassment, driving the people most affected by this epidemic underground," Sidibe said.
Noting that Russia had increased its anti-AIDS funding 30 times since 2006, he said the country "needs to transform this great statement into access to prevention for most at risk for HIV."
"This is the only region of the world where the epidemic isn't turning the corner," said the executive director of the International Aids Society, Robin Gorna said.
She praised Russia for its "impressive" improvement on treatment levels, but argued with Onishchenko, saying that over 200 pieces of research support methadone programmes.
"There have been numerous reports that have shown the effect of opiate substitution," Gorna said, citing a World Health Organisation report from 2009 that showed HIV infection rates cut by half.
Onishchenko replied that "we so far haven't seen convincing proof that methadone therapy gives an effect. There isn't any exact data."
He said that Russia is an exceptional case due to the amount of drugs flowing in from Afghanistan and said methadone therapy would lead to "free drug trading."
"We use more humanitarian but not dubious methods to solve the question," Onishchenko said, adding that the country was pinning "huge hopes" on its religious leaders.
"The Russian Orthodox Church around three years ago presented a concept of working with HIV infected people and prevention," he said.
"Our country is turning from atheism to faith," Onishchenko said. "It's good and helpful.
More than 60 percent of those infected with HIV in Eastern Europe and Central Asia received the virus through intravenous drug use, Onishchenko told the conference.
Onischehnko said that Russia will invest no less on prevention programmes in 2010 than it had promised over the last three years.
Michel Kazatchkine, executive global director of the Global Fund to Fight AIDS, Tuberculosis and Malaria told AFP that Russia stood in stark contrast to Ukraine, which had introduced methadone programmes.
"I think Dr Onishchenko is a genuinely committed physician to public health, he perfectly understands the problem, he has to manoeuvre between tensions," said Kazatchkine.
"We have difficult times with strong conservative opinion, with xenophobia and homophobia and an economic crisis as well."