Pubdate: Sun, 23 Jan 2011 Source: New York Times (NY) Copyright: 2011 The New York Times Company Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html Website: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Referenced: http://www.mapinc.org/drugnews/v11/n037/a01.html Author: Maria Golovanevskaya H.I.V. IN RUSSIA To the Editor: Russian government reluctance to providing methadone treatment or clean needles is only one of the fatal impediments to effectively addressing H.I.V. in Russia ("Inadequate Fight Against Drugs Hampers Russia's Ability to Curb H.I.V.," Memo From Russia, Jan. 17). Access to antiretroviral treatment, despite government promises to make it universally available, continues to be denied to injecting drug users, who are the majority of those infected. A recent study in 19 cities found that in half, medical commissions used questions about drug use as criteria for denying treatment. An outdated Soviet-era system of linking health care to residence means that thousands of internal migrants can't get care. Organizations of people living with H.I.V. have also documented consistent irregularities in how Russia procures H.I.V. medications and prices paid for medications that are far above market value - suggesting that while those most at risk are not benefiting from the national AIDS program, corrupt officials may be. Russia's increasing allocation of resources to stop its H.I.V. epidemic is commendable. Yet these efforts will be in vain unless drug users and other vulnerable groups who are most affected by H.I.V. are placed at the core of the country's treatment and prevention strategy. Maria Golovanevskaya The writer is program officer for the Open Society Foundation's Public Health Program. - --- MAP posted-by: Richard Lake