(Repeats to fix garble in section "Population Problems")
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* Russia has world's third highest heroin abuse rate
* Government neglects addicts, bans methadone treatment
* Inaction, dirty needles, fuel HIV/AIDS epidemic
* Moscow says foreign health groups make problem worse
By Amie Ferris-Rotman
TVER, RUSSIA, Jan 25 (Reuters) - In her one-room flat, as a small shelf of porcelain cats looks on and the smell of mould hangs in the air, Zoya pulls down the left shoulder of her black blouse and readies herself for her next hit.
A friend and ex-addict uses a lighter to heat a dark, pebble-like lump of Afghan heroin in a tiny glass jar, mixes it with filtered water and injects it into Zoya's shoulder. The 44-year-old widow is a wreck: HIV-positive, overweight and diabetic. After 12 years of dealing and drug abuse, the veins in her forearms and feet are covered in bloody scabs and abscesses, too weak and sore to take fresh injections.
Crimson-dyed hair frames her bloated face, which is made up to match a hot pink manicure. As the syrupy brown mixture enters her system, Zoya's eyes glass over and she ponders her fate and that of her country.
"There are a lot of us. What do they (the government) want to do? Kill us?" she says. "They want to gather us together and drown us? I worry for tomorrow's generation."
If Zoya is anything to go by, today's Russians are hardly flourishing. Russia has one of the world's biggest heroin problems, with up to three million addicts according to local non-governmental organisations. Twenty one percent of the 375 tonnes of heroin produced from Afghanistan's opium fields now finds its way through central Asia into Russia, according to the United Nations. (By contrast, China, with nine times more people, consumes just 13 percent.) The Russian government estimates its citizens bought ${esc.dollar}17 billion worth of street-traded heroin last year -- about seven billion doses. The addiction kills at least 30,000 Russians a year, which is a third of the world's total heroin-related deaths, adding to pressures on the country's already shrinking population.
So grave is the problem that President Dmitry Medvedev last year branded heroin a threat to national security.
That's one reason why last October, 21 years after the end of the decade-long Soviet war in Afghanistan, Russian troops joined forces with U.S. soldiers for a joint drug raid on four Afghan labs. The operation, which destroyed nearly a tonne of heroin, was hailed a success and the Cold War foes said they would like to see more such operations in Afghanistan, which is responsible for 90 percent of the world's heroin production.
At home, though, Russia has been far less active in tackling the problem. Critics go as far as to accuse Moscow of wilfully neglecting its citizens and thereby fuelling what the World Health Organisation says is one of the fastest growing HIV/AIDS epidemics in the world.
Unlike most countries around the world, Russia refuses to finance harm reduction programmes such as needle exchanges, or to legalise methadone. Over the past few months, Moscow has decided to discontinue the work of foreign donors and NGOs with heroin addicts. It even recently blamed foreign groups for worsening the country's HIV epidemic.
Health experts and drug addicts alike point to official inaction as the real culprit. It's as if Moscow has misinterpreted the old U.S. anti-drugs slogan "Just Say No" and turned its back on the crisis. "My government does nothing for me. I am no longer a person in this society," says Zoya, who lives in Tver, a drab city of half a million just off the Moscow-St Petersburg highway, and whose husband, also an addict, died from AIDS several years ago.
Anya Sarang from the Andrey Rylkov Foundation for Health and Social Justice, a small UN-funded Russian organisation set up in June 2009, says Russia is failing its people. "For the main groups prone to the disease -- drug users, sex workers, migrants -- there is absolutely nothing for them," says Sarang.
THE PROUD BEAR
Russian officials have a long history of denying crises. From the Soviet government's refusal to help during the famine of the 1920s to its delay in responding to the 1986 Chernobyl nuclear accident, responses from the top have often mixed disregard and cover-up. During last August's heat wave, as peat fires and acrid smoke killed hundreds, officials kept silent on the wider health effects of the smoke for weeks.
One of the reasons for the rush to denial lies in the national psyche. Russia is a deeply patriotic country, with a long history of strong governments far removed from the everyday concerns of ordinary citizens. After the humiliating collapse of the Soviet Union 20 years ago and the calamity and poverty that followed, the strongman rule of Vladimir Putin (former president and current Prime Minister) has allowed the Russian bear to flex its muscles on the international stage again.
But while Moscow crows about hosting such high-profile sporting events as the Winter Olympics and soccer World Cup, it ignores daily reality, says health worker Sarang. "Russia is trying to preserve a certain political image, showing that everything is fine," she says. "This has shown to be nothing more than a lie."
Most Russians see the truth all around them. Zoya's story is repeated so often across the country's nine time zones that the reality is hard to ignore. Even the government estimates there are 1.8 million heroin users; activists and doctors put the number closer to 3 million, and in a study last June, the United Nations put it at 2.34 million or 1.64 percent of Russia's population. That's the world's third highest heroin abuse rate in per capita terms after Afghanistan and Iran. In absolute numbers, the UN says, Russia is number one.
Heroin was virtually unheard-of during the Soviet era, but is now easy to buy in any city in the country. In Tver, a medium-sized city with relatively little industry and few job prospects for the young, the detritus of addiction -- used syringes, needles -- litters the streets. Deals are a regular sight on street corners.
Russia's anti-drugs tsar, Viktor Ivanov, who heads the Federal Drug Control Service -- a powerful government body given to U.S.-style rhetoric about the 'War on Drugs'-- blames the country's porous Central Asian borders for the heroin hunger.
"Unfortunately, in 1991 we suddenly found ourselves without borders," Ivanov told reporters in December, referring to the collapse of the Soviet Union.
Ex-Soviet Tajikistan, which borders Afghanistan and is one of the world's poorest countries, has long been a haven for drug smuggling out of Afghanistan, where the Tajiks have ethnic ties. From there the heroin flows through Kyrgyzstan and Kazakhstan and into Russia. <^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Russian HIV prevalance rate: http://graphics.thomsonreuters.com/11/01/GLB_AIDSR0111.gif
Aids drugs use: Russia and others: http://graphics.thomsonreuters.com/11/01/GLB_AIDST0111.gif
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