We, the undersigned non-governmental organizations representing affected communities and
working in the field of HIV/AIDS prevention, care and treatment, in Canada and around the
world, address you in advance of the Millennium Development Goal 6 (MDG 6) International
Forum taking place in Moscow, Russia on October 10–12, 2011. This meeting is a critical
opportunity to urge the governments of countries from the region to live up to their commitments
in meeting MDG 6 goals by 2015.

Eastern Europe and Central Asia has one of the fastest growing HIV epidemics in the world,
with Russia and Ukraine together accounting for 90 percent of new HIV infections in this
region.1 Injecting drug use remains a major driver of the epidemic in these countries. In Russia,
the number of opiate users is estimated at 1.7 million,2 the majority administering opiates
through injecting. Globally, 37 percent of people who inject drugs live with HIV,3 and in some
regions of Russia, HIV prevalence amongst people who inject drugs is as high as 61 percent.4

Russia has positioned itself as a regional leader in the fight against HIV/AIDS, despite the fact
that it is currently providing very limited funding for evidence-based HIV prevention among
people who inject drugs. Critical HIV prevention programs for drug users, including needle and
syringe programs (NSP), are currently supported largely through the Global Fund to Fight AIDS,
TB and Malaria. This external funding is time-bound and is currently only reaching an estimated
7 percent of those in need of these vital services.5 Opiate substitution therapy (OST), recognized
by the WHO, UNAIDS and UNODC as the most effective means of opioid dependence
treatment and of reducing HIV among people who inject drugs, is illegal. Such an approach is
untenable given the nature of the epidemic in Russia as well as the wider region of Eastern
Europe and Central Asia. Russia’s rejection of these evidence-based policies — endorsed by UN