UZBEKISTAN: SWISS CONCLUDE DRUG HARM REDUCTION PROJECT AT

C O N F I D E N T I A L SECTION 01 OF 02 TASHKENT 001023 SIPDIS DEPARTMENT FOR INL ANDREW BUHLER AND THE OFFICE OF THE GLOBAL AIDS COORDINATOR ANKARA FOR DEA CHRIS MELINK ASTANA FOR ALMATY USAID AMEMBASSY BELGRADE PASS TO AMEMBASSY PODGORICA AMEMBASSY ATHENS PASS TO AMCONSUL THESSALONIKI AMEMBASSY MOSCOW PASS TO AMCONSUL YEKATERINBURG AMEMBASSY HELSINKI PASS TO AMCONSUL ST PETERSBURG AMEMBASSY MOSCOW PASS TO AMCONSUL VLADIVOSTOK E.O. 12958: DECL: 2019/06/19 TAGS: PREL PHUM KHIV SNAR SZ DEA UZ SUBJECT: UZBEKISTAN: SWISS CONCLUDE DRUG HARM REDUCTION PROJECT AT UNCERTAIN JUNCTURE CLASSIFIED BY: Timothy P. Buckley, Second Secretary, Department of State, Political and Economic Section; REASON: 1.4(B),(D) ¶1. (SBU) Summary: The Swiss Embassy in Tashkent marked the end of what it saw as a successful six-year drug harm reduction project, which included provision of clean needles and condoms to thousands of drug users in Uzbekistan with the goal of stopping the spread of disease, particularly HIV and viral hepatitis, before focusing on treatment for drug addiction. However, the Government of Uzbekistan is not stepping forward with funds to continue the work, which could cause local NGO partners to suspend services. UN officials also reported government backsliding on HIV programs, with authorities reverting to denial mode on domestic policy towards drug users. We remain optimistic that a planned INL drug demand reduction program will go forward since it focuses on prevention rather than treatment, and the Swiss hope that the U.S. will be more open to needle exchange programs. End summary. ¶2. (C) On June 12, poloff attended a reception hosted by Swiss Ambassador Anne Bauty marking the closure of the Swiss-Uzbek project on reducing the harmful consequences of illicit drug use. It was a bittersweet event since, after six years of collaboration, the key local NGO partners and two client service centers will lose funding support. Jakob Huber, representing the Swiss Ministry of Health, had been the point person since the project's inception in 2003, and he told poloff that the Government of Uzbekistan seemed unlikely to ante up any funds to continue the work. Huber also noted that the initial project was for a 3-year timeframe but that Switzerland extended it for an additional three years in the hopes the progress would encourage the government to carry on. "They are actually backsliding," Huber (protect) lamented, opining that "the NGOs were essentially told they have been too successful in reaching people and they need to tone it down." An NGO worker from "Ayol" (meaning "Woman" in Uzbek),which does a range of other work, confirmed that no additional funds were on the horizon and her organization would have to find other ways to make ends meet or suspend services. ¶3. (SBU) Huber explained that Swiss drug policy has four pillars: prevention, therapy, law enforcement, and harm reduction, with the latter being the main focus in the Swiss-Uzbek project. "They only reach a drop in the ocean with reliance on law enforcement," according to Huber, "and when we opened our centers in Tashkent and Samarkand we immediately began reaching 2,500 on a daily basis - far more than the Uzbek system reached in a month." The immediate goal is to try to stop the spread of HIV and other sexually transmitted diseases among drug users by providing clean needles and condoms, with treatment to break the addictions to follow gradually. Uzbekistan's National Center for Drug Control, under the leadership of former Director Kamol Dusmetov, recognized the importance of addressing the serious and growing societal threat posed by drug use and provided political support for the project even though the methodology was considered very sensitive in this society. ¶4. (SBU) Poloff noted that the U.S. Embassy has previously supported drug demand reduction projects through the Bureau of International Narcotics and Law Enforcement Affairs (INL) as well as USAID and that a new INL project was set to begin soon under the auspices of the United Nations Office on Drugs and Crime (UNODC). Huber stated that drug demand reduction is helpful but that it will not reach enough drug-users to stem the spread of diseases, which is especially needed given the volume of drugs emanating from Afghanistan and the infiltration throughout Uzbek society. Huber urged the U.S. to consider supporting the type of needle exchange and condom distribution project that the Swiss advocate, which he said was inconsistent with past U.S. policies. He reminded that "many prostitutes are also drug users, so you need to do something to stop them from spreading disease as well as from just among drug users." Huber also said there are some "very progressive" programs TASHKENT 00001023 002 OF 002 that he has visited in the U.S. that could be role models for U.S. assistance, but he understands they were not previously eligible for Federal funding support. No More Drug Addicts in Uzbekistan -------------- ¶5. (C) James Callahan, Head of the United Nations Office on Drugs and Crime (UNODC) Regional Office in Central Asia, told poloff on June 15 that Uzbekistan was backsliding on HIV prevention and had formally stopped its drug substitution therapy program. UN Representative in Uzbekistan Anita Narody (please protect) noted in a June 15 e-mail message to other UN officials that "this is clearly very disturbing" and "has serious implications for the Global Fund." Dr. Michael Tailhades (please protect) from the World Health Organization confirmed this in an e-mail response and added that Uzbek authorities instructed his organization to refer only to ex-drug addicts "as officially there are no more drug addicts in Uzbekistan." Tailhades added that "I believe we are taking a step back that will definitely close the door to Global Fund application." Callahan agreed that it was "certainly a step backward" but noted that it would not affect the planned INL-funded drug demand reduction program since it is not a treatment project. Comment: -------------- ¶6. (SBU) We submit Mr. Huber's recommendations as feedback from the field to guide future programming discussions and do not have sufficient insight to advocate for programs like those the Swiss Embassy has sponsored. Nonetheless, it is impressive that in a restrictive environment that so many Uzbek drug users were willing to regularly visit the two safe houses rather than stay away out of fear that law enforcement agencies would arrest them. Many Uzbeks will certainly miss the loss of a social service, yet the Government of Uzbekistan appears to have decided to simply let the activity cease rather than step in to pick up where the Swiss left off. We also share the concerns of Huber as well as UN officials about the apparent backsliding on drug and HIV policy. NORLAND