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

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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

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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:

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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