A prominent watchdog group has released a report saying civil rights abuses against intravenous drug users and sex workers in Kazakhstan are fueling one of the fastest growing HIV epidemics in the world. In its report, Human Rights Watch documents instances of brutality, lack of due process, harassment, and stigmatization that are driving drug users and sex workers underground and impeding their access to HIV-prevention services.
Prague, 4 July 2003 (RFE/RL) -- By global standards, the prevalence of HIV/AIDS remains relatively low in Kazakhstan, but the country is suffering from one of the fastest infection rates in the world.
In 2002, the Kazakh government estimated some 25,000 persons were living with HIV/AIDS. Kazakhstan is believed to have more than double the number of persons with HIV/AIDS than the other four Central Asian nations combined.
According to UNAIDS, which coordinates UN AIDS programs, 85 percent of new HIV/AIDS cases in Kazakhstan involve intravenous drug users, of which there are some 200,000 in the country.
In a report released this week, New York-based Human Rights Watch (HRW) says the HIV/AIDS epidemic in Kazakhstan is being fueled by human rights abuses against intravenous drug users and sex workers.
Marie Struthers is a Moscow-based consultant for HRW on Central Asia and Russia and was a co-researcher of the report, titled "Fanning the Flames."
She says, "Routine police abuse, including instances of violent police brutality, a lack of due process, and constant harassment and stigmatization drive injecting drug users and sex workers -- who are among the persons most vulnerable to contracting the HIV virus -- underground. And this means that it increases their reluctance to approach services, which could result in saving their lives."
Struthers says sex workers, whose numbers have grown dramatically since Kazakhstan's independence in 1991, are regularly raped, beaten, and extorted by police.
Struthers says drug users are often arrested for possessing small amounts of narcotics. She says police find it easy to pin false charges on them, and that they are convenient targets when arrest quotas need to be fulfilled.
"Qazihan" -- who didn't want his real name used -- is a drug addict in Kazakhstan and spoke to RFE/RL about what he alleges is police harassment of drug users.
"The KNB [security] service and police are controlling all the drug dealers. Ask any drug addict, and he will tell you about it. Go to five, 10, 20 points where they sell drugs. There is always a police car parked nearby. The police control everything. They do nothing to drug dealers, but they arrest the poor drug addicts, those who took 500 tenges (less than $4) from their parents to buy a dose. Then their parents have to bribe the police by giving them $100 to $800 every time they detain their child. Otherwise, the kids go to jail. That is business."
Natasha is a drug addict at the Almaty City Rehabilitation Center. In an interview with RFE/RL, she also alleged police brutality.
She said the police "treated me as if I were an animal. They used bad words to offend me. Two policemen even tried to rape me. They did not consider me a human. Some of my acquaintances -- girlfriends -- were raped in a circle, one by one, by many policemen."
Nurlan Abdirov, the chairman of the Anti-Drugs Committee at Kazakhstan's Justice Ministry, declined to comment on the allegations. He says his ministry is working on all these problems in cooperation with the United Nations.
Struthers of Human Rights Watch says the Kazakh government has taken some positive steps in combating HIV/AIDS by setting up health centers and needle-exchange programs. The country established a five-year prevention and treatment plan to combat HIV/AIDS for 2001-2005 that is estimated to cost about $150 million, most of which is expected to come from outside sources. And she notes the government has taken the progressive step of ordering a full review of existing laws and regulations with respect to international standards on HIV/AIDS and human rights.
But Struthers insists the Kazakh government needs to set a tone of tolerance and respect for the rights of intravenous drug users, sex workers, and people living with HIV/AIDS.
According to Struthers, many of those who are infected with HIV/AIDS hesitate to access information that could save their lives because they fear they will be detained or identified. Some drug users told HRW they are reluctant to use AIDS centers that feature needle-exchange facilities or condom distribution.
"We have a situation where one state agency is working against the other, even though these AIDS centers have been set up and are operating under the auspices of the Ministry of Health," Struthers says. "We have the law enforcement agents who are working against this by harassing and stigmatizing drug users and sex workers, making them reluctant to approach these services. Because if they approach these services, then they're identified as either a sex worker or a drug user, which then subjects them to this abuse and harassment."
Struthers stresses that police abuse only contributes to discrimination already being felt by Kazakhs infected with HIV/AIDS. These include abandonment by their families, rejection in the workplace, and discrimination in access to government services.
Few people with HIV/AIDS in Kazakhstan have access to modern drugs. Intravenous drug users are particularly excluded from this treatment.
Gaukhar Isaeva is head of the Jusan Rehabilitation Center for HIV patients and drug addicts in Almaty.
"The problem is that there is not a single concrete organization solely treating AIDS patients in Kazakhstan," she said. "There might be many articles in the press [about AIDS], and there are many discussions, but those discussing that issue have not seen HIV patients with their own eyes. There are no organizations uniting HIV/AIDS patients and protecting their rights in Kazakhstan."
Struthers urges the Kazakh government to end its policy of forcibly testing all detainees for HIV, as well as the policy of segregating HIV-positive prisoners. Moreover, she says the government needs to institute a long-promised pilot program of methadone treatment that would allow some heroin users to avoid injecting drugs.
Though the situation is most severe in Kazakhstan, HIV/AIDS is also seriously threatening the four other Central Asian republics -- Uzbekistan, Kyrgyzstan, Tajikistan, and Turkmenistan.
Struthers notes that preliminary reports from these countries point to the same kind of abuses that are helping the epidemic spread in Kazakhstan. This is particularly worrisome, she adds, because those countries have so far taken fewer steps to combat the virus.
The full text of the HRW report can be found at www.hrw.org/reports/2003/kazak0603/
(RFE/RL Kazakh Service Director Merhat Sharipzhanov contributed to this report.)