A quarter century after the dissolution of the USSR in December 1991, an HIV epidemic, closely bound up with massive heroin consumption, is raging in Russia. It is a devastating indictment of the social catastrophe that was brought about by the restoration of capitalism.
According to Vadim Pokrovski, head of the Federal AIDS Centre in Moscow, around 850,000 Russians were diagnosed with HIV at the beginning of 2016. Another 220,000 have died of AIDS since the late 1980s. He estimates that another half-million Russians are infected, but not diagnosed, with HIV. An estimated 100,000 were newly infected in 2016.
This is by far the highest rate in Europe and constitutes almost 1 percent of the total population of Russia. The HIV epidemic has reached bigger dimensions only in sub-Saharan Africa. The development in Russia is contrary to the international trend: According to data by UNAIDS, the worldwide number of new HIV infections declined by 6 percent since 2010. Even in Africa, while the infection rate is still high, the epidemic is not spreading. By contrast, the number of new infections in the former USSR rose dramatically by 57 percent.
In several regions, HIV is now officially recognised as having reached the stage of an epidemic, with more than 1 percent of the population infected. This includes the oblast Sverdlov, where some 1.7 percent of the population have HIV, as well as the oblasts Tomsk, Novosibirsk, Cheliabinsk, Samara, Irkutsk, Perm and Krasnoiarsk.
Most of these regions were important centres of Soviet industry. In some areas up to 5 percent, often men between age 20 and 40, are HIV-positive, according to the German daily Frankfurter Allgemeinen Zeitung. Russian Health Minister Veronika Skvortsova has warned that the epidemic might get out of control by 2020, with the number of infected possibly rising by up to 250 percent.
The spread of the virus is made easier by the fact that there is little to no education about HIV and other sexually transmitted diseases in schools and the public sphere. However, a more significant factor for this horrendous number of sick is the heroin epidemic that has been raging in the country since the 1990s.
The great majority of new HIV infections—54 percent according to official data, others estimate up to two thirds—are a result of the use of infected needles. Most people who are HIV-positive were or still are addicted to heroin. According to UNAIDS, in 2013 1.8 million Russians were injecting drug users, more than in any other country in the world.
The medical journal The Lancet reported that 90 percent of those drug users are also infected with hepatitis C and 24.6 percent of them with HIV. Although Russia’s population of 146 million comprises only 1.9 percent of the world’s total population, the country accounted for a third of the world’s total heroin deaths in 2010 (30,000). The Federal Agency for Drug Control reported that annually about 90,000 young people aged 15 to 34 die of drug overdoses. There are a total of between 8 and 9 million drug addicts in Russia, according to official numbers.
Given that many heroin addicts learn only later about their HIV infection, thousands of children are born every year with HIV, as their mothers cannot take the needed medication in time during their pregnancy to prevent the infection.
Even though the massive drug consumption has been recognised by the Kremlin as a problem—in 2009, the then incumbent president Dmitri Medvedev declared drug abuse a “threat to national security”—neither the sources nor the consequences are being seriously combatted. The reason is that this horrendous drug epidemic is a result of capitalist restoration, the social and historical basis for the ruling oligarchy.
The consumption of heroin exploded in the 1990s under conditions of a catastrophic social crisis. The scale of the socioeconomic disaster that hit millions of workers and youth virtually overnight is still difficult to grasp. The Russian GDP collapsed by around 40 percent, more than during the Great Depression in the US in the 1930s. The last time a similar economic breakdown occurred in Russia was during the Nazi war against the Soviet Union.
The hyperinflation, which amounted to 10,000 percent between 1991 and 1995, threw broad layers of the working and middle classes into extreme poverty. While a small layer of former Stalinist bureaucrats and rising criminals shamelessly enriched themselves, and mafia turf wars raged over the control of the raw material resources of the country, millions of workers could feed their families only by growing their own food or searching for it in the forest. Life expectancy declined dramatically, particularly for men, and the rates of child mortality and suicides rose rapidly. Between 1991 and 2015, an estimated 1 million Russians ended their lives with suicide.
Especially industrial centres like Yekaterinburg in the Urals and the “mono towns”—industrial cities that had been built around one or a few enterprises—were socially devastated. Workers on a regular basis had to work for months without receiving their salary, or only a portion of it. Unemployment, virtually unknown in the USSR, became a serious social problem for millions of families. In the countryside, people witnessed how the destruction of the kolkhoz (collective farm) system resulted in a collapse in agricultural production and the entire social infrastructure.
The social crisis was complemented by a political one: decades of Stalinism and its eventual collapse left the working class politically disoriented and without a perspective. The generation of 15- to 35-years-old, who are now forming the bulk of drug addicts and HIV-infected, grew up under these conditions of social devastation and political disorientation. The drugs have become the desperate response of millions to a situation where they lack any social and political perspective.
Access to heroin has been relatively easy in Russia since the 1990s. Neighbouring Afghanistan, destabilised by the war in the 1970s, became the centre of international drug trafficking and is now producing around 90 percent of all heroin produced worldwide. Given the short transport route, the substance was relatively cheap. Moreover, significant sections of the state apparatus, especially the police, were and still are involved in drug trafficking.
Experts estimate that over 40 percent of Russian GDP is still a result of the shadow economy, which comprises, apart from illegal profits from the energy sector, human and drug trafficking as well as prostitution.
Since the early 2000s, a highly poisonous heroin substitute has been spreading called “Crocodile.” It can be produced based on simple ingredients that anyone could buy in a pharmacy. Estimates put the number of those addicted to Crocodile since 2002 between 1 and 3 million. Their average life expectancy upon addiction does not exceed one year, and the death is usually extremely painful, as the drug corrodes the inner organs of the addict.
The government forbid the ingredients that were used to produce Crocodile in 2012, leading to a slight decline of the official numbers of addicts. However, the drug has now found its way to western Europe, Latin America and the US, where a heroin epidemic has developed as well in recent years due to the extreme social crisis.
At the same time, there are few countries where it is as difficult to rid one’s self of addiction as it is in Russia. This is, first of all, the result of the continuing social crisis, which has even worsened since the beginning of the Western sanctions in 2014. Second, the health care system, chronically underfinanced since the 1990s, offers almost no help to addicts.
According to the Moscow Times, in 2015 there were no more than four state institutions nationwide for the treatment of drug addiction, with a total number of places of just 200. The therapy of heroin addiction on the basis of methadone—internationally recognised as one of the most effective and least painful therapies for heroin addicts—is forbidden in Russia.