Interview with Maksim Malyshev, “Andrey Rylkov Foundation” (ARF), Russia.

In 2021 “Andrey Rylkov Foundation” implemented a small grant within “We Will Not End AIDS Without Harm Reduction” project framework.

What violations of the rights of people who use drugs related to the Covid-19 situation have you registered during the pandemic?

During the pandemic we noticed a decrease in the availability of treatment for people who use drugs, which constitutes a violation of the right to health. In particular, we have documented the fact that a test for Covid-19 was added to the usual list of tests that are required for admission to drug addiction treatment programs in hospital setting.

For many people who use drugs it becomes an overwhelming task to do this test free of charge at the expense of compulsory health insurance (OMC), since they do not always hold an OMC policy nor are registered with a local clinic. Commercial tests at [private] laboratories are an additional financial burden, too great for a person who uses drugs.

Such a problem was identified, for example, at the hospital of the National Scientific Center for Narcology of the Serbsky State Scientific Center of Moscow.

How did the small grant help you assist the people whose rights were violated?

ARF provided several types of assistance within the framework of the grant:

– targeted assistance and social support services for people who use drugs in the context of ensuring the rights to free medical care in various fields. Such assistance included social support, provision of legal support, dialogue and mediation with government agencies responsible for provision of healthcare services;

– broader assistance for the community of people who use drugs included government advocacy to reduce barriers to accessing health services in the setting of the coronavirus pandemic. These activities incorporated launching complaints and appeals to various organizations, and even a lawsuit against one public health service provider. We can also here mention creation and dissemination of templates for appeals to remove barriers to accessing health services due to the pandemic, which have emerged before people who use drugs;

– and finally, people who use drugs were provided with information assistance in the form of actualization of the problems caused by coronavirus infection, as well as provision of access to information about the infection itself and its effect on psychoactive substances and antiretroviral therapy drugs. Also, an important informational focus was put on development of a pamphlet regarding vital importance and possibilities of vaccination for people who use drugs.

Covid-19 has created new challenges not only for people who use drugs, but also for civil society organizations working with the community. Please tell us about the new challenges you have faced.

The most important challenges for us were:

– restructuring of work and partial refocus from offline work towards remote services. It proved to be difficult both for us and our clients as well;

– difficulties caused by changes how medical institutions and other authorities themselves worked [during the pandemic]: quarantines, lockdowns, increased secrecy under the pretext of a pandemic;

– safety of our clients in the context of Covid-19 infections was also an important topic, and we had to correlate every action with the risk of infection of our clients;

– and at the end of the day, another important challenge was ensuring safety of our staff in the context of Covid-19.

What would help you overcome the difficulties / challenges that have arisen in a more successful, more effective manner?

First of all, we were helped by our client-centeredness and by being part of the community we work with. These qualities allowed us to always side with people who use drugs and to effectively overcome the difficulties.

Strengthening this vector could be helped by ensuring our greater resilience, both in financial and psychological sense.