How to improve law enforcement knowledge about HIV and to work with drug users and sex workers: experiences from Kyrgyzstan Aleksandr Zelichenko, Director of Public Fund Central-Asian Center on Drug Policy, Police Colonel, PhD Vienna, July 2010.

Background The Kyrgyz Republic in Central Asia is situated on a drug trafficking route. According to official estimations the number of drug users is not more than (probably an underestimation), but other experts put it much higher, to thousand. A more realistic number is the estimation made by the UNODC, which is people who use illicit drugs in the whole country. As most of them use drugs intravenously, this means that the country faces a danger of severe HIV epidemic.

Kyrgyzstan has been the first in the region to introduce science and evidence based harm reduction strategies, like needle and syringe exchange programs and methadone maintenance therapy; methadone and sterile syringes are even available for prisoners.

Effective cooperation is result of effective education In last few years Kyrgyzstan accumulated good practical experience in cooperation of police, governmental, non-governmental organizations and local communities in HR activities and HIV/AIDS prevention This became possible in result of the long-term educational campaign against police “illiteracy” in Harm Reduction and HIV/AIDS problem, which started in 1998 and still in developing

First steps Initially we focused the education process on the units in most probable direct contact with HIV/AIDS problem – district police, police inspection for juvenile offenders, patrol forces, road police...

The next step – the educating institutions of the Kyrgyz Ministry of Interior started to develop and implement the special training programs. A good example is 36-hours training course on HIV/AIDS, other common infections (e.g. tuberculosis, hepatitis С) and ways of invasion prevention, included into the curriculum of Bishkek Police Academy since 2004.

Building up knowledge The Medical Department of MIA also joined the process of police staff educating and actively distribute knowledge about HIV/AIDS, other sexual transmitted diseases, ways of prevention. They scheduled the special site visits to the police stations to give lectures and seminars, using video materials, poster presentations, and other teaching aids. All these lessons are included into the service training plan; the curriculum and timetable are approved by the chief of the city or regional police station.

In the year 2005 the police newspapers started to publish the corresponding materials in Russian and Kyrgyz languages. Almost each weekly issue included digests of the international Mass-Media on the problem and articles by specialists in infectious diseases, science of laws and police practice aimed to address needs in police education.

Scaling-up police training in HIV/AIDS In 2005 we started a project aimed on the developing the training course in the Police Academy of MIA. The course is not limited by the general, basic principles of HIV prevention, although this is the large component of the program. The ultimate goal of the course is to teach the police community in new approaches, to develop the tolerant attitude towards drug-users, HIV – infected people and sex-workers. In the framework of the project a textbook, “Legal Basis of Harm Reduction Theory and Practice” was published in March 2009 by the group of experts.

On June 27, 2005, the Parliament adopted, and on August 13 the President signed the Law "On HIV/AIDS in Kyrgyzstan". The normative act had passed through a competent international expertise and is recognized fully correspondent to the time and situation. I would like to mention that the Law reliably protects the rights of those with the virus of AIDS and PLWHA.

In this situation addressed the training process to the specific nature of police officers. Law enforcement, as you know, usually responsive to orders. The idea was raised to develop “the Instruction for Police Forces for HIV/AIDS prevention in vulnerable groups of population”, and to approve it by Ministry of Interior order, so the Instruction should be subject for compulsory implementation. Second edition of the Instruction had been published in 2008.

In 2009 number of workshops focused on above- mentioned “Instruction” were carried out in 18 town/regional police stations. The group of instructors and facilitators were formed from specially trained police instructors, representatives of NGOs and drug-addicted people, commercial sex workers and people leaving with HIV/AIDS. For the first time ever, these diverse groups directly addressed a police audience

By the end of 2009 this experience had been extended on the all territory of the country. This year the Instruction was incorporated as an integral part of the in-service training for each police station.

The next step was the introduction of a syringes exchange program in the penitentiary in order to prevent HIV/AIDS epidemics. We started about 3 years ago with a pilot project of methadone substitution therapy in the pre-trial detention center and few penitentiaries. This involves close cooperation with medical workers and number of HIV-servicing NGOs and would be absolutely impossible without special education, focused on penitentiary personnel. In 2008 we trained first 20 experts in advocacy program on harm reduction in colonies and detention cells. The results are really promising.

Scaling up on regional level In 2009 Kyrgyzstan hosted regional seminars on harm reduction programs advocacy for law enforcement (penitentiary and militia/police personnel) and NGOs from Central Asian Region. The goals and objectives of seminars: –To provide comprehensive information on HR theory and practice; and modern approaches to the problem of HIV-infection control, especially in IDU –To enable participants to get acquainted with best practices of harm reduction programs introduction and implementing within the penitentiary institutions (international best practices, and domestic developments) –To provide information on available training forms and methods of police involvement in HR programs, Kyrgyz model –To discuss challenges & prospects for HR programs introduction and implementation in Central Asian countries; to develop plans for future

Cooperation with social workers and NGOs An integral part of all these programs is psychological aid provided by NGO “Atlantis”: a “Twelve Step” program and others. All of these programs have proven their effectiveness. Case Management and Rehabilitation programs are aimed at the ultimate goal – to develop life skills that will help in maintaining a productive, drug and alcohol-free life.

Starting six months before the release date, the inmates, especially those sentenced to long terms, get enrolled in the rehabilitation program. The program prepares them for a new and, sometimes absolutely unfamiliar life “outside the wire.” After their release from prison, the same program continues on the outside, helping former inmates with housing; obtaining civil documents; travel expenses, etc. Those programs encourage former inmates and offer strong psychological support, so these “Helping Hands” programs for inmates have grown in popularity. A first social hostel for women who use drugs and were released from prison was opened in August It is the only social hostel so far where women can find shelter up to 2 months, during which they will be given rehabilitation services.

And on international level This year, with OSI support, in cooperation with Nossal Institute for Global Health, the University of Melbourne, we started a new project: a website Law Enforcement and Harm Reduction Network (LEAHRN) in English ( and Russian ( In conclusion I’d like to give you few citations from the homepage of LEAHRN website: LEAHRN aims to connect people who want to know more about how police and harm reduction services can work together more effectively.

LEHRN seeks to promote harmony and a better understanding between police and health service providers so that more programs involving clean needles and syringes, methadone, condoms and supervised injecting facilities can be successfully delivered.

‘Harm Reduction cannot and will not work without the active participation of police.’ ‘Police can be the best friend or the worst enemy of harm reduction.’ From my side, I’d like to add: the future success of our cooperation directly depends on our ability to find the common language.