The Economist - USA (2020-06-27)

The EconomistJune 27th 2020 Europe 43

AsfortheAmericansandChinese,usually

ferriedintothelittleportfromtowering

cruiselinersdockedinnearbyMarseille,

theyareabsent.

ThispointiscrucialfortheFrenchMed.

Localtourism,howeverwelcome,cannot

replacetheforeignvariety.A Frenchtourist

ontheRivieraspendsanaverageof€58a

day.Russians,AmericansandMiddleEast-

ernerssplurgenearlythreetimesasmuch.

Inpreparationforanexpectedeasingon

July1stofeurulesfortravel,theregionis

launchingmarketingcampaignstoremind

peopleofitscharmsandtoreassurethem

aboutcovid-19.Niceairporthasalreadybe-

guntoscheduleflightstoandfromother

EuropeancitiesfromJuly.Thecityisalso

thestarting-pointthisyearfortheTourde

Francecyclingrace,rescheduledforAugust

29th.TheaimfortheRiviera,saysMsBe-

har,is“tosavetherestoftheseason”.

In themeantimelocalsare getting a

hintofwhatthesouthofFrancemusthave

feltlikeinthe1950s,whenStTropezwas

stilla fishingvillage.Fewcarswithforeign

numberplatesaretobeseenontheroads.

OftheFrenchwhoplana holidaythissum-

mer,71%tolda polltheyintendtostayin

France.Localsmaysecretlyratherlikehav-

ingtheirbeachesandrestaurantstothem-

selves.Butthoseinthetouristindustry

yearnforhigh-spendingGermansandRus-

sianstoreturn,eveniftheiryachtssome-

timesspoiltheview. 7

S

vitlanamorozstartedinjectingopium

asa16-year-oldinUkraine. Soonshe

grewaccustomedtopolicemenandtheir

friends taunting her, or assaulting her.

Theirattitude,sherecalls,was“youarea

womanwhousesdrugs,sowecanuseyou

howwewant.”At19,shereceiveda double

diagnosis: pregnant and hiv-positive.

Scaredofharmingherbaby,shedecidedto

quitdrugs,buttodosoalone.Ifshesought

treatmentshewouldneedtoregisterasa

druguserwiththestate.Thenwouldcome

coaxingbydoctorstohaveanabortion,or

later,threatsoflosingparentalrights:drug

abuseisgroundsenough.If thathappened,

shewouldneedproofofmaternalstabil-

ity—an income, aresidence—to gether

child back. But adrug-user designation

scaresoffemployers.

Suchcycleschurnacrossmuchofcul-

turallyconservativeeasternEurope,where

druguseishighandpunishmentsarese-

vere. Devised in the Soviet Union and

knowntodayinRussiaas“socialintoler-

ance”,theregion’sstandardapproachisto

makedrugusers’livesmiserablesothey

willstop.WesternEurope,bycontrast,in-

herited another strategy, this one from

Switzerlandinthe1980sandothercoun-

tries.“Harmreduction”encouragespeople

toaddresstheiraddictionsgraduallywith

supportratherthanpunishment.Onpaper,

thewesternwayhasgainedground.In 2019

alleasternEuropeancountriesexceptRus-

sia had some national commitment to

harmreduction(thoughimplementation

ispatchy).Almostnonefocusedonthepro-

blemsoffemaledrugusers;globally,too,

just2%ofresolutionsadoptedbytheUn-

ited Nations Commission on Narcotic

Drugsovernineyears(2009-18)did so. Yet

womenoftensufferthemost.

Morethana thirdofwomenaddicted to

opioids in Ukraine say they have been

threatenedwithviolencebypolice;13% say

theyhavebeenrapedbythem.InStPeters-

burg,81%ofhiv-positivewomenwho in-

jectdrugssaytheyhavesufferedviolence

atthehandsofpartners.Buttheregion’s

domestic-violencesheltersfrequently turn

awaywomenwhoabusedrugsoralcohol.

Tomakemattersworse,easternEurope

plus central Asia now has the world’s fast-

est-growing hivepidemic. It is unsurpris-

ing, then, that Ukraine, home to the re-

gion’s second-largest hivscourge, behind

Russia, has outlawed knowingly putting

someone at risk of hiv. The rule is sup-

posed to drive down infection rates, but it

doubles as an excuse to punish the hiv-

positive, especially women. From 2015 to

2018, only women were sentenced under

the provision. And in late 2018, a judge used

it to give a Ukrainian woman five years in

jail for biting someone. Such harshness re-

flects cultural stereotypes, reckons Maria

Plotko of the Eurasian Harm Reduction As-

sociation in Vilnius: that a man can “drink

a lot” but a woman is “a mother first of all

and mothers cannot use drugs.”

Stigma helps explain why women strug-

gle to get treatment. Some do not want to be

spotted at treatment centres or harassed by

male addicts there; others have no child

care. In Ukraine, about 17% of harm-reduc-

tion sites had not one female patient. Preg-

nant users may suffer worst. The World

Health Organisation recommends they

protect themselves and their babies by

undergoing opioid-substitution therapy, a

process of replacing injectable drugs with

pills dispensed in careful doses. Russia

bans the therapy, so its drug users who get

pregnant are simply told to go cold turkey

or pushed to try unproven treatment such

as antipsychotic medication or religion.

Harm-reduction advocates have tried to

help. Ukrainian activists are lobbying to

nix the part of the family code that deprives

drug users of parental rights. In Hungary,

Chicks Day, a weekly women-only needle-

and-syringe exchange service, has provid-

ed clean equipment. Such services matter

for female users, who often get “second on

the needle” after men have used it.

Most portents, though, are bleak. Last

year Russia’s President Vladimir Putin

urged tougher punishment for spreading

“drug propaganda”, or any information

“encouraging” drug use, which includes

harm-reduction charities. Anya Sarang,

president of the Andrey Rylkov Foundation

in Moscow, has resigned herself to remov-

ing some of the most controversial materi-

al from her organisation’s website or risk

bankruptcy from unaffordable fines. Bul-

garia temporarily stopped its safe-needle-

and-syringe programmes after the Global

Fund, a health charity, withdrew funding.

Advocates fear the same could soon hap-

pen in Ukraine.

Twelve years into her recovery, Ms Mo-

roz, now a human-rights campaigner and

mother of two, started using drugs again,

though these days it is cannabis and pills,

rather than the injectable sort. The relapse

was the result of wartime despair in Uk-

raine, which left her displaced and her hus-

band captured. Female drug users are still

fighting to become anything else. 7

Tough-on-drugspoliciesoftenhitwomenhardest

Womenanddrugs

Overdosed

In need of help, not punishment

2