Don't give us false illusions of hope: injecting drug users

Photo by bobbyramakantRepeated calls for harm reduction approaches to HIV prevention, treatment and care, particularly for injection drug users (IDUs), were answered with a reality check on the second day of the first Asian Consultation on Prevention of HIV Related to Drug Use, in Goa.

During a session that brought together parliamentarians, civil society activists and IDUs, the voices of several users provided delegates with a stark reminder of the reality on the ground.

“Drug users are treated as criminals, as sub-human beings” said Bijaya Pandey from Nepal.

“For the past few years we have been hearing about ‘3 by 5’ and ‘2010’– please, please, don’t give us a false illusion of hope,” Pandey said, referring to the World Health Organization’s (WHO) failed initiative to provide antiretroviral drugs (ARVs) to three million people by end of 2005, and the promise of universal access to prevention, treatment and care by 2010.

Opioid substitution therapy (OST) and needle syringe exchange programmes are not operating or even legal in some Asian countries. Only a handful of states in the region have government-supported OST or syringe exchange programmes.

The combination of the criminalization of injection drug use and a lack of a coherent legal and policy framework on drugs, means that not only are IDUs are at risk while accessing existing services, but service providers are also at risk of being penalized for offering them.

“Bijaya, Tamara and I are the lucky survivors of the war – the war on drugs,” said Fredy Edi, a board member of the International Network of People who Use Drugs and the Indonesian Drug User Network, referring to IDU representatives Pandey and Tamara Speed from Australia. “The war on drugs is also war on health,” Fredy added.

There is evidence to suggest that ‘war on drugs’ has caused a rise in HIV infections, particularly among IDUs, across the region. The number of new hepatitis C (HCV) infections has also increased since the war on drugs was launched. HCV infection rates are believed to have reached epidemic proportions in many parts of Asia, such as Manipur in India.

“We have buprenorphine but distribution is limited to less than 10% of people who need it,” a delegate from Manipur said during the meeting.

Another delegate raised the issue ARV treatment for IDUs. Many IDUs are reportedly being told that they must stop taking drugs before they can receive treatment from ARV centres.

Delegates also expressed concern over the lack of programmes designed to tackle inhaling drug use and the lack of programmes tailored towards women, transgendered users or the partners of male users.

“It is very difficult to find female drug users in public spots,” Dr Tasnim Azim from Bangladesh told the session. About 15% of female IDUs in Bangladesh become pregnant within two years of developing a habit, Dr Azim said, adding that there were no antenatal clinics or services for female drug users.

While we eye the goal of Universal Access for 80% of IDUs, Bijaya’s plea ‘not give a false illusion’ serves as a grim reminder of the reality faced by those who need these services the most.

Bobby Ramakant-CNS

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