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"Harm reduction" needed to cut drug-user AIDS risk
LONDON |
LONDON (Reuters) - Barely a twentieth of the estimated $3.2 billion needed is put into preventing drug users spreading the AIDS virus, experts said on Monday, and the shortfall is fuelling HIV epidemics in parts of Europe and Asia.
In a report on the use of "harm reduction" measures like clean needle exchanges and safer drug substitutes, the experts found that in countries which fail to take prevention steps, drug-related HIV infection accounts for the vast majority of new cases.
The proportion of new HIV cases linked to injecting drug use is 90 percent in Bangladesh, 66 percent in Russia and 50 percent in Indonesia, the report said; yet only around three U.S. cents a day is spent on trying to halt drug-related spread of the virus in low- and middle-income countries.
"We have known now for well over two decades that HIV is preventable -- it is untenable that today in some 100 (poorer) countries nearly all people who inject drugs have absolutely no access to clean needles or methadone," said Professor Gerry Stimson, a co-author of the report and the director of the International Harm Reduction Association (IHRA).
About 33.4 million people worldwide are infected with the AIDS virus. Since AIDS emerged in the 1980s, almost 60 million people have been infected and 25 million have died.
Drug users can spread the human immunodeficiency virus (HIV) that causes AIDS by sharing needles with an HIV-infected person, or pass it on by having unprotected sex.
Harm reduction measures for drug users -- like providing clean needles, condoms and the drug substitute methadone -- were introduced some 25 years ago in countries such as Australia and in European cities like Rotterdam and Liverpool, where AIDS spreading among addicts was a major problem.
'WAR ON DRUGS'
Similar policies have since been adopted by public health authorities in many European and other rich nations and, along with safe sex campaigns, are considered a major factor in the relatively low rates of HIV in those places.
But the report found 20 countries in eastern Europe and Asia where injecting drug use is now the major cause of HIV infection, and said the failure to protect drug users is driving the world's fast growing HIV/AIDS epidemic in eastern Europe.
"Three cents a day is a terrifying figure and equally terrifying are the HIV infection rates amongst injecting drug users in parts of Eastern Europe and Asia," said Stimson.
Stimson, who is heading an international conference on harm reduction in the British city of Liverpool this week, said one fifth of the all global funding for HIV prevention should be dedicated to HIV prevention steps for drug users. "Harm reduction is a low-cost, high-impact intervention," he said.
The report said a full package of HIV-related harm reduction steps in Asia would cost $39 per life-year saved, and treatment with AIDS drugs would be around $2,000 per life-year saved.
Alvaro Bermejo, head of the International HIV/AIDS Alliance, said a less punitive approach to drug users would reduce HIV.
"The 'war on drugs' is a war on drug users and it is fuelling the HIV epidemic, making public health responses much more difficult," he said in a statement on the report.
"It's time to move away from the detention center system and to provide services for users in their communities and in government health clinics so they can see them as places where they can get help and not be badly treated."
(Editing by Ralph Boulton)
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An unholy alliance of ignorance, greed and hate which works to destroy all our hard fought freedoms, wealth and security.
We will always have adults who are too immature to responsibly deal with tobacco alcohol, heroin amphetamines, cocaine, various prescription drugs and even food. Our answer to them should always be: “Get a Nanny, and stop turning the government into one for the rest of us!”
Nobody wants to see an end to prohibition because they want to use drugs. They wish to see proper legalized regulation because they are witnessing, on a daily basis, the dangers and futility of prohibition. ‘Legalized Regulation’ won’t be the complete answer to all our drug problems, but it’ll greatly ameliorate the crime and violence on our streets, and only then can we provide effective education and treatment.
The whole nonsense of ‘disaster will happen if we end prohibition’ sentiment sums up the delusional ‘chicken little’ stance of those who foolishly insist on continuing down this blind alley. As if disaster wasn’t already happening. As if prohibition has ever worked.
To support prohibition is such a strange mind-set. In fact, It’s outrageous insanity! –Literally not one prohibitionist argument survives scrutiny. Not one!
The only people that believe prohibition is working are the ones making a living by enforcing laws in it’s name, and those amassing huge fortunes on the black market profits. This situation is wholly unsustainable, and as history has shown us, conditions will continue to deteriorate until we finally, just like our forefathers, see sense and revert back to tried and tested methods of regulation. None of these substances, legal or illegal, are ever going to go away, but we CAN decide to implement policies that do far more good than harm.
During alcohol prohibition in the 1920s, all profits went to enrich thugs and criminals. Young men died every day on inner-city streets while battling over turf. A fortune was wasted on enforcement that could have gone on treatment. On top of the budget-busting prosecution and incarceration costs, billions in taxes were lost. Finally the economy collapsed. Sound familiar?
In an underground drug market, criminals and terrorists, needing an incentive to risk their own lives and liberty, grossly inflate prices which are further driven higher to pay those who ‘take a cut’ like corrupt law enforcement officials who are paid many times their wages to look the other way. This forces many users to become dealers themselves in order to afford their own consumption. This whole vicious circle turns ad infinitum. You literally couldn’t dream up a worse scenario even if your life depended on it. For the second time within a century, we’ve carelessly lost “love’s labour,” and, “with the hue of dungeons and the scowl of night,” have wantonly created our own worst nightmare.
So should the safety and freedom of the rest of us be compromised because of the few who cannot control themselves?
Many of us no longer think it should!
However, there is much that sometimes gets included under the topic of “harm reduction” that doesn’t reduce harm at all.
The giving of substitute drugs, such as Methadone, is a perfect example. There is nothing about taking methadone that prevents an addict from continuing to inject drugs and indeed many do. It would be different if there was some real drug screening included in a Methadone programme, but the very limited screening that does exist is for looks alone and there are no real consequences for turning in a positive.
The sad truth is we now have Methadone killing more people than heroin, so I don’t think it is harm reduction at all.
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