Drug users must be helped to halt AIDS spread: U.N.

LONDON (Reuters) - Countries in eastern Europe and central Asia face spiralling AIDS epidemics if they fail to help people who inject drugs and stop the spread of infection, the head of the United Nations agency for HIV/AIDS said on Friday.

Michel Sidibe told Reuters countries such as Russia, Ukraine and others could halt or buck the global downward trend in new HIV infections if they ignored the threat posed by drug users and failed to introduce effective “harm reduction” steps.

“HIV infection has slowed down globally, but it is expanding in this region of eastern Europe and central Asia,” he said. “We’re not seeing anything like this in any other region of the world.”

Sidibe, who was due to address a conference on harm reduction in the British city of Liverpool on Sunday, said of the 3.7 million people in the region who inject drugs, a quarter have the human immunodeficiency virus that causes AIDS.

Drug users, often criminalized and marginalized from health and social services, can spread the virus by sharing needles with an HIV-infected person or pass it on by having unprotected sex.

Infection prevention steps like providing needles, condoms and substitute drugs like methadone -- collectively known as harm reduction -- are seen by many experts as key to halting the spread of HIV and AIDS, but some governments are reluctant to provide them for fear of being seen to condone drug use.

Sidibe warned newly-emerging and growing pockets of HIV spread among drug users could propel a wave of infections and undermine gains in curbing sexual transmission of the disease.

“What is unacceptable is knowing there is this multitude of epidemics among drug users, we have on average each drug user getting less than two clean needles a month, and only about four percent of those living with HIV getting treatment,” he said.

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.

A report published last month showed that more than 90 percent of the world’s 16 million injecting drug users are offered no help to avoid contracting AIDS.


Sidibe said there was now “rock solid scientific evidence” to show harm reduction measures were effective in cutting the numbers of new infections with HIV.

He pointed to a 2002 study conducted in 103 cities in 24 countries which found the HIV infection rate fell by an average of almost 19 percent a year in places with needle and syringe programs, but increased by an average of 8.1 percent a year in cities with no such policies.

“But people are scared ... and there is a lack of proper understanding of harm reduction,” he said.

Sidibe called on Russia, where the government outlaws the heroin substitute methadone, to show leadership for the region and recognize that protecting drug users, not punishing them, would cost less and help more in the long run.

The UNAIDS chief said in Ukraine protecting a drug user from HIV/AIDS infection would cost less than $100, a fraction of the estimated $825 a year it costs to treat someone with AIDS drugs.

Sidibe pointed to countries like China, which has moved in recent years from a zero-tolerance approach to injecting drug users to what he described as a more “pragmatic” policy of helping them reduce HIV/AIDS infection risk.

“Today they have one of the biggest programs in Asia,” he said. “Our goals will be reached only if we persuade all governments and authorities that harm reduction is more effective than punishment.”