Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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‘War on drugs’ and HIV prevention


Aids Alliance

The Alliance has welcomed the new report from the Global Commission on Drug Policy that launched this week, which clearly outlines a series of recommendations on how to deal effectively and humanely with illicit drug use and people who use drugs.

The report (which can be downloaded here) condemns the current ‘war on drugs’ strategy as failing. The approach has resulted in thousands of people jailed for the act of using drugs, and is described as ‘inefficient and ineffective’ in the report. The report highlights the need to start treating drug dependency as a health issue.

The Alliance works across the world with community groups of people who use drugs, preventing HIV transmission, and providing treatment and care, and we know that many people who are criminalised or jailed because of drug use will be very poor and dependent on drugs.

People sent to jail continue to use drugs in prisons or detention centres even though they rarely have access to clean syringes, health services and information about the different harms associated with different drugs or how to avoid HIV or hepatitis C transmission.  For many drug users, a prison sentence increases their risk of HIV or hepatitis C transmission.

“This report is important because it is such a distinguished group of high-level leaders who are calling for change and its taking place at a critical moment with the UN High Level Meeting on AIDS taking place next week in New York. We will be watching to see how governments commit to effective and rights based approaches to HIV such as harm reduction,” said Susie McLean, Senior Advisor on harm reduction and drug use at the International HIV/AIDS Alliance.

The report recommends that opiate substitution therapies such as methadone and buprenorphine treatment are made available. The Alliance is seeing the benefits of a national methadone programme in Ukraine. People who use drugs have the highest HIV burden in the country and therefore have the greatest need for services. But many HIV positive drug users are not getting life-saving antiretroviral treatment.  Opiate substitution treatment can help HIV positive drug users to manage antiretroviral treatment better, so not only is methadone an effective drug dependence treatment, it is also a supportive treatment to antiretroviral treatment for people who use drugs.  Harm reduction approaches - including improved access to methadone programmes - have grown in Ukraine in the last few years, and have contributed to the reduction in HIV rates amongst new injectors Ukraine.

Despite this success, in recent months clinics across the country providing methadone, along with activists who support people who use drugs with harm reduction interventions, have been targeted by security officials demanding official papers and clinic data from these methadone clinics.  These practices are intimidating clinic staff and patients, and we are seeing the closure of some of the methadone clinics across the country. We are deeply concerned about this change in policy, especially following such a history of a progressive HIV response in Ukraine.

“Harm reduction approaches such as the provision of clean needles and syringes and methadone are evidence-based, effective ways of tackling HIV amongst people who use drugs. We endorse the report’s recommendations calling for an end to criminalisation, marginalisation and stigmatisation of people who use drugs. Dealing with these issues will make it easier to reach people who use drugs with HIV prevention, treatment and care and provide harm reduction interventions to those who are often in desperate need,” says McLean.

Susie McLean has written a blog about her views on HIV and drug use in Kenya and the Global Commission on Drug Policy that you can read here.

You can also download the Alliance's Good Practice Guide on HIV and Drug Use.