Global Voice

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Global Voice

The Global Network on the Reduction of Drug Related Harm

Press Release: Toronto, December 1^st, 1999

HIV rates among injection drug users rise rapidly around the world but governments still fail to implement proven harm reduction measures

The AIDS pandemic continues to gain momentum rapidly in most countries of the world. Many of the new HIV infections in both rich and poor countries are among injection drug users. The latest UNAIDS figures show that the HIV rate in the former Soviet Union has more than doubled in the last two years, largely due to injection drug use. In the remote Siberian city of Irkutsk there have been more than 1300 new infections this year, reflecting the fact that injection drug-use has increased 20-fold in the region in the last few years. The number of new cases reported in Moscow so far this year more than four times greater than in all of 1998.

Levels of HIV infection among injection drug users are already high in many regions. For example, some of the prevalence rates are: Manipur, India, 73% Myanmar, more than 60%; Thailand 40%; Brazil and Argentina, more than 30%; Kazakhstan and other parts of Central and Eastern Europe, more than 30%. In many of these countries, injection drug users represent the majority of HIV infections. For example, in Kazakhstan, more than 85% of HIV cases are in injection drug users and more than 67% of the rapidly exploding epidemic in China is due to injection drug use. North America has nothing to be complacent about either: in Vancouver, Canada, prevalence rates in injectors are estimated at between 25 and 35% and, several Canadian cities have incidence rates that are among the highest in the developed world. In the United States over 250,000 individuals have developed AIDS as a result of contracting HIV through a shared syringe. States with restrictive syringe purchase and possession laws, such as New Jersey and New York, have HIV incidence rates as high as 50% among their drug injectors and have the largest numbers of women with AIDS and pediatric AIDS cases.

Yet some countries (Australia, UK) have managed to avoid or some to turn around (Switzerland) an HIV epidemic among injection drug users through implementation of harm reduction policies and programs. Harm reduction, or health maintenance--the policy and practice of providing knowledge and means to drug users so that they can avoid HIV and other harms while continuing to use drugs--works very well indeed. Numerous reports from many countries in both the developed and developing countries demonstrated the cost-effectiveness and efficiency of harm reduction and that these programs can be run successfully even in the most difficult financial and social circumstances, and even in prisons. The data supported what is already known about syringe exchange: that it reduces the incidence of HIV in users without increasing the number of injectors or the amount of drugs used. It was also made clear that too be truly effective harm reduction approaches must be comprehensive. That is, they must go beyond syringe exchange alone to include counseling, referral to a variety of treatment options and, where possible, to prescription of substitute, legally supplied, drugs such as methadone, heroin and stimulants. Harm reduction approaches are not only successful at reducing the spread of HIV but also reduce or risks and harms such as hepatitis, drug-related crime and violence and the economic and human costs of drug use and drug policy.

The rational conclusion from these findings would be to implement harm reduction programs and policies as swiftly as possible in order to help stem the tidal wave of HIV infections. It was quite apparent, however, that attempts to practice harm reduction are still hampered in many regions, including North America, by lack of political will. Harm reduction is viewed as politically “incorrect” because it works with users who cannot or will not stop using drugs. It is also equated, quite erroneously, with support for drug legalization, and therefore as a threat to Prohibition, the official drug policy of the United States.

We, the Global Voice on Reduction of Drug Related Harm, call upon the United Nations, governments and communities throughout the world to support harm reduction approaches and to thereby help to reduce the spread of HIV and other infections among drug users, their partners and their communities. Harm reduction is effective, inexpensive and, above all, it is humane.

The Global Voice

African Harm Reduction Network

Moruf Adelakan adelekan@infoweb.abs.net

Asian Harm Reduction Network

Tom Smit ahrn@loxinfo.co.th Palani Narayan nyawa13@hotmail.com

Canadian Harm Reduction Network

Walter Cavalieri walter.cavalieri@sympatico.ca

Central and Eastern European Harm Reduction Network

Dr Judit Honti jhonti@mail.tiszanet.hu

Drugtext Foundation

Mario Lap mario@lap.nl

Harm Reduction Coalition (United States)