HEALTH: Injecting Drug Use Spreads HIV in Eastern Europe

• by Stephen Leahy (liverpool)
• Wednesday, April 28, 2010
• Inter Press Service

Shockingly, a mere three US cents a day per injecting drug user are being invested to prevent the spread of HIV/AIDS and TB, according to the study released at the opening of the Harm Reduction 2010 conference this week in this English port city.

'Our report shows that just 160 million US dollars a year are being used in total for all the harm reduction programmes to prevent the spread of HIV around the world,' says Gerry Stimson, executive director of the International Harm Reduction Association.

Harm reduction involves providing access to the drug methadone, needle exchange services, and counselling. 'Barack Obama's presidential inauguration cost at least that much,' Stimson, emeritus professor at the Imperial College, London, told IPS in an interview.

In Russia there are an estimated 1.6 million IDUs of which 60 to 70 percent have HIV-related illnesses. In the past decade the number of HIV-infected people increased tenfold from an estimated 100,000 to one million, he said.

'Three cents a day is a terrifying figure and equally terrifying are the HIV infection rates amongst IDUs in parts of Eastern Europe and Asia.'

The ‘Three cents a day is not enough’ report found only one-twentieth of the recommended 3.2 billion dollars in funding being directed to preventing IDU-related HIV infection. The number of new HIV cases linked with injecting drug use in Bangladesh is 90 percent, Russia 66 percent and Indonesia 50 percent.

Clean needle exchange services were introduced in the West to prevent HIV infection some 25 years ago. (Sharing injection equipment is three times more likely to transmit HIV than sexual intercourse.)

There is enough evidence to show that harm reduction has been highly effective in reducing illegal drug use, crime and the associated violence. Harm reduction keeps drug users healthier and enables many to get jobs. It is also far more cost-effective with every dollar spent resulting in a savings to society of three to seven dollars, the report found.

While there is some ideological opposition and moralistic confusion over needle exchange and methadone treatments in North America and Europe, much of the rest of the world sees harm reduction as an effective way to reduce the spread of HIV among drug users and general population even if countries dramatically underfund such programmes, Stimson says.

'Governments and even philanthropic donors would really prefer that the drug-using population would simply go away.'

As a result, in some 90 low- and middle-income countries nearly all people who inject drugs have absolutely no access to HIV prevention drugs such as methadone and in some 70 countries they are without access to needle exchange services. It is well established that prevention measures such as these are significantly cheaper than treatment, said Stimson.

'Harm reduction is a low-cost, high-impact intervention,’’ the report says and recommends that 20 percent of global HIV prevention funds should be dedicated to it.

China has had a rapid scale-up of harm reduction programmes over the last three or four years. Iran has a very good harm reduction programme in place. It is even widely promoted that these programmess are acceptable under Islamic law. Malaysia has also increased its programmes in recent years.

It is a completely different story in Russia and neighbouring Uzbekistan where mentioning the word ‘methadone’ can get you thrown in jail. Psychologist Maksim Popov, who headed a United Nations-funded NGO promoting harm reduction, in Uzbekistan, ended up with being awarded a seven-year jail sentence.

'Methadone is illegal in Russia and even advocating its use is illegal,' says Anya Sarang, president of the Andrey Rylkov Foundation for Health and Social Justice.

Local and international civil society organisations had been running needle exchange programmes in Russia for many years but many of these are banned and the government is not supporting them, Sarang told IPS.

'The Russian health ministry calls harm reduction ineffective. The Russian government and health officials have convinced themselves the problem doesn't exist,’’ said Sarang, adding that what Russia is really concerned about is its political image as a modern, progressive G8 nation. 'What is going on here is not the description of a civilised country.'

Not only have HIV rates increased tenfold, TB prevalence is high and the country has the world's highest rates of drug-resistant TB which takes two years to treat and extensively drug-resistant TB that resists all treatment. IDUs with HIV are at extremely high risk for contracting TB.

‘’Ironically such people are commonly thrown in jail for possessing amounts scraped from under a fingernail,’’ says Sarang.

Russia's prisons are well documented as the incubators for these diseases and the country has the second highest prison population in the world, incarcerating nearly one million after the United States which has twice that number.

'One in every two Russian males has been in jail at some point in their lives,' says Sarang. A staggering statistic that cannot be verified but there is evidence that millions of men have been through the prison system priming what health experts call Russia's 'epidemiological pump' for spreading disease throughout the general population.

'Every day it’s getting worse and worse,' Sarang says.

© Inter Press Service (2010) — All Rights ReservedOriginal source: Inter Press Service

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