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Treating people who use drugs as criminals is destined to fuel the rise of HIV

By Guest
December 1, 2010 at 11:55 am

Someone, somewhere, right now is in a basement room with a needle and a spoon, trying to take away the pain. In fact, if everyone who is injecting drugs was gathered in one place right now – an estimated 16 million people – it would amount to four times the population of Madrid.

In the shooting galleries of the world, from Mumbai to Managua, the frequent use of shared needles is providing easy passage for the transfer of tainted blood from one body to another. It is simply the most effective way to spread the transmission of HIV and reverse years of hard-won progress.

There are many reasons why people choose to inject drugs rather than snort, smoke or swallow. Chief among these reasons is the fact that injectable drugs are cheaper, easier to find, quicker to take (handy if the police are about) and reputedly produce a faster, more intense high.

Taking drugs by needle injection has escalated in recent years and it is a trend on every continent. When injecting drugs is combined with selling sex to pay for drug habits, it creates a cocktail that massively increases the likelihood of spreading HIV into an unsuspecting public.

In Sichuan province in China, for instance, we know that almost 60 per cent of the women sex workers are also injecting drugs with shared, dirty needles. In parts of the UK, it is as high as 78 per cent, and in Syria more than 50 per cent.

Many governments around the world – indeed more than 80 per cent of them – and not unlike drug users themselves, are inclined to artificial realities, impervious to the evidence that treating people who inject drugs as criminals is a failed policy that contributes to the spread of HIV.

Public health officials are ignoring the evidence that to be successful in containing HIV, health services must provide as harm reduction interventions that combine free exchange of sterile needles, drug replacement therapy, addiction counselling, and other forms of health and social support.

Instead, the best injecting drug users can hope for is to be driven underground to live with the addiction in the dark back streets and abandoned buildings of our towns and cities. Or even worse, they are criminalized and jailed with little or no regard for their healthcare rights or the impact of this policy on the health of their communities.

Misguided government policies are, without doubt, contributing to the growing rate of HIV transmission that is on the rise among drug-injecting communities. We know that more than 10 per cent of new HIV infections result from needle-sharing. If we are to take sub-Saharan Africa out of the equation – where needle sharing is less common but nevertheless firmly on the rise – the new rates of infection from unregulated needle sharing rises to more than 30 per cent.

If we drill down to the country level, in Russia for instance, HIV transmission amongst injecting drug users is a staggering 83 per cent. In Ukraine, it is 64 per cent, in Malaysia 72 per cent, in Vietnam 52 per cent and so on. The levels of HIV-positive people who inject drugs is so high that some countries are edging dangerously close to generalized epidemic. Yet laws and policies continue with enforcement tactics that have proven not to work.

Left unchecked and untreated, injecting drug use constitutes a serious public health concern that can only be addressed through rational public health services that are informed by evidence rather than misinformed laws. All the evidence points towards the effectiveness of harm reduction programmes. This is worth repeating. Harm reduction works.

Treating people who use drugs as criminals is destined to fuel the rise of HIV infection, not only among those unfortunate enough to have a serious drug addiction, but also for children born into addiction and ordinary members of the public who are not normally exposed to HIV risks. Injecting drug use is a public health issue. It is an issue of human rights. It cannot be condoned, but neither should it be criminalized.

Guest post from Alyson Lewis, Head of Health Advisory Team, British Red Cross and Bekele Geleta, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC), the world’s largest humanitarian network.

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Tags: HIV, wad, World AIDS Day

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