IAS statement on the International Day against Drug Abuse and Illicit Trafficking
As the United Nations marks the International Day against Drug Abuse and Illicit Trafficking on June 26, the International AIDS Society (IAS) would like to call on countries with laws restricting proven life-saving interventions for injecting drug users to be repealed. IAS is concerned that worldwide efforts to control the use and trafficking of drugs are often implemented in punitive ways that harm and restrict vital public health services for drug users living with HIV.
Research that has resulted in effective HIV prevention care and treatment programs for those who are users of injecting drugs, for example, demonstrate that HIV interventions that include opioid (methadone and buprenorphine) substitution therapy can be crucial for prevention of HIV transmission and help injecting drug users gain access to life saving medical services. Merely criminalizing drug use without providing services to keep people off drugs and protect their health is not an effective approach.
Unfortunately, these interventions, known commonly as “substitution therapy” are not only illegal in many countries, but fiercely resisted by many governments, encumbering HIV prevention efforts and undermining the provision of comprehensive HIV care, treatment and adherence support for PLHIV injecting drug users.
According to UNAIDS, nearly one-third of all new HIV infections outside of sub-Saharan Africa are due to injecting drug use. Despite commitments made in the 2006 Political Declaration on HIV/AIDS towards “universal access” by 2010, only 34 percent of countries with concentrated or low epidemics have implemented programmes to reduce risk among injecting drug users.
The UNGASS report also shows that access to key components of harm reduction, including opioid substitution therapy, remains especially limited in many countries in Eastern Europe and Central Asia, the region where two thirds of new HIV infections occur due to injecting drug use. The 2nd Eastern Europe and Central Asia AIDS Conference, held in May 2008, in Moscow, Russia, recognized that given the high rates of injection drug use in this region, access to comprehensive drug treatment of high quality remains unacceptably low; public health care services and general medical institutions are not fully involved in programs for people living with HIV.
IAS is concerned that policies in many countries where injecting drug use is a major driver of the epidemic continue to emphasize law enforcement rather than publichealth measures to address this challenge. This is reflected in the finding that while 74 percent of countries have in place policies to ensure equal access to HIV-related services for vulnerable groups, 57 per cent of these have legislation or enforcement policies that impede access to HIV services.
The recently concluded UN High Level Meeting affirmed that scaling up focused HIV-prevention strategies for populations most at risk represents an urgent public health imperative, requiring a degree of political courage and leadership that has often been lacking.
“Throughout the world, methadone and buprenorphine therapy for opioid dependence has been shown to be effective. One of the goals of the International AIDS Society is for science and reason to prevail over ideology in the response to HIV/AIDS. But scientific evidence often does not prevail on its own,” said Craig McClure, IAS Executive Director, “greater leadership is needed from scientists, health professionals, governments and the UN in working towards elimination of legal obstacles to harm reduction and substitution therapy.”
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