27 June 2001


Press Briefing


Injecting drugs was one of the most efficient ways of spreading HIV/AIDS, Dr. Diane Riley of the International Harm Reduction Association told correspondents this afternoon during a press conference at Headquarters.

It was one reason why HIV/AIDS spread explosively when it entered the population of injecting drug users, their partners and their families.  There were more than 130 countries where drug injecting took place, and that number was rising.  “In all the focus on reducing the rate of spreading of various epidemics and the HIV/AIDS pandemic, far too little attention is paid to the role of drug use”, she said.

Twenty two per cent of the people with HIV/AIDS used drugs, and that number was rising.  In many countries, HIV/AIDS related to injecting drug use accounted for the bulk of the infected population.  That was especially true in Central and Eastern Europe and Asia.

Ton Smits, Asian Harm Reduction Network, said his organization, based in Thailand, had almost 2,000 members, consisting of individuals, programmes, non-governmental organizations, government officials and international organizations.  Injecting drug use was the main mode of HIV/AIDS transmission in an increasing number of countries in Asia.   Projections for 2004 on total infections in India and China were mounting up to 30 million.  In China, Viet Nam, Malaysia and Myanmar, a majority of all new infections occurred among injecting drug users.  For China, that number was 70 per cent.  He noted that most projections from the past had been very optimistic.

This was alarming, Mr. Smits said, because in most countries in the region there were no policies in place to support harm reduction.  There was a lot of misunderstanding and a double stigma surrounding drug use and HIV in Asia.  The United Nations position paper on “Preventing the Transmission of HIV among Drug Abusers” was very clear on drug policies.  It was sad to observe that during the special session, delegates had not used this and other existing papers to do something about the challenge.  Investing in services to drug users was investing in the entire population, because by assisting drug users in their needs, one could prevent a further spread of HIV/AIDS into the general population.

Answering a correspondent’s remark about the lack of care and diagnostic services in India, Mr. Smits said that there was a lack of infrastructure and a lack of access to appropriate services for drug users.  Many drug users would like to enter treatment, but the number of slots available was not adequate -- not only in India -- but everywhere in the world.  Dr. Riley added that in Central and Eastern Europe the rate of spread was alarming.  Often in war-torn areas, drug use and injection tended to increase.  It was also true in the United States and in Canada among urban, young populations, as well as among the aboriginal population.  “The numbers there are staggering”, she said.

Asked how the spread of the disease among drug users could be prevented, Mr. Smits said drug users were often in an isolated position.  It was important that somebody tapped into their needs.  If services were not provided, it would be

extremely difficult to get drug users involved in prevention of the spread of HIV/AIDS to others.  Services needed to be tailored to the needs of drug users.  A comprehensive approach varied from outreach to drug treatment, drug substitution, needle exchange and peer education.

In answer to a question about the distinction between harm reduction and legalization of drugs, Dr. Riley said the harm reduction group and the legalization group were two different movements.  However, one aspect of harm reduction was to reduce the harm caused by drug policies and laws.  Harm reduction had to look at laws at the national and regional levels and in terms of international treaties that were exacerbating harms by contributing to the spread of HIV and Hepatitis C and the increase in violence due to the drug trade.  There were many shades of drug control.  At the moment there was no control at all.  She would like to see more regulation of drugs.

Mr. Smits said the regional perspective was very important in that regard.  In Central and Eastern Europe and Asia, harm reduction was simply about “If you can’t be good, be safe”.  In those parts of the world, harm reduction did not stand for drug law reform.  Social marketing of harm reduction as a strategy for preventing HIV was critical.

While people were not ready to kick their habits, he said, provisions needed to be put in place to protect them and their partners against HIV and other drug-related harms.  Providing (under strict conditions) needles and syringes to drug users offered an opportunity to talk to them.  It was an entry-point for the provision of other services.  Those services also included talking about safer sex.

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For information media. Not an official record.