Tuesday, 19 July, 2011 (Rome, Italy) -- As a part of its new initiative, Expanding Access to Opioid Substitution Therapy (OST) for People Who Inject Drugs in Eastern Europe and Central Asia (EECA), the International AIDS Society (IAS) will launch a Virtual Knowledge Centre (VKC) in partnership with the Ukrainian Institute on Public Health Policy (UIPHP).
The announcement was made today at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011), which runs from 17-20 July in Rome and is being attended by more than 5,000 researchers, clinicians and community leaders.
The VKC initiative is a scaling up of the commitment by IAS to drug policy which it adopted as one if its four key priority areas in late 2010. Provision of OST, a call for expanded access to antiretroviral therapy (ART) for injecting drug users living with HIV, campaigning against the criminalization of injecting drug users, and a special focus on the EECA region underpin the policy. (1)
The VKC will strive to contribute to improved knowledge and strengthened operations research capacity for scale up of HIV/OST programmes for people who inject drugs by creating an increased Russian-language evidence base around OST, harm reduction and HIV, as well as specialized documents and training modules relevant to professionals, public health experts, narcologists, students, parliamentarians, NGOs and any other interested and involved parties working in this field in EECA. (2)
"The IAS believes that evidence-based interventions are the best way to implement HIV treatment scale-up and will continue to advocate for expanding access to Opioid substitution therapy," said IAS governing Council member Chris Beyrer, who is the Director of the Johns Hopkins Center for Public Health and Human Rights in Baltimore, USA. "The science has been in since the very beginning of the AIDS epidemic 30 years ago - OST and clean needle exchange programs save lives."
Outside of sub-Saharan Africa, injecting drug use accounts for approximately one in three new cases of HIV. In some areas of rapid HIV spread, such as in Eastern Europe and Central Asia, injecting drug use is the primary cause of new HIV infections. Legal barriers to scientifically proven prevention services such as needle and syringe programs and OST mean hundreds of thousands of people become infected with HIV and Hepatitis C every year. In Russia for instance some 60 per cent of new HIV infections are linked to injecting drug use and some 80 per cent of the one million people living with HIV are estimated to be less than 30 years of age. OST is illegal in Russia.
OST is proven to be one of the most effective methods of intervention, prevention and care for people who inject drugs and hence prevent the transmission of HIV. However, globally, treatment with methadone and buprenorphine reaches only eight per cent of injecting drug users. In 2007, only 2 per cent of injecting drug users in developing countries with injection-driven HIV epidemics was accessing treatment for Opioid dependence.
Many countries in the EECA regions have been slow to adopt human rights based public health approaches to illicit drug policy, despite compelling evidence that a human rights based policy and decriminalization of drug use is the most effective approach to decreasing HIV transmission and improving treatment outcomes.
Another major challenge is the criminalization and drug policy laws that many governments have in place. Because drug use is illegal, many local police forces increase surveillance near needle exchange programs or drug treatment facilities. This increased surveillance causes fear amongst drug users and increases syringe sharing while decreasing the amount of individuals seeking health-care. For those who are arrested or caught for illegal drug use, punishment includes harassment, beatings, or detainment.
"It really is time to switch from criminality to care and put an end to registries, put an end to compulsory drug detention and ended the imprisonment for drug use/possession for personal use, " said Patrizia Carrieri, a researcher at the French National Institute for Health and Medical Research (INSERM U912). "Governments need to stop portraying drug users as less than human and therefore less deserving of their human rights and access to proper treatment and care."
In the Ukraine up to 75 per cent of people living with HIV are dying from tuberculosis, and prisons are becoming incubators of MDR-TB filled with people convicted for minor possession. Irina Borushek , an activist with the All-Ukrainian Network of People Living with HIV/AIDS is patient pointed out that the recent implementation of a high quality drug dependency treatment programme on which she herself is a patient, should become the norm, not the exception.
."Unless we make radical changes in drug policy, ensure effective scale up of drug comprehensive drug treatment, first of all, substitution treatment, and prioritize healthcare principles over repressive drug policy - we will fail to overcome HIV epidemic," said Borushek.
Liudmyla Sulga from the International HIV/AIDS Alliance in Ukraine and a Senior Lecturer in the School of Public Health at the National University of Kyiv-Mohyla Academy in Kiev said that law reform was an essential step if treatment was to be expanded across the Ukraine.
Alliance Ukraine is the largest NGO in the field of AIDS in Ukraine providing HIV prevention programmes to more than 240,000 people. The organization was instrumental in starting and rolling out medically assisted treatment for people who inject drugs.
In recent months however Alliance Ukraine has been lobbying to stop the systematic obstructions to the legal substitution treatment programmes for people who use drugs. Interference of law enforcement bodies into treatment programmes has created an atmosphere of fear for both patients and medical staff and has resulted in the failure to meet the National AIDS programme targets.
"Further treatment programme expansion in the Ukraine will only be possible if there is a revision on drugs administration, using liquid forms of methadone and making drug administration and control more flexible for medical institutions," concluded Shulga.
|Contact: Lindsey Rodger|
International AIDS Society