UN drug policy 'out of touch' says expert
Updated
Later this morning the 20th International Harm Reduction Association's annual conference will get under way in the Thai capital Bangkok.
The IHRA promotes policies that attempt to reduce the adverse health, social and economic consequences of drug use. This year's theme is "Harm Reduction and Human Rights".
Presenter: Joanna McCarthy
Speaker: Professor Gerry Stimson, Executive Director of the International Harm Reduction Association
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STIMSON: Harm reduction really tries to be pragmatic and tackle the consequences of drug use and, in fact, alcohol use as well. In fact, harm reduction really started 20 years ago in Australia, Europe and elsewhere trying to tackle the spread of HIV amongst people who inject drugs. Quite simple interventions, needles and syringes, methadone treatments and it's been really effective in many parts of the world. Australia is a really good example of how HIV epidemics have been controlled through harm reduction interventions.
McCARTHY: Well George W Bush's government of course put a whole lot of money into the battle against HIV but wasn't particularly fond of harm reduction measures. Have you seen a change to the US approach under the new administration?
STIMSON: Those two words, harm reduction, still send fears amongst many American policy-makers but there is really beginning to be a shift. We've had a problem over the last 20 years both domestically in the US and internationally because the US funds a lot of AIDS prevention work but wouldn't fund anything to do with needles and syringes. The turn-around is beginning to happen. Obama is in favour of needle exchange and just last month the US Government said that it would no longer object to needle exchange internationally. I mean it's been a big problem internationally because the US has interfered at an international political level. So there's a shift, the US is now in favour of the needle exchange and, of course, the US has always been in favour of methadone. Methadone started there. So they're unlikely to use those two words "harm reduction" but they're endorsing the main components.
McCARTHY: The United Nations meanwhile has just released its Political Declaration on Drugs which will guide drug policy for the next 10 years, but you're quite critical of their approach, why is that?
STIMSON: Really critical. There was a long, long battle again about these words "harm reduction" and at one stage these words were in the text of the political declaration, then they were relegated to a footnote and at the last minute they were voted out by a number of countries. The Commission on Narcotic Drugs is a small bit of the UN and it's really out of touch with the rest of the UN on harm reduction. The United Nations General Assembly endorses harm reduction, the World Health Organization endorses harm reduction, all the major UN agencies endorse it except this one bit. So it's a real difficulty because, you know, there are many countries who go to this Commission of Narcotic Drugs who are still banging on for repressive supply and demand reduction measures and won't accept the reality of the world that we've got to do some realistic pragmatic things to prevent drug related harms.
McCARTHY: Looking at our own region, in South-East Asia, only 3% of people who inject drugs actually have access to harm reduction measures. After so many years of NGOs and governments and UN agencies working on preventing the spread of HIV, that seems like an extraordinarily low number, what accounts for that?
STIMSON: Is it is a scandal. There are some good things. If we were talking 20, 25 years ago we'd be thinking of maybe, you know, maybe 5 or 10 countries which were doing harm reduction. There are now over 80 countries which support harm reduction around the world. There are another 74 where there are people inject drugs who get absolutely no harm reduction at all. But the coverage issue that you just mentioned, how many people have accessed the services, is a real, real problem. And part of it is about resources. We just done some calculations and we think there's only about 200 million US dollars a year going into harm reduction in poor countries. That's just 2 per cent of the total global AIDS budget. It amounts to about 4 US cents per drug-injector per day. It's really scandalous and we've got to put a lot of pressure on international agencies and the Global Fund on AIDS, Tuberculosis and Malaria to really up the investment in harm reduction.
McCARTHY: Well on that point the Global Fund is announcing a US $100 million project to tackle HIV in Thailand. That's going to include $20 million for IV drug-user program, how significant is that program?
STIMSON: It's very important. Thailand has made very good progress on other aspects of AIDS prevention here. You know, the 100 per cent condom campaign. Thailand really has lagged behind. I mean they've known in Thailand - one of the first visits I made to Thailand was in 1988, 21 years ago when they first discovered HIV among injectors. They'd had a lot of advice over the years but really had not got to grips with this key area. So the Global Fund money is really important and we hope that the Thai Government around now is really going to make some strong public statements in support of HIV prevention for people who inject drugs.
