“Despite pledges from governments across Eastern Europe and Central Asia to fight HIV/AIDS — one of the eight Millennium Development Goals — the region has the world’s fastest-growing HIV epidemic,” Inter Press Service reports in an article examining challenges to stemming the spread of the disease, particularly among injection drug users. “Punitive drug policies, discrimination and problems with access to medicines and important therapy are all driving an epidemic which is unlikely to be contained, world experts say, until governments in countries with the worst problems change key policies and approaches to the disease,” the news service writes. According to experts and activists, a lack of opiate-substitution therapy (OST) and needle-exchange programs, as well as discrimination against and “active persecution” of drug users who try to access therapy programs, contributes to the spread of HIV, IPS notes (Stracansky, 9/3).
The Center for Global Health Policy’s “Science Speaks” blog examines how the “U.S. travel bans on people involved in sex work and people who have used illegal drugs … kept many of the people at highest risk from coming to the [XIX International AIDS Conference (AIDS 2012)]” in Washington, D.C., last month. “The result, observers said afterward, was a larger conference with fewer sex workers than had brought their first-hand experiences and concerns to Vienna and Mexico City,” according to the blog. Carlos Laudari, senior technical adviser for HIV AIDS prevention at Pathfinder, “and others said those in absentia were not the only ones disempowered; the loss of sex worker and drug user input on how to realize the goals of treatment as prevention, on barriers to funding, testing, health care access, and for that matter, on the difference between sex work and sex trafficking — commonly, and erroneously equated — weakened the dialogue and the action they were intended to inform,” the blog writes and quotes several other advocates (Barton, 8/8).
“Methadone treatment is proving to be the most efficient way to wean people in Bangladesh from addiction to buprenorphine, a pharmaceutical drug, and health experts say it should be expanded to reach thousands more drug users to prevent the spread of HIV,” IRIN reports. The news service notes that “illegal use of pharmaceutical substances, mostly buprenorphine, is on the rise” in the country. “Buprenorphine was intended to be used to wean injecting drug users, also known as people who inject drugs (PWID), from narcotics like heroin, but has itself become a substance of addiction, with users injecting a liquid form of it,” the news service notes, adding, “Methadone, a pain reliever, suppresses withdrawal symptoms and blocks craving.”
IRIN reports on HIV prevention efforts aimed at injecting drug users (IDUs) in Thailand, noting HIV prevalence among Thai IDUs is “among the highest in the Southeast Asia region, according to the Global AIDS Response progress report by” UNAIDS. “Providing free clean needles and syringes has proven to be the safest and most effective way to prevent new infections among injecting drug users,” but “the Council of State, Thailand’s central legal advisory body, has interpreted any needle distribution program as promoting drug use, Petsri Siriniran, director of the National AIDS Management Centre in the Public Health Ministry’s Department of Disease Control, told IRIN,” the news service writes. However, “the ministry is collaborating on a pilot project, run by PSI since 2009, in which counseling and sterile syringes are provided through drop-in centers and outreach services in 19 of Thailand’s 76 provinces,” according to IRIN.
“Excitement about turning the tide in the fight against HIV is being tempered by researchers who worry some of the most vulnerable populations will miss out on medical advances,” delegates of the XIX International AIDS Conference (AIDS 2012) heard at Thursday’s plenary session, VOA News reports (Seldin, 7/26). Ugandan physician Paul Semugoma, who works with homosexual and transgender patients, told the session that one of the biggest challenges is reaching people at risk of HIV infection with prevention information, especially when stigma and discrimination are prevalent, VOA says in another article (7/26). “Semugoma says too many physicians fail to ask their patients about their sexual histories in a misguided effort not to discriminate,” VOA writes (7/26). Researcher Cheryl Overs of Australia’s Monash University spoke about how discrimination and stigma hinder the AIDS response among sex workers, VOA reports in yet another article (Seldin, 7/26). Speaking about new HIV prevention methods, Overs said, “The risk to sex workers of all genders will be enormous if condoms are replaced by partially effective HIV methods that do not protect against STIs [i.e., sexually transmitted infections] or unwanted pregnancies,” according to the news service.
“It is outrageous that, in 2012, when we have everything we need to beat AIDS, we are still fighting prejudice, stigma, and exclusion,” UNAIDS Executive Director Michel Sidibe writes on the Human Rights and HIV/AIDS “Now More Than Ever” blog, adding, “It is my daily reminder that the AIDS response is not just about an epidemic; the AIDS response is, has been, and must be, an instrument to fight for social justice.” He concludes, “[O]ur common aspiration is clear: a world where no one gets infected with a preventable virus, no one dies of a treatable disease, and no one faces discrimination for a health condition. We have tools to stop HIV transmission, deaths and discrimination. Human rights demand that we deliver these tools to every community and person affected. By doing so, we help to transform societies into the inclusive places they should be” (7/25).
“AIDS activists gathering in Washington, D.C., and Kolkata, India, this week have denounced conditions attached to U.S. global AIDS funding, which they say have damaged the response to the epidemic by further marginalizing sex workers — among those hardest hit” by the epidemic, the Guardian reports. “International organizations that receive funds through [PEPFAR] must sign an ‘anti-prostitution pledge’ prohibiting them from doing anything that could be perceived as supporting sex work,” the news service notes. According to the Guardian, “U.S. organizations that receive PEPFAR money are no longer bound by the pledge, after successfully taking the government to court on the basis that the conditions attached to funding violate first amendment rights,” but “organizations outside the U.S. are still required to sign it” (Provost, 7/25).
Noting that former British Prime Minister Margaret Thatcher’s special cabinet committee on AIDS in 1986 “decided there should be clean needle exchanges for injecting drug users (IDUs) to prevent the spread of HIV,” Norman Fowler, a member of the British House of Lords and former British health secretary, writes in The Hill’s “Congress Blog,” There is no question that needle exchanges and drug substitution have reduced HIV: only two percent of new infections in Britain now come through that route.” In addition, “The policy has neither encouraged drug taking nor crime. Similar reports come from other nations that have adopted this approach,” he says, continuing, “Tragically, not all nations have followed such a lead,” including the U.S. and the Ukraine. Fowler adds, “If the U.S. was to reconsider [its recently reinstated] ban [on funding domestic and international needle exchanges] and recognize that without needle-exchange programs it is impossible to provide full protection from the spread of HIV and the death and suffering that goes with it, it would send a message around the world” (7/20).
Punitive Laws, Human Rights Violations Inhibiting Global AIDS Response, Global Commission On HIV And Law Report Says
“Punitive laws and human rights abuses are costing lives, wasting money, and stifling the global AIDS response,” according to a report (.pdf) released Monday by the independent Global Commission on HIV and the Law, which estimated the number of new HIV infections worldwide could be halved from 2.1 million to 1.2 million annually with changes in law and public policy, BMJ reports (Roehr, 7/9). The report, “based on 18 months of extensive research and analysis, as well as first-hand accounts from more than 1,000 people in 140 countries,” “finds evidence that governments in every region of the world have wasted the potential of legal systems in the fight against HIV,” according to the U.N. News Centre. The commission comprises “former heads of state and leading legal, human rights and HIV experts, and [is] supported by the U.N. Development Programme (UNDP) on behalf of the Joint United Nations Programme on HIV/AIDS (UNAIDS),” the news service notes (7/9).
African Leaders Should 'Take Action' To Implement Human-Rights Based Laws, Policies To Enhance HIV Response
Noting the release of a report (.pdf) from the Global Commission on HIV and the Law showing that “punitive laws are standing in the way of effective AIDS responses,” Festus Mogae, former president of Botswana, and Stephen Lewis, co-director and co-founder of AIDS-Free World, both members of the commission, write in a health-e opinion piece, “We cannot hope for an HIV-free generation when we have laws that marginalize and punish those most vulnerable to the disease.” They state that certain laws and customs in Africa “undermine the ability of women to protect themselves” and marginalize sex workers and men who have sex with men (MSM).