|The Asian Harm Reduction Network (UNAIDS, 2001, 48 p.)|
In the past two decades, many countries in the Asian region have witnessed dramatic changes in drug-use patterns, with more individuals switching from smoking to injecting. These changes have resulted in the deterioration of the health status of drug users. Newer and more potent forms of drugs have flooded the Asian markets, and there has been a rapid increase in the numbers of drug users all across Asia. Legal and social impediments to needle and syringe availability have caused users to inject with inappropriate equipment in unhygienic circumstances. We have begun to see ugly wounds and abscesses among the injecting drug users (IDUs) and a rapid increase in the numbers of drug users infected with hepatitis B/C and HIV.
While the adverse consequences of injecting drug use have increased dramatically over the years, the prevention, treatment, and care services provided for drug users still remain far from adequate. Most of the existing services often provide only short-term detoxification or rehabilitation regimens, sometimes under inhuman and punitive conditions. Most services still do not take into account the fact that drug use is a chronically relapsing problem and needs long-term treatment and care. In some parts of Asia, hospitals still refuse to treat a sick person if the doctors find out that he or she is a drug user. In other parts of the region, authorities continue to jail drug users and even threaten with legal action those individuals and organizations that attempt to provide services to them.
Despite large-scale offensives in the various wars on drugs in Asia, the prevalence of drug use continues to rise. In some Asian countries injecting drug use has fuelled the HIV epidemic, and we see alarmingly high prevalence rates among IDUs. Yet, very little research exists to establish why drug users resort to sharing injecting equipment despite the knowledge of the inherent danger to health and welfare.
It is alarming to see that, despite the compelling evidence of high relapse rates and the failure of detoxification alone to address the serious public health issues of drug use, traditional methods striving for abstinence continue to be used across the region. Many of us who work in the field began in a similar manner but, on seeing the poor outcomes, have implemented innovative and appropriate treatment, rehabilitation, and care programmes that have proven to be more effective. Nonetheless, these programmes are few and far between, and there is an urgent need to scale them up to meet the challenges that HIV/AIDS poses to our communities. Members of the Asian Harm Reduction Network have more than 20 years of experience in working with drug users to protect them from the adverse consequences of drug use.
As this case study shows, programmes addressing drug-related harm in Asia often worked in isolation and lacked support, and their staff frequently suffered from severe stress and burnout, having all too often been subjected to unreasonable criticism and harassment.
With the creation of the Asian Harm Reduction Network, an unprecedented mechanism was established to support these pioneering programmes and assist others in their efforts to The Asian Harm Reduction Network set up much-needed harm-reduction programmes. The network initiated processes to sensitize governments to the problems facing drug users and their families, and it continues to provide technical assistance and support to agencies in Asia.
I would like to take this opportunity to thank all our members for their trust and support and to urge them to continue to strive for humane and pragmatic approaches for reducing drug-related harm in their countries. I would also like to thank all the international organizations and their staff members, bilateral donors and agencies, and the many individuals for their continuing support to AHRN. I hope this case study will be a valuable source of information for all our colleagues and friends addressing drug use and HIV/AIDS, and that it contributes to a deeper understanding of the benefit of networks and, in the final analysis, helps those who need help most - the drug users, their families, and our communities.
Chair, Executive Committee, Asian Harm Reduction Network