HIV infection, people who inject drugs and drug prohibition

© Ari Hatziz

Alex Wodak commented for Pacific Friends on the recent Global Commission on Drug Policy, which released its groundbreaking report on 26th June. The Commission, which includes six former national presidents, Richard Branson and other world leaders, argues that the global War on Drugs is driving the HIV pandemic among people who use drugs and their sexual partners. The report is released in advance of the world’s largest gathering of HIV & AIDS experts, the International AIDS Conference, to be held in the US this July 22-27, in Washington, DC.

Dr. Wodak comments:

30% of the new HIV infections in the world occur outside Sub Saharan Africa and 30% of these involve the sharing of injection equipment in people who inject drugs. The world has known for more than two decades how to substantially reduce new HIV infections in people who inject drugs but mostly too little has been done too late. The major barrier preventing an effective response in many countries has been and still is an entrenched commitment to global drug prohibition.

As UN Secretary-General Ban Ki-Moon said in 2009 ‘In addition to criminalizing HIV transmission, many countries impose criminal sanctions for same-sex sex, commercial sex and drug injection. Such laws constitute major barriers to reaching key populations with HIV services. Those behaviours should be decriminalized, and people addicted to drugs should receive health services for the treatment of their addiction’.

In low and middle income countries, funding allocated to prevent HIV among people who inject drugs is estimated to be only 3% of that required to control the number of new infections. Global drug prohibition began just over a century ago but the contemporary system began in 1961 with the first of three international drug treaties. In the last half century, global drug production and consumption has soared and adverse consequences including deaths, disease, crime and corruption have increased in many countries. So drug prohibition has greatly magnified the twin epidemics of injecting drug use and HIV.

Fortunately civil society, including Pacific Friends of the Global Fund to Fight AIDS, TB and Malaria, have been an important part of a global push back urging respect for human rights of all citizens, protection of public health and the prudent use of scarce resources. In the last 12 months, there has been a growing recognition that drug prohibition is ineffective, often seriously counter-productive and always expensive. The Global Commission on Drug Policy has played a critical role in changing the international perception about drug prohibition and increasing support for a new and more effective response to drugs and HIV infection among people who inject drugs. 

Why has this all taken so long?