From Policy to Practice: Responding Comprehensively to Drugs and HIV
With the following words, Deputy Executive Director and Global Coordinator for HIV/AIDS of the United Nations Office on Drugs and Crime, Mr Aldo Lale-Demoz, greeted the opening of the regional Conference titled: “From policy to practice: Responding comprehensively to drugs and HIV”, held in Astana, Kazakhstan on 26th-27th June 2014.
Ladies and gentlemen, friends, good morning? It is a great pleasure for me to address you via this video message. Today, as we begin two days of discussions on how to respond comprehensively to drugs and HIV, the world also commemorates the international day to recognize drug abuse and illicit trafficking.
It is no coincidence that we kick off this meeting on the 26th of June. It is a way to remind ourselves that when responding to illicit drugs, the issue of health needs to be at the center of a comprehensive response.
I would like to welcome and thank you for joining UNODC in Astana Kazakhstan. It is a rare opportunity to have high-level policy makers as well as experts, and representatives of civil society organizations from eight central and west Asian countries in one room to discuss drugs and HIV. This would make for good discussions I am sure. I also welcome and thank participants from international organizations, donors and colleagues from the UN family. And last but not least, my sincere thanks to the government of Kazakhstan for hosting this event and for its unwavering support to the implementation of the UNODC programs and projects. Our office is mandated to assess countries in the struggle against illicit drugs, crime and terrorism. Also within the UNAIDS family, UNODC is a convening agency for addressing HIV prevention, treatment and care among people who use drugs, and for people living in prisons. At the UNODC we promote a balanced approach to illicit drugs; one that is founded on fundamental human rights. UNODC assists countries to achieve universal access to comprehensive HIV services for people who use drugs and for people living in prisons, following an approach that puts people’s health and human rights at the center of our technical assistance provision, as we advocate for comprehensive national HIV responses. HIV transmission, through unsafe injecting drug use, is one of the main unresolved challenges facing the international community. It is largely due to continued high threats of HIV transmission in Eastern Europe, central Asia, south Asia, and south East Asia as well as worrying trends in parts of the sub-Saharan Africa. Unfortunately, these high rates have often been the result of widespread stigma, discrimination and lack of evidence-informed HIV services, including services for women and young people.
Considerable progress has been made but we still have a huge task ahead of us. The 2011 UNGUST target of reducing renewed HIV infections by 50% among people who inject drugs by the year 2015 is just around the corner. We need to intensify efforts if we are to reach the target. In this context, UNODC is doing its utmost to strategically use its experts and to leverage its modest financial resources to assist countries to move toward meeting this target.
In 2013, jointly with key civil society organizations and other stakeholders UNODC selected 24 high priority countries where we have intensified our war, and six of them are represented here today: Iran, Kazakhstan, Kiersten, Pakistan, Tajikistan, and Uzbekistan. The objective is to support you and your efforts to reach optimum coverage of the nine core interventions for people who inject drugs as recommended by WHO, UNODC, and by the UNAIDS.
Ladies and gentlemen, reaching this target would certainly require a shift in mindset, and an increase in access to services in all high priority countries, But it will also require considerable investments. Still today, the global HIV spending is just too little to reach the target. In 2011, the global HIV spending for people who inject drugs represented only 22% of the estimated 2.3 billion dollars needed annually. International donors account for 92% of that funding. While a large number of countries have increased their domestic investment for AIDS in general, only a few prioritized the provision of essential HIV services for people who inject drugs.
Interventions are good value for money. There is compelling evidence of the cost effectiveness of each of the three interventions, namely, needle-syringe programs, OST and antiretroviral therapy across all regions of the world with average costs per HIV infections averted, ranging from a hundred to a thousand U.S. dollars. I encourage you to advocate for greater domestic investment, for this essential life-saving HIV services, both in the community and in prison settings and include these interventions in the national health budgets.
We know that the absence of an enabling, legal and policy environment, and supporting regulatory framework continues to hamper effective implementation of this harm production interventions. Also, too many people are unnecessarily incarcerated because of drug use. But prison is not a treatment of drug use. Instead, prisons increase the risk of HIV transmission among the prisoners as well as the broader community. We all have a role to play in ensuring that policy in legislative changes required in countries do take place. In that context, I also encourage you to advocate for investing in alternatives to incarceration for drug use.
The world can only achieve the United Nations target by ensuring that the needs of one of its most vulnerable and affected population groups are met. We have the science on our side; we know what needs to be done; and now it is a matter of putting together science, public health and human rights considerations in all drug-related responses. We can literally save thousands of lives.
On this words, I wish you all a productive and fruitful conference. May the outcomes of your discussions and the key messages of this meeting find a way back home and into your communities, and may they spark changes to ensure no one is left behind. Thank you for your attention.