Rising drug use presents HIV Threat in Asia
Asia is under threat of an explosion in HIV infection due to a rise in drug injection and a lack of effective interventions to address the problem, the World Health Organization warned.
The use of drugs - mainly methamphetamines but also heroin - has risen across the Region as drugs have become cheaper and more widely available. Changing social environments and the loss of traditional social support systems have also fuelled the problem.
As HIV can be easily transmitted through the sharing of injecting equipment, the virus has spread rapidly among some groups of drug users. In the 1990s, HIV infection rates among injecting drug users (IDUs) increased rapidly by over 50% within only a few months in some areas of India, Myanmar and Thailand and also recently in Indonesia.
Drug injecting has historically been closely linked to Asia's AIDS problem and is still the driving factor behind the epidemic in many countries. It accounts for 60% to 70% of all HIV infections in Malaysia, Myanmar, Viet Nam and China.
In China, some estimates have put the number of IDUs at three million, about half of whom share needles and syringes. In Indonesia, studies indicate that more than a third of IDUs are infected with HIV and it is estimated that one drug-related death from AIDS occurs in Jakarta every day. In Myanmar, as well as in Viet Nam, there are some areas where HIV prevalence among IDUs is as high as 85%.
"There is a real public health crisis here which has not been well recognized," said Dr Shigeru Omi, Regional Director of WHO's Western Pacific Region. But despite the growth of the problem and its impact on public health, not nearly enough has been done to address the crisis. Effective HIV prevention and drug treatment programmes are few, while punitive treatment and incarceration are common. "People must have access to drug treatment and information and resources to protect themselves from HIV," advocated Dr Omi.
In response to this issue, WHO is holding a three-day meeting on harm reduction among IDUs in Ha Noi, Viet Nam. Participants include national policy-makers and nongovernmental workers from four critically affected Asian countries - China, Indonesia, Myanmar and Viet Nam - together with experts of various agencies, partners of WHO.
"The problem has not been dealt with adequately," Dr Uton Muchtar Rafei, Regional Director of WHO's South East Asia Region, also said. "We want to show that this is a public health issue, that there are strategies that work and that WHO will support such programmes in the Region."
Harm reduction programmes - which involve information campaigns, education, needle and syringe exchange programmes, and expanded drug treatment - have helped to stabilize HIV infection rates as low as 1% among IDUs in Australia.
The Ha Noi meeting aims to develop culturally appropriate national harm reduction programmes within a Regional partnership framework. Participants will also be updated on harm reduction tools and guidelines developed by WHO in collaboration with the Harm Reduction Centre of the Macfarlane Burnett Institute in Australia.
For more information, please email Dr Bernard Fabre-Teste, WHO/WPRO Regional Adviser on Sexually Transmitted Infections, including HIV/AIDS (FabreTesteB@wpro.who.int) or Dr Ying-ru Lo, WHO/SEARO Medical Officer ( loy@WHOSEA.ORG ).