Implementing social media and internet-based interventions for LGBT in Brazil; increasing life skills of young women and girls involved in sex work in Uganda; introducing mobile CD4 count machines to efficiently screen PLHIV who need Antiretroviral Therapy (ART) in Pakistan; addressing forced drug treatment centres across Eastern Europe and Central Asia; and developing a global advocacy agenda for key populations living with HIV. These are just a few examples of activities and results of the first phase of the Bridging the Gaps programme. In September 2011, five Dutch NGOs, four global key population networks and more than 70 in-country partner organisations started working together in the programme Bridging the Gaps – Health and Rights for Key Populations. Main goal of this partnership, which is funded by the Dutch Ministry of Foreign affairs, is to achieve universal access to HIV/STI prevention, treatment, care and support for key populations. Two years into the programme, Bridging the Gaps has collected some of its main achievements thus far in this publication ‘Universal Access? Not without Rights!’.

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Universal access? Not without rights! 

As world leaders prepare to meet at the United Nations General Assembly to review progress towards the Millennium Development Goals—a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows dramatic acceleration towards reaching 2015 global targets on HIV.

New HIV infections among adults and children were estimated at 2.3 million in 2012, a 33% reduction since 2001. New HIV infections among children have been reduced to 260 000 in 2012, a reduction of 52% since 2001. AIDS-related deaths have also dropped by 30% since the peak in 2005 as access to antiretroviral treatment expands.

By the end of 2012, some 9.7 million people in low- and middle-income countries were accessing antiretroviral therapy, an increase of nearly 20% in just one year. In 2011, UN Member States agreed to a 2015 target of reaching 15 million people with HIV treatment. However, as countries scaled up their treatment coverage and as new evidence emerged showing the HIV prevention benefits of antiretroviral therapy, the World Health Organization set new HIV treatment guidelines, expanding the total number of people estimated to be in need of treatment by more than 10 million.

This report on the global AIDS epidemic contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children.

Global report – UNAIDS report on the global AIDS epidemic 2013

A change of drug policy paradigm is necessary, placing the restoration of drug users' dignity at the centre of the debate, respecting the international rules of human righst and promoting inter-sectorial responses based on integrated perspectives.

Drug policies in Latin America and Asia: Towards the construction of responses focused in human rights

The expert seminar on “Where next for Europe on drug policy reform?” took place in Lisbon, Portugal, from 20th to 21st June 2013. As per tradition, the meeting was held under Chatham House rule to ensure confidentiality and allow participants a free exchange of ideas. Over 40 participants attended the meeting, including European and national policy makers, practitioners, academics and representatives from non-governmental and governmental organisations. Four themes were discussed:

the EU Drugs Strategy and Action Plan and its public health implications

the EU Drugs Strategy and Action Plan and its law enforcement implications

regional challenges and the issue of new psychoactive substances

the role of Europe in global drug policy and the European voice in preparation for the 2016 UNGASS.

Each session started with introductory remarks from key experts, followed by discussions. This report highlights the main issues covered during the seminar. The ideas expressed in the report are those of the participants in their capacity as experts in the drug policy field, and should not be interpreted as reflecting consensus among the group, or endorsement by the organisers.

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Report of IDPC/SICAD Expert seminar - Where next for Europe on drug policy reform?

A new study published in the British Medical Journal Open finds that the prices of illegal drugs have generally declined while their purity has increased over the past twenty years, raising questions about the effectiveness of international law enforcement efforts to reduce drug supply. Researchers from the International Centre for Science in Drug Policy reviewed two decades of global drug surveillance data, finding that the supply of major illegal drugs has increased, as measured through a decline in the price, while there has been a corresponding general increase in the purity of illegal drugs.

“These findings add to the growing body of evidence that the war on drugs has failed,” said study co-author Dr. Evan Wood, Scientific Chair of the International Centre for Science in Drug Policy and Canada Research Chair in Inner City Medicine at the University of British Columbia. “We should look to implement policies that place community health and safety at the forefront of our efforts, and consider drug use a public health issue rather than a criminal justice issue. With the recognition that efforts to reduce drug supply are unlikely to be successful, there is a clear need to scale up addiction treatment and other strategies that can effectively reduce drug-related harm.”

Researchers reviewed indicators of drug supply in consumer markets such as Europe, the United States, and Australia, and drug seizures in drug-producing regions such as Latin America, Afghanistan, and Southeast Asia. Data were derived from government surveillance systems. The study found that:

With the exception of powder cocaine, the purity and/or potency of illegal drugs in the U.S. generally increased during the study period;

The price of illegal drugs, with few exceptions, generally decreased globally; and,

Seizures of cannabis, cocaine, and opiates generally increased in major drug production regions and major domestic markets.

The temporal relationship between drug supply indicators: An audit of international government surveillance systems

This set of brochures provides information on HIV and hepatitis prevention and treatment, harm reduction services and safer ways of injection.

Skoun Brochures on harm reduction

The Ministry of Health, Treatment and Medical Education of Iran has recently announced an estimated figure of 200,000 injecting drug users (IDUs). The aim of this study was to pilot a national program using demographics, types of drug abuse and prevalence of blood-borne infections among IDUs.

Prevention programs about harm reduction, treatment and counseling should include young IDUs as a core focus of their intervention structure.

Click here to read the full publication (restricted access).

Descriptive aspects of injection drug users in Iran’s national harm reduction program by methadone maintenance treatment

Kabul, the capital of Afghanistan, consists of 7 million populations from original Kabuli and from different provinces and returnees from neighbor’s countries. Kabul is known as heroin transient smuggling way, consist of more than 1000,000 people who use drug countrywide and more than 20,000 injecting drug users, there is increment of drug users.

Since April 2006, MdM has been running a model Harm Reduction (HR) program targeting Injecting Drug Users (IDUs) in Kabul within the Afghan National HIV/AIDS framework. This program was designed to introduce HR in the country. Two of the major services introduced were ART (AntiRetroviral Therapy) in April 2009 and methadone (used as Opioid Substitution Therapy) in February 2010, to mitigate and reduce HIV/AIDS and other blood borne viruses (BBV) among IDUs.

For many years detoxification was the only intervention available, some authorities were opposite for the Harm Reduction Program even, much still to MMT. As detoxification has 90% relapsed (WHO), HIV prevalence and other BBV are increased day by day, and that’s why MDM attempted to start a Pilot MMT program in Afghanistan-Kabul for People who use drug particularly for injectors. Finally after much more attempts and struggling against Ministry of Counter Narcotic and DRC, MDM succeed to start Methadone Maintenance Therapy Practically in Kabul February 2010.

Drug users and methadone maintenance therapy impact

A multiannual EU Drugs Strategy (the current one covers the period 2013-2020) sets out the priorities and objectives for the action on drugs of EU countries, the Commission and other EU Institutions and bodies.

The Council endorsed the EU Drugs Strategy (2013-2020) on 7 December 2012. The aim of this strategy is:

reduction in drug demand and drug supply 

within the EU, as well as a reduction as regards the health and social risks and harms caused by drugs.

The Strategy is centred around two pillars: drug demand reduction and drug supply reduction. These are complemented with three cross-cutting themes that represent the horizontal nature of the drugs problem:

information, research, monitoring and evaluation

Two successive EU Drugs Action Plans, covering the period 2013-2016 and 2017-2020 respectively, set out concrete actions to implement the EU Drugs Strategy: EU Action Plan on Drugs (2013-2016) and the EU Action Plan on Drugs (2017-2020).

The EU Drugs Strategy (2013-2020)

The report by Tony Kirby and Michelle Thornber-Dunwell (July 27, p 295)uncovers an emerging and troubling public health and community issue. The intersection of unprotected sex and use of street and party drugs is likely to amplify the transmission of HIV, hepatitis C virus (HCV), and sexually transmitted infections (STI) in men who have sex with men (MSM).

Early diagnosis and treatment is increasingly becoming, or will likely become, the dominant approach to control STIs, HIV, and viral hepatitis. With use of a similar approach for these related infections, it might become more feasible to implement coordinated control strategies that are effective. However, one of the large dangers for which we provide warning is risk disinhibition and primary prevention fatigue, which we are seeing as starting to counteract the benefits of improved access to diagnostic testing and effective treatment. In the longer term, research with vulnerable MSM is needed to better understand the range of relevant factors including how these men perceive risk and balance that against pleasure and the causes of the increased incidence of unprotected sex and substance use. The results of such research can be used to strengthen the health and wellbeing of communities of MSM around the world.

Click here to read the full publication (restricted access)

HIV, HCV, and drug use in men who have sex with men

As with many western countries, New Zealand’s drug laws are out of date and are causing more harm than was originally intended. The laws carry the shadow of a prohibitionist past, have failed to keep up with innovations in drug production and supply and do not relate well to modern understandings of harm reduction and health protection.

The challenge of Benzylpiperazine (BZP) ‘party pills’ in the late 1990s and early 2000s made deficiencies in New Zealand’s drug law abundantly clear. No framework for controlling BZP and other party pills could be found within existing laws and regulations. An endless cat and mouse game began between the Government and the ‘legal high’ industry, with new psychoactive substances (NPS) coming onto the market as quickly as existing substances could be banned.

This prompted the New Zealand Government to order a review by the New Zealand Law Commission of the Misuse of Drugs Act 1975 (MODA).

The recommendations from this review led to New Zealand’s ground-breaking and worldleading Psychoactive Substances Act 2013.

New Zealand’s small population and remote location make for a poor and risky market for international drug rings. Drugs like heroin and cocaine, which are present in other parts of the world, are relatively rare. The creation of NPS continues a long history of New Zealanders making the most of available resources to create
substitutes for drugs that are unavailable.

It is fitting then, that New Zealand has become the first country to pass legislation that seeks to regulate NPS to ensure they are low risk, rather than to control them through prohibition and punitive measures.

The Psychoactive Substances Act 2013 has been generally well-received by politicians, the ‘legal high’ industry and the public. It is also receiving considerable attention from like-minded jurisdictions around the world.

As we shall see, if is far from a perfect or final solution, but it bodes extremely well for future drug policy development and reform, both here and overseas.

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IDPC Briefing Paper - New Zealand’s psychoactive substances legislation

Evidence documents successful hepatitis C virus (HCV) treatment outcomes for people who inject drugs (PWID) and interest in HCV treatment among this population. Maximising HCV treatment for PWID can be an effective HCV preventative measure. Yet HCV treatment among PWID remains suboptimal. This review seeks to map social factors mediating HCV treatment access.

Combination intervention approaches need to encompass social interventions in relation to housing, stigma reduction and systemic changes in policy and health care delivery. Future research needs to better delineate social factors affecting treatment access.

Publications