Sunday, April 27, 2008

DALYs for DC

Interesting story below about the expansion of needle exchange in DC, set for the summer.

Looks like DC is in for some significant DALYs gained through needle distribution!


More Money for Needle Exchanges
With Congressional Ban Lifted, City to Provide Funding

By Susan Levine
Washington Post Staff Writer
Friday, April 25, 2008; Page B04

Needle-exchange efforts in the District will expand significantly by summer as $494,000 in city funding -- the first local appropriation allowed in a decade -- begins flowing to four organizations on the front line of the fight against HIV/AIDS.

Last summer, Congress lifted a ban prohibiting the city from spending its tax dollars to provide drug addicts with clean needles, an approach that jurisdictions across the country have taken to stop the disease's transmission through shared, potentially contaminated syringes. No other city or state faced the same restriction, which dated to 1998.

More than half the money will go to PreventionWorks!, the sole group involved in such work during the ban, often despite tenuous private funding. It now will expand outreach to include more comprehensive disease screening of the people served through its mobile van.

Shannon Hader, director of the city's HIV/AIDS Administration, said yesterday that the other nonprofit groups that were awarded grants bring "three very different" approaches to the initiative.

Those recipients are Helping Individual Prostitutes Survive (HIPS), whose focus is men and women engaged in sex work in the District; Bread for the City, which assists the poor and homeless with a range of programs; and the Family Medical and Counseling Service, a more traditional health care provider in Ward 8.

Each will build on the work it does with intravenous drug users, Hader said. The grants are expected to double next year and be continued through 2010.

The District's rates of HIV and AIDS infection are among the worst in the country, with intravenous drug users accounting for a sizable portion of new cases annually.

Sunday, April 20, 2008

Safer Injecting Guide

FYI, a new guidebook on safer injecting for IDUs can be found at the below URL:


Heroin Blocking - Some new evidence


Review of heroin-blocking implant urged

April 17, 2008 - 11:56PM

Use of a controversial stomach implant designed to block the effects of heroin must be urgently reined in, according to drug specialists who say addicts are being harmed.

A new report found that naltrexone implants commonly cause severe adverse reactions, including extreme dehydration and acute renal failure in those who are fitted with them.

Nine Sydney specialists writing in the Medical Journal of Australia have called for an urgent review of use of the product, which blocks the effects of heroin and stops cravings for about six months.

It has not been registered or rigorously tested in Australia but about 1,500 addicts have obtained it through the Therapeutic Goods Administration's Special Access Scheme for people with a life-threatening need.

Controversy has surrounded the use of the implants for several years, with advocates arguing they offer addicts the best chance of overcoming their addiction and opponents branding them dangerous and ineffective.

One study published last March linked the implant to five deaths.

A new study published has found that of 12 implant patients who were admitted to two Sydney hospitals last year, eight hospitalisations were implant-related.

Six were suffering severe dehydration, one had acute renal failure and another had an abscess at the implant site.

"These cases challenge the notion that a naltrexone implant is a safe procedure," said study leader Nicholas Lintzeris, a senior addiction specialist at the Sydney South West Area Health Service.

He called for the widespread and unregulated use of implants to be restricted until they have been properly tested for safety and effectiveness.

Professor Robert Ali, director of the Drug Alcohol Services Council in Adelaide, agreed the product should not be so widely available.

"The disturbing suggestions of mortality and morbidity from unregistered naltrexone implants makes a strong case for an independent review to determine whether this treatment is sufficiently safe for such widespread use," Prof Ali said.

However, another specialist, University of Western Australia Professor of Addiction Gary Hulse, said a trial he had undertaken had found the implant to be just as safe and effective as the oral form of the drug.

He defended its use and said many of the criticisms levelled at naltrexone occurred because people's withdrawals from heroin were not being managed properly.

© 2008 AAP

Friday, April 11, 2008

Harm Reduction Developments 2008 - New report from Soros Foundation

Soros Foundation has published a new report: Harm Reduction Developments 2008.

The report provides a snapshot of key developments in HIV prevention, policy, and treatment for injecting drug users in countries with injection-driven HIV epidemics.

Please find a link to the report, and a summary of its contents, below.


Harm Reduction Developments 2008
Countries with Injection-Driven HIV Epidemics
March 2008

In 2007, injecting drug users (IDUs) comprised the largest share of total HIV cases in at least 20 nations in Asia and the former Soviet Union. The percentage of cases attributed to injecting drug use is over 70 percent in some countries in Eastern Europe and Central Asia, the region where HIV grew fastest in 2006.

In many of these countries, harm reduction has made important inroads—all countries in Eastern Europe and the former Soviet Union except Turkmenistan had needle exchange programs in 2007. In most, they remain too small to contain the HIV epidemic. Reports that new HIV cases among drug users have stabilized often reflect trends in testing rather than the impact of prevention. In Asia, home to more than half the world’s population, even low percentage rates of HIV cases translate into huge numbers of people infected, with profound economic and social implications. China, Indonesia, Malaysia, and Vietnam all have injection-driven HIV epidemics, and have all shown a willingness to adopt some of the measures necessary to halt the spread of HIV among IDUs and their sexual partners. The challenge for many of the hardest-hit countries, however, lies in turning commitments into practice, without sacrificing protection of human rights.

This OSI report provides a snapshot of some key developments in HIV prevention, policy, and treatment for IDUs in developing and transitional countries with injection-driven epidemics, and includes overviews on such issues as community mobilization, methadone and buprenorphine treatment availability, harm reduction in prisons, and HIV treatment for IDUs.

Wednesday, April 9, 2008

Drug use and HIV in Africa

In October 2007, the "sub-Saharan Africa Harm Reduction Network" (SAHRN) was formed to address the growing problem of drug use and HIV (and other harms) in Africa. The meeting notes are available at the following site:

PSI does not currently run interventions in Africa to directly address the issues of drug use and its associated harms, such as HIV, HEP C, overdose, etc. But HIV rates are on the rise among IDUs in many African countries. If this is an issue in your country, and you'd like to add IDU to your target groups, please don't hesitate to contact me or Mariah ( for assistance.


Thursday, April 3, 2008

New War on Drugs in Thailand

Tuesday, 1 April 2008
New Thai anti-drug policy to be announced tomorrow

A new anti-drug policy will be announced in Thailand tomorrow which many fear will mark a reinstatement 2003's brutal war on drugs.

In February 2003, the Thai government, under then Prime Minister Thaksin Shinawatra, launched a violent and murderous ‘war on drugs’ aimed at the ‘suppression’ of drug trafficking and the ‘prevention’ of drug use. In the first three months of the campaign there were 2,275 extrajudicial killings,[i] a figure that reached well over 2,500 by the end of the ‘war’. In 2007, it was found that more than half of those killed had no connection whatsoever to drugs.[ii] Added to the thousands who lost their lives, thousands more were forced into coercive drug treatment. HIV prevention efforts were also seriously compromised with fear of arrest and mistreatment driving people who inject drugs underground and away from essential harm reduction services.[iii]

In 2005, the UN Human Rights Committee raised serious concerns about the “extraordinarily large number of killings” that took place during the ‘war’ and recommended that thorough and independent investigations be undertaken.[iv] The then UN Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions, Asma Jahangir, sent an urgent communication to the Thai government in 2003.[v] In its response, Thailand said that every unnatural death would be thoroughly investigated in accordance with the law.[vi] To date, none of the perpetrators have been brought to justice.

In recent weeks, the government of Thailand has publicly stated its intention to again pursue its war on drugs. On 20 February, according to Human Rights Watch representatives in Thailand, Interior Minister, Chalerm Yubamrung, told parliament that

“… For drug dealers if they do not want to die, they had better quit staying on that road... drugs suppression in my time as Interior Minister will follow the approach of [former Prime Minister] Thaksin. If that will lead to 3,000-4,000 deaths of those who break the law, then so be it. That has to be done ... For those of you from the opposition party, I will say you care more about human rights than drug problems in Thailand”.

At the 51st session of the UN Commission on Narcotic Drugs, held in Vienna in March 2008, Thai government representatives assured fellow government delegations, UN representatives and NGOs that human rights would be respected in any anti-drug campaign. However, at the same session Thailand was among those attempting to block a resolution recognising the Universal Declaration of Human Rights and calling for all drug control to be in full conflormity with human rights.

According to the Bangkok Post, a new anti-drug campaign will be launched on April 2nd. Given the events of 2003 and the impunity for perpetrators since then, there is growing concern in Thailand and internationally at the Thai government’s plans. Human Rights Watch has already noted with concern the murders of alleged drug traffickers across Thailand since the announcement of the Interior Minister — two in Chiang Mai, one in Kalasin, and one in Krabi.

Drug law enforcement must accord with international human rights law, as stated repeatedly by the General Assembly and this year by the International Narcotics Control Board. A reinstatement of the brutal war on drugs would be a considerable retrograde step in Thailand’s progress on human rights, including its accession to the UN Convention Against Torture in October 2007.

On Human Rights Day 2007, to commemorate the 60th anniversary of the Universal Declaration of Human Rights, Thailand reaffirmed at the Human Rights Council its “unwavering commitment to the cause of human rights”.[vii] There can be no exceptions to this commitment.

The Thai government must comply with its human rights obligations before many thousands more are killed. It must announce publicly that it will not proceed with a second war on drugs.

Any new 'anti-drug campaign' must consist of integrated and comprehensive drug strategies, including harm reduction services, that comply fully with all human rights and fundamental freedoms.

A new 'war on drugs' cannot be tolerated. The international community and national and international NGOs will be watching closely.

2008 report on the possible revival of the 'war on drugs'

Report on the 2003 'war on drugs' (In English but some Thai statements are not translated)

Report on the 2007 investigation into the 2003 killings: Part 1 - Part 2

[i] See ‘Not Enough Graves: The War on Drugs, HIV/AIDS, and Violations of Human Rights’ A Human Rights Watch Report, Vol 16 No 8 (C), June 2004, p.9 (Not Enough Graves)
[ii] ‘Most of those killed in war on drug not involved in drug (sic),’ The Nation, November 27, 2007 (online at In August 2007, the military-installed government of General Surayud Chalanont appointed a special committee to investigate the extrajudicial killings during the 2003 war on drugs. The committee’s report – which has never been made public – said that of 2,819 people killed between February and April 2003, more than 1400 were unrelated to drug dealing or had no apparent reason for their killings. Human Rights Watch, ‘Thailand: Prosecute Anti-Drugs Police Identified in Abuses,’ February 7, 2008 (online at; ‘Southeast Asia: Most Killed in Thailand's 2003 Drug War Not Involved With Drugs, Panel Finds’, Drug War Chronicle, Issue 512, March 2007, (Date of last access: 5 March 2008).
[iii] ‘Not Enough Graves’, pp.36-40
[iv] Concluding Observations of the Human Rights Committee: Thailand, UN Doc. No. CCPR/CO/84/THA, 8 July 2005, paras 10 & 11
[v] Report of the Special Rapporteur on extrajudicial, summary and arbitrary executions: Summary of cases transmitted to governments and replies received UN Doc. No. E/CN.4/2004/7/Add.1, 24 March 2004, paras 557-558
[vi] ibid., para 558
[vii] Webcast available at (Date of last access: 5 March 2008)

Posted by HR2 at 13:17

Tuesday, April 1, 2008

UN Secretary General calls for decriminalisation of injecting drug users

Monday, March 31, 2008
UN Secretary General calls for decriminalisation of injecting drug users

UN Secretary-General supports calls for Asian governments to amend outdated laws criminalising injecting drug users and other stigmatized groups.

At the launch of a major new report on HIV in Asia (March 26), UN Secretary-General Ban Ki-Moon called for increased health and human rights protections for people living with HIV, sex workers, men who have sex with men, and young people who inject drugs.

"Legislation can also stand in the way [of] scaling up towards universal access -- in cases where vulnerable groups are criminalized for their lifestyles" said Ban Ki-Moon, adding in his statement on the launch of the report; "As you have heard, I fully support the recommendations of the Commission."

UNAIDS Executive Director Dr Peter Piot (left), with United Nations Secretary-General Mr. Ban Ki-Moon, during the presentation of the new report “Redefining AIDS in Asia – Crafting an effective response” on 26 March in New York.

The 258 page report by the Independent Commission on AIDS in Asia (established by UNAIDS) is entitled Redefining AIDS in Asia: Crafting an Effective Response. Commenting on the report at the UN launch press conference on March 26th UNAIDS director Peter Piot said : "I look to Asian Governments to amend outdated laws criminalizing the most vulnerable sections of society, and take all the measures needed to ensure they live in dignity,"

Professor C. Rangarajan (right), Chair of the Commission on AIDS in Asia, presented the report of the Commission to the United Nations Secretary-General Ban Ki-Moon, 26 March 2008.

The report urges governments to provide a comprehensive package of harm reduction, including needle exchange programs and opiate substitution treatment, and says governments should abandon counterproductive "war on drugs" programmes. One of its key recommendations is to:

Avoid programmes that accentuate AIDS-related stigma

It is important to recognize that not all interventions aimed at most-at-risk groups are effective, and to note which have been proven to be ineffective, or even counter-productive. In their enthusiasm to initiate large-scale prevention programmes, Governments are seen to adopt certain programmes which accentuate stigma and violate the human rights of most-at-risk groups. These include ‘crack-downs’ on red-light areas and arrest of sex workers, large-scale arrests of young drug users under the ‘war on drugs’ programmes, mandatory testing in healthcare settings without the consent of the person concerned and releasing confidential information on people who are HIV positive through the media.

These initiatives can be counterproductive and can keep large numbers of at-risk groups and people living with HIV from accessing even the limited services being provided by the countries.

Full report (1.6 megs)