Published on Thursday, March 3, 2005 by the Inter-Press Service
'Just Say No' Called Deadly Advice by Drug Experts
by Ulysses de la Torre
UNITED NATIONS -- More than 300 groups and individuals from 56 countries released an open letter Tuesday urging delegates of the U.N. Commission on Narcotic Drugs (CND) to resist U.S. pressure to withdraw support for syringe exchange programs.
The letter, signed by scientists, policy analysts, human rights groups and AIDS activists, comes in anticipation of a CND session to take place in Vienna next week.
”Strategies that attempt solely to achieve abstinence from drug use do not constitute an acceptable alternative to programs., such as syringe exchange, that help active drug users protect themselves from HIV/AIDS,” according to the letter.
Of particular concern is a meeting reported to have taken place last November between Robert Charles, chief of the U.S. State Department's Bureau for International and Law Enforcement Affairs, and Antonio Maria Costa, the head of the U.N. Office on Drugs and Crime (UNODC), a co-sponsor of the joint U.N. program on HIV/AIDS.
Costa apparently emerged from the meeting with new ideas about omitting certain language from UNODC documents that specifically referred to syringe exchange programs.
”Every independent body to study needle exchange -- including bodies that are part of or funded by the U.S. government -- has concluded that needle exchange reduces rates of HIV among drug users without increasing drug use,” said Jonathan Cohen, a researcher with the HIV/AIDS and human rights program at Human Rights Watch.
Officials from the UNODC and the Bureau for International Narcotics and Law Enforcement Affairs were not available for comment.
But a number of news outlets in the past week, including the Wall Street Journal and the Washington Post, have chronicled growing opposition among both the George W. Bush administration as well as Republican lawmakers to continue funding organizations that encourage clean needle programs. for injection drug users.
Sen. Sam Brownback, a Kansas Republican, told the Wall Street Journal in a Feb. 28 article that although ”there is a conservative support” for AIDS programs., other areas of concern ”risk the continued support from a number of conservative members and conservative groups.”
One of these areas of concern is the concept of ”harm reduction,” a strategy that acknowledges that some people will engage in high-risk behaviors such as commercial sex work and injection drug use and attempts to make those actions less dangerous.
Harm reduction was also among the language that the UNODC saw fit to remove from its documents after the November meeting with the Bureau for International and Law Enforcement Affairs.
A 1997 study of 81 cities in the British medical journal, the Lancet, found that HIV infection rates among intravenous drug users rose by nearly six percent a year in cities without needle exchange programs., while infection rates decreased by nearly the same magnitude in cities with needle exchange programs.
”In total, seven government-funded reports between 1991 and 1997 found that syringe exchange reduced HIV transmission without increasing drug use,” according to a September 2003 report from Human Rights Watch on HIV prevention for injection drug users.
”As of a 2001 review of syringe exchange research, no established medical, scientific or legal body to study the issue had concluded otherwise.”
The report also found that while injection drug use accounts for just 36 percent of AIDS cases in the United States, it is estimated to have caused 80 percent of infections in Russia, whose infection rates have surpassed North America's.
It also has caused the majority of HIV cases in China, Iran, Afghanistan, Nepal, the Baltic States and all of Central Asia, as well as much of Southeast Asia and South America.
”The fastest growing epidemics in the world are being driven by injection-drug use, and provision of sterile injection equipment is among the most important, proven strategies to contain them,” said Kasia Malinowska-Sempruch of the Open Society Institute, another of the letter's signatories.
”It is reprehensible that the United States would try to compel the United Nations to keep silent about one of the best studied and most effective HIV prevention measures.”
Pres. Bush asked Congress for 3.2 billion dollars to fund international HIV programs. in fiscal 2006. While most of the money is allocated to the U.S. Agency for International Development and the Dept. of Health and Human Services, it is unclear how much has been earmarked for the UNODC.
Meanwhile, Washington is also requiring that U.S. HIV/AIDS organizations seeking funding to provide services in other countries make a pledge opposing commercial sex work.
Under the new policy, even groups whose HIV/AIDS work in other countries has ”nothing to do” with commercial sex workers must submit a written pledge opposing commercial sex work or risk losing federal funding, according to the Wall Street Journal.
The directive stems from two laws on HIV/AIDS funding and sex trafficking passed in 2003, and a measure included as an amendment to the 15-billion-dollar President's Emergency Plan for AIDS Relief, which bars funding for any group that does not have a policy ”explicitly opposing prostitution and sex trafficking”.
Although Justice Department lawyers initially took the position that the requirement should be applied only to overseas groups because of constitutional free speech concerns relating to domestic organizations, the Journal reports that the agency reversed itself last year and said that the administration could apply the rule to U.S. groups.
Copyright © 2005 IPS-Inter Press Service