Overly punitive approaches to drug use are not helping to stem growing HIV infections among injection drug users worldwide, according to Alex Wodak, director of the Alcohol and Drug Service at Sydney's St. Vincent's Hospital.
One in 10 new HIV infections occur among injection drug users, who account for about 30% of new infections outside of Africa, Wodak says, 'and the proportion of global HIV infections attributable to injection drug use is growing.'
Illegal drugs command more than $332 billion annually, or 8% of the value of international trade, according to the U.N. Office on Drugs and Crime. Of that, 26% to 58% is pure profit, estimated a report delivered to British prime minister Tony Blair's government. For at least 15 years harm-reduction experts have known how to prevent HIV among injection drug users: by educating them, providing them with clean needles, and getting 'dirty equipment out of circulation,' Wodak says. Drug rehabilitation centers and methadone substitution therapy for heroin users, he adds, are proved successes.
The major barrier to harm-reduction programs is 'excessive reliance on drug enforcement worldwide,' says Wodak, especially in high-incidence countries in central and eastern Europe and central Asia, where the epidemic among injection drug users is of alarming proportions.
Among industrialized nations, the highest AIDS incidence is in America, in part because of its failure to stop HIV among injection drug users, Wodak says. 'Nonetheless,' he says, 'the United States prevents these pragmatic approaches being spread throughout the world.'