Feature Drug Misuse

Tensions between drug use policies and infection control

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e4930 (Published 23 July 2012) Cite this as: BMJ 2012;345:e4930
  1. Jeremy Sare, freelance journalist
  1. 1Woodbridge, UK
  1. jeremysare{at}btinternet.com

Despite repressive laws on drug use being linked to increased transmission of HIV, persuading countries to change their approach is difficult, Jeremy Sare reports

The Global Commission on Drug Policy last month condemned the international war on drugs for “fuelling an epidemic of HIV infection.”1 Its latest report seeks to show how repressive drug laws force drug users away from public health services and into hidden environments where HIV risk is higher.2

The commission, which was established in 2011, aims to promote international discussion, based on science, about “humane and effective ways to reduce the harm caused by drugs to people and societies” and comprises a prestigious group of politicians, experts, and public figures. The report was launched in London on 27 June by four commission members: former president of Brazil, Fernando Cardoso; Virgin chairman, Richard Branson; former president of Switzerland, Ruth Dreifuss; and executive director of the Global Fund to fight AIDS, Tuberculosis and Malaria, Michel Kazatchkine.

During the press conference, the commissioners showed examples of how “ideological” approaches to drug addiction tended to exacerbate the incidence of bloodborne viruses like HIV and hepatitis C, warning that “millions of lives are at stake.” Injecting drug use accounts for one third of new HIV infections outside of sub-Saharan Africa, and a fifth of the 16 million injecting drug users in the world are infected with HIV.2

The report highlighted how “aggressive law enforcement practices targeting drug users have also been proven to create barriers to HIV treatment.” The commission has advocated the introduction of minimum measures that all countries should introduce to contain, then drive down, rates of HIV infection. They include distribution of sterile syringes, safer injecting facilities, and heroin prescription programmes. “Failure to take these steps is criminal,” it says, “otherwise we are passive observers …

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