Feature story

Protecting drug users from becoming infected with HIV in Lithuania

19 February 2010

A WHO study, published in 2008, shows that opioid substitution therapy in low- and middle- income countries (as elsewhere) significantly reduces risky behaviour, improves the health of patients and helps them to re-integrate into society. Credit: WHO/Piotr Malecki

The pioneering Vilnius Centre for Addictive Disorders in Lithuania is the focus of the second Dispatch from the Field, a web series designed to highlight the World Health Organization’s work at country level. 

The centre is considered a model of best practice in treating drug dependence. Heroin users are offered daily methadone and have access to a mobile needle-syringe exchange service called the ‘Blue bus.' Five days a week, social workers who run the bus go to places frequented by drug users and dispense both sterile equipment and advice about health and social services. Drug users are often marginalized and do not tend to seek health care.

Cooperating closely with the World Health Organization, the centre uses WHO guidelines and advocacy to strengthen its work.

Harm reduction interventions in Lithuania started early in the course of the HIV epidemic and are credited with helping to keep the country’s HIV prevalence relatively low. In 2008, Lithuania’s prevalence was less than one tenth that of some neighbouring countries, and the proportion of new cases of HIV caused by injecting drug use has been steadily decreasing. 

Working with injecting drug users in Eastern Europe and central Asia is of paramount importance. Injecting drug use is the main mode of HIV transmission in the region, accounting for some 75-80 percent of all cases. A 2008 WHO study shows that opioid substitution therapy in low- and middle-income countries significantly reduces high risk behaviour, improves health and helps drug users re-integrate into society.

Three regional WHO-supported Harm Reduction Knowledge Hubs have been established, in which the Vilnius centre plays a pivotal role.  The Hubs bring together the collective knowledge of regional and international experts and provide technical assistance, training and a forum for the exchange of ideas to widen and deepen the AIDS response.

This latest Dispatch from the Field features a photo essay on the Vilnius Centre for Addictive Disorders, an interview with its Director, Dr Emilis Subata and an article on the WHO Knowledge Hubs.