Feature Story

In wide-ranging opening remarks to the current session of the Commission on Narcotic Drugs in Vienna, the Executive Director of the UN Office on Drugs and Crime (UNODC) Yury Fedotov placed HIV and drug use at the heart of the global agenda.

“HIV transmission through injecting drug use continues to be one of the main unresolved challenges of the international community. Widespread stigma, discrimination and lack of access to evidence-informed HIV services are among the key challenges,” he said.

Addressing the gathering of more than 1 000 representatives of Member States and civil society, he suggested that despite “notable progress” in increasing access to HIV services for people who inject drugs, there is still a long way to go.

In an apparent nod to the post-2015 development agenda Mr Fedotov put the challenge of the epidemic within the context of a health and rights-based prism: “[H]uman rights and public health considerations must be at the core of the international response to drug use and HIV,” he maintained.

The global challenge to this pressing issue has been gaining momentum. Through the June 2011 United Nations General Assembly Political Declaration on HIV and AIDS, the world is committed to halving the number of drug users who acquire HIV by 2015.

According to UNAIDS, harm reduction strategies are key to prevent new HIV infections among people who use drugs. A comprehensive, evidence-informed package requires: needle and syringe programmes, opioid substitution therapy, HIV testing and counselling, antiretroviral therapy and condom programmes for people who use drugs and their sexual partners. It also entails prevention and treatment of sexually transmitted infections, tuberculosis and hepatitis as well as information, education and communication materials intended specifically for people who use drugs.

This stigmatized population bears a very heavy burden of the virus, which is often transmitted through the use of unsterilized needles. UNAIDS’ global report 2012 contains some sobering statistics. In 49 countries HIV prevalence among people who inject drugs is at least 22 times higher than among the population as a whole and in 11 countries their level of infection is more than 50 times higher. 

A very large number of individuals are affected. According to the 2012 UNODC World Drug Report, an estimated 15 to 16 million people, in 151 countries, inject drugs.  A 2008 global study showed that 3 million were living with HIV. In several countries—notably in Eastern Europe and Central Asia, one of two regions where the number of new infections is increasing—the AIDS epidemic is being driven by unsafe injecting drug use.

People who use drugs are much less likely to be reached by HIV-related services, such as testing. HIV-positive women who use drugs do not access programmes to prevent their children being born with the virus as often as other women. Surveys in capital cities reveal that drug users also report lower condom use than men who have sex with men or sex workers.

At the fifty-sixth session of the Commission on Narcotic, which is running from 11-15 March, drug use and HIV will be addressed through a number of channels, including a draft resolution calling for the intensification of efforts to reduce HIV to attain the targets of the 2011 Political Declaration on HIV and AIDS.

On Tuesday a side-event will explore the opportunities and challenges facing women who use drugs and how to make care and support services more gender-responsive. The meeting will be chaired by UNODC Director, Division for Operations and Global Coordinator for HIV/AIDS, Aldo Lale-Demoz. Michel Kazatchkine, the United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia, is scheduled to attend the event as a special guest.

The Commission on Narcotic Drugs is the United Nations central policy-making body mandated to deal with a broad range of drug-related issues.