By Fionnuala Murphy

Earlier this fall, an international team of researchers sounded a grim warning about the state of the global HIV epidemic among people who inject drugs. In two long-awaited research papers published in the Lancet, they laid out the evidence that not only is the scale of this epidemic worse than we thought, but that most countries are failing to provide the basic harm reduction interventions, like needle and syringe exchange programs and opioid substitution therapy, that are crucial to halting its spread.

In light of this evidence, world leaders and global agencies charged with leading the HIV response need to recognize that they can’t continue with business as usual. It’s time for them to call on governments to rethink their approach to drug policy and invest in harm reduction.

At Harm Reduction International, we’ve been tracking the global state of harm reduction since 2006, but the new data still surprised and alarmed us. The research shows that just one percent of the world’s people who inject drugs live in countries with widespread availability of two lifesaving harm reduction measures. Only 16 percent of them have access to opioid substitution therapy or medicines prescribed for opioid dependence—which is proven to significantly reduce transmission of HIV and hepatitis.

Meanwhile, harm reduction programs across the globe provide only a third of the number of sterile needles and syringes the World Health Organization deems necessary. The failure to invest in effective harm reduction measures has had a devastating effect. The new data suggests the UN has significantly underestimated the scope of the epidemic—the number of people who inject drugs who are living with HIV could be as high as 2.8 million worldwide, a huge leap from the 1.6 million figure currently used by UN agencies.

Although some of this gap may be the result of different research methods, it should still set alarm bells ringing. By providing a global snapshot of the experiences of people who use drugs, these studies also hint at the reasons behind the shortcomings in the worldwide HIV response. For example, the second of the two papers estimates that a staggering 57.9 percent have a history of incarceration—proof that in far too many countries, there is always money for police raids and prisons, even as harm reduction services go unfunded. Governments continue to focus on drug control, even as the evidence mounts that the “war on drugs” has been a public health catastrophe.

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Thumbnail: Flickr CC Todd Huffman