For IDPC purposes, the South East Asian region includes the following countries: Cambodia, China, Hong Kong, Indonesia, Laos PDR, Macau, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, Vietnam.
South East Asia is home to one of the world’s largest drug production zones, namely the Golden Triangle. Drug use patterns have been shifting in the region, with type and extent of drug use, as well as the routes of administration and production and trafficking of drugs is widespread. It is difficult to determine which drugs are most commonly used but the use of heroin and other opiates, benzodiazepines, cannabis, alcohol, tobacco and amphetamine-type stimulants (ATS) and pharmaceuticals is widely reported. Drug related harms remain largely unaddressed by national governments, leaving much of the work to civil society groups.
Although countries in the region are culturally, linguistically, and politically different and unique, the majority of nations in South East Asia share a common approach to drug control where governments have favored repressive tactics such as incarceration and compulsory drug treatment in labor camps to deter further drug use. This paradigm has left millions of drug users in the region vulnerable to HIV and HCV, with little or no services to prevent or treat such health issues, while reinforcing the stigma attached to drugs and leaving many wanting for their human rights to be respected. Recent estimates indicate that over 3 million individuals inject drugs in the region.
HIV remains one of the main drivers behind the development and implementation of harm reduction policies in places such as Cambodia, China, Hong Kong, Indonesia, Laos PDR, Myanmar, Taiwan and Vietnam. However, the implementation of harm reduction is subsumed under national HIV strategies and has little recognition or support from drug control agencies. This schizophrenic approach implies that while national commitments on HIV are made by health sector officials, those commitments are generally ignored, if not willfully broken by law enforcement and drug control officials.
However, some positive examples from the region are emerging. Indeed, the situation in Taiwan points to a rapidly expanding harm reduction programme. The results and outcomes obtained by the Taiwanese government is a reflection of the high level leadership provided by the Ministers of Health and of Justice in effectively addressing injecting drug use and HIV. With a harmonized policy environment between HIV frameworks and drug control, Taiwan has achieved impressive results in significantly decreasing HIV transmission as well as local crime rates.
In the region, several bodies provide avenues for IDPC’s work to be pursued. Of course, ASEAN is a key platform for engagement with governments, with the ASEAN Senior Officials on Drugs (ASOD) being a key entry point for collaboration with law enforcement agencies. The UN Regional Task Force on HIV/AIDS and Injecting Drug Use for Asia and the Pacific is also an effective platform for discussions around policy issues.