The empowering and dangerous work of harm reduction in Afghanistan

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The empowering and dangerous work of harm reduction in Afghanistan

12 September 2019
Filter Mag

By Michelle Tolson

Idris Azizi speaks softly when he relates how, as a person living with HIV, he was told to sit in the trunk of a car, with the door open, when traveling to a 2017 Global Fund committee meeting in Kabul, Afghanistan. The two doctors from the Ministry of Public Health with whom he was traveling sat in the car cabin.

“The [committee] members were not comfortable with me⁠—these were doctors,” Azizi (pictured above, right) told Filter. “When they were going to the oversight meeting⁠, they did not tell me. They didn’t share the schedule, the meals, the car,” he said, referring also to the per diems that cover costs during official meetings. “And the one time that they did share the car, they put me the trunk.”

With his easy-going demeanor, he could easily be talking about an unfortunate misunderstanding. But Azizi is an official spokesperson for PLHIV, or People Living with HIV, and paid a monthly stipend of 10,160 AFN a month ($129) through Afghanistan’s Global Fund. He speaks on behalf of Afghans who do not feel safe disclosing their HIV status.

The Global Fund, which was set up by the United Nations, describes itself as an organization dedicated to fighting AIDS, tuberculosis and malaria, all of which are present in Afghanistan. To ensure that people directly impacted by these diseases have a say in how resources are used within their countries, the Fund set up the Country Coordinating Mechanism (CCM), with an oversight committee made up of community members, like Azizi, as well as technical experts, such as the doctors who shunned him.

Afghanistan struggles with insecurity, ongoing war, poverty and one of the highest unemployment rates in the world. In a country where the poppy harvest produces more than 90 percent of the world’s illicit heroin, despite the US military’s failed efforts to prevent this, opiates have provided solace to populations affected by mental traumas or physical health issues. People use them to manage stress and physical pain. But visible use can lead to people being pushed from society.