Injecting drug use is a growing problem in Africa and a growing risk factor for contracting HIV in the region. It is imperative that HIV research includes injecting drug users so that they too are able to benefit from safe and effective behavioural interventions and biomedical HIV prevention and treatment products.

This article relates a critical review of the findings of a desk review of previously published literature. The article examines injecting drug use in relation to HIV-related risk and research in Kenya, Mauritius, Nigeria, South Africa and Tanzania. The ethical challenges of including people who inject drugs in HIV research in Africa are also presented. The review found injecting drug use to be on the increase in all the countries reviewed.

HIV-risk behaviour among people who inject drugs, such as needle-sharing and higher-risk sexual behaviour, was also found to be widespread. Furthermore, criminalisation of drug use and strict anti-drug laws are common in the countries reviewed, while harm-reduction programmes for people who inject drugs were found to be limited.

The review identified a number of ethical challenges to the involvement of people who inject drugs in HIV research in Africa. This includes the illegal status and stigma surrounding injecting drug use, which may complicate participant recruitment, enrolment and retention. In addition, a lack of funding for supportive programmes to help injecting drug users may hinder the provision of appropriate standards of prevention and care and treatment for those who seroconvert.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

The ethics of HIV research with people who inject drugs in Africa: a desk review

Guerra as drogas

This comic book by Stuart McMillen highlights the consequences of the war on drugs. To read the full document, please click here.

War on drugs

El mercado y sus dimensiones: una propuesta para usuarios y autoridades

As the 2015 target date for achieving the Millennium Development Goals (MDGs) approaches the United Nations, governments, civil society and other global and national stakeholders are involved in a series of processes that will determine the new development goals. These processes are evolving quickly without strong participation of HIV and AIDS groups or stakeholders.

There are key opportunities for the HIV community to engage in these processes and to influence for the inclusion of HIV in the post-2015 development framework.

A High-Level Panel has been appointed by the UN Secretary-General to advise on the global development agenda beyond 2015. The panel will deliver a report with recommendations informed by country and global thematic consultations. Donors such as the European Union and the UK Government have also conducted consultations to develop their positions on the post-2015 framework. A number of parallel processes will also inform the final set of development goals, in particular the Sustainable Development Goals as a follow-up from the Rio+20 Summit and the 20 year review of the International Conference on Population and Development (ICPD+20).

This paper aims to support discussion and engagement with the post-2015 development agenda among the HIV community. It explores the barriers and opportunities for including HIV in the process and suggests how HIV and related global health needs should be addressed in the new development framework.

Discussion Paper: How the HIV community can shape the future HIV and development agenda post-2015

With a total area of over 58,000 hectares in 2012, most opium poppy cultivation in South-East Asia takes place in Lao People's Democratic Republic, Myanmar and Thailand. In order to assess the scope of opium poppy cultivation and opium production in the region, UNODC has been conducting opium surveys in cooperation with the Governments of Lao People's Democratic Republic (since 1992) and Myanmar (since 2002), while Thailand has established its own monitoring system. This report contains the results of the UNODC-supported opium poppy cultivation surveys in Lao People's Democratic Republic and Myanmar. In addition, the results from the opium poppy surveys implemented by the Government of Thailand are presented in this regional overview.

South-East Asia : Opium survey 2012

This Selected issue gives a broad overview on the extent of, and available responses to, the problems of pregnant drug users and families that are affected by drug use.

In the first part of the report, a description of the available data on the extent of drug use during pregnancy and associated risks is followed by a review of responses to drug use among pregnant women across Europe.

The second part of the publication focuses on children living in the care of drug users. Here, a review of the risks related to drug use in the family sets the scene for European overviews of responses targeting drug-using parents and responses aimed at the children of drug users. The policy and legal frameworks concerning the two situations are described, both for pregnant drug users and drug-using parents and their children.

Pregnancy, childcare and the family: key issues for Europe’s response to drugs 

Community Action on Harm Reduction (CAHR) is an ambitious project that aims to expand harm reduction services to more than 180,000 injecting drug users, their partners and children in China, India, Indonesia, Kenya, and Malaysia, over a four year period.

During 2012 the Community Action on Harm Reduction project has been fully operational in 5 project countries providing services to people who inject drugs, their families and partners. As of 1 October 2012, almost 15,000 people who inject drugs and 50,000 beneficiaries have been reached through the project.

A detailed review of project achievements and challenges in 2012 is presented in CAHR 2012 progress update.

Updates on the Community Action on Harm Reduction project

The HIV epidemic in the Middle East and North Africa has continued to grow, aggravated by an increase in injecting drug users with high-risk practices such as sharing contaminated syringes. An approach known as harm reduction has been proven to be effective in reducing negative health consequences among this vulnerable group. Yet the provision of harm reduction services to this population has been hindered because drug use and HIV are considered taboo in many parts of the region. Nongovernmental organizations in civil society can fill this gap, but their potential has been underdeveloped.

These were the challenges addressed by the formation of the Middle East and North Africa Harm Reduction Association (MENAHRA). MENAHRA provided a framework through which practitioners in civil society reached out to colleagues in other civil society organizations throughout the region to strengthen their active role in harm reduction while engaging policy-makers to lessen obstacles to the acceptability of harm reduction. Guided by a vision combining public health and human rights, MENAHRA became an umbrella for the empowerment of civil society

This document was produced to share the experiences of the establishment and development of the association. The challenges and accomplishments of launching MENAHRA provide useful lessons and best practices in strengthening civil society organizations in the response to HIV, increasing their involvement in effective interventions and advocacy, and overcoming obstacles.

The document begins by describing the nature and extent of HIV and injecting drug use in the Middle East and North Africa. It explains the concept of harm reduction as an approach to these challenges, as well as the uniquely valuable role that can be played by civil society. After describing the impetus that led to the creation of the association, the document describes the structure and achievements of the association in each of its components. The concluding section considers lessons that were learned during the project period that led to the association’s graduation into a self-organizing initiative with independent funding.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Best practices in strengthening civil society’s  role in delivering harm reduction services

This newsletter from the International Doctors on Healthy Drug Policies (IDHDP) offers highlights on the work of IDHDP and ongoing developments regarding international drug policy.

IDHDP Newsletter Volume 7 October 12

This study concludes that inadequate drug treatment practices act as structural obstacles to realizing HIV treatment. Evidence internationally suggests that effective drug treatment, including opioid substitution therapy, improves access and adherence to antiretroviral treatment among people who inject drugs. Policy shifts are urgently needed in this setting to enable systemic improvements to drug treatment, especially given large HIV treatment demand.

Read the full article [restricted access].

Drug treatment and the conditionality of HIV treatment access: a qualitative study in a Russian city

26 June 2012 saw the launch of the United Nations Office on Drugs and Crime (UNODC)’s flagship publication, the World Drug Report.

This IDPC response provides an overview of the data and topics presented in the Report and where appropriate, within the broader context of the current state of the UN drug control framework, offer a critical analysis of both.

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