AIDS/HIV:
Harm
Reduction
Wins
Battle
in
UN
AIDS
Session
7/1/05
US efforts to remove harm reduction in general and needle access programs in particular from the anti-AIDS vocabulary suffered a setback this week in Geneva, where the United Nations' AIDS agency (UNAIDS) shrugged off demands from Washington that it block the use of needle exchange programs (NEPS) in countries where injection drug use is a major factor in the spread of the disease. Controversy over the Bush administration's abstinence-focused stance erupted in March at the 48th session of the UN Commission on Narcotic Drugs, where the US threatened to block funding unless the UN Office on Drugs and Crime removed all references to supporting NEPS despite a thick pile of studies showing that the programs are effective in reducing the spread of AIDS and do not encourage drug use. The US wanted to do the same at the UNAIDS session, but was defeated by countries more amenable to science-based solutions to the problem of AIDS transmission. With injection drug use responsible for 80% of AIDS cases in Europe and Central Asia, the problem was too serious to be derailed by American moralizing. The writing on the wall was evident as the meeting opened, with Gareth Thomas, Britain's international development minister telling the agency his government wants to see "efforts to intensify harm reduction strategies, including needle and syringe exchange programs. We support effective harm reduction programs, especially needle and syringe exchange and methadone substitution therapy because they have been proven to reduce HIV infection among infecting drug users and their sexual partners in many countries." US officials asked that all references to NEPS be dropped from the agency's governing policy statement on prevention in the context of antiretroviral drug therapy (ART). Instead they got this from the final statement issued Wednesday: "Injecting drug users have specific prevention and treatment needs, including testing and counseling, needle and syringe programs, drug substitution therapy and ART. While the need to implement and integrate these services for this population is becoming increasingly clear in the era of ART, political commitment is still lacking in many of the countries where these services are needed most." At least the words are now back in the official international anti-AIDS vocabulary.
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