The effectiveness of "harm reduction" programs in helping minimize new HIV infections among drug addicts was highlighted at an international forum held in Taipei yesterday.
The programs, which include providing sterile needles and syringes and offering Methadone, a substitute narcotic, to intravenous drug users (IDUs), have been on trial in four areas in Taiwan for a year, said the Center for Disease Control's division director Yang Shih-yan (
Yang said the center's risk factor analysis showed that, Taiwan, like other countries, is faced with a surge of infections among IDUs, particularly among women and young people.
Globally there are estimated to be over 13 million IDUs, and most of them live in developing countries, according to executive director of the International Harm Reduction Association.
"New `epidemics' of injecting drug use have often been followed by explosive epidemics of HIV and other blood-borne infections and adverse health consequences," Gerry Stimson told the audience.
A 40 percent growth in HIV infections among IDUs worldwide may be reached within two years, he said, adding that the rapid increase points to "the need for preemptive measures" to combat the spread.
Alex Wodak, president of the Australian Drug Law Reform Foundation, called the rapid growth "the biggest global threat since the Black Plague."
The harm reduction program, Stimson said, is a cost-effective prevention method for HIV infections among IDUs because the programs come as a comprehensive package.
Key components include contacting the target population, raising their awareness and knowledge about intravenous drug use and harm reduction, making outreach services user friendly, providing tools so as to change IDU behavior and offering medical treatment and care.
The UN and WHO have endorsed harm reduction programs over the past two years, said Stimson, adding that Britain has also made harm reduction a key component of its international and domestic drug policy.
About 65 countries, including Islamic and communist nations, had committed to harm reduction programs by 2003, Stimson said, but Wodak added that Asia still has only less than five percent coverage.
The success of harm reduction programs is a matter of striking a balance between public health policies and law enforcement, Stimson said, adding that Taiwan is lucky to have high-level policy commitment to the program.
The government should also set goals in implementation instead of instituting a series of "perpetual pilots," Stimson said.
"I think we should also accept Methadone addiction if this stops serious threats to the community and society," Wodak said.
Bill Nelles, a Methadone treatment expert from Canada, said at the conference that offering Methadone to IDUs does not prolong the length of drug dependence and is even more effective in promoting long-term drug abstinence than normal rehabilitation methods.
Nelles, who has also received the treatment for 22 years, emphasized the importance of having IDUs see themselves as "patients" instead of "drug users."