World drug report 2014: more needs to be done to tackle injecting drug use and HIV

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World drug report 2014: more needs to be done to tackle injecting drug use and HIV

26 June 2014

There must be a stronger focus on the health needs and human rights of all people who use drugs, especially people who inject drugs and are living with HIV, according to World drug report 2014, launched on 26 June—International Day against Drug Abuse and Illicit Trafficking—by UNODC Executive Director Yury Fedotov.

For many of the world’s drug users there is a worrying lack of evidence-informed programmes focusing on prevention, treatment, social rehabilitation and integration. “There remain serious gaps in service provision. In recent years, only one in six drug users globally has had access to or received drug dependence treatment services each year,” Mr Fedotov said.

Injecting drug use and the associated increased vulnerability to HIV remains a critical issue and is worsening in some regions, such as parts of Europe. Using joint estimates for the first time from UNODC, UNAIDS, the World Bank and the World Health Organization, the report states that of the 12.7 million people who inject drugs globally, around 1.7 million are living with HIV (13%).

The situation is said to be particularly serious in two regions, south-west Asia and eastern Europe, where HIV prevalence among people who inject drugs is 28.8% and 23%, respectively. The report cites statistics showing that for the 49 countries for which data are available, HIV prevalence among injecting drug users is more than 22 times higher than in the general population, and at least 50 times higher for 11 countries.

We have seen that countries that have adequately invested in harm reduction services have lowered remarkably HIV transmission among people who inject drugs.

Yury Fedotov, Executive Director, United Nations Office on Drugs and Crime

The World drug report 2014 emphasizes the need to implement harm reduction services, the most important of which for avoiding HIV infection are needle and syringe programmes, opioid substitution therapy, voluntary counselling and testing, and antiretroviral therapy. Where these programmes are available, such as countries in western and central Europe, there has been a decline in both HIV incidence and in the number of AIDS-related deaths caused by unsafe injecting drug use.

As Mr Fedotov maintains in the preface to the report, “We have seen that countries that have adequately invested in harm reduction services have lowered remarkably HIV transmission among people who inject drugs.”

As well as examining injecting drug use and HIV, the report explores a number of other central issues in a world where drug use prevalence is reported as now stable. These include: the effects of a surge in opium production in Afghanistan; the decreasing global cocaine supply; the mixed picture of cannabis use dropping globally but increasing in North America; and the more than doubling in seizures of methamphetamine between 2010 and 2012.