Analysis: Southeast Asia slowly accepting harm reduction
Southeast Asia is slowly embracing harm reduction in an effort to curb illicit drug use and HIV/AIDS, but huge obstacles remain, experts say.
The region is home to hundreds of thousands of IDUs.
“There's rhetorical acceptance of harm reduction in many Southeast Asian countries, although it remains at the fringe of national anti-drugs policies,” Joe Amon, director of the health and human rights division at Human Rights Watch, told IRIN.
Almost all countries in the region now have some form of harm reduction, a strategy to prevent dangers associated with drug use. However, many programmes lack government funding, are ill-equipped to meet demand, or fail to comply with UN standards.
At the same time, national drug policies encourage law enforcement to criminalize drug users, with police known to receive cash bonuses for drug-related arrests, say experts.
Moreover, authorities then herd thousands of drug users into compulsory treatment centres, ignoring evidence-based approaches, and despite a joint UN statement in 2012 calling for the closure of such centres, which are deemed costly with high relapse rates and a threat to detainee health and human rights.
While most countries allow key harm reduction strategies, such as needle and syringe exchange programmes (NSPs) and opioid substitution therapy (OST), a harsh “war on drugs” method often prevails as the Association of Southeast Asian Nations (ASEAN), a 10-member economic bloc, struggles with the “unrealistic hope” of a drug-free region by 2015, Amon said.
Laws, policies and practices can also obstruct access to HIV services for at-risk groups, particularly injecting drug users (IDUs).
The UN General Assembly passed HIV/AIDS targets in 2011, including a 50-percent drop in HIV transmission among IDUs in four years. A comprehensive package was also set up to guide nations to treat drug users with nine interventions such as NSP, OST, antiretroviral therapy (ART), blood tests, counselling and others, backed by scientific evidence.
To date, not a single Southeast Asian nation has been able to implement the entire package, although it is uncommon for any country to do so, according to UN officials.
“The key policymakers aren't convinced enough about the effectiveness of harm reduction services,” Bijay Pandey, chairperson of the Asian Network of People who Use Drugs, explained, noting a lack of political will and a push for drug abstinence often shapes government responses.
According to Harm Reduction International, a global NGO, more than 570,000 IDUs live across Southeast Asia. More than half of them come from Indonesia, Thailand and Vietnam, which are listed by the UN as high priority with major HIV epidemics in IDU populations.
IRIN looked at each country to better discern where they stand.
Thailand
In late 2011, the Thai government issued a new drug control strategy to end the nation’s spread of drug abuse by focusing on the prevention of drug use and recidivism.
The following year, at least 400,000 drug users - many of whom inject drugs - were put into government treatment centres run by the military. In 2013, another 300,000 people are expected to go through the system, which previously saw roughly 100,000 patients annually. About half of the patients are forced into the centres, Thai government officials said.
“We want to give them a second chance to be a positive part of the community,” Sukhum Opasniputh, deputy secretary-general of Thailand’s Office of the Narcotics Control Board (ONCB), told IRIN.
However, heightened focus on drug crime has resulted in 297,000 drug-related arrests in the past nine months, Opasniputh said. Previous drug efforts had much fewer arrests, but still staggering tallies, with almost 250,000 in 2011 and about 208,000 the year before that, according to the UN Office on Drugs and Crime (UNODC).
Source: IRIN
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