Asia - Regional Overview
The large and diverse Asian region is home to significant numbers of people who inject drugs. They represent at least one-quarter of the total number of people injecting drugs around the world. HIV epidemics in many Asian countries are being driven by injecting drug use. At the regional level, it is estimated that 16% of people who inject drugs are living with HIV. Significant developments in policy and practice in parts of Asia have signalled a shift towards harm reduction in recent years. More countries in the region have introduced some form of needle and syringe programme (NSP) and have begun to prescribe opioid substitution therapy (OST) to some extent. However, across the region coverage remains far below levels necessary to have an impact on HIV epidemics.
The investment of funds into harm reduction in Asia is poor, with estimates suggesting that currently available funding for the region amounts to only 10% of actual need. A lack of supportive legal and policy frameworks in many countries continues to impede harm reduction responses, with several states prohibiting possession and/or provision of needles and syringes, methadone and/or buprenorphine. Imprisonment or detention in compulsory centres for drug users remains the dominant response to drug use in many Asian countries. Over half the countries in the region retain the death penalty for drug offences, with China, Malaysia, Singapore and Viet Nam considered ‘high-commitment’ states, executing death sentences with regularity.
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| Country/territory with reported injecting drug use | People who inject drugs | Adult HIV prevalence amongst people who inject drugs | Harm reduction response | |
|---|---|---|---|---|
| NSP | OST | |||
| Afghanistan | 6,900 | 3.40% | Y (18-28)(NP) | Y (1)(M) |
| Bangladesh | 30,000 | 1.35% | Y (93)(P) | N |
| Bhutan | nk | nk | N | N |
| Brunei Darussalam | nk | nk | N | N |
| Cambodia | 1,750 | 22.80% | Y (2) | N |
| China | 2,350,000 | 12.30% | Y(897-901) | Y (600-675)(B,M) |
| Hong Kong | 30,000 | nk | N | Y |
| India | 164,820 | 11.15% | Y (200-219) | Y (61-63)(B,O) |
| Indonesia | 219,130 | 42.50% | Y (182-323) | Y (35-46)(B,M) |
| Japan | 400,000 | nk | N | N |
| Korea (Republic of) | nk | nk | N | N |
| PDR Laos | nk | nk | N | N |
| Malaysia | 205,000 | 10.30% | Y(117-130)(P) | Y(?95) (B,M) |
| Maldives | nk | nk | N | Y(1)(M) |
| Mongolia | nk | nk | Y(1) | |
| Myanmar | 75,000 | 42.60% | Y(18-24)(P) | Y(7)(M) |
| Nepal | 29,500 | 41.39% | Y(43) | Y(2)(B,M) |
| Pakistan | 141,000 | 21% | Y(81) | N |
| Phillipines | 15,500 | 0.40% | Y(3) | N |
| Singapore | nk | nk | N | N |
| Sri Lanka | nk | nk | N | N |
| Taiwan | nk | 13.80% | Y (1,103)(P) | Y (90)(B,M) |
| Thailand | 160,528 | 42.50% | Y (10)(P) | Y (147)(B,M) |
| Vietnam | 135,305 | 33.85% | Y (382-2,023)(P) | Y (6)(M) |
