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26th February 2010
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Methadone Programme Launches in Kabul
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The first methadone programme in Afghanistan began treating patients on 22 February.
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Médecins du Monde (MDM) Harm Reduction Programme in Kabul was launched in September 2006 in Kabul. Opium substitution treatment component is now available two years after the National Consensus Conference on Opioid Substitution Therapy, which was held with the involvement of the Afghan Ministry of Public Health. The agency, along with other officials and public health specialists, provided pivotal support for the life-saving programme, including antiretroviral therapy.
Methadone treatment joins a growing programme of harm reduction services in the country, though much more is needed. In November, the Transnational Institute reported swiftly growing rates of heroin dependence and high-risk injecting practices. Country specialists also report that injecting drug users face additional dangers of exposure and disease in the bitter winter months.
It is hoped that MDM’s Harm Reduction Programme will help serve as a model for other service-providers.
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22nd February 2010
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UNODC Documents Support for Harm Reduction in 2009
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A report of the executive director of the United Nations Office on Drugs and Crime summarised the agency’s support for harm reduction strategies internationally.
The UNODC outlined nine interventions in its package of HIV-related services including needle and syringe programmes; opioid substitution therapy; HIV testing and counselling and antiretroviral therapy.
However, the UNODC added, “In many countries, the HIV response is insufficiently grounded in evidence and fails to meet international legal obligations to promote, protect and respect human rights. For example, in 40 per cent of the 129 countries submitting reports to UNAIDS there continue to be laws, regulations or policies that interfere with access to and effectiveness of HIV-related services for people who inject drugs.”
The report, titled “Responding to the prevalence of HIV/AIDS and other blood-borne diseases among drug users,” emphasises the need to "advocate and facilitate human rights-focused policies and legislation" and "to involve, in a meaningful way, people who use drugs in policy and programme reviews."
The agency highlighted women and prisoners as particularly vulnerable populations.
The UNODC emphasised gaps that still need to be addressed including “low access to services; inconsistencies in policy approaches to support key activities in relation to drug use and HIV prevention, treatment, care and support services; resource shortages; stigmatization and marginalization of drug users; legal and policy restraints on opioid substitution therapy; low access to hepatitis C diagnostics and treatment; extremely low access to services in prisons; HIV prevalence among prisoners; weak data and mechanisms for identifying emerging epidemics; and lack of systematic attention to HIV and forms of drug use other than injecting.”
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18th February 2010
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Cambodia’s Looming ‘Health Crisis’
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Harm reduction advocates in Cambodia are warning of a rise in the deadly practice of needle sharing after the government failed to renew a local needle exchange programme’s license.
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Harm reduction NGO, Korsang, had operated a needle exchange programme in Phnom Penn until 1 January. The group’s license was not renewed after it refused to cooperate with the National Authority for Combating Drugs, which was looking for participants for a controversial detoxification drug programme, according to the story in the Phnom Penn Post.
The organisation has since reported an increase in needle sharing. According to IHRA’s Global State of Harm Reduction adult HIV prevalence among injecting drug users is close to 23 percent, which advocates fear could swell.
“There has been no consistent access to sterile injection equipment since our licence was not renewed,” Korsang’s founder, Holly Bradford, told the Phnom Penn Post. “Blood-borne viruses are definitely being transmitted. The only way to stop that is to get back in there and make everybody use a new syringe for each injection.”
David Harding, the international coordinator for drugs programmes with Friends-International, added, “This is the first time I’m deeply concerned that harm reduction is not serving its population … I would say this is a developing health crisis. What we have right now is a situation where we simply don’t know how serious this is going to get.”
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15th February 2010
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Pakistan’s HIV Response in Danger
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The HIV response in Pakistan, which includes critical harm reduction programmes, is under threat due to a shortage of resources.
The country produced a comprehensive plan of action that was estimated to cost $293 million (USD) over five years. The plan includes services for at-risk populations and evidence-based direction for programmes aimed at injecting drug users and other vulnerable populations.
“Pakistan has made substantial progress over recent years, including in addressing sensitive social issues and increasingly involving people living with HIV in the forefront of the AIDS response” says Oussama Tawil, UNAIDS Country Coordinator. “However, it is now critical that a collective effort be made to sustain the momentum in these life-saving measures”.
As IHRA reported in its Global State of Harm Reduction, adult HIV prevalence among injecting drug users had been 10.8 percent in 2005. That number grew to an alarming 21 percent in 2008, according to UNAIDS.
Pakistan has tried to scale up its harm reduction services in response and integrated HIV-prevention into existing health programmes. However, funding supplied by the World Bank, bilateral donors and government sources, are inadequate to cover the need.
Later this year, IHRA will be releasing a report which examines the current spending on harm reduction programmes within the HIV response and explores what would be necessary in order to reach 'universal access' for people who inject drugs.
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8th February 2010
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Harm Reduction in Prison is Best Practice
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The Chief Executive of the English National Treatment Agency for Substance Misuse wrote an excellent commentary defending prison methadone programmes in The Guardian.
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Responding to a series of attacks on methadone programmes in UK prisons that such services were initiated following a costly class-action suit by almost 200 former prisoners who argued that their human rights were violated because they could not access the same medical treatment in prison that they had received outside.
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Hayes wrote, "[O]ver half the prison population are heroin and crack users who will remain in custody for three months or less - either serving short sentences, or on remand. They are not in the system long enough to undergo these residential programmes. Good clinical practice will either continue the treatment the prisoner had before arrest, or prepare them for the treatment they will receive on the outside. Otherwise individuals would be vulnerable to suicide while they were in custody, and to overdose on release."
The editorial coincided with the release of a report from the Canadian HIV/AIDS Legal Network, which documented the importance of needle and syringe programmes (NSP) as a means of reducing new infections among injecting drug users.
In 2006, the Public Health Agency of Canada recognised the benefits of prison NSPs and that these harm reduction programmes did not result in syringes being used as weapons, an increase in drug use or increased initiation of people injecting drugs while in prison. Despite this evidence, currently no Canadian prisons permit the distribution of clean needles.
The report includes testimony from former prisoners about injecting practices in prison. One former prisoner recalled, "The first time I injected drugs I shared a syringe. One syringe would probably be used for three or four months everyday for at least 20 times a day. We would sharpen it on a matchbook cover to keep it sharpened."
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4th February 2010
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Call for Nominations for Directors of IHRA
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Nominations are currently being invited for IHRA members to serve as Directors and Trustees of the International Harm Reduction Association (IHRA), and to sit on the Board of Directors (also known as the Executive Committee). Directors and Trustees are responsible for the governance of the organisation and the broad strategy. They have ultimate responsibility for directing the affairs of IHRA, ensuring that it is well-run and delivering the charitable outcomes for the benefit of the public for which it was set up.
IHRA is a UK company registered under Company Law in England and Wales, and also a Charity registered in England and Wales. Therefore, those elected as Directors are both Directors of the Company and Trustees of the Charity.
Meetings of the Directors – and all documentation and communication – are in English. Directors need to be available for at least one face-to-face meeting each year, together with a number of teleconferences, and to read and comment on documents for meetings. Good telephone and internet access is essential. Directors are expected to become members of at least one IHRA sub-committee and be available to provide advice and comments between meetings.
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Nominations must be made on the relevant form by March 19th 2010 and sent to IHRA Administrator or fax to +61 3 9328 3008. Nominations must include the following information:
a) The name of the person being nominated and their agreement to the nomination (please note that they must be an IHRA member at the time the nomination is received).
b) The name of the person making the nomination (who must be a paying member of IHRA at the time of making the nomination)
c) The name of a second person supporting the nomination (who must also be a paying member of IHRA)
d) A short profile of the nominee (absolutely no more than 250 words), which will be posted on the IHRA website (please note that IHRA reserves the right to edit this profile for any reason). In order to support a nomination, it is strongly recommended that this profile includes comments referring to the skills and experience that the nominee will bring to IHRA.
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Elections will be held during the IHRA Annual General Meeting – which is scheduled to take place on April 26th 2010 at 12.30pm, Room 4 at the BT Convention Centre (conference venue) – during Harm Reduction 2010: IHRA’s 21st International Conference in Liverpool, England.
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2nd February 2010
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MENAHRA’s First Regional Conference on Harm Reduction was a Highlight of 2009
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UNAIDS recognised the Middle East and North Africa Harm Reduction Association’s (MENAHRA) stellar conference last November as one of the year’s “positive initiatives” in the region.
In its “Spotlight on the Middle East and North Africa Region,” UNAIDS emphasised that HIV prevalence is rising steadily and issues such as stigma and discrimination are impeding effective responses. Yet despite these challenges, progress in the region has been made, such as the expansion of opioid substitution therapy programmes in Morocco and Lebanon.
The piece adds, “Another positive initiative was the first regional conference on Harm Reduction held in Lebanon last year. This conference was a break-through for the region and brought several experts and partners together and mobilized political support form parliamentarians, national governments and UN agencies.”
The conference took place last November in Lebanon and attracted close to 200 participants from 25 countries. The conference featured speeches from the Lebanese Government, the Drosos Foundation, Elie Aaraj from MENAHRA , Professor Gerry Stimson from IHRA, , and Dr. Hussein Gezairi from the World Health Organization.
MENAHRA is supported by IHRA and the World Health Organization with funding from the Drosos Foundation.
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