|
|
|
|
|
Oceania - Regional Overview
|
The early implementation of harm reduction in both Australia and New Zealand has resulted in generally low levels of HIV amongst injecting populations. Australia also has the region’s only safer injecting facility (in Sydney). However, there are indications that particular groups – such as gay men who inject drugs and indigenous populations – may be more at risk of HIV transmission. Although Australia is often considered to set the world standard for needle and syringe provision, there are several difficulties still faced in accessing services, including cultural inappropriateness of services, inflexible opening hours, lack of coverage in rural areas, and stigma.
Across the Pacific Islands, harm reduction services are not available and more research is necessary to determine the levels of drug use and its related harms.
Both Australia and New Zealand include supportive references to harm reduction in national policies on HIV and/or drugs. However, government funding for harm reduction initiatives remains limited in Australia.
Prisoners do not have access to sterile injecting equipment across the region, but opioid substitution therapy is available in most Australian and New Zealand prisons.
Across the Pacific Islands, harm reduction services are not available and more research is necessary to determine the levels of drug use and its related harms.
|
|
|
|
 |
|
Injecting Drug Use, HIV and Hepatitis C
|
The following maps and table outline the current available data on injecting drug use, as well as the prevalence of HIV and hepatitis C among injecting populations in Oceania.
|
The map below illustrates HIV prevalence among injecting drug users in countries of the region.
|
 |
|
The map below illustrates hepatitis C prevalence among injecting drug users in countries of the region.
|
 |
|
The following table provides the latest estimates of HIV and hepatitis C prevalence within injecting populations, as well as the estimated total number of injecting drug users in countries of the region.
|
Countries/territory with reported injecting drug use
|
| | Adult HIV prevalence amongst people who inject drugs**
|
| Adult HCV prevalence amongst people who inject drugs***
|
| | | | | | | | | | | | | Fed. States of Micronesia
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
|
*Mathers, B. et al. Reference Group to the United Nations on HIV and injecting drug use (2008)
|
The global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet 2008, Volume 372.
**Mathers, B. et al. Reference Group to the United Nations on HIV and injecting drug use (2008) The global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet 2008, Volume 372.
***Cook, C & Kanaef, N (2008) The Global State of Harm Reduction: Mapping the global response to drug-related HIV and hepatitis C epidemics. International Harm Reduction Association, UK
|
|
|
Harm Reduction Policies
|
Although Pacific Island Countries and Territories (PICT) policies do not currently mention harm reduction, Australia and New Zealand include it in their national policies, as illustrated in the map and table below.
Although policy wording is not necessarily indicative of the implementation of effective harm reduction measures in a country, it does indicate governmental commitment to tackling drug related harms and is therefore an important advocacy target.
|
 |
|
| Explicit reference to harm reduction policies in official documents*
|
| | | | | | | Fed. States of Micronesia
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
|
*International Harm Reduction Association (March 2009) Harm Reduction Policy and Practice Worldwide: An overview of national support for harm reduction in policy and practice [PDF:2.59KB]
|
|
|
Harm Reduction Programmes
|
Key harm reduction interventions (including needle and syringe exchange and opioid substitution therapy) are available in both Australia and New Zealand but not in the PICTs, as illustrated in the maps and table below.
Although harm reduction coverage in New Zealand and particularly in Australia is good, there are still difficulties faced by some in accessing NSP and OST services. These include the lack of services in rural or regional areas, fear of police harassment in some areas, availability, accessibility and costs of OST, as well as fear of stigma.
Prisoners do not have access to sterile injecting equipment across the region, but opioid substitution therapy is available in most Australian and New Zealand prisons.
The following table indicates which countries have a) one or more needle and syringe exchange sites operational both in and outside prisons, b) prescription of opioid substitution therapy for maintenance in and outside of prisons c) one or more drug consumption rooms in countries of the region.
A tick in this table does not indicate the scope, quality or coverage of services. Also it should be noted that in some countries, harm reduction services, NSP in particular, are NGO-driven and may be operating without government support.
|
| | | | | | | | | | | | | | | | | | | | | | | | Fed. States of Micronesia
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
*International Harm Reduction Association (March 2009) Harm Reduction Policy and Practice Worldwide: An overview of national support for harm reduction in policy and practice [PDF:2.59KB]
|
The map below shows which countries have operational needle and syringe programmes and opioid substitution therapy programmes. Countries which have drug consumption rooms are also indicated.
|
 |
|
The map below shows which countries have prison-based needle and syringe exchange programmes and opioid substitution therapy prescription.
|
 |
|
|
|
