United Nations: Decriminalize drug use

With more than 1,000 people becoming infected with human immunodeficiency virus (HIV) in Asia each day, the United Nations Joint Program on HIV-Acquired Immunodeficiency Syndrome (UNAIDS) has urged governments to decriminalize consensual adult sexual behavior and drug use.

In his report titled Hope to Reality: Transforming the Asia-Pacific AIDS response, UNAIDS Executive Director Michel Sidibé noted that many countries are beginning to change their laws that criminalize consensual adult sexual behavior (including sex work) and drug use, and courts are helping to clarify bad laws.

He disclosed that in Indonesia, the Supreme Court ruled that drug users need care, not imprisonment, while Nepal’s highest court has established that transgenders and men who have sex with men have equality under the Constitution. India’s Delhi High Court has read down an archaic law that discriminated against men who have sex with men.

“New Zealand has legalized sex work and reaped the dual benefits of public health and public safety, while Australia has demonstrated that law enforcement and public-health goals can go hand in hand while dealing with drug use,” Sidibé said. “We can remove punitive laws and policies that block effective responses to AIDS.”

According to him, however, real transformation has to be in the hearts and minds of people.

“Courts and parliaments can only create an enabling environment. Societies and communities have to change the social norms that allow stigma and discrimination,” he said.
Sidibe cited the case of a pregnant woman in India, who was recently branded on her forehead as being HIV positive by hospital staff during a routine check-up. This inhumane treatment of the woman, according to him, triggered protests by the local community and by human rights activists, which then led the Gujarat government to investigate the matter.

The UN official said that it is women who bear the most of the suffering resulting from such bad laws and a discriminatory society, with many women in Asia becoming infected with the deadly virus because their husbands or male partners contracted HIV through drug use or through sex with another man or with a sex worker.

To back up his claims, he revealed that being monogamous is the only risk factor for an estimated 90 percent of women living with HIV in India, while 35 percent of adults living with HIV in Asia were women, and most of them were in steady relationships, as of 2008.

In the Philippines, majority of the HIV/AIDS cases involve men who have sex with men (MSMs) and transgenders (men who have undergone sex change). As a result, the country posted a record-setting 85 new cases of HIV/AIDS in May 2009 alone—the highest in a month since the Philippines registered its first HIV/AIDS case in 1984.

Moreover, the May 2009 figure represented a 143-percent increase compared to the number of infected people in the same month last year.

Sibide called on government authorities to invest in evidence-informed HIV prevention, treatment, care and support programs.

HIV prevention programs, according to him, must be scaled-up, with political leaders ensuring that existing HIV services are expanded to reach the most vulnerable. These measures include starting needle exchange programs and offering oral substation therapy to drug users (which great strides have been made in Bangladesh, China, Malaysia, India and Vietnam), increasing access to antiretroviral drugs, distributing condoms and offering voluntary HIV counseling and testing services to those at higher risk.

Sibide said that while requests to the Global Fund to Fight AIDS, tuberculosis and malaria for such programs increased substantially in recent years, Asia still needs $7.5 billion by 2010 to reach country targets. Only 10 percent of this needed funding was available in 2007.

“If only we had invested in reaching populations at higher risk and their partners, most of these infections could have been averted—at a cost of less than half a US dollar per person. Therefore, we must invest wisely and equitably, especially now in the midst of an economic crisis,” he added.

Sidibé is also seeking an AIDS plus Millennium Development Goal (MDG) approach, in which reducing poverty, increasing education and investment in health must become the foundations for sustainable economic growth in the region.

“Unlike Africa, where the AIDS epidemic can overwhelm development efforts, the Asia and Pacific region can combine development and the AIDS response,” he said.

Sibide mentioned a woman from Nepal named Nisha who lived with HIV but came out well after ample treatment. Nisha lost her husband in 2004 when there was no access to treatment but then went on an antiretroviral therapy that made her stay healthy, enabling her to go back to work and look after her three children.

“Her family has come to accept her, and her children go to school, where they are being taught how to protect themselves. Access to treatment has given her an opportunity to fulfill her dreams—this is hope becoming reality,” he said. –Llanesca T. Panti, Reporter, Manila Times