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"HIV/AIDS and drug use are intertwined" - Speech by Peter Piot, UNAIDS
UNAIDS Speech by Peter Piot, UNAIDS Executive Director. 17 April 2003.
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Peter Piot, UNAIDS Executive Director, gave this speech to the Commission on Narcotic Drugs in Vienna in April 2003.
"Thank you for the opportunity to join you on behalf of UNAIDS, the Joint United Nations Programme on HIV/AIDS. As the governing board of one of the eight Cosponsors which together constitute the Programme, this Commission is of course integral to the success of UNAIDS. When UNAIDS welcomed UNDCP as a new Cosponsor in 1999 we greatly boosted out collective capacity to address the links between HIV/AIDS and drug use. Today, UNAIDS aims to remain at the leading edge of UN practice, with greater emphasis than ever on maximising our joint action in advocacy, information and technical support for country-led HIV/AIDS responses.
HIV/AIDS and drug use are intertwined problems. If we don't offer young people decent jobs and hope for the future, then drug use will seem an attractive option. If we don't give young people life skills, they will not be able to protect themselves from using drugs or from HIV infection. If we don't offer drug users humane treatment, they will be unable to escape the cycle of addiction. And if we don't provide injecting drug users with clean needles, condoms and prevention education, then we will be unable to stop them contracting and transmitting HIV.
From the Baltic to Central Asia, around the Mediterranean and Middle-East, in South-East and East Asia and in the Americas, injecting drug use is responsible for between 30 and 90 per cent of the HIV/AIDS epidemic. Everywhere in the world, drug use is also associated with heightened sexual transmission of HIV.
Today, the link between drug use and HIV/AIDS must become core business both of national drug control agencies and of UNAIDS, led by our Cosponsor UNODC. It stands alongside the vital mandate of deterring drug use, which itself remains the best option for preventing the spread of HIV in many societies.
As Executive Director Mr Costa's report to this Commission on HIV in the context of drug use shows, on every continent there are communities and nations that have demonstrated it is possible to curb a drug-use-driven HIV epidemic. But we are sorely lacking the collective capacity to move beyond isolated examples to comprehensive world-wide practice.
One barrier is resources. The cost of comprehensive HIV prevention and care in developing countries is $10 billion annually. Last year around $3 billion was spent - by national governments, donor countries and the United Nations system. Mr Costa's report notes financial constraints are by far the biggest difficulty member states report in implementing drug-related programmes. Closing the resources gap on AIDS will require increases from all channels, including the new Global Fund to Fight AIDS, Tuberculosis and Malaria.
But resources are not the only barrier - another is the energy which continues to be spent in battles over language. Let me frankly state that the delivery of comprehensive HIV prevention to drug users on the ground is more important than whether the particular English-language phrase 'harm reduction' is used in a policy document. Comprehensive approaches mean HIV education and clean needles and condom access and substitution treatment and rehabilitation and voluntary HIV counselling and testing and AIDS treatment.
Science - including the science of programme evaluation - tells us that the best responses are built on the three pillars of supply reduction, demand reduction and minimising drug-related harms. Experience tells us that cooperation with drug users gets better results than persecuting them. New experience with alternative punishment modalities suggests there is a way out of the drug use/prison/HIV spiral.
The just completed Chiang Mai International Conference on the Reduction of Drug Related Harm testified to the inconsistency in programmes reaching drug users. But the Conference advanced understanding both of needs and successful responses. Especially illuminating was the direct testimony the Conference heard from young ex-drug users from South-East Asia.
The challenge today is to scale up programmes rapidly, before we lose another generation to drug use and HIV/AIDS, because they never had access to any intervention, service or treatment. This Commission, in its decisions of 2002 on 'Preventing the transmission of HIV among drug abusers', has made a major contribution towards implementing the Declaration of Commitment on HIV/AIDS, adopted unanimously at the 2001 UN General Assembly Special Session on HIV/AIDS. Of course, the real test of commitment will be made in countries.
The most recent meeting of the UNAIDS Programme Coordinating Board, in Lisbon last December, made wide-ranging decisions designed to strengthen UNAIDS in delivering joint and coordinated UN action in countries. We have an obligation to ensure that multilateral action amounts to more than the sum of its parts, by focussing our resources, targeting our technical support, and making our information strategically effective. The commitment to effective joint action extends to governance, and I am sure that this Commission would endorse the finding of the recent 5-year external evaluation of UNAIDS that there is a need to strengthen Cosponsor linkages at governing board level.
I look forward to the expansion of the collective efforts of UNAIDS and UNODC in fighting HIV/AIDS and drug use together. Our past work has laid the groundwork, and Mr Costa and I have already discussed ways we might best focus increasing action. Among the highest priorities will have to be the large and growing twin epidemics of HIV and drug use in Eastern Europe and Asia.
The previous meeting of this Commission broke new ground in supporting the implementation of the Declaration of Commitment on HIV/AIDS. Today, the need for large scale programmes tackling the spread of HIV among drug users is ever more urgent. The activities of UNODC and the whole of UNAIDS must be underpinned by supportive policies and vigorous action by member states.
Acting collectively, in governing one of the UNAIDS Cosponsors, and individually, in the action you take in each of your States, you hold the future of a substantial part of the global HIV/AIDS epidemic in your hands". |
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