18
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Partnering with law enforcement to deliver good public health: the experience of the HIV/AIDS Asia regional program

      research-article
      1 , , 2
      Harm Reduction Journal
      BioMed Central

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          In the South-East Asia region, the drug control and supply reduction agenda is of high political importance. A multitude of law enforcement agencies are engaged in this work. Nationwide campaigns such as the “Strike- Hard” campaign in China or the “war on drugs” in Thailand dominate the landscape. Viet Nam’s response to drug use has historically focused on deterrence through punishment and supply-side measures. This policy environment is further complicated by lack of evidence-based drug dependence treatment in several settings. The public health consequences of this approach have been extremely serious, with some of the highest documented prevalence of preventable blood-borne viral infections, including HIV, and hepatitis B and C. The wider socioeconomic consequences of this have been borne by families, communities and the governments themselves.

          The HIV/AIDS Asia Regional Program (HAARP) aims to stop the spread of HIV associated with drug use in South-East Asia and parts of southern China. HAARP works across five countries (Cambodia, China Burma, Laos, Viet Nam) chiefly through the Ministries of Health and Social Affairs, National Drug Control Agencies, and Public Security sectors, including prisons. HAARP has also engaged with UN agencies and a wide range of civil society organisations, including organisations of people who use drugs, to ensure their meaningful involvement in matters that directly affect them. We describe the experience of HAARP in implementing a large-scale harm reduction programme in the Sub-Mekong Region. HAARP chose to direct its efforts in three main areas: supporting an enabling environment for effective harm reduction policies, building core capacity among national health and law enforcement agencies, and supporting “universal access” goals by making effective, high-coverage services available to injecting drug users and their partners.

          The activities supported by HAARP are humble yet important steps. However, a much higher political-level dialogue is needed. The current huge gap of human rights standards in drug control practices also needs to be bridged immediately. Public health that embraces a rights-based approach must be given its fair share of policy space, budget and influence.

          Related collections

          Most cited references1

          • Record: found
          • Abstract: found
          • Article: not found

          'Social evils' and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam.

          This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective 'champions' for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi-sectoral training, collaboration and support are also needed.
            Bookmark

            Author and article information

            Contributors
            Journal
            Harm Reduct J
            Harm Reduct J
            Harm Reduction Journal
            BioMed Central
            1477-7517
            2012
            9 July 2012
            : 9
            : 24
            Affiliations
            [1 ]Technical Support Unit, HIV/AIDS Asia Regional Program, Bangkok, Thailand
            [2 ]UNAIDS Regional Support Team, Johannesburg, South Africa
            Article
            1477-7517-9-24
            10.1186/1477-7517-9-24
            3504507
            22769065
            54ea905c-6285-404c-927a-01cbf0f350fd
            Copyright ©2012 Sharma and Chatterjee; licensee BioMed Central Ltd.

            This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            History
            : 30 May 2012
            : 6 June 2012
            Categories
            Commentary

            Health & Social care
            Health & Social care

            Comments

            Comment on this article