Harsh drug laws undermine India’s HIV response

Bini Philips 20 November, 2014

A national consultation was held on 18^th November 2014 in New Delhi to discuss the emerging challenges faced by India’s drug-using communities. Harsh laws, policies and practices that punish drug users only perpetuate the harms of drug use, and there is increasing evidence that India’s drug laws stifle the country’s HIV response.

Organised by India HIV/AIDS Alliance (Alliance India) in collaboration with United Nations Office on Drugs and Crime (UNODC), the consultation saw more than 100 stakeholders from government, affected drug-using communities, media, international agencies, and civil society come together to discuss the emerging challenges faced by India’s drug-using communities and synergies to address this crisis of health and rights.

Worldwide 16 million people are estimated to inject drugs, and three million of them are living with HIV. In India, HIV prevalence in this group is 24-times that of the general population. Though progress has been made, the HIV epidemic continues to be fueled by the stigma and discrimination often experienced by drug users. In India, the lack of access to services can effectively be a death sentence for people who inject drugs. While some parts of the country, especially the Northeast, have developed a range of services for this vulnerable population, most other states have few if any such services. Even in places where basic services exist, it remains difficult for beneficiaries to access them.

The simple reality is that drug users are dying due to lack of attention to a variety of their health problems, including Hepatitis C, HIV, overdose, and detoxification. Some of these services remain controversial and currently not part of India’s basic harm reduction service package, while others are often not available where needed.

Addressing the event Oscar Fernandes, former Union Cabinet Minister for Transport, Road and Highways and Labour and Employment and Convener, Forum of Parliamentarians on HIV/AIDS said, “Enhanced collaboration between government, civil society and affected communities can ensure rights and health for people who use drugs, and we are committed for it.”

Held at Lalit Hotel, New Delhi, the consultation supported by Alliance India’s Hridaya and Asia Action on Harm Reduction programmes, discussed issues faced by people who use drugs in India. It also mapped the next steps for improving health services; rationalise laws, and steps to sensitise key stakeholders to bring about policy reforms. It included panel discussions on:

• HIV and drug-use trends and evidences
• Gender, Community and Rights: Addressing inequalities and exclusions
• Legislative reform and social protection for people who use drugs

The meeting also presented findings and best practices from Alliance India’s harm reduction work in Bihar, Haryana, Uttarakhand, Manipur, and Jammu & Kashmir.  Results from the studies indicate that as many as half of drug users interviewed in four states across the country have cited fear of police action as a major barrier to accessing health and HIV services.

Speaking at the event Cristina Albertin, South Asia Representative of UNODC said, “Interventions designed to reach vulnerable and most-at-risk populations can only be successful if existing policy, legal and financial barriers are addressed.”

The consultation had a strong participation from representatives from Union Ministry of Health, Social Justice and Empowerment, Narcotics Control, UN bodies, All India Institute of Medical Sciences (AIIMS), National Institute of Mental Health and Neurosciences (NIMHANS), Lawyers Collective, and International Drug Policy Consortium (IDPC).

According to James Robertson, Executive Director, India HIV/AIDS Alliance, “Unsafe injection practices along with low condom use are putting people who inject drugs at dual risk for HIV. We can only successfully intervene and reach those vulnerable and most at risk if we proactively address existing legal and policy barriers.”

Abou Mere, President, Indian Drug Users’ Forum and a leading activist urged the government and stakeholders to empower and meaningfully involve the community to protect their health and rights, “Drug users are dying due to lack of treatment and care for Hepatitis C and overdose. Families are burdened with expensive de-addiction and rehabilitation options. Women who use drug are worst affected with not a single such facility designed for them. ”

India faces one of the largest HIV epidemics in the world. While sexual transmission remains the primary mode of HIV transmission in the country, drug users are also disproportionately affected and they are at high risk of acquiring HIV and other blood-borne viruses, such as Hepatitis B and C.