Pubdate: Fri, 04 Mar 2005
Source: International Herald-Tribune (International)
Copyright: International Herald Tribune 2005
Contact:  http://www.iht.com/
Details: http://www.mapinc.org/media/212
Author: Aryeh Neier
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

U.S. IDEOLOGUES PUT MILLIONS AT RISK

NEW YORK -- Global fanfare accompanies every International AIDS Conference, 
but an obscure United Nations meeting next week in Vienna may prove more 
critical to the course of the global HIV epidemic.

Delegates are gathering for the 48th meeting of the Commission on Narcotic 
Drugs, a largely unpublicized UN entity that sets the international drug 
control agenda and that this year is focusing on questions of HIV 
prevention. If recent events are any gauge, the commission - cowed by 
American hard-liners - will challenge the efficacy of programs, like needle 
exchange, proven to reduce HIV transmission among active drug users.

With the world's fastest-growing epidemics now fueled by intravenous drug 
use, millions of people at risk for HIV, particularly in Asia and the 
former Soviet Union, will pay the price.

Shown in dozens of studies in America and elsewhere to reduce transmission 
without increasing drug use, needle exchange is perhaps the most effective 
of all strategies to prevent the spread of HIV. Yet in a pattern familiar 
from debates over sex education, Washington conservatives seem eager to 
hold up distortions of science as a model for the rest of the world.

At last year's meeting of the Commission on Narcotic Drugs, Europeans and 
Australians watched in amazement as American delegates declared the 
evidence for needle exchange "unconvincing."

U.S. representatives also blasted as a "counsel of despair" the 
harm-reduction approach, which recognizes that even drug users unable or 
unwilling to stop using drugs can be helped to avoid the AIDS virus and 
other problems.

Backed by a coalition of prohibitionists that included Russia, Sweden and 
Japan, the United States ensured that the resolutions adopted by last 
year's commission were stripped of every mention of harm reduction. Any 
discussion of human rights of drug users was similarly excised.

This year the United States has not waited for a global gathering to force 
the UN to pledge allegiance to "zero tolerance." American officials have 
put significant back-channel pressure on the UN Office on Drugs and Crime - 
the current chair of the UN's joint program on HIV/AIDS - to retreat from 
needle exchange and other harm-reduction measures.

After a November meeting with Robert Charles, an assistant secretary of 
state in charge of the U.S. Bureau of International Narcotics and Law 
Enforcement Affairs, the director of the Office on Drugs and Crime, Antonio 
Maria Costa, promised that he would review all of the office's printed and 
electronic statements to remove references to harm reduction.

Costa also pledged that the office would be "even more vigilant in the 
future." As a start, a senior staffer directed subordinates to "ensure that 
references to harm reduction and needle/syringe exchange are avoided in 
UNODC documents, publications and statements." . More than semantic 
sanitation is at stake. In Russia, where estimated HIV cases now surpass 
those in all of North America and where 75 percent of new infections are 
attributable to intravenous drug use, officials have long pointed to the 
proceedings of the Commission on Narcotic Drugs to justify misgivings about 
needle exchange and refusal to treat addicts with noninjectable opiate 
substitutes like methadone. Last year, Ukrainian officials returned from 
the commission to announce that they were shelving plans for a methadone 
pilot program.

In Thailand, government officials claimed that Costa had given his blessing 
to drug control efforts that included mass arrests, forced internments and 
more than 2,500 killings of suspected drug dealers.

Costa strenuously denied the claim.

But his office recently suspended a Bangkok-based program dedicated to 
reducing intravenous drug users' vulnerability to the AIDS virus in East Asia.

Completely dependent on donor contributions - the largest share from the 
United States - the Office on Drugs and Crime is caught between the rock of 
American intransigence on drug policy and the hard facts that show needle 
exchange and other harm-reduction strategies to be effective.

Having removed condom information from federal Web sites and insisting on 
abstinence-only sex education at home and abroad, the Bush administration 
is now poised to override the best available evidence in deciding how best 
to fight HIV related to drug use. What is needed at this year's Commission 
on Narcotic Drugs is unanimous commitment to deploying the tools, including 
needle exchange, known to reduce HIV among drug users, not the American 
policy of scuttling prevention methods proven to save lives.
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MAP posted-by: Beth