World AIDS Day: We Can’t “Get to Zero” Until We End the Drug War

The official theme of this year’s World AIDS Day is “Getting to Zero.” As we acknowledge the vast suffering of the hundreds of millions of people who have been infected or impacted by HIV/AIDS on December 1st, it is impossible to ignore an inconvenient truth: that the global war on drugs is severely jeopardizing the overall "fight against AIDS."  

Throughout the world, research has consistently shown that drug criminalization forces people who use drugs away from public health services and into hidden environments where HIV risks become significantly elevated. Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic, as inhumane conditions and lack of HIV prevention or treatment measures in prison lead to HIV outbreaks and AIDS cases behind bars – and among families and communities once those imprisoned are released.

Roughly 33 million people worldwide are currently living with HIV – and injection drug use accounts for one-third of all new HIV infections outside sub-Saharan Africa. New infections have been falling since the late 1990s, but HIV incidence has increased by more than 25 percent in seven countries over this time span, largely as a result of syringe sharing.

This year two powerful reports were released – by the Global Commission on Drug Policy and the Global Commission on HIV and the Law – with the backing of distinguished world leaders and medical experts. Both reports concluded that the criminalization of people who use drugs is fuelling the HIV/AIDS pandemic and undermining efforts to protect them, their families and communities.

In the U.S., injection drug use has accounted for more than one-third (36 percent) of AIDS cases – more than 354,000 people, according to the Centers for Disease Control and Prevention (CDC). Yet the U.S. bans federal funding for sterile syringe access programs, even though the CDC has found that such programs lower incidence of HIV/AIDS among people who inject drugs by 80 percent.  This refusal to adopt an evidence-based prevention strategy has cost the U.S. hundreds of thousands of lives and billions of dollars. After finally repealing the ban in 2009, Congress re-instated it a year ago – a move that will cost thousands of more lives in years to come.

Few countries are as backward in this area as Russia – where the epidemic is largely driven by people who inject drugs and the number of infected individuals has more than quadrupled since 2000. In Russia, more than one in 100 adults are now infected with HIV.

It doesn’t have to be this way. Health-centered policies that include syringe access programs have a proven track record of effectiveness and cost-efficiency. They also link people to health care, connect people to addiction treatment, and can reduce overall drug use.

In countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. New HIV infections in countries such as Australia, Germany and Switzerland have been virtually eliminated among people who use drugs, just as mother-to-child HIV transmission has been eliminated in countries that make medicines for pregnant women accessible.

• In 2001, Portugal decriminalized drug possession and scaled up their harm reduction programs. HIV cases among people who inject drugs plummeted by 34 percent between 2000 and 2008.
• Switzerland has successfully implemented public health approaches such as syringe access programs, supervised injection facilities, and replacement therapy programs, including heroin-assisted therapy. As a result, new HIV cases fell by 82 percent between 1990 and 2002.
• In Australia, by 2001 syringe exchange programs had already prevented 25,000 HIV infections and 21,000 hepatitis C infections, and had prevented 4,500 AIDS deaths – generating savings of between $1.3 billion and $4.2 billion (on an investment of $83 million).
• In Brazil, HIV cases associated with injection drug use dropped from 28 percent in the early 1990s to just 10 percent by 2003 following the implementation of harm reduction programs such as sterile syringe exchanges.

Want to know more about the drug war and AIDS? Check out the infographic below – and take action by urging Congress to end the syringe access funding ban.

Millions of people have died of AIDS because of bad drug policy – and millions more lives hang in the balance.

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