A British Med­ical Jour­nal says that the US President’s AIDS-fighting pro­gram could do more to pre­vent trans­mis­sion among drug users. The AIDS pro­gram called PEPFAR which began with our last Pres­i­dent, George Bush, does not do nee­dle exchanges or treat­ment for drug dependency.

The out­go­ing admin­is­tra­tion left it up to future the Obama Pres­i­dency to change PEPFAR to begin nee­dle exchanges or drug treat­ment, and Obama has been on record as being in favor for it. PREFAR cur­rently only uses edu­ca­tion projects for drug users. The lack of these pro­grams is fur­ther com­pli­cated by nee­dle exchanges being ille­gal in some African countries.

From this IRIN arti­cle that we found at Reuters Alert­Net, we see more details about PEPFAR’s pref­er­ences to com­bat AIDS.

Researchers have esti­mated that 1.2 mil­lion deaths in Africa were averted between 2004 and 2007 as a direct result of inter­ven­tions funded by PEPFAR.

How­ever, HIV activists have heav­ily crit­i­cised its pre­ven­tion track record, includ­ing stip­u­la­tions that one-third of fund­ing be spent on pro­grammes pro­mot­ing absti­nence out­side of mar­riage, and lim­ited funds for progammes tar­get­ing high-risk pop­u­la­tions such as sex work­ers and intra­venous drug users.

PEPFAR was reau­tho­rized for an addi­tional five years in 2008, but stayed mute on the issue of needle-exchange ini­tia­tives; media reports quoted for­mer US Global AIDS Coor­di­na­tor Mark Dybul as say­ing that it would be up to Pres­i­dent Barack Obama’s admin­is­tra­tion and the US Con­gress to decide whether to imple­ment such programmes.

In Kenya, PEPFAR rep­re­sen­ta­tives were reluc­tant to com­ment on the Lancet report but said in a state­ment: “Our work with IDUs and non-injecting drug users is part of a bal­anced pre­ven­tion port­fo­lio that reflects the dri­vers of the epi­demic in Kenya.”

Although het­ero­sex­ual trans­mis­sion is still the main means of HIV infec­tion, in sub-Saharan Africa there could be up to three mil­lion peo­ple who inject drugs, with more than 200,000 in Kenya and at least 250,000 in South Africa; preva­lence is often higher among intra­venous drug users than in the gen­eral population.

“The crim­i­nal nature of drug use in these coun­tries means drug users are usu­ally arrested and impris­oned, rarely ever get­ting treat­ment for their addic­tions,” Anne Gath­umbi, of the Open Soci­ety of East Africa, a think-tank based in Nairobi, the Kenyan cap­i­tal. “The few treat­ment pro­grammes that exist are mainly detox cen­tres with very high rates of relapse.”

Like

Unlike