July 12, 2010

The New York Times

By DONALD G. McNEIL Jr.

Desperate heroin users in a few African cities have begun engaging in a practice that is so dangerous it is almost unthinkable: they deliberately inject themselves with another addict’s blood, researchers say, in an effort to share the high or stave off the pangs of withdrawal.

The practice, called flashblood or sometimes flushblood, is not common, but has been reported in Dar es Salaam, Tanzania, on the island of Zanzibar and in Mombasa, Kenya.

It puts users at the highest possible risk of contracting AIDS and hepatitis. While most AIDS transmission in Africa is by heterosexual sex, the use of heroin is growing in some cities, and experts are warning that flashblood — along with syringe-sharing and other dangerous habits — could fuel a new wave of AIDS infections.

“Injecting yourself with fresh blood is a crazy practice — it’s the most effective way of infecting yourself with H.I.V.,” said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, which supports the researchers who discovered the practice. “Even though the number who do it is a relatively small group, they are vectors for H.I.V. because they support themselves by sex work.”

Sheryl A. McCurdy, a professor of public health at the University of Texas in Houston, first described the practice five years ago in a brief letter to The British Medical Journal and recently published a study of it in the journal Addiction.

“I don’t really know how widespread it is,” said Dr. McCurdy who is contacting other researchers working with addicts to get them to survey their subjects about it. “There’s pretty circular movement in East Africa, so I wouldn’t be surprised if it’s in other cities.”

Increasing use of heroin in parts of Africa has the potential to magnify the AIDS epidemic.

In most East African countries like Tanzania and Kenya, only 3 to 8 percent of adults are infected with the AIDS virus, far fewer than in southern Africa, where the rates reach 15 to 25 percent.

But among those who inject heroin, the rates are far higher. In Tanzania, about 42 percent of addicts are infected. The rate is even higher — 64 percent — among female addicts, Dr. McCurdy said, and since most support themselves through prostitution, they are in two high-risk groups, and their customers are at risk of catching the disease.

Most of the addicts she has interviewed who practice flashblood, Dr. McCurdy said, are women. For them, sharing blood is more of an act of kindness than an attempt to get high: a woman who has made enough money to buy a sachet of heroin will share blood to help a friend avoid withdrawal. The friend is often a fellow sex worker who has become too old or sick to find customers.

By contrast, on Zanzibar, it is mostly among men, according to a 2006 study in The African Journal of Drug and Alcohol Studies, which found that about 9 percent of the 200 drug-injectors interviewed practiced it.

There have also been reports in East African newspapers of addicts selling their blood, but those have not been confirmed by medical researchers.

And, there have been scattered reports of flashblood-type practices in other countries with large numbers of heroin addicts, including Pakistan, but they also have not been confirmed by researchers.

Whether or not someone can actually a get drug rush from such a relatively tiny amount of blood has never been tested, Dr. McCurdy said. Humans have about five quarts of blood and the flashblood-user injects less than a teaspoon.

“They say they do,” she said. “They pass out as if they just got a high. But I’ve talked to doctors who say that could be entirely the placebo effect.”

One possibility, she said, is that traces of the drug are still in the syringe. After piercing a vein, an addict will typically draw some blood into the syringe, push it back out and repeat that three or four times to make sure all the heroin has been flushed into their blood. Those offering flashblood will usually hand over the syringe after only one in-out cycle.

The heroin sold in East Africa, she added, is often quite strong because it has come from relatively pure shipments on their way to Europe from Afghanistan or Asia.

Until recently, heroin use was uncommon on the continent because most Africans are too poor for traffickers to bother with. But in the last decade, smugglers have begun using port cities like Dar es Salaam and Mombasa and airport cities like Nairobi and Johannesburg as way stations on their routes: law-enforcement officials can often be bribed, and couriers from countries with no history of drug smuggling may escape searches by European border officers. The couriers may be paid in drugs, which they resell.

With more local users, more heroin is being sold in Africa. In the last decade, law-enforcement and drug treatment agencies said, heroin use has increased, especially in Kenya and Tanzania, South Africa and Nigeria. Brown heroin that must be heated and inhaled — “chasing the dragon” — has given way to water-soluble white heroin that can be injected. Prices have fallen by as much as 90 percent.

While a teaspoon of blood is more than enough to transfer diseases like AIDS, said Dr. James AuBuchon, president-elect of the American Association of Blood Banks, it would not be enough to cause a life-threatening immune reaction, as can ensue when a patient gets a transfusion from someone of the wrong blood type. Instead, “you’d likely get only brief symptoms,” he said.

Dr. AuBuchon, who practices in Seattle, said he had never heard of flashblood, but added that he was horrified by the idea.

“What,” he asked, “are they thinking?”

Campaign headed by actors, academics and lawyers says current drugs laws stigmatise people and damage communities

Alan Travis, home affairs editor

The Guardian, Thursday 2 June 2011
Article history

Dame Judi Dench, Sting and Sir Richard Branson are among those who have signed an open letter to David Cameron urging that possession of drugs be decriminalised. Photograph: Jockmans/Rex Features

Dame Judi Dench, Sir Richard Branson, and Sting have joined an ex-drugsminister and three former chief constables in calling for the decriminalisation of the possession of all drugs.
The high-profile celebrities together with leading lawyers, academics, artists and politicians have signed an open letter to David Cameron to mark this week’s 40th anniversary of the 1971 Misuse of Drugs Act. The letter, published in a full-page advertisement in Thursday’s Guardian, calls for a “swift and transparent” review of the effectiveness of current drugs policies.
Its signatories say that all the past 40 years has produced is a rapid growth in illicit drug use in Britain, and significant harm caused by the application of the criminal law to the personal use and possession of all drugs.
“This policy is costly for taxpayers and damaging for communities,” they claim. “Criminalising people who use drugs leads to greater social exclusion and stigmatisation making it much more difficult for them to gain employment and to play a productive role in society. It creates a society full of wasted resources.”
The letter launching the campaign, Drugs – It’s Time for Better Laws, has been organised by the national drugs charity Release. Other signatories include the film director Mike Leigh, actors Julie Christie and Kathy Burke and leading lawyer Sir Geoffrey Bindman QC. The former Labour drugs minister Bob Ainsworth and three former chief constables, Paul Whitehouse, Francis Wilkinson and Tom Lloyd, have all put their names to the letter.
It points out that nearly 80,000 people were found guilty or cautioned for the possession of illegal drugs – most of whom were young, black or poor – in 2010. Over the past decade, more than a million people have ended up with a criminal record as a result of the drug laws.
The letter coincides with Thursday’s New York launch of the report of the Global Commission on Drug Policy, which counts three former South American presidents, the former secretary-general of the United Nations Kofi Annan and Sir Richard Branson among its membership.
“The war on drugs has failed to cut drug usage, but has filled our jails, cost millions in tax payer dollars, fuelled organised crime and caused thousands of deaths. We need a new approach, one that takes the power out of the hands of organised crime and treats people with addiction problems like patients, not criminals,” said Branson, founder of the Virgin Group, who is to appear at the launch.
“The good news is new approaches focused on regulation and decriminalisation have worked. We need our leaders, including business people, looking at alternative, fact-based approaches.
“We need more humane and effective ways to reduce the harm caused by drugs. The one thing we cannot afford to do is to go on pretending the ‘war on drugs’ is working.”
Sting, who also signed the letter to Cameron, said: “Giving young people criminal records for minor drug possession serves little purpose – it is time to think of more imaginative ways of addressing drug use in our society.”
Ainsworth, the former Home Office drugs minister and defence secretary, last December described the war on drugs as “nothing short of a disaster” and called for the legal regulation of their production and supply.
The campaign defines decriminalisation as a model that adopts civil rather than criminal sanctions such as confiscation and warnings and fixed penalty fines rather than arrest, prosecution and a criminal record.
The high-profile campaigners point to the Portuguese experience as evidence that decriminalisation does not lead to an increase in drug use. Portugal became the first European country in July 2001 to introduce “administrative” penalties – similar to parking fines – for the possession of all illicit drugs.
The immediate reaction from the Home Office last night was to rule out any such move: “We have no intention of liberalising our drugs laws. Drugs are illegal because they are harmful – they destroy lives and cause untold misery to families and communities.
“Those caught in the cycle of dependency must be supported to live drug-free lives, but giving people a green light to possess drugs through decriminalisation is clearly not the answer,” said a spokesman.
“We are taking action through tough enforcement, both inland and abroad, alongside introducing temporary banning powers and robust treatment programmes that lead people into drug free recovery.”

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Speech by Irina Teplinskaya-Abdyusheva at the IHRA conference in Beirut April 2011.

Good afternoon! My cordial greetings to everyone who came here today. I am very much honoured to speak at the final session of this Conference, and I am actually very nervous about it. Unlike most of you, I am very new to the activists community, I have become an activist just recently, and this is my first real experience at the International conference. And I not only feel highly privileged but also deeply responsible to speak up on behalf of all Russian drug users. For the first time ever, this marginalized community is now getting chance to have a personal representative speaking publicly about our problems and giving a first-hand evidence about widespread violations of our human rights. I do not speak good English, but I speak from my heart, and I believe that speaking heart to heart will help us understand each other even if we speak different languages.
My life is like a small mirror showing a bigger general picture; it gives an example of what’s happening to millions of people using drugs in Russia and most other countries of the former Soviet Union. I am 44, and for the past 30 years I have been suffering from a chronic opioid drug addiction. According to the definitions of the World Health Organisation and the United Nations Organisation, drug addiction is a chronic recurrent disease. However in my country, people suffering from drug addiction are outcast by default, they are socially isolated and deprived of their civic rights! I was born in the Soviet Union in a high-rank family. I could have had great prospects and a brightest future, I could have done something good for my country. But this future has never come. When I was 14, I had my first experience with opium, and since then I have been living in my country as an outlaw, persona non-grata. I had multiple unsuccessful attempts to treat drug addiction in different clinics, but they all failed, and every time I got back to drugs. I spent 16 years in prisons, sentenced to jail for purchasing and possessing drugs for personal use – which means, for behaviours directly caused by and symptomatic to my disease! My family abandoned me, I became homeless and for 2 years lived literally in the street. Whatever happened to me, I continued using drugs, I lost my battle with the disease. Through contaminated syringes, I have acquired hepatitis C and HIV. Last time I was in prison, in 2007, I developed AIDS and had tuberculosis. At this moment I, for the first time in my life, have undertaken efforts – though not quite deliberately – to protect my major right, the right to life. The HIV therapy in Russia is guaranteed by the government, but to get the vital and essential medicines for HIV treatment in prison, I had to go on hunger strikes and to open veins. As a result, I almost killed myself, my life was in danger, and before it was too late I was sent from prison to a tuberculosis hospital.
God knows why I did not die, I survived just despite everything – even though nobody actually cared for me: neither my family, nor friends, nor my country. I had no place to go. Two years I have lived in the tuberculosis hospital, working as an aid-woman in the HIV-TB coinfection department. In this two-year period, I witnessed deaths of more than 100 friends of mine and people who I knew – all young people, quite talented and promising. Almost all of them died for one common reason – they were opioid-addicted, and they came for treatment on last stages of the disease, when it was already too late to help them. Drug-addicted people have little opportunity to receive an adequate HIV and TB treatment, as they just cannot stop being addicted, and their addiction force them into never-ending hunts for illegal drugs and money for the drugs, involving criminal activities.
I could never understand one thing. All those officials who is responsible for the deaths of thousands of young people in Russia – either because of their lack of professional expertise, or their negligence, or narrow-minded stubbornness, or personal idleness – how can they live in piece and sleep easily? They leave people to die doing nothing to help them, while most of those who died could have lived and loved, and raised their children, or at least could have died with dignity. Those officials and public servants, I wish they saw how people dying without help. I wish they looked into the eyes of those living without a hope. These eyes, I will never forget; I could never forget how they look at you… and in these eyes you see horror, a cry for help, and a subtle reproof that unlike you, they’ve got no miraculous escape. Before they died, almost all of them had asked for heroin, and I was bringing it to them. I also made injections, because many of these dying people could do no more efforts, not even find a vein. I think that doctors understood what I was doing, but they never punished me for that, I think because they could do nothing themselves to relieve suffering. What I did was illegal, I could have been sentenced as a drug-dealer for doing that. If I were caught, the judge would not care that I did it to fulfil the last wish of people who were dying – that’s how their “humanistic” principles work, indeed!
To love them and to remember, to make sure that other people do not forget these deaths. There are different ways to do it, and everyone does what they can: someone is mourning, someone is praying, someone is bringing flowers to their tombs. Someone else chooses to act instead of talking. I think it is a right thing when our love, friendship feelings and memories are manifested in concrete deals, not only in nice words. This was my reason to become an activist: I realized that I cannot stay like that any longer, doing nothing; if the government does not care about us, we can protect our rights on our own. I took a number of training courses and started to work at one AIDS servicing organisation that provides services to people living with HIV and drug users. Being drug- addicted myself, I had difficult times trying to work, and at the same time struggling with withdrawal symptoms, trying to get drugs or money for new drugs. Many times I failed, lost everything and had to start all over again. My life felt like a deadlock labyrinth, often I did not want to live. Everything changed last year when I have met Anya Sarang, President of Andrei Rylkov Foundation – the only non-governmental organisation in Russia openly advocating for substitution treatment programs for opioid drug users. I became a member of the Working Group on Advocacy of Substitution Therapy in Russia, and finally I’ve got the opportunity to protect my human rights and rights of millions of other drug-addicted people in Russia, working in a team instead of trying to do it alone, on my own. Everyone has the non-discriminatory right to health!
Dozens of young people in Russia die every year because, according to the national law, it is prohibited to use the opioid substitution therapy with methadone and buprenorphine, which are recommended by the United Nations and have proved their efficiency in all developed countries of the world. Needle and syringe programs have recently been banned in Russia, too – although according to the General Assembly of the United Nations Organisation, these are a major component of comprehensive HIV prevention programs among people who inject drugs. Even scientific discussions of issues related to the use of methadone – one of the essential medicines recommended by the World Health Organisation – is considered illegal and can be classified as “propaganda of drug use” in Russia. Russia officially approves prohibitory approaches in drug addiction treatment, based on forced abstinence and involving humiliation and deprivation of rights of people using drugs. In a case that recently was widely discussed throughout the country, one regional organisation, the foundation City Free Of Drugs, offered drug addiction treatment services based on the use of such ‘methods’ as kidnapping drug addicted people, chaining them with handcuffs, starving, beating and torturing. A considerable part of the general public expressed support to the use of such approaches in drug addiction treatment. Even human rights organisations did not protest against the use of such approaches; some human rights activists have actually even supported them. Drug use-related stigma is so high in our country that even human rights professionals often do not consider us humans that have undeniable rights, just like the other citizens. Pregnant women are not given any specialised narcological assistance; they have either to terminate pregnancy or to continue using illegal drugs till they have their babies. In the countries where substitution therapy is available, drug-addicted women, like any other women, can have babies, nurse and raise them without risking their health or lives. In our country, there is no specialised crisis center for drug addicted women with children who wants treatment to stop using drugs.
In October 2010, I appealed to Mr. Anand Grover – UN Special Rapporteur on the Right of Everyone to the Highest Attainable Standard of Physical and Mental Health – with a complaint against Russia, asking for an international decision or other measures to make Russia provide proper treatment to drug users. Currently I am preparing similar appeals to the Constitutional Court of the Russian Federation and the European Court of Human Rights. My actions received a wide coverage in the national media – many papers wrote stories and interviewed me about my initiative. Almost all interviewers asked one same question: “You want Russia to pay compensation to you by decision of the European Court? You do not want to get treatment to stop using drugs, but you request that your country provides you drugs at the expense of public funds?”
No, I do not want Russia to pay me a compensation! Thousands of my friends have died of AIDS, tuberculosis or overdose. As to myself, I’ve lost everything in my life: health, family relations, home, hopeful future. I spent half of my life in prisons, I was humiliated and broken only because I am ill. How can one assess it in terms of money??? Does anyone really think I had it all on purpose, just to avoid treatment? Having a chronic disease, I am striving to enforce my right to health, which is guaranteed by the Constitution of the Russian Federation, as well as the rights of 5 million people who use drugs in Russia! I want to have access to sterile syringes, to prevent thousands of young people annually from getting infected with HIV and HVC through contaminated injections. I want my friends to have access to treatment of HIV, tuberculosis and hepatitis – the deceases few people dying of nowadays in the developed world. I want my female friends to have no need to sell sex for drugs, I want them to be protected against violence and be able to have healthy babies and raise their children. I do not want hundreds of thousands lives to be broken every year in prisons for minor drug-related offences. I want the health officials to give us treatment, not throwing us away from life! Russia’s refusal to use opioid substitution treatment programs is absolutely ungrounded and not evidence-based; more over, it results in the violation of human rights. In October 2010, UN Secretary-General Ban Ki-moon visited a methadone clinic in Cambodia, demonstrating to the world that methadone maintenance therapy programs are legal, important and should be available to people with drug-related problems. UN Secretary-General himself handed methadone to patients at Cambodia’s methadone clinic. In Russia, we are also humans with universal human rights, and we also have the right to live!
In February 2011, during an official visit to Russia of the UN High Commissioner for Human Rights, Navanethem Pillay, I participated in her meeting with Russian human rights organisations. I had a privilege to speak to Ms. Navanethem Pillay on behalf of 5 million people using drugs in Russia, asking to interfere in the situation to protect human rights of people with drug-related problems in Russia, particularly their right to health. I handed to the Commissioner a letter signed by 17 international organisations working in the field of HIV/AIDS and harm reduction, that also called for measures to improve the situation with violations of right to health of drug users in Russia. Following our meeting, the UN High Commissioner for Human Rights delivered two recommendations to the Government of Russia:
1) to remove legal restrictions and to launch pilot programs of substitution treatment in Russia;
2) to provide financial and political support to needle and syringe programs, to ensure comprehensive HIV prevention measures, as well as drug users involvement in and adherence to health services.
The feedback from the Government was given immediately. The next day, a number of federal papers published interviews of Minister of Health Tatiana Golikova, and Head of Rospotrebnazor (Federal Service on Customers’ Rights Protection and Human Well-Being Surveillance) Gennady Onischenko. In their interviews the state officials declared that according to their data, there is no evidence of OST programs efficiency; substitution treatment is not a proper treatment but just a replacement of one drug with some other; and pilot syringe programs, previously held in some regions of Russia, all failed to decrease HIV transmission among people injecting drugs and had no influence on HIV situation. I would say, Russian officials are used to lie and to break their promises, because they are perfectly sure they can get away with this. This is why I decided I would not be speechless, I am not going to wait till I die of AIDS or overdose. I am going to appeal to international organisations for help. The right to health is one of the fundamental, inalienable human rights, guaranteed by a number of international conventions as well as the Constitution of Russia and the national law. I am sick of being frightened, of going through withdrawals, of hunting for money to get illegal drugs, of failing to adhere to HIV treatment program… I had enough; I am ready to fight for my rights till the end, because I am a human and I am a citizen of my country!
I do realise that it might be still too early to hope that my complains and appeals influence the official position of the Russian government so much that they ensure the human rights of people using drugs. But I am glad that the number of my supporters among drug users is growing already in my country. It means that my example has inspired people and they see that they should not be afraid to protect their rights because any discrimination of the basis of illness is illegal. Following my example, two other Russian drug users made individual complaints to the UN Special Rapporteur Anand Grover, and to the European Court of Human Rights. I think this is a great achievement. In November 2010 I was elected to the Eurasian Harm Reduction Network (EHRN) Steering Committee from the sub-region of Russia, which gives me more opportunities to fight for human rights of people using drugs. Currently, with the support from the International Network of People Using Drugs, we are actively working to establish the Eurasian Network of People Using Drugs. I strongly believe that this is just a beginning, first stage in the development of activism among Russian drug users; that people will finally overcome their fears, unite and stand out to protect their rights – we have nothing to lose! And in this, of course, we need and very much count on your support.
It is a pity that the Conference is over, but I am very grateful to all of you for sharing your experience with me. I am happy to have many new friends – it makes me stronger, keeps me alive and helps to work. I am not alone now – you all are my big and supportive family, and I will live in hope of new meetings and fruitful cooperation in the future. And finally, I would like to express my gratitude to managers of the International Harm Reduction Association and the International Network of People Using Drugs for the financial support of my participation in this conference. 1

Published on Drugreporter (http://drogriporter.hu)

By sarosip

Created 2011-04-01 19:33

Submitted by sarosip on April 1, 2011.

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In our short movie we ask Mr. Fedotov, the head of the UN drug agency and his critics to express their views on the 50 years of global drug prohibition

Last week the HCLU’s video advocacy team attended the 54th session of the Commission on Narcotic Drugs (CND) in Vienna. We asked both Mr. Yuri Fedotov, the head of UNODC and his NGO critics about the 50 years of drug prohibition – watch our short film to find out what they said!

“This year is the 50th anniversary of the keystones of the international drug control system, the 1961 Single Convention on Narcotic Drugs” said Mr. Yuri Fedotov, the director of the UN Office on Drugs and Crime (UNODC) in his opening speech at the 54th session of the Commission on Narcotic Drugs (CND) in Vienna. “Some critics say this convention is out of date but I disagree. The provisions of the convention remain valid as it does center focus on the protection of health. I urge the international community to rejuvenate the convention and I encourage member states to rededicate yourselves to implement its provisions.”

The HCLU is one of critics saying this convention is out of date. It is out of date because its main guiding principle is out of date. This convention, in the name of “the health and welfare of mankind”, attempted to limit the use of some drugs exclusively to medical and scientific purposes and decided to eliminate other forms of drug use. One of the provisions of the Single Convention say the chewing of coca leaves should be eliminated within 25 years: does Mr. Fedotov think that the aim to uproot an ancient Andean tradition within a quarter of a century was realistic?

This convention created the global war on drugs, a war driven by the dangerous utopia of a drug-free world. I disagree with Mr. Fedotov that either the global drug war or the dream of a drug-free world should be rejuvenated. How can we rejuvenate a public policy that was not evaluated properly? Despite the efforts of the international community, drugs are more available than ever. We know from countless studies that the global war on drugs undermines development in poor countries, fuels the global HIV epidemic, creates a lucrative and violent black market, fills prisons with non-violent offenders and devastates ethnic minorites all over the world.

Rather than rejuvenating the convention, we suggest to rejuvenate the funding principles of the United Nations and have a fresh look at the international drug control system in the light of the Universal Declaration of Human Rights: does this system work? What are the intended and unintended consequences of the enforcement of the conventions? Are there feasible alternative policies to be considered by the member states? If you want to know the answers to these questions please join a new civil society campaign [4] led by Transform, that calls on the governments to count the costs of the global war on drugs!

posted by Peter Sarosi

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http://www.independent.co.uk/

March 25, 2011.

By Enjoli Liston in Vienna

International efforts to tackle the “global threat” of illicit drugs must be “rejuvenated” in accordance with a 50-year-old convention despite a series of major failings, the head of the UN drugs and crime agency has told The Independent.

This week, Yury Fedotov acknowledged that global opium production increased by almost 80 per cent between 1998 and 2009, and the international market for drugs is now worth as much as $320bn (£199bn) a year – making it the world’s 30th-largest industry.

In the face of such daunting statistics, Mr Fedotov, the new executive-director for the UN Office on Drugs and Crime (UNODC), said the Single Convention of 1961 – the first international treaty to lay the framework for global drug-control systems – is still the most appropriate mechanism for tackling what he described as the “global, hydra-headed threat” of drugs and crime. He called on member states to “re-dedicate” themselves to the convention to take a tougher line against drug traffickers and “the drug threat originating from Afghanistan”.

Champions of drug-policy reform agree that trafficking is a major global problem, but some worry that a call to invigorate the convention could be interpreted as a call to reinforce punitive approaches to drug problems – one of the biggest criticisms of the 1961 pact. “We all have to acknowledge the key convention is now 50 years old,” said Mike Trace, chairman of the International Drug Policy Consortium (IDPC), a global network of NGOs.

“It was drafted in a time when our understanding of drugs problems was very limited.

“Strategies to strengthen repressive measures in source countries like Afghanistan, prohibition and the punishment of drug users have all been employed in the past, and none of them have been able to create the situation we want – which is to stifle the supply of illegal substances and stop young people from wanting to use them.”

Peter Sarosi, drug policy expert for the human rights organisation the Hungarian Civil Liberties Union, said: “The continuing focus on criminal justice and prohibition has already proved to be ineffective.” His group protested outside the UN building this week to raise awareness of the undesirable side-effects of drug prohibition.

Mr Fedotov argued that drugs and crime “share the same blood supply” but said he did not see the Single Convention as “punitive”.

He said: “It’s a preventive convention. Its main purpose is to protect people’s health.”

A former Russian ambassador to the UK, Mr Fedotov came under fire for his links to the Russian government when he was appointed as the UN drugs chief last year. Groups such as the IDPC highlighted Russia’s status as the world’s largest heroin consumer with a rapidly growing number of HIV cases.

As the Russian drugs tsar, Viktor Ivanov, confirmed this week, Moscow remains averse to implementing several UN-endorsed harm-reduction treatments – such as needle-exchange programmes, which are proven to reduce HIV infection rates. Instead, the government prioritises a hard-line approach to trafficking and Afghanistan’s drug cultivation.

When asked about Russia’s drug problem, Mr Fedotov said allegations concerning the treatment of drugs users in Russia were exaggerated. “There may be some shortcomings but it is not very different to what happens in other countries,” he said.

He said he understands the need for the UNODC to advocate “a comprehensive package of intervention for injecting-drug users” as well as drug-prevention and education measures.

Mr Trace of the IDPC praised Mr Fedotov for admitting that there are problems with the current system. Mr Fedotov’s predecessor, former UN drugs chief Antonio Maria Costa, declared “undeniable success” in 2009.

“That doesn’t mean that Mr Fedotov or the member states have any intention of fundamentally changing our structures,” said Mr Trace. “But it is very encouraging that they seem to be more open to a proper review process.

http://www.independent.co.uk/news/world/politics/un-drugs-chief-sticks-to-punitive-policy-despite-major-failings-2252477.html

New York Times

February 21, 2011

By DONALD G. McNEIL Jr.

With the help of the American government, the first methadone maintenance program in sub-Saharan Africa opened this month in a hospital in Dar es Salaam, Tanzania. While heroin use is not common in Africa, it has been growing recently in Tanzania’s port cities, which are used to ship the drug, usually from Afghanistan to Europe.

Drug couriers may be paid in heroin, creating a new group of addicts.

Tanzania now has an estimated 25,000 drug injectors, 40 percent of them infected with H.I.V., according to the Pangaea Global AIDS Foundation, a San Francisco-based group that is advising the Tanzanian government on the program. The United States President’s Emergency Plan for AIDS Relief, created by President George W. Bush, is paying for it.

Needle-sharing spreads both H.I.V. and hepatitis. Last year, an American researcher reported finding Tanzanians practicing
“flashblood,” in which one addict injects herself with another’s blood in the hopes of sharing the high.

In Africa, fear of the unfamiliar often leads to accusations of witchcraft, and if heroin use is unfamiliar, methadone is even more so.

Methadone is even more addictive than heroin, though it is given in oral doses meant to be small enough to produce no high.

In announcing the opening of the program at Muhimbili Hospital, the American Embassy in Tanzania said it was “fully aware that challenges will likely be encountered whilst services are being established.”