Title

Why do we fail in responding to the epidemic among people who inject drugs?

Code

WEBS02

Session Type

Bridging Session

Venue

Hall 10

Date Time

Wednesday 25 July, 16:30 - 18:00

Co-Chairs:

Julie Bates, Curtin University, Australia
Frederick Altice, Yale University, United States

The world has failed in responding to the HIV epidemic among PWID. New infections increased by 33% between 2011 and 2015 – the UN goal was to reduce that number by 50% by 2015. This massive global failure of the AIDS response is particularly acute among PWID in EECA where lack of harm reduction and inappropriate strategies are driving the HIV epidemic and concomitant hepatitis and tuberculosis/MDR-TB epidemics. We will bring together the views of science, law enforcement and affected communities in a panel discussion moderated by two internationally recognized experts. We will devote significant time for debate and discussion with the audience. The moderator may also call on a Dutch representative in the audience to give a two-minute overview of the remarkable record of the Netherlands in eliminating new HIV infections among PWID.

16:30 WEBS0201	Introduction

16:35 WEBS0202	View from law enforcement Nick Crofts, The University of Melbourne, Australia

16:45 WEBS0203	View from science M-J Milloy, BC Centre on Substance Use, Canada	Slides

16:55 WEBS0204	View from impacted community Anya Sarang, SKOSH, Netherlands

17:05 WEBS0205	What about hepatitis and TB/MDR-TB: Why are we also failing PWID? Nathasha Martin, University of California San Diego, United States	Slides

17:15 WEBS0206	Debate between panellists and Q&A

17:55 WEBS0207	Summary and concluding remarks

AUTHOR

Mauro Guarinieri

SUMMARY

The session brought together science, law enforcement and community in a panel that tried to answer a recurring question: why we are failing to respond to skyrocketing epidemics among PWID, particularly in Eastern Europe, where the lack of appropriate responses is accounting for unprecedented levels of HIV transmission?

HIGHLIGHTS

“Changing the police behaviour may be the single most important factor affecting the success of any response to HIV among PWID”. Nick Croft, Universtiy of Melbourne, Australia, pointed out that while decriminalization should be always the ultimate end game, law enforcement can either be our best ally of worse enemy in implementing sensible responses to HIV and drug use. M-J Milloy, from the BC Centre or Excellence in HIV/AIDS, Canada, shared data from multiple studies showing how incarceration can reduce access to ART among PWID by almost 50%, “PWID is the only key population where life expectancy has declined over the last years. Something we should be ashamed of”, he said. Anya Sarang shared powerful stories from Russia, the third largest growing HIV epidemic in the world, accounting for over 2/3 all HIV transmission in Europe, where harm reduction is still considered “a threat to the HIV national strategy”.

CRITICAL ASSESSMENT

It is disheartening to keep hearing the extent to which the global response to HIV is failing people who use drugs. Some of the stories shared by Anya Sarang, Andrey Rylkov Foundation in Russia and SKOSH in the Netherlands, are simply hearth-breaking. A country where the only response to drug use is still violence and mass-incarceration, and where basic rights are denied as a matter of course, Russia did not face HIV until fifteen years into the global pandemic. Instead of benefiting from the experiences of other countries in confronting it, Russia has systematically rejected all well established lessons.