Health officials in Asia say harsh legal penalties against drug trafficking and abuse may increase the rate of HIV infection among drug users. Health experts are now urging governments to use of so-called harm reduction strategies to combat drug abuse and stem the rise in AIDS infection.
Most Asian nations have little tolerance for illicit drug users and traffickers. Many impose stiff penalties, including the death penalty for the transportation and sale of opiates such as heroin and amphetamine type stimulants (ATS).
Prison populations in Asia have increased as a result of drug-related convictions. The prison population doubled in Thailand between 1996 and 2004 due to the criminalization of methamphetamines in 1996.
Now, a growing number of analysts and health officials say such harsh penalties may contribute to the spread of HIV, the virus that causes AIDS.
Ton Smits is executive director of the Asian Harm Reduction Network, based in Chiang Mai, Thailand. He says repressive environments, such as Thailand's war on drugs initiative that began in 2003 creates a climate of fear. He says a new approach is necessary.
"As long as we have a black and white approach where we have a zero tolerance position then it will be difficult to make any progress," he said. "Thailand is not alone. All countries and governments in the region that are struggling to accept a policy. The challenge really is that once you agree this needs to be done that action is taken, but what is happening is basically too little, too slow and too late."
A study conducted by the Asian Harm Reduction Network, and funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, found that as heroin use declined ATS abuse increased, including injecting such drugs as a substitute for heroin.
Thailand has some 600,000 people with the AIDS virus. Within this group, 30 to 50 percent of intravenous drug users are HIV-positive. But Thailand, like other Asian countries, imposes tough penalties on drug traffickers and users.
Health officials and non-government groups are pressing governments to adopt more harm reduction strategies to reduce the spread of the AIDS virus. Such strategies include needle exchanges and programs to substitute heroin with less addictive drugs, like methadone.
The Thai Government is moving to adopt harm reduction strategies in its drugs policies. Dr. Nicholas Thomson, of the John Hopkins School of Public Health, says harm reduction policies in Australia have succeeded in lowering HIV rates among intravenous drug users to less than one per cent.
Thomson says promoting links with key groups in society, including the judiciary and police, hold the key to a harm reduction policy being put in place.
"The issues and promoting partnerships with public health and public security at both a district village level and also at the national level, it's the way to go and we're not going to get anywhere unless we can bring the Interior Ministry and the Ministry of Justice fully on board," said Thomson.
Thomson says the fact that Thailand has been unable to lower HIV rates among intravenous drug users indicates the need for a different strategy.