Burying one's head in the sand must be the most
comfortable thing to do.
How else would anyone explain, the constant refusal
to deal with issues that won't go away unless someone deals with them
realistically?
But it is so much easier to act like they do not exist.
After all, some of these issues do not quite affect us - at least not directly.
Like the drug problem.
Once in a while a sordid television documentary
shows us dazed zombies in drug abuse hot- spots. They speak of living in a self-inflicted
hell that they cannot get out of; and tell of the careless risks they take to
get money to feed their drug habit, without which their lives would be incomplete.
And as they share the spoils of violent robberies, the needles, the blood, the
high - they also share the virus.
Since most of us still have hearts, we are moved
into wordy protests by the helplessness of the drug abuse victims.
“The drug lords are well-known and should be
arrested!” we bay for blood, before we resign to fate as we realize that it is
a complex affair; and slowly slide back to our relatively drug-free existence.
But for public health officials, drug users,
particularly those who inject drugs, pose a big problem in their efforts to
control the spread of HIV.
A report by three UN organisations
indicated that HIV prevalence among injecting drug users in Kenya was at
21 per cent. In Nairobi an estimated one in three injecting drug users
are infected with HIV.
As they share needles, and possibly infected blood,
they are not only a risk unto themselves, but also to the general population.
Thus, this is a group we cannot afford to ignore as
we talk about getting to zero new infections. Remember the promise?
It is against this backdrop that Kenya will join 82
other countries, worldwide, that have needle exchange programmes. The programme
will be rolled out in Nairobi and Mombasa this month, and targets 49,000
injecting drug users.
In needle exchange programmes, injecting drug users
are provided with clean/sterile needles and syringes, and safe disposal of used
syringes; to reduce sharing of needles and the spread of HIV, Hepatitis C and
other blood-borne diseases.
Moreover, needle exchange programmes are not just
about providing clean needles, they also provide an opportunity for drug users
to learn about safe injection practices and disposal, safe sex and get referral
for therapy, rehabilitation and treatment.
The evidence speaks for itself in countries that
have adopted this kind of programme.
According to avert.org a 1997 study carried out in 81 cities worldwide,
found that HIV infection rates increased by 5.9 per cent in 52 cities without a
needle exchange programme. The study published in The Lancet also found that
the infection rate decreased by 5.8 per year in the 29 cities that had a needle
exchange programme.
Moreover, in a ten-year study of injecting drug
users in New York, HIV prevalence fell from 54 to 13 per cent following the
introduction of needle exchange programmes.
However, needle exchange programmes are
controversy-rousing affairs. Should government (taxes) fund programmes to give people
who are self-destructing clean needles?
It is no different in Kenya, where as soon as the
plan (funded by the Global Fund) was announced, opposition against it began. Many
have claimed that it will only escalate the drug problem and attract new users.
It could also be argued that those who get HIV in
the course of using drugs are reaping the sins of drug abuse and the risks that
come with it. But at what cost to the public health system?
It seems those who are against the programme, are
seeing this from one narrow angle.
I remember a Daily Nation feature by Arthur Okwemba
in March, where religious leaders were quoted saying that they regretted their previous
approach to fighting HIV, after realising that using a moral lens just did not
work.
They realised, 27 years after HIV was first
diagnosed in Kenya, that their method contributed to among other things
silence, denial, inaction and mis-action, and undermined national HIV
prevention, treatment and care efforts.
According to the 2008 Kenya Aids Indicator Survey,
100,000 people are infected with HIV every year.
While married people account for the highest rate of
new infections at 44 per cent; Drug users specifically
account for 3.8 per cent of the new infections.
Sharing needles among drug abusers is a major HIV
transmission route. So what better way to reduce this transmission among drug
users who cannot drop the habit, than needle replacement programmes that provide
them with sterile needles and remove contaminated needles from circulation?
Anyone who is committed to promoting safer practices
and to zero new infections, would support any programme that will help reach
that mark sooner rather than later.
It is probably more expensive to treat a person
living with HIV than it is to provide free needles.
You may not agree with all the interventions to
fight the virus, but if something works, we should embrace it.
The Catholic Church had, for a long time, been
opposed to the use of condoms, but last year in a book by Peter Seewald titled:
Light of the World: The Pope, the Church
and the Signs of the Times, Pope Benedict XVI hinted at a change in
stance. He said contraceptives could be used in exceptional circumstances to
reduce infections among certain groups.
What about you? Are you going to be part of the
problem, or are you going to support a solution?
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