U.S., U.N. Drug Policy Heads Disagree on Needle Exchange for HIV/AIDS Prevention
Director of the White House Office of National Drug Control Policy John Walters and Antonio Maria Costa, head of the U.N. Office on Drugs and Crime, on Monday at the 48th session of the Commission on Narcotic Drugs in Vienna, Austria, disagreed over the practice of using needle-exchange programs to curb HIV transmission among injection drug users, AFP/Yahoo! News reports (AFP/Yahoo! News, 3/7). Costa said UNODC views needle exchanges, in which injection drug users can turn in used needles and obtain clean ones, as "appropriate as long as they are part of a comprehensive strategy to battle the overall drug problem," the Associated Press reports (Loof, Associated Press, 3/7). He said that contaminated needles are a "major source" of infection with HIV and other diseases, including hepatitis, especially among injection drug users, according to AFP/Yahoo! News. "We must not deny these addicts any genuine opportunities to remain HIV-negative," Costa said in a speech to open the CND session. He added, "We reject the false dichotomy that either drug control prevails, with no consideration for HIV, or that HIV prevention prevails with no consideration for drug abuse" (AFP/Yahoo! News, 3/7). However, Walters said drug use itself -- not a lack of needle exchanges or other programs for drug users, such as safe injection sites -- is "behind the danger" of HIV and other bloodborne diseases, Reuters reports. "Continued drug use is a fundamental cause of the dangers we face from bloodborne diseases," Walters said (Charbonneau, Reuters, 3/7). However, Walters added that the "points of agreement" between himself and Costa in the fight against illegal drug use "far outweighed the differences," according to AFP/Yahoo! News. "[T]he single greatest way of preventing the spread of HIV/AIDS through drug users is taking those addicted and get them to recover," Walters said (AFP/Yahoo! News, 3/7).
An unnamed U.S. government official at the meeting said that the CND "should not be involved with needle exchange because this is promoting drug use." However, Costa in a November 2004 letter to the State Department said that the United Nations does not "endorse needle exchanges as a solution for drug abuse nor support public statements advocating such practices" and feels such "prophylactic measures to prevent the spread of HIV/AIDS should be undertaken only within the overall effort to reduce drug abuse." The letter also said U.S. objections to needle exchanges "continue to place ... [UNODC] in a difficult position," AFP/Tribune de Geneve reports (AFP/Tribune de Geneve, 3/8). Walters on Monday at a news conference said that he does not view the ongoing "candid debate" about drug policy as "pressure," according to the Associated Press. "Those who suggest that candor is a kind of intimidation I think want to silence debate and discussion," Walters said (Associated Press, 3/7).
More than 300 scientists, policy analysts, human rights and HIV/AIDS advocacy groups and advocates from 56 countries last week released an open letter expressing "concern about U.S. efforts to force a UNODC retreat from support of syringe exchange and other measures proven to contain the spread of HIV among drug users" and urging delegates attending the CND session to resist such pressure. The letter states, "Strategies that attempt solely to achieve abstinence from drug use do not constitute an acceptable alternative to programs, such as syringe exchange, that help active drug users protect themselves from HIV/AIDS." Of particular concern for those who signed the letter was a meeting reported to have taken place in November 2004 between Costa and Robert Charles, chief of the State Department's Bureau for International Narcotics and Law Enforcement Affairs. Following that meeting, Costa allegedly expressed new ideas about omitting from UNODC documents specific language that referred to needle-exchange programs (Kaiser Daily HIV/AIDS Report, 3/4).