Partnership for Action on Comprehensive Treatment (PACT) - Treating Drug Dependence and its Health Consequences / OFID-UNODC Joint Programme to Prevent HIV and AIDS through Treatnet Phase II, in Sub-Saharan Africa.

Developing countries, and particularly the least developed ones, are affected by enormous economic and social problems including a dramatic lack of health care facilities, poor or inexistent welfare and educational systems, lack of state presence, and corruption. Social inequalities induce social exclusion, deprivation, marginalization and hopelessness. In these conditions drug abuse, violence and crime are common undermining public health, social and economic development, community cohesion and in general the future of new generations.

One of the most severe consequences of drug use is the spread of HIV and other blood borne disease such as Hepatitis B and C. Drug use, especially injecting drug use (IDU) is closely linked to HIV transmission through the sharing needles, but also in relationship to the risky behaviours of non-injecting drug users.

Data on the size of IDU population from 130 countries indicates that there are 13.2 million IDUs worldwide. It also indicates that sharing of contaminated injection equipment is a major route of HIV transmission in many regions, including Eastern Europe, Central, South and South East Asia and some countries in Latin America (UN Reference Group on the Prevention and Care of HIV among Injecting Drug Users, 2003). Up to 10% of global HIV infections are due to unsafe injecting drug use. If Sub-Saharan Africa is excluded, up to 30% of global HIV infections are due to unsafe injecting drug use. In many countries individuals affected by drug dependence, psychiatric disorders and HIV are concentrated in prison settings, usually in destitute condition, excluded from real opportunities for rehabilitation and treatment.

The efforts to reduce illicit drug demand, with appropriate prevention, treatment and sustainable livelihood programs may consistently prevent the severe health and social consequences of long lasting drug use, such as HIV, Hepatitis and many other medical disorders. Comprehensive demand reduction interventions, including specific harm reduction activities, have been proven effective in counteracting HIV epidemics and breaking its vicious circle with poverty/underdevelopment and substance abuse.

Unfortunately, although an increasing body of knowledge demonstrates that drug dependence treatment and measures to reduce the harm caused by drugs are effective if implemented through a number of qualified comprehensive interventions, the dissemination of good practice facilities is still scarce, often not based on sound scientific evidence and not fully accessible to those most in need.



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