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Following UNAIDS Study, Govt. Declares War on Injecting Drug Use
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20 February 2008
Aditi Tandon, Tribune News Service
Within months of a UNAIDS study showing high HIV prevalence (13.80 per cent) among injecting drug users (IDUs) in Punjab, the state government today admitted to having destroyed prescription drugs worth Rs 1.60 crore across the state over the past year. This is the largest ever seizure of prescription drugs in the state.
Health minister Laxmi Kanta Chawla today said more seizures would happen in the near future to block supply chains of injecting pharmaceutical preparations like buprenorphine, pentazocine and sedatives, including diazepam and promethazine, which Punjab's population is getting increasingly addicted to. In a bid to discourage drug use in her department, Chawla said anyone found under the influence of drugs while on duty would be immediately suspended.
Punjab, along with Haryana and Chandigarh, is now being seen as worse than the northeast in terms of IDU-HIV linkages. The study puts the number of IDUs in Punjab between 2,600 and 18,148 and recommends immediate implementation of harm reduction and oral substitution strategies, including shifting injecting drug users to agonist (oral) medicines.
The recommendations come from Dr Atul Ambekar of AIIMS, who has been working under Government of India programme for drug abuse treatment for about over a decade now.
In Chandigarh, along with Alankar Malviya of UNAIDS and Rajesh Kumar of Society for Promotion of Youth and Masses which conducted the study for Punjab, Dr Ambekar today sensitised deputy commissioners and civil surgeons from across the state on the IDU-HIV issue.
He said the strategy had to first accept the fact that drug use in some form would always exist. "Our focus must be on improving injecting practices and making them safer. If you can't stop drug use, you should try substitution. If that fails, provide sterile and clean injections to users and tell them to minimize sharers," he said.
The expert also warned the state to move fast unless it wanted an epidemic situation. "In Manipur and Nagaland, HIV epidemic among IDUs became the most explosive. So much so that general populations remained infected long after the situation had stabilised among IDUs. Oral substitution is the key. It is also important for the success of antiretroviral treatment," he said. Punjab currently has 2802 persons on ART.
The danger, however, is being posed by the fact that integrated counseling and testing centres in the state have yet detected only 8436 persons living with HIV whereas the estimated population of infected people is 18,556.
"The gap is worrisome. So is the fact that voluntary blood donation in the state is only 20.9 per cent of the total donation. Obviously a lot of our blood is coming from the grey market where sources of donation can be unhealthy and diseased," said health secretary T.R. Sarangal, directing deputy commissioners to enhance voluntary blood donation in their areas.
As regards HIV prevalence - IDUs are the highest at risk in Punjab, with HIV positivity among them being 13.80 per cent. The ther two high risk groups of men having sex with men and female sex workers have reported HIV prevalence of 4.8 per cent and 1.4 per cent, respectively, clearly indicating the HIV risk to IDUs and from IDUs to the uninfected populations.