India: Law enforcement officials, health service providers and civil society organizations come together to pave the way for better HIV prevention and care

The HIV epidemic in India is concentrated amongst vulnerable groups, including men and women who inject drugs (PWID), men who have sex with men (MSM) and sex workers (SWs). There are an estimated 170,000 PWID among whom some 7.1 percent are living with HIV. HIV prevalence in this population group is even higher in some states. It is therefore important to meet the needs and requirements of people who live with HIV and to provide a holistic health and social response. 

Although India has a number of services for HIV prevention, treatment, care and support in place, affected people, especially people who inject drugs face a number of barriers while accessing them. 

One of them is a gap in the understanding of the responsibilities of both the public health and the law enforcement sector. Law enforcement personnel are bound to implement the drug law as it stands and often do not understand the impact of their action on necessary and guaranteed HIV services to those who need them. According to testimonies by people who use drugs, this has often led to arbitrary arrests, detention and discrimination.

In an effort to effectively address these concerns, UNODC under its Global HIV Programme conducted a workshop in partnership with the National AIDS Control Organisation (NACO) and the Narcotics Control Bureau (NCB) in November 2014, in New Delhi. The two-day workshop titled 'Enhancing partnerships between law enforcement and civil society organizations in the context of drug use and HIV' brought together 35 law enforcement personnel, public health officials and civil society organizations (CSOs).

It was the first time that the three stakeholders discussed in an open platform the practical problems and dilemmas faced in their daily work when dealing with drug use.  Law enforcement officials shared openly their practical problems when dealing with drug users, such as the lack of capacity to deal with withdrawal symptoms while a drug user is under detention, the lack of legal aid for the arrested/ detained drug user and the lack of trust and collaboration between law enforcement agencies, health service providers and CSOs.  They also underlined a series of general problems affecting prisons, such as lack of enough food, space and general health services for inmates. In turn, health sector officials also acknowledged their lack of understanding of the legal context under which law enforcement works. 

Representatives from CSOs and health service providers recognized that the workshop had created an opportunity to interact with law enforcement officials and that only more interaction among all will help to increase understanding, awareness and sensitivity amongst officials who deal directly with vulnerable groups. 

Working in mixed groups, participants deliberated and proposed measures that should be adopted so that HIV services can reach those in need. Some of the suggestions included: 

  1. Establishing a coordination mechanism within existing systems to bring together health service providers and law enforcement to assist in providing medical and legal aid to persons under police custody and to liaise between the police and local health service providers.
  2. Organizing regular interactions between local law enforcement authorities and health service providers to sustain partnerships.
  3. Counselling for the detained / arrested persons, so that they are aware of their rights and the services they can access.
  4. Inclusion of the judiciary in future workshops to raise awareness on the existing law that allows differentiation between a drug user and a trafficker and foresees an option for the drug user to attend drug treatment instead of being sent to prison.
  5. Capacity building for law enforcement officials through sustained training at the various training academies. 

Partnerships between health and criminal justice officials as well as CSOs can result in better access to health services for people who use drugs, decreases in crime and increase in trust between the community and law enforcement officials.  Continued advocacy for this critical initiative remains a priority for UNODC. The UNODC Regional Office for South Asia will continue to conduct a series of similar workshops in different parts of the country in partnership with NACO and NCB. 

 

The workshop was conducted under the UNODC Global HIV Programme with financial support from UNAIDS