Strategic investments are pivotal to curb HIV epidemics among people who inject drugs

Vilnius , 12 June - Yesterday, the plenary session of the International Harm Reduction Conference addressed the financing of harm reduction in the context of HIV. Victoria Macdonald, Health and Social Care Correspondent at Channel 4 (UK), guided a lively session into the disparity between resource availability and the actual needs to curb HIV epidemics. Speakers, David Wilson (World Bank), Aldo Lale-Demoz (UNODC), Daniel Wolfe (OSF), and Raminta Stuikyte (European AIDS Treatment Group) highlighted the importance for countries to assume greater responsibility and invest a larger share of their domestic resources in HIV responses that are evidence and human rights-based, as well as people-centred. David Wilson made a clear case for harm reduction investment while referring to Australia: "For every dollar invested in needle and syringe programmes, AUD$27 was returned in cost savings".

  Investing now in harm reduction is smart economics;

a return on investment is inevitable.

Following the plenary, in an effort to further the discussion on the cost-effectiveness of implementing HIV services for people who inject drugs, UNODC, the World Bank, UNAIDS, WHO, and the Global Fund to fight TB, HIV, and Malaria, organized a side event entitled "Economics and Financing of effective Harm Reduction Strategies in the context of HIV". 

Senior Officials of ministries of finance from six Centr al Asian and Eastern European countries (Azerbaijan, Georgia, Kyrgyzstan, Moldova , Tajikistan and Ukraine), including the Honourable Olga Lavrova, Minister of Finance of Kyrgyzstan, discussed the challenges associated with addressing, in a harsh economic climate, HIV epidemic among people who inject drugs - "How, in the midst of severe austerity measures, are investments in harm reduction services reasonable and cost effective?"

Aldo Lale-Demoz, who chaired the meeting, emphasised the need to invest wisely and stressed the necessity to scale-up evidence-based interventions, specifically referring to the nine core interventions for HIV prevention, treatment and care among people who inject drugs. He pointed out that only wise investment decisions could change the trajectories of current epidemics. To reach the 2011 target of reducing new HIV infection by 50%, countries were encouraged to make bold investments and remove any barrier hampering the delivery of the full package of services.

Dr. Martin Donoghoe, Programme Manager at the WHO Regional Office for Europe, provided participants with an epidemiological overview of the HIV epidemic among people who inject drugs in the region. He pointed out that albeit the region's high HIV infection rates, only a handful of  the countries offered a range of harm reduction services.

Reinforcing the need to scale up services, David Wilson pointed to the advantage of implementing a combination of three priority harm reductions interventions that he calls the "corner stones" ; Referring to needle syringe programmes, opioid substitution therapy and antiretroviral therapy, he presented empirical evidence demonstrating how a combination of these three interventions is sure to have greatest impact on HIV incidence among people who inject drugs.

The participants unanimously agreed that the Eastern European and Central Asian countries need to urgently think about transitioning their AIDS budget from international funding to national funding. The meeting ended with a call for better use of existing resources, for example, by ensuring that the AIDS budget is spent on evidence-based interventions, procuring better, implementing efficiently, contracting local grass root civil society organizations, adopting good policies, and last but not the least, by investing in effective prevention today to reduce cost in the future.