Central Asian countries urged to act now to avert worsening AIDS epidemic

United Nations report calls for critical legal and policy changes

Almaty, January 19, 2011 - Today, at a regional consultative meeting, the Central Asian Regional Office of the United Nations Office on Drugs and Crime (UNODC), in partnership with other leading international experts, urged government leaders and Parliamentarians in six countries to take prompt and decisive action to address the growing HIV/AIDS crisis facing their respective nations.

Indeed, today's event marks the highly anticipated release of a report resulting from an extensive legislative and policy analysis in Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.

The report presents 60 general recommendations, plus numerous detailed recommendations for each of the 6 countries that participated in the project.  The recommendations for legislative and policy reform are based on evidence of what works and is needed to turn the tide in the HIV epidemic, including respecting and protecting the human rights of people living with HIV and those particularly vulnerable to HIV.

The report shines a spotlight on numerous changes to laws and policies that are desperately needed to support effective, evidence-based HIV prevention and treatment efforts. Despite some positive legislative reforms started in some countries of the region, many  laws, as they currently exist, undermine such efforts, particularly for vulnerable populations such as people who use drugs and people in prison.

"While the global incidence of HIV infection has declined in the past ten years, such has unfortunately not been the case in most of the countries in Eastern Europe and Central Asia.  New infections are on the rise, and we know that this troubling trend is inextricably linked to injection drug use, both in and outside our prison systems," said Nina Kerimi, Regional Project Coordinator of UNODC's Regional Office for Central Asia.

According to UNODC figures, between 2000 and 2008, the number of new officially recorded cases of HIV in the Central Asian region has increased 11-fold, and there is reason to believe these figures significantly underestimate the real prevalence.  Unsafe drug injection is the single greatest factor driving the HIV epidemic in the region, accounting for an estimated 60% of all HIV infections, however, in  some countries, there is increasing evidence that the failure to respond effectively to protect and promote the health of people using drugs is now having a broader effect on the public health, with HIV spread increasing in other populations.

"We need to address these public health issues - issues that ultimately affect us all - with effective laws and services that are realistic, pragmatic and sensible," said Richard  Elliott, Executive Director of the Canadian HIV/AIDS Legal Network.   "Government policy-makers and Parliamentarians must ensure that ill-advised laws don't exacerbate public health problems but instead are transformed to improve the situation.  The evidence is clear: simply pursuing harsher and more punitive laws will not work and will only make matters worse.  This is a public health issue and needs to be dealt with as such."

Among the many recommendations in the report are the following:

  • Countries should  reform criminal and administrative legislation by raising the threshold of the minimum quantities of drugs that trigger prosecution for possession, which are often set unrealistically low, so that criminal and administrative penalties for possession of small amounts of drugs without intention to sell would be removed. .
  • Create more alternatives to prosecution and imprisonment for drug-related offences.
  • Ensure that criminal and administrative laws do not impede the effective operation of programmes aimed at providing health services to people who use drugs, such as needle exchange programmes.  This means that police should not target such programmes for extra surveillance or people who use such programmes.
  • Governments also need to commit resources to scaling up effective health services such as opioid substitution treatment, a key service for treating drug dependence and for preventing HIV among people with opioid dependence, as well as needle exchange programmes to reduce the risks of transmitting HIV and viral hepatitis through sharing injection equipment.
  • Limit  the application of compulsory drug  dependence treatment  and introduce WHO clinical standards in those limited instances where it may be still applied.  In addition, significantly increased  accessibility of  evidence-based, cost-effective voluntary treatment for drug dependence  will make it easier to reduce  the resort to coercive measures.
  • There is an urgent need to improve access to basic HIV prevention measures in prisons throughout the region, including access to condoms and sterile needles.  Prisoners also need much improved access to voluntary, effective treatment for drug dependence and antiretroviral and other treatment for HIV infection, viral hepatitis and tuberculosis.
  • Action is needed to address discrimination against people living with HIV and people with drug dependence, including protecting against involuntary HIV and drug  testing and protecting the confidentiality of health information.  Discriminatory policies relating to employment, education and travel restrictions also need to be reformed.

The report was prepared by UNODC and technical experts from the Canadian HIV/AIDS Legal Network ( www.aidslaw.ca), a leading international expert group on HIV-related legal and human rights issues.  The process included national expert groups from each of the 6 project countries, who undertook an initial assessment of law and policy at the national level and then identified various recommended reforms.  During the process, results of the analysis and proposed draft recommendations for reform have been presented and discussed at various fora with parliamentarians, government policy-makers and others.

The full report - entitled Accessibility of HIV Prevention, Treatment and Care Services for People who Use Drugs and Incarcerated People in Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan: Legislative and Policy Analysis and Recommendations for Reform - is online at www.unodc.org/centralasia (English and Russian versions).

For further information please , contact:

Nina Kerimi, UNODC Regional Project Coordinator , nina.kerimi@unodc.org,