Statement of Mr Costa
at the
15th Meeting of the UNAIDS
Programme Coordinating Board
Geneva, 23-24 June 2004
Mr Chairman, Ladies and Gentlemen;
In a week time the United Nations Office on Drugs and Crime (UNODC) will assume the chair of the UNAIDS Committee of Co-sponsoring Organisations (CCO). Therefore, I should like to take this opportunity to provide you with some background on the work of the Office in the field of HIV/AIDS, with emphasis on the activities we have in mind during the CCO chairmanship.
The past two decades have shown that drugs and crime are important, often neglected, factors in the evolution of the AIDS pandemic. This is particularly true in Eastern Europe, the CIS countries and most regions of Asia. These lands are the home of approximately 9 million injecting drug users, about 2/3 of the world total (13 millions). Injecting drug users, as we all know, are at a great risk of being infected with HIV through the use of contaminated needles and syringes, as well as for careless sex under intoxication or under the pressing need to acquire drug money. Indeed, our data indicate that in several countries more than 80 per cent of IDU addicts live with HIV/AIDS.
We face the risk of an HIV/AIDS epidemic that seems to follow a well-known pattern. What we have observed in Viet Nam, Thailand, Cambodia and Myanmar during the past dozen years or so, namely an HIV/AIDS epidemic that started in drug injecting cohorts and then spread to the general population, the same pattern is being observed today in the CIS region, the Baltic countries, China and Central Asia. The real difference between then and now is that a dozen years ago the crisis concerned countries with population of about 200-250 million. Today at risk are countries with a total population of 2.5 billion people or more. With demographic numbers getting so big, the pandemic risks are of course big, as some of the most populous lands of the planet are under threat.
News is not all bad. During the past decade we have also learned that the HIV/AIDS epidemic among injecting drug users can be stopped and even reversed if drug users are provided, at an early stage and at a large scale, with comprehensive services. It is, however, a sad fact that less than five per cent, and in many high-risk areas, less than one per cent of all drug users has access to them. In too many countries drug users are simply incarcerated. Not only this is not a solution. Actually this contributes to the rapid increase in the number of people living with HIV/AIDS.
Indeed a related, yet more serious problem concerns the detention centres a problem which goes beyond the incarcerated drug users. Worldwide, at any given time there are 10 million prisons inmates with an annual turnover of 30 million. A large proportion of them are drug users, in Europe raging from 30% (Italy) to 70% (Portugal). In the Russian Federation indicate that in some prisons up to half of all inmates are injecting drug users, while in Kazakhstan the proportion is close to 2/3.
Let us recognize it. In too many countries detention centres are breeding ground for HIV infection. Overcrowding, homosexual relations, gangs violence, lack of protection for the weakest inmates, and corrupt prison management create an environment, which increases vulnerability to HIV transmission through unsafe sexual practices, sharing of injecting equipment or crude substitutes, tattooing, violence and rape. According to our data, prisons are overcrowded in over 100 countries, with prisons housing 4 even 5 times the numbers of inmates originally planned. As a consequence, around the world the percentage of people with HIV/AIDS in prisons is significantly higher than in the community. After discharge, inmates spread the virus to their partners.
Let me now address a third area of UNODC concern: the growing problem of trafficking in persons for the purpose of sexual exploitation. These generally forgotten modern slaves are at a high risk for HIV infection. Worldwide there are several millions of them under various forms of bondage, their tragic cohorts increasing by as much as 1 million per year. I assure you that during my Offices CCO chairmanship, these people and their vulnerability to HIV/AIDS, will not be forgotten.
Fourth, and finally, another important area that UNODCs chair of CCO would like to highlight concerns conflict and post-conflict situations. My friend Peter Piot noted this morning current efforts by UNAIDS in this area, including the fielding of missions to Haiti and the ongoing work with DPKO.
Just in the African continent, there are 17 countries in a war/post-war environment. The concurrent presence of weak institutions, crime, violence and illegality juxtaposed to the deadly impact of the HIV virus is a fertile ground for eroding countries efforts to overcome mass poverty.
I hope that this specific work-programme of the United Nations Office on Drugs and Crime will supplement and complement the good work of Mr Matsuura and his team, and build on the CCO foundation they have laid down. We are committed to work in close cooperation and consultation with all cosponsors and partners. I therefore thank you for the invitation to address this PCB forum.
Thank you for your attention.