Drug dependence treatment and HIV prevention in Kenya

Globally, there are an estimated 16 million injecting drug users, around 3 million of whom live with HIV. As a major route of HIV transmission in many countries, the use of contaminated injecting equipment contributes up to 10 per cent of all HIV cases worldwide. As the lead UN agency in countering illicit drugs and in HIV and injecting drug use, UNODC works with countries to review and develop laws, policies and standards of care that enable them to put in place effective services for people who inject drugs.

During his first visit to East Africa since taking office as head of UNODC, Executive Director Yury Fedotov visited the Nairobi Outreach Services Trust in Kenya, an NGO working to prevent HIV among injecting drug users and other vulnerable sections of the population in the capital.

The visit directly follows the recently concluded Commission on Narcotic Drugs where Mr. Fedotov expressed the importance of civil society in working in the area of drug use prevention in all areas of the world: "We must continue to expand efforts to prevent drug dependence and strive to provide all drug users with the treatment, care and support they need. As we move to achieve this, we regard the NGO community as a key partner and a powerful voice in reaching the people whom UNODC ultimately work to serve."

While considerable progress has been made in the global HIV response over the past two decades, coverage of the most effective HIV interventions for men and women who inject drugs across the world remains low. Only 8 per cent of injecting drug users are on opioid substitution therapy and a mere 4 per cent on HIV treatment.

For this reason, UNODC's work and that of state and non-state partners in the areas of drug demand reduction and HIV among injecting drug users is critical.

In January 2011, the UNODC Regional Office for Eastern Africa supported the Government of Kenya and various partners, to respond to a crisis in Mombasa, following a sudden decrease in the availability of heroin in the Coast province. Recently, the Government decentralized drug dependence treatment to 12 primary health care centres in Mombasa to respond to a sudden upsurge in demand for treatment. This is being supplemented by an innovative approach to reduce new HIV infections among injecting drug users by providing free access to HIV prevention and treatment services. In the same month, the Government has announced that it will adopt effective interventions, including opiate substitution therapy and needle and syringe programmes to further reduce HIV infection among injecting drug users.

While instances and progress such as these are commendable, in many parts of the world access to HIV services is often impeded by factors including restrictive policies, poor availability of services and their high costs , or compulsory or ineffective drug dependence treatment approaches to name a few. In this, Mr. Fedotov calls on more Governments around the world to adopt evidence-informed, human rights based and gender-responsive policies and programmes in drug dependence treatment and HIV prevention: "In many countries, legislation and practices continue to result in widespread discrimination towards people who use drugs. Drug users remain socially marginalized, subjected to violations of their basic rights, and incarcerated in large numbers or confined to detention centres. This undermines effective HIV responses and stops users from accessing services needed to prevent new HIV infections. It is crucial that these actions be stopped."