Improving health and protecting human rights for individuals, communities, and society
Alisher Latypov, Eurasian Harm Reduction Network, VilniusAsya Bidordinova, Independent Consultant, TorontoAvet Khachatrian, Independent Consultant, Toronto
Opioid Substitution Therapy in Eurasia: Increasing Access, Improving Quality
Washington D.C., 23 July 2012XIX International AIDS Conference
Background and Methodology
Washington D.C., 23 July 2012XIX International AIDS Conference
• 29 countries, 6 sub-regions: The Baltics, Central Europe, South-Eastern Europe, European countries of CIS, South Caucasus and Central Asia
Data collection: Interviews and literature review between August – November 2011
Updated data: Initial findings updated based on UNGASS 2012 country reports, data collected by EHRN for HRI GSHR 2012; feedback from EHRN members and national OST experts
Countries with OST and Year of OST Introduction
Washington D.C., 23 July 2012XIX International AIDS Conference
OST in Prisons and Authorization of Take-home Dosages
Washington D.C., 23 July 2012XIX International AIDS Conference
Number of Individuals Receiving OST
Washington D.C., 23 July 2012XIX International AIDS Conference
Percentage of People Who Inject Drugs Receiving OST
Washington D.C., 23 July 2012XIX International AIDS Conference
OST Coverage and Prevalence of HIV among PWID, %
Washington D.C., 23 July 2012XIX International AIDS Conference
Recent OST Assessments in the Region
Washington D.C., 23 July 2012XIX International AIDS Conference
• Subata, Karymbaeva, Moller, WHO Europe, 2011, Penitentiary Institution No. 47 in Bishkek (Kyrgyzstan):“Results of the study indicate the consistent improvement of health and quality of life among opioid substitution therapy patients, as well as the significant reduction of injecting risk behaviour in relation to transmission of HIV and other bloodborne viruses” (p. 2).
• Boltaev, Deryabina, Howard, ICAP, Columbia University, 2012, OST Pilot Program in Kazakhstan:Results include reductions in use of illicit opiates, criminality, HIV risk behavior, and self-assessed improvements in health functioning (p. 5).
Kyrgyz National Funding & The War on Drug Users
• State Drug Control Service: 358,500 USD per year for 962 cases of possession of ≥ 10g• Ministry of Internal Affairs: 474,500 USD per year for 1,800 cases of possession of ≥ 10g• State Service for Correctional Affairs: 402,200 USD per year on inmates sentenced for possession of ≥ 10g
TOTAL direct costs of prosecution of possession of “small” (≥ 10g) amounts of drugs without intent to sell = 1,250,000 USD per year or almost as much as Kyrgyz HIV domestic public spending in 2008XIX International AIDS Conference
Washington D.C., 23 July 2012
‘Self-induced’ Challenges
1. Political ambivalence, poor financial commitment and strong opposition
2. Containing OST within the remits of narcology
3. Police harassment of OST clients & service providers
4. Keeping OST out of prisons
XIX International AIDS Conference
Washington D.C., 23 July 2012
Increasing Access and Improving Quality
1. National ownership of OST through strong political commitment and sustained national funding
2. Policy reform and adopting supportive legislation
3. Investing in building local capacities for OST advocacy
4. Strengthening human resource capacities and ensuring that patients’ perspective is present
XIX International AIDS Conference
Washington D.C., 23 July 2012
Thank you!
XIX International AIDS Conference
Washington D.C., 23 July 2012
