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Afghanistan: Joint Drug-Treatment Effort Targets HIV/AIDS

  • Jan Jun

http://gdb.rferl.org/cbb4d645-e3bc-4322-8cfc-ee5331d0726d_w203.jpg --> http://gdb.rferl.org/cbb4d645-e3bc-4322-8cfc-ee5331d0726d_mw800_mh600.jpg (AFP) LONDON, 20 September 2006 (RFE/RL) -- An effort at drug treatment in Afghanistan announced on September 18 brings together the Italian Red Cross, the Afghan Red Crescent, and an international think tank in an effort to combat the threat of a deadly HIV/AIDS epidemic. Organizers hope their project can provide a shining example amid a rapidly deteriorating situation that they fear could engulf the region.

Despite its decades-old battle with drugs, Afghanistan has not generally been regarded as a country of drug-injecting addicts.

But the return of hundreds of thousands of refugees from neighboring countries where drugs are more commonly injected -- like Pakistan, Iran, or Uzbekistan -- has some experts concerned that could change.

Early Warning

Intravenous drug use is now widespread enough in Afghanistan that authorities fear an accompanying spread of HIV/AIDS borne by contaminated needles.

Italy's Red Cross, the Afghan Red Crescent, and The Senlis Council -- a security and development policy group -- think they can help head off such an outbreak.

"When I visited Kabul last 1st of December [2005], I met many drug addicts, and I saw that the help that they receive is inadequate," says Dr. Massimo Barra, president of the Italian Red Cross in Rome.

Barra points out that the United Nations estimates the total number of drug abusers in Afghanistan is 920,000. That represents 4 percent of the total population. And many of the country's addicts share needles.

The situation is following disturbing patterns in neighboring countries. Iran has already experienced a 10-fold increase in HIV/AIDS infections over the past six years. Drug users making up the vast majority of new infections in Iran.

The virus has spread even more rapidly in Uzbekistan. The Italian Red Cross says a 10-fold increase in intravenous drug use in the last decade there has led to 200 times the number of HIV and AIDS cases.

"If you look at neighboring countries like Iran, Tajikistan, Uzbekistan, and beyond -- like, for example, Russia -- the connection between injection drug use, such as heroin, and HIV/AIDS is very strong," says Fabrice Pothier, head of policy analysis at The Senlis Council, an international drug policy think tank with specialist field workers in Afghanistan. "Actually heroin drug use is fueling the HIV/AIDS epidemic in those countries. Afghanistan is still at a very early stage."

Pothier stresses that Senlis and the other organizers worked to launch their new Afghan drug-treatment project before it was too late.

Growing Problem

He says local Senlis field workers in Kabul, Herat, Lashkar Gar, and Kandahar have mapped mounting evidence of heroin injection in urban centers heavily populated with returning refugees. The information helped alert medical authorities and led to the idea of the drug-treatment initiative.

Barra says the project's course should resemble a similar initiative that he has been directing for the past 30 years at the Villa Maraini center in Rome. Or, perhaps more aptly, he stresses a recent joint drug-treatment initiative with the Iranians.

"We initiated collaboration as Italian Red Cross with the Iranian Red Crescent to prevent [drug] overdose in Tehran," Barra says. "Every day, there are people who die from overdose. And we want to do some intervention, like we do in Rome, to prevent overdose and to use [the drug] Naloxon to save lives."

The program includes a 50-bed center in a wing of the Red Crescent hospital that already operates in the Afghan capital, Kabul. It will complement other drug-treatment services currently available.

The center's staff will receive training in Rome, and Barra's specialists will then help launch the Kabul operations. The center will be open 24 hours a day, year-round, and Barra says its specialists will go out in search of addicts who they think need help.

"If we wait for the drug addicts, we can see only a part of them," Barra says. "But the biggest part [of the addict population] cannot bear the frustration to ask for help in the street."

Barra thinks the center can easily apply experience gained elsewhere to preventing the HIV/AIDS infection among Afghans. After all, he says, the problems of addicts and HIV/AIDS sufferers around the world are very similar.

The Senlis Council's Pothier says the stakes are high in Afghanistan: Either drug use and addiction soars and the country faces an imminent HIV/AIDS epidemic, or the initiative succeeds and provides a blueprint for tackling the threat quickly.

"It will be actually one of the few examples of a country which has managed to stop the HIV/AIDS crisis before it started to hit the population," Pothier says.

For Afghanistan's population of 29 million and the rest of the region, such success would mark a notable victory amid otherwise bleak news on the front to combat HIV and AIDS.
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