Dispatches: How Not to Stop the Spread of HIV in the Philippines
By Carlos Conde
June 2, 2015
Philippine Senator Vicente Sotto III may have his way in scuttling a study on needle exchange, which is designed to reverse the rise of HIV infection among people who inject drugs. Giving clean needles to intravenous drug users, he argued in the Senate, is like giving murderers clean knives in place of their rusty ones so that they can kill people without infecting them with tetanus.
Tragically, his Senate colleagues seem to agree with him and have asked the Department of Health to suspend the study, which was sanctioned by the government, funded by the World Bank, and supported by local and international health-oriented nongovernmental organizations.
The focus of the study is the central Philippine city of Cebu. In 2013, a staggering 52.3 percent of people who inject drugs in that city are infected with HIV, up from 0.4 percent in 2007, according to the Philippine National AIDS Council’s 2014 annual report.
The fear is that the trend of intravenous drug users rapidly transmitting HIV will spread to other cities, said a 2014 briefing paper prepared by the World Health Organization, the Department of Health and the Cebu City Health Department. The paper called Cebu’s HIV epidemic “explosive,” saying it was time for “urgent action.” Intravenous drug use has overtaken sexual contact as Cebu City’s main mode of HIV transmission.
There is compelling evidence that reducing the sharing of infected needles by providing clean needles helps to combat AIDS. Access to clean syringes also helps prevent overdose and provide a gateway for drug treatment programs, Human Rights Watch said in a 2013 report, “In Harm’s Way,” which examined drug users and HIV in the US city of New Orleans. Providing clean needles, experts and advocates agree, would be a key step in the right direction.
Other Asian countries, including China, Cambodia, Malaysia, Indonesia, India, Vietnam and Thailand, have already implemented needle and syringe exchange programs. China first implemented needle and syringe exchange in 1999 and overall millions of needles and syringes have been exchanged in thousands of sites. A recent meta-analysis found that these programs reduced risk of HIV infection by one-third.
But for Sotto, whose anti-drug campaign has increased his popularity, the needle exchange program promotes drug dependency.
A suspension of the study, which now seems likely, would be a step backwards for the Philippines. Adopting needle exchanges is not only cost-effective and good for the health outcomes of people who use drugs, it is also good for their families and the communities in which they live.
Carlos Conde is the Philippines researcher at Human Rights Watch.
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