Indonesia Allows Operation of Needle-Exchange Programs in Attempt To Curb Spread of HIV, Hepatitis, Despite Strict Drug Laws

Indonesia, which has strict drug laws, including penalties for carrying a needle without a prescription, is allowing needle-exchange programs to operate in health clinics in an attempt to curb an "alarming rise" in HIV and hepatitis infections transmitted through needle-sharing, the Christian Science Monitor reports. A similar "sea change" in policy is occuring in other Asian countries, "where traditional law-and-order responses to illegal drugs are mixing, often uneasily, with efforts to reach out to drug users," according to the Monitor. China recently approved needle-exchange programs in six provinces, India already has similar programs and Iran operates needle-exchange and methadone projects with assistance from the World Health Organization. Harm reduction advocates say that they are not promoting drug use by operating the needle exchanges but rather acknowledging that until drug users are able to break their habit, safer behavior will help prevent HIV transmission. "Indonesia's youth are injecting [drugs] in large numbers," Jane Wilson, country director for UNAIDS in Indonesia, said, adding, "If we want to do something about HIV in the drug community, we only have a limited window open to act." However, the programs remain controversial in Indonesia, as well as many other countries, often resulting in "clash[es]" between public health officials and security officials "who dislike bending the rules," the Monitor reports. "This [harm reduction] is a new approach in Asia, so of course it can be hard for police to accept ... because in the meantime the [drug] laws haven't been changed, so it requires some pragmatism," Dr. Sandro Calvani, regional director of the U.N. Office on Drugs and Crime, said (Montlake, Christian Science Monitor, 5/8).