The global war on drugs has failed and a more humane approach must be taken to contain the spread of HIV, a top envoy told the 20th international AIDS conference on Tuesday.
United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, Michel Kazatchkine, said the decades-old prohibitionist approach to drugs needed to be replaced with one that put health and safety first.
This included offering needle exchange and methadone programs for drug users, who were often among the more vulnerable and marginalised members of society.
Professor Kazatchkine, a French physician, said one in five injecting drug users globally, about three million people, were infected with HIV.
He said in Russia, where methadone programs were banned, about 1.7 million people injected drugs. Almost 40 per cent of them were HIV positive. The pro-Russian rebel occupation of Crimea in May saw the methadone ban extended to the Ukrainian peninsula, where UNAIDS Commissioner Svetlana Moroz said 800 HIV patients lived. Only 57 of them have moved to continental Ukraine to continue treatment.
"Drug policies that penalise users are inconsistent with health goals," Professor Kazatchkine said.
Sir Richard Branson, a commissioner with the Global Commission on Drug Policy, joined the conference via video link and echoed the call for a more health-focused approach.
"People who use drugs or have a drug problem should be treated with compassion rather than being criminalised," he said. "And yet every day people around the world continue to suffer as a result of prohibitionist drug policies."
Former Australian High Court Judge Michael Kirby noted there were other benefits to a health-focused approach. By protecting vulnerable groups, such as injecting drug users, society more broadly was protected from the spread of the disease.
Justice Kirby, who recently worked for the Global Commission on HIV and the Law and was a member of the inaugural WHO Global Commission on AIDS, said laws that criminalised and penalised drug users were counter productive.
"That system makes people alienated from their society and outside the messages that are essential to protect them," he said.
Meanwhile, for some Australian injecting drug users, the emergence of HIV in the 1980s had a silver lining. The disease brought with it greater access to clean needles, methadone programs and education campaigns.
"HIV was a blessing," said former heroin user Jude Byrne. "Until HIV came along, you couldn't get any medication or injecting equipment and it was a very small and isolated community."
A trained nurse, Melbourne-born Ms Byrne had her first heroin hit as a curious 17-year-old after reading about it. For 40 years, the mother of three was an injecting drug user. During that time she picked up hepatitis C, for which she has since had successful treatment.
Chair of the international Network of People Who Use Drugs, Ms Byrne said HIV allowed injecting drug users to connect with health services such as methadone programs, which she said helped her enormously.
"Until you get on something like an opiate substitution program it's really hard to work and live your life," she said. "Methadone and needle exchange programs save people's lives."
