Heroin, health and HIV: An international development perspective 4 th March 2011 .

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Slide 2 Heroin, health and HIV: An international development perspective 4 th March 2011 www.abdn.ac.uk/sustainable-international-development Slide 3 Overview Why an international development perspective? From Aberdeen to Afghanistan Failed reconstruction & over-reliance on cash crops Governance, poverty & youth unemployment Health consequences HIV Slide 4 Photo MST programme King Street Slide 5 Injecting drugs in Aberdeen AreaEstimated numberEstimated prevalence Aberdeen shire6830.43% Aberdeen2,2461.56% Mainland Scotland23,9330.71% Aberdeen city has the second highest rate of injecting drug use in Scotland 27 drug related deaths were recorded in Aberdeen city in 2008 cause of most deaths were heroin/morphine, benzodiazepine and alcohol Slide 6 Britain Afghanistan links 1 st March 2011 David Cameron and Hamid Karzai held talks on Afghanistan's future Slide 7 Big changes to Britain's foreign aid programme Funds cut to 16 countries Angola, Bosnia i Herzegovina, Cambodia, Kosovo, Vietnam no more UK aid Aid to Russia and China cut by millions pa Freezing funding for India Afghanistan, Somalia, Zimbabwe Slide 8 2001 Fall of the Taliban Aid pledges made not fully met Result re-introduction of opium poppy plantations Drug production in Afghanistan increased almost tenfold since the U.S.-led invasion toppled the Taliban in 2001. Slide 9 Opium plantation Slide 10 Opium pod, powdered heroin, heroin block Slide 11 Injecting drugs inside the ruined cultural palace, Kabul Slide 12 Inside the morgue, Kabul injecting drug user who had overdosed Slide 13 Bags of heroin ready to export Slide 14 Slide 15 Governance and crime Drug trafficking linked with people trafficking and sex trafficking Porous borders Increasing inequalities and poverty Slide 16 Youth Youth unemployment about 20% for CEE/CIS...boredom Adolescence...experimentation Slide 17 Displaced male youth in Georgia bored and unemployed Slide 18 Evidence of Common Roots* Risk & Protective factors for adolescents Early SexSubstance Use Depression A positive relationship with parents A positive relationship with adults in the community Engaging in other risky behaviours Conflict in the family A positive school environment Friends who are negative role models Having spiritual beliefs *Broadening the Horizon Evidence from 52 countries Protective factor Risk factor Slide 19 Numbers of injecting drug users Slide 20 % of IDUs per population Slide 21 Russia At least 30,000 people die in Russia every year from heroin, 90% of it smuggled in from Afghanistan. Russia and the European Union are working hard to develop a 5 year plan to tackle the Afghan drug trade. Viktor Ivanov Director of Russia's Federal Service for the Control of Narcotics 21/02/2011 Slide 22 HIV epidemic is disproportionately affecting Eastern Europe About 80 percent of the more than 100,000 new HIV infections were reported in Europe in 2008 Ukraine the fastest growing HIV epidemic in the world HIV Slide 23 HIV due to injecting drugs Slide 24 Slide 25 Age of first injecting decreasing In Kazakhstan, 54% of IDUs under age 25. Adolescent IDUs (< 19 years): St. Petersburg, Russia, almost 1/3 IDUs, Ukraine, 20% & Armenia 13%. Young IDUs first injecting: Albania the median age of first injection 16 years Romania 76% & 67% started injecting before age 18 Ukraine average age of first injection 14.4 years Serbia 20% of all IDUs started injecting before 18 Slide 26 The Problem: Use / injecting of heroin driving HIV epidemic The Intervention: Program targeting pre-injectors to reduce transition to heroin use / injecting Slide 27 Not only HIV... Hepatitis Drug dependency in children Linkages between sexual and injecting drug transmission Problems with rehabilitation Slide 28 Conclusion Lack of support for international development has devastating consequences not only for the country concerned, but for a wide range of other countries and cities close to home. Failure to meet MDG 6 to reduce HIV infection Slide 29 MDG 6 Halt and reverse the spread of HIV Slide 30 Conclusion Need to invest in economic, social and environmental development i.e. sustainable international development