Drug war drives HIV transmission

By Richard Branson

In a striking report this month, the Global Commission on Drug Policy showed that the continued criminalization of drug use drives the spread of HIV. People have long known that drug use is linked to disease, but this is the first clear analysis of how our enforcement of drug laws condemns thousands to Aids, hepatitis C and other life-threatening ailments.

This happens because repressive law enforcement activities drive drug users to the fringes of society, away from health services, and into environments and practices that elevate the risk of HIV transmission. Dirty, shared needles become commonplace when users must hide and depend on criminal networks, and HIV rates soar.

About 33 million people in the world have HIV, and injection drug use now accounts for one-third of new HIV infections outside of sub-Saharan Africa. In Russia, an epidemic driven substantially through injection drug use has left one in 100 adults battling HIV. Russia strictly enforces drug laws and, by some estimates, one in three Russian intravenous drug users has HIV.

This month, the USA hosts the massive International AIDS Conference. It brings more than 25,000 of the world’s leaders in HIV research, care and treatment to Washington, D.C., to further global efforts to treat and eradicate HIV. The United States has been a global leader in expanding HIV treatment around the world. Just seven months ago, the international community welcomed the U.S. commitment to an AIDS-free generation.

Yet the United States and dozens of other countries, including China, Russia, Thailand and Canada continue to enforce policies that criminalize drug use and drive HIV transmission. The Global Commission urges national leaders and U.N. agencies such as the United Nations Office on Drugs and Crime to reject the failed war on drugs and evaluate drug policy success through measures that are meaningful, such as reduced rates of HIV and disease transmission, fewer overdose deaths, and reduced drug market violence.

Arresting and imprisoning non-violent people who use drugs must end. It consumes vast resources because treatment is many times cheaper than prosecution and incarceration. Resources that now go to these arrests should instead be devoted to evidence-based treatment and care options for drug dependence, and the scaling up of strategies to reduce HIV infection and protect the health of people who use drugs, including with syringe exchanges and drug substitution, or maintenance therapies. Law enforcement resources should focus on violent criminal cartels.

Decriminalization policies can work. In Australia, Portugal and Switzerland, newly diagnosed HIV infections among drug users have been greatly reduced because drug users are offered treatment instead of prison. British Columbia has been successful in combating HIV in its large population of intravenous drug users. Through evidence-based measures — including needle exchanges, HIV treatment for all and the first supervised injection site in North America — B.C. has reduced HIV infections among people who inject drugs from nearly 400 in 1996 to about 50 in 2010. Refusing to implement such proven public health measures that reduce HIV infection and protect people who use drugs is criminal.

Unfortunately, even in the face of incontrovertible evidence that public health policies meaningfully reduce HIV transmission in injection drug users, national governments continue to persecute and prosecute non-violent drug users. In fact, the U.S. recently re-instated a ban on the use of federal funds for syringe exchange programs. It is time to fight such shortsighted and destructive policies. By embracing evidence-based health policies, China, the United States, Russia, Canada and many other countries can prevent millions of HIV infections and save countless lives.

With my fellow commissioners, I call on national leaders to recognize the causal links between war on drugs and the spread of HIV, and take immediate steps to implement proven public health approaches to drug policy. The status quo is no longer an option.

Sir Richard Branson serves on the Global Commission on Drug Policy and is the founder of the Virgin Group and Virgin Unite.