The session began with the call for urgent actions to address the HIV Epidemic among people who inject drugs.

Italian Red Cross Programme, Villa Mariani Foundation is a programme that advocates for the removal of legal barriers and decriminalisation so that legal environments to reduce public health problems by being able to access treatment, harm reduction and health services. There is also good prevention work as well as anti-stigma work. They also promote contacts with people most marginalized in society. Services are not open just to drug users but to other people as well. It offers health care services, testing for HIV and other diseases, etc.

The project: “Improving access to HIV/TB testing for marginalised groups” was presented. Drug users and migrants and also people living with HIV and/or TB should have access to treatment. We also seek to reduce risk behaviours. We develop common tools for TB and HIV testing. The project started in September 2010 and will end in December 2012. Three phases:

• Development of common tools and methodology for the provision of HIV and TB testing in different regions, exchange of information and experiences.
• Implementation of HHIV and TB tests in low-threshold services
• Comparative analysis and assessment of the effectiveness of the interventions

Results:

• 3,000 people were approached
• 1,561 people were tested
• Still high refusal rate
• Sharing of syringes is common among people who first come to the centre. They usually get tested for HIV for the first time when they arrive in the centre.

Kenya Red Cross
Towards the end of 2010, we had a crisis in terms of drug trafficking and drug use. A large number of drug dealers and users were arrested. In 2009, UNODC stated that there were 100,000 cocaine users, 200,000 opiate users, 4 million users of cannabis. There is a big problem of combination of alcohol and drug use. There is a particularly high incidence of drug abuse in the coast. Mombasa is a worldwide transit route for drug trafficking.
40% of users are IDUs, 88% are living with HIV and exposed to hepatitis C and TB. Gender issues: 2/3 of female heroin users are infected with HIV due to unsafe sex.

The Ministry of Health sought support from the Red Cross during the crisis caused by the heroin drought in January 2010 as many people were suffering from withdrawal symptoms. The Kenyan Red Cross set up mobile clinics, basic psychological and medical care, provided training, community mobilisation including in prison, etc. We need a supportive drug policy in Kenya and to scale up harm reduction services. We also need to expand and enhance existing structures.

Stop TB partnership – this is an initiative hosted by the World Health Organisation to fight tuberculosis. We work on advocacy and communication, break the silence related with TB. We try to engage with affected communities.

The majority of people think that TB is something of the past. If treated adequately, TB is always curable. However, if patients are not properly followed, they can develop resistance to the medication.

Latest data: 8.8 million cases of TB in 2010 and 1.1 million deaths. From 1995 to 2010: 6.8 million lives saved. Anyone can catch TB. People at higher risk involve undernourished, poor, people living in poor ventilated and congested areas. Drug users have poor access to services. WHO, UNODC and UNAIDS have developed guidelines on tuberculosis. The issue was how to go from paper to practice.

UNODC, Gilberto Gerra
We need to remove stigma and discrimination in improving access to treatment. We want to reach young people in Europe. We want to disseminate the idea of social and health protection. Our dream is to disseminate to member states that harm reduction cannot be given in isolation from drug treatment. We teach people to accompany patients at all stages of the disease. We also have a high rate of relapse. The measures to protect the health of drug users should be unconditional. We have developed a package of 9 interventions to protect drug users from HIV, including NSP and OST which we are advocating for. People have said that UNODC is not supporting these but we are because we support the comprehensive package.