Technical Support Unit, HIV/AIDS Asia Regional Program, Bangkok, Thailand.
Harm Reduct J. 2012 Jul 9;9:24. doi: 10.1186/1477-7517-9-24.
In the South-East Asia region, the drug control and supply reduction agenda is of high political importance. A multitude of law enforcement agencies are engaged in this work. Nationwide campaigns such as the "Strike- Hard" campaign in China or the "war on drugs" in Thailand dominate the landscape. Viet Nam's response to drug use has historically focused on deterrence through punishment and supply-side measures. This policy environment is further complicated by lack of evidence-based drug dependence treatment in several settings. The public health consequences of this approach have been extremely serious, with some of the highest documented prevalence of preventable blood-borne viral infections, including HIV, and hepatitis B and C. The wider socioeconomic consequences of this have been borne by families, communities and the governments themselves.The HIV/AIDS Asia Regional Program (HAARP) aims to stop the spread of HIV associated with drug use in South-East Asia and parts of southern China. HAARP works across five countries (Cambodia, China Burma, Laos, Viet Nam) chiefly through the Ministries of Health and Social Affairs, National Drug Control Agencies, and Public Security sectors, including prisons. HAARP has also engaged with UN agencies and a wide range of civil society organisations, including organisations of people who use drugs, to ensure their meaningful involvement in matters that directly affect them. We describe the experience of HAARP in implementing a large-scale harm reduction programme in the Sub-Mekong Region. HAARP chose to direct its efforts in three main areas: supporting an enabling environment for effective harm reduction policies, building core capacity among national health and law enforcement agencies, and supporting "universal access" goals by making effective, high-coverage services available to injecting drug users and their partners.The activities supported by HAARP are humble yet important steps. However, a much higher political-level dialogue is needed. The current huge gap of human rights standards in drug control practices also needs to be bridged immediately. Public health that embraces a rights-based approach must be given its fair share of policy space, budget and influence.
在东南亚地区，药物管制和减少供应议程具有高度的政治重要性。众多执法机构参与了这项工作。中国的“严打”运动或泰国的“禁毒战争”等全国性运动主导着这一领域。越南对吸毒问题的应对措施历来侧重于通过惩罚和供应方面的措施来威慑。这种政策环境因缺乏在几个环境中的基于证据的药物依赖治疗而进一步复杂化。这种方法的公共卫生后果极其严重，包括艾滋病毒以及乙型和丙型肝炎在内的一些可预防的血源性病毒感染的记录患病率最高。这种情况的更广泛的社会经济后果由家庭、社区和政府本身承担。
艾滋病病毒/艾滋病亚洲区域方案（HAARP）旨在阻止与东南亚和中国南部部分地区的药物使用相关的艾滋病毒传播。HAARP 在五个国家（柬埔寨、缅甸、老挝、越南）开展工作，主要通过卫生部和社会事务部、国家药物管制机构以及包括监狱在内的公共安全部门进行。HAARP 还与联合国机构和广泛的民间社会组织，包括吸毒者组织，进行了接触，以确保他们能够参与直接影响他们的事务。我们描述了 HAARP 在实施湄公河次区域大规模减少伤害方案方面的经验。HAARP 选择将其努力集中在三个主要领域：支持有利于有效减少伤害政策的环境、在国家卫生和执法机构中建立核心能力以及通过向注射吸毒者及其伙伴提供有效、高覆盖率的服务来支持“普遍获取”目标。
HAARP 支持的活动虽然微不足道，但却很重要。然而，还需要进行更高层次的政治对话。目前在药物管制做法中的人权标准差距也需要立即弥合。必须在政策空间、预算和影响力方面给予以权利为基础的公共卫生应有的份额。
