Addictions and HIV in Sub-Saharan AfricaExperience of the Corridor Project ICASA Satellite Symposium, Dakar 4 December 2008 J KOFFI, J OJO, L DE SOUZA, O CAPOCHICHI, H DE HARDT-KAFFILS Abidjan-Lagos Corridor Organization
Outline • Introduction • Why people abuse drugs • Experience of the Corridor project • Corridor Project’s Response • Possible Barriers to interventions • What Next? • Conclusion
INTRODUCTION • Around 16 million people worldwide inject drugs, with 3 million infected with HIV • IDU in 148 countries worldwide of which the five Corridor Countries • IDUs now account for 10% of all new global HIV infections: growing Injection drug use has resulted in the spread of AIDS in the African nations: • Kenya, Nigeria, South Africa and Tanzania • IDUs in South Africa share and use same needle up to 15 times despiste risks associated with the practice • Drug users have poor knowledge of HIV prevention techniques and other HIV/AIDS treatment services • CSWs sometimes forced to take drugs and are not able to use condoms consistently.
Why people abuse drugs • Because of their work • Truck drivers • Sex workers • Peer pressure • to join in with others and belong to a ‘special’ group. • Escape route • problems at home and school • outside pressures • To relax and ‘feel good’ • Some medications, e.g. painkillers, physically addictive
Hilla Condji Noé Kraké Plage Kodjoviakopé Aflao Elubo Sanvee Condji Experience of the Corridor Project • Length: 1022 km • Resident population: 30.000.000 inhabitants • Population in transit: about 47,000,000 people/year migrate along the corridor • The most important corridor in West Africa (65% of West Africa economic activity) Sèmè -
The Abidjan-Lagos Corridor Organization (ALCO) Project Established in 2001 by Govts. of the 5 countries (Cote d’Ivoire, Ghana, Togo, Benin, and Nigeria) Project Development Objective: To increase access to HIV/AIDS prevention, treatment and care services for vulnerable populations along the Abidjan-Lagos transport corridor, presently underserved by national responses. Particular attention to be paid to: Transport sector workers Migrant populations Communities living along the corridor Funding: World Bank (2003-2007), Counterpart funding by member countries, Global Fund (2007 – to date), Technical Assistance: UNAIDS
Why should a multi-country, cross-border project pay attention to drug addiction and HIV?
The Abidjan-Lagos Corridor border areas a melting point for activities predisposing to HIV infection
The Corridor project’s response • Recognition of addiction (IDU) as an emerging problem • Currently reviewing reference document to include these behaviours • Some border AIDS control committees widening their interventions to include drug abuse
Possible barriers we envisage to implementation of interventions • Stigma associated with drug use • No-man’s land between borders • Easy availability of illicit drugs • ‘If demand persists, it's going to find ways to get what it wants. And if it isn't from Colombia, it's going to be from someplace else.’Rumsfeld, 2001 • Interventions targeting drug users not a priority for national programs • Lack of reliable statistics to support advocacy
Suggested Next Steps • Assessment of the magnitude of drug addiction along the corridor • Planning and implementation of appropriate interventions targeting IDUs and other forms of addiction: • Harm reduction measures including needle exchange programs • Peer-based education of IDUs • Drug treatment • Stigma and discrimination against drug users to be tackled • Support from partners with core competence and comparative advantage in this area needed by ALCO.
CONCLUSION • HIV among injecting drug users very important in sub-Saharan Africa as it is globally • It has been clearly identified as an emerging problem along the Abidjan-Lagos Corridor • Based on the field assessment, what has been reported is just a tip-of-the-iceberg • Therefore, an aggressive ownership by national programs and other key partners is needed to nip in the bud likely surge in new infections that may arise from these emerging behaviours
Acknowledgements • Global Fund • World Bank • UNAIDS • ALCO Board Chairman – Pr. B. Osotimehin • Pr. S. EHOLIE • RESAPSI • SOLTHIS
End of presentation Thank You