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Drug Users Need Doctors not Policemen

The government has in recent years increasingly embraced various public health interventions for reducing exposure to harm by people who use drugs.

First was the introduction of the needle and syringe programmes and more recently, the Medically Assisted Treatment (MAT) using methadone – a substitute drug for treating heroin addiction – under what is known as the Harm Reduction strategy.

Harm Reduction refers to policies, programme and practices that aim to reduce the dangers associated with use of psychotropic drugs in people unable or unwilling to break drug addiction.

The recent increase in drug use in the country, coupled with the rising HIV epidemic among key populations calls for a critical review of how drug using populations are managed.

The National Aids and STIs Control Programme estimates that people who inject drugs are responsible for 3.8 per cent of new HIV infections. The prevalence rate among this population is 18 per cent, three times that of the general population (5.6 per cent).

With an estimated 18,000 people in Kenya who inject drugs, it is crucial to scale up drug dependency treatment. 

The MAT programme was consequently initiated and now acts as an effective tool and evidence-based treatment meant to help wean people from injecting drug use and reduce their risk of HIV infection. 

It is largely due to successes in this regard that the United States President’s Emergency Plan for Aids Relief (PEPFAR) chose to make this programme part of a package of services to address the needs of those most vulnerable to HIV infection. 

Mathari Teaching and Referral Hospital in Kenya hosts the country’s first-ever MAT programme funded by the United States Agency for International Development (USAID).

But these gains notwithstanding, drug policies around the globe have conventionally focused on the principle of deterrence and demand reduction. This has been done through attempts to eliminate production, distribution, sale and use of drugs.

To achieve this, severe penalties and fines have been imposed on those involved in the drugs trade or consumption. It was believed that such punishment or the threat of it would reduce, and eventually cripple the global drug market.

It has now been widely admitted that this approach has failed to reduce the scale of the drug market and spawned negative consequences, which include an increased number of people in prisons around the world due to drugs.

The Narcotics Act Cap 245 of the Laws of Kenya, criminalises the distribution use or intent to use narcotic drugs, up to and including being found with paraphernalia used in drug administration.

The disconnect, therefore, is that while there are policies regulating narcotic drugs and their use in Kenya, there is still lack of supportive legislation for implementation of Harm Reduction programmes for people who inject drugs. Social workers, too, still get arrested by law enforcement officers while prisons authorities do not allow such a crucial programme to be administered to inmates.

In order to facilitate a broader consultation with stakeholder entities, international and regional, the Kenya Aids NGOs Consortium (Kanco) is coordinating an initiative to enable national and regional dialogue in drug policies and harm reduction.

Kanco is a linking tool for the civil society organisations in Kenya and the region as it prepares for the United Nations General Assembly Special Session (UNGASS 2016) on drug laws to be held in New York, on April 19. We must now create an enabling environment to protect drug users and the social workers. Drug users need a doctor, not a policeman.

By BERNICE APONDI, policy and advocacy officer at Kanco.

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