Pubdate: Fri, 12 Mar 2004
Source: Business Day (South Africa)
Copyright: 2004 Business Day.
Contact:  http://www.bday.co.za/
Details: http://www.mapinc.org/media/2925
Author: Jason Lott
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

SA FACES SCOURGE OF HEROIN AS WELL AS HIV

Johannesburg

THE United Nations (UN) has recently reported an upsurge in heroin use 
among impoverished teenagers and young adults in SA, troublesome news for 
those concerned about combating HIV, hepatitis C, and other needle-borne 
diseases.

As an injected drug, increased incidence of heroin use among SA's poor 
further increases the chances of contracting HIV or hepatitis C, suggesting 
prevention strategies which stress informed sexual activities may not 
suffice to combat the spread of these diseases in the near future.

The burgeoning heroin problem is mainly due to the expansion of poppy plant 
production (from which heroin is ultimately manufactured) following the 
fall of the Taliban regime in Afghanistan, which severely restricted such 
farming.

The increase in supply has been met with a concordant decrease in price, 
making heroin a more accessible and popular drug among those who previously 
could neither find nor afford it.

Given that heroin is devastatingly addictive more so than any other illegal 
drug its consumption will likely spread and continue an upward trend in 
demand, persisting among users even if the drug becomes scarcer and street 
prices rise.

In the absence of an adequate rehabilitation infrastructure (including, for 
example, government-subsidised methadone clinics and public awareness 
program-mes), violence in SA could escalate as users seek to fund their 
habit by any means possible, edging the battle against HIV much closer to 
the war on drugs.

Organised drug trafficking and distribution will inevitably become 
intimately intertwined with disease epidemiology. This is already the case, 
for example, in certain parts of the US and UK, where heroin availability 
and consumption have soared over the past year in parallel with reported 
HIV rates.

The need for an immediate response from SA's government cannot be 
overstated. Convenient access to heroin in a population with the highest 
number of HIV/AIDS cases in the world could thwart all progress made in 
controlling the HIV epidemic and throw the country's health and economy 
into shambles.

As the UN report recognises, some appropriate first steps have already been 
made, such as heightened scrutiny of foreign shipping containers and the 
establishment of the Financial Intelligence Centre to crack down on money 
laundering.

The limited success of similar endeavours in other countries, however, 
should be sufficient forewarning that more action is needed, especially at 
consumer level. Setting up a nationwide heroin/HIV awareness campaign, 
maybe modelled on the UN "Ke Moja" ("No thanks I'm fine") project, along 
with more funding for community-based drug task forces and treatment 
clinics might help curtail this emerging threat before it evolves into a 
crisis.

Pre-emptively starting more needle-exchange programmes where used or 
"dirty" needles could be exchanged for new or "clean" ones might also be 
reasonably implemented at low cost to help to contain the spread of HIV.

The appearance of heroin among SA's poor makes one thing frighteningly 
clear: the battle against HIV and AIDS can no longer be waged merely 
through condoms and pillow talk. Sadly, the battle may have only just begun.

Lott is a Marshall scholar at Oxford University.
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MAP posted-by: Jay Bergstrom