Society’s outlook towards drug addicts and HIV positive people must be changed. They should be considered as human beings and not as criminals. They must be given proper treatment and rehabilitation scope. In this way, they could be included in the mainstream of society.
Discussants made these remarks at a roundtable, titled ‘Drugs and HIV in Bangladesh: Structural barriers and the way ahead’ organised by Save The Children in Bangladesh and Prothom Alo with the support of the HIV/AIDS Programme of the Directorate General of Health Services at the Prothom Alo office in capital’s Karwan Bazar area on Thursday.
Ahmedul Kabir, additional director general (admin), Directorate General of Health Services, Azizul Islam, additional director general (admin), Department of Narcotics Control, Md Khurshid Alam, line director (TB-L & ASP), Directorate of Health Services, Habibur Rahamna, deputy inspector general of police, Dhaka Range and Lima Rahman, director-health, Nutrition and HIV/AIDS (HN and HIV), Save the Children in Bangladesh spoke as discussants at the roundtable.
Among others, Shoedur Reza Chowdhury, chief consultant, CTC, DNC, Tasnim Azim, former senior scientist, WHO, SEARO and head, HIV Programme, icddr,b and former regional adviser, Research and Policy Coordination, Saima Khan, country manager, UNAIDS Bangladesh, Ikhtiar Uddin Khandaker, director-Health Program CARE Bangladesh, Manaj Kumar Biswas, BCCM coordinator, The Global Fund's (GFATM) Bangladesh CCM Secretariat, HSD, MOHFW, Niaz Morshed Khan, senior research investigator at icddr,b and Shahed Ibne Obaed, president, Network of People Who Use Drugs (NPUD) also spoke at the event.
Akhtaruzzaman, senior manager, (HIV Programme), AIDS/STD Programme (ASP), Directorate General of Health Services and Akhter Jahan, team leader, GF-PWID Project were also present.
The keynote was presented by Ezazul Islam Chowdhury, advisor, HIV/AIDS Programme, Save the Children in Bangladesh.
Three main issues were discussed in the programme : how to remove or amend legal barriers including the narcotics control act in favour of HIV and drug users’ intervention, how to arrange sustainable drug-free life by engaging the department of social welfare and other social safety nets and how to engage law enforcing agencies more with the HIV intervention.
It was said that according to the World Drug Report-2021, there were about 275 million drug users in 2020 while in 2010, the number was only 226 million. And 36 million people suffered from drug user disorder in 2019 and drug abuse killed almost half a million people in 2019. Meanwhile, about 11.3 million people inject drugs globally and HIV and HCV prevalence are estimated to be 12.6 per cent.
Lima Rahman, director-health, Nutrition and HIV/AIDS (HN and HIV), Save the Children in Bangladesh said there were several setbacks in preventing infection and transmission of HIV. These included the use and sharing of single use syringes, failing to identify HIV positive people, being unable to provide antiretroviral therapy.
Assistance from law enforcing agencies and the Department of Narcotics Control (DNC) in providing Oral Substitution Therapy (OST) played a vital role in overcoming these obstacles. However, the outcome of the society towards drug users must be changed. They are considered as criminals instead of human beings or patients. So, they go into hiding and this creates a structural barrier. We need consider amendments in this regard, she added.
Habibur Rahman, deputy inspector general of police, Dhaka Range said it is essential to prevent drug use in the initial stage so that they don’t move towards using drugs with syringes. Besides, ensuring accountability of the taskforce that is there for the prevention of drug entering into the country through various borders is also important. In all proper coordination among concerned ministries and departments is required for an all-out action for preventing this crisis.
Apart from that, initiatives to mobilise awareness among field level police members of these issues are important too. If the police force is included in a roadmap to prevent drug use, they can play a vital role. Police can prevent spread of drugs that are not used for medical purposes. They can make people aware of the issue on the field level by going to mosques or school and colleges, he added.
Md Khurshid Alam, line director (TB-L & ASP), Directorate of Health Services as the chairman of the programme said, HIV is a major health problem in the whole world and one of main causes of its transmission is the use of injectable drugs. Even in Bangladesh, the number of injectable drug users is quite high and if this rate continues it will create a deadly disaster. Blood borne diseases like HIV are highly pathogenic and its fatality rate is also high.
He further said, to combat this situation, globally acclaimed supply, harm and demand reduction approaches are required. The whole process is a coordinated activity and no agency can implement this alone. For doing that an inter-departmental coordination is required. This activity must be conducted consciously to eradicate the existent problems.
Besides, people who are HIV positive and already undergoing treatment must be handled carefully so that they don’t rebound to drug use again or spread it even further. Meanwhile, there are many unregistered drug rehabilitation centres running across the country which must be brought under the jurisdiction of law to ensure proper quality of service. With all these steps taken, we’ll hopefully be able to fight this crisis in future, he added.
Ahmedul Kabir, additional director general (admin), Directorate General of Health Services said, there are some local, national and international issues related to this. Harm reduction has a huge impact not only on individual level but also on community, social and national levels. Coordination between law enforcing and health agencies should be deployed to address these issues. And, awareness on these issues should be spread to the root level.
He also said that the sale and availability of drugs that are not prescribed should be monitored. Besides, these patients require proper rehabilitation as most of them are rootless people. The crisis we are facing is still at a limited scale if these issues are not addressed properly it can turn into a larger crisis.
Plus, there are some social responsibilities as well which should be considered as well. These people should be treated as human beings not as criminals; they should be rehabilitated and socially accepted. In addition, if a coordinated cell can be formed including people from all the concerning agencies, local challenges can be addressed, he added.
Azizul Islam, additional director general (admin), Department of Narcotics Control said, “My department is working for supply, harm and demand reduction to address the issue based on their ability. Drug crisis is a huge problem on our way to becoming a developed country by 2041. If we don’t think out of the box to address this crisis we won’t be able to fulfill our development goals.
“For that we have planned a coordinated action including supply, harm and demand reduction. We’ll provide treatment to drug addicts from the community level which will run centrally. We are organising workshops to form that plan by this year. Moreover we are also working on a database of drug addicts for real time data sharing among different agencies”, he added.
Abdul Quayum, associate editor of Prothom Alo gave the welcome speech. The roundtable was moderated by Firoz Choudhury, assistant editor of Prothom Alo.