By Daphne Machiri
Despite advancements in the HIV response, people who inject drugs (PWID) continue to face significant barriers in accessing HIV prevention, care, and treatment services. This population is disproportionately affected by HIV, with a higher prevalence of HIV infection compared to the general population. Criminalization of drug use and stigma and discrimination against people who inject drugs contribute to ongoing epidemics of HIV, viral hepatitis and TB. This is because people who inject drugs fail to access harm reduction and other health services. In many settings, harm reduction programmes are simply not available, or are extremely limited in accessibility and availability due to restrictive and ineffective policies and laws.
According to World Health Organisation, Injecting drug use accounts for approximately 10% of new HIV infections globally (UNAIDS, 2020). And an estimated 23–39% of new liver infection causes by the Hepatitis C Virus (HCV) infections occur among people who inject drugs.
The Eastern and Southern African accounts for approximately 54% of all the people living with HIV in the world, yet there is an estimate of about 410,000 people who use injectable drugs (PWID) and about 21.8% of them are living with HIV.
More so United Nations Office on Drugs and Crime (UNODC) states that substance use in Africa is on the rise, with projections estimating a 40% increase in people who use substances between 2018 to 2030.
Coming down to Zimbabwe there have been an increase in drug and substance use especially among its youthful population.
Over 60% of admissions at Zimbabwe’s mental health institutions are cases linked to drug use. Of these admissions the majority falls in the 16-40 age groups and it is mostly the males who are affected.
Several factors are contributing to drug use among young people and use for many reasons, including, peer pressure and social influence, family history and dynamics for example parental substance use, mental health issues for example depression or anxiety, low self-esteem and self-image, rebellion and experimentation, coping with trauma or stress ,media and social media influence and lack of education and awareness to mention but a few.
With the above disheartening statics there is need to ensure an enabling environment for substance use treatment and harm reduction services and essential components of comprehensive strategies for reducing the harms of drug use and overdose and also to counter HIV infections among the population.
According to Ministry of Health and Child Care E library in Zimbabwe, commonly abused drugs include Codeine; Methamphetamine (crystal meth, commonly known as meth, speed, mutoriro, Chalk, Ice, Crank, Guka; Glue; Broncleer (Bronco); Solvents —Fembo and Genkem; Chlorpromazine — Maragado; Mangemba; Cane spirit; Cocaine, Cannabis/Marijuana/Mbanje (which is mostly abused or traded under a variety of street names such as — Mbanje, Ganja, Dope, Weed, Blunt, Grass, Pot, Boom, Spliff, Mary-Jane, Skunk, Kiff).
Aiding environments are essential for addressing the complex issues surrounding substance use and overdose, and require a collaborative effort from governments, healthcare systems, communities, and individuals.
This saw Zimbabwe Civil Liberties and Drugs Network (ZCLDN working towards minimizing the harms associated with drug use and misuse and the governing drug policies in Zimbabwe. It strives to establish workable policies that are grounded in science, public health and human rights.
Addressing gaps in regards to access to harm reduction services and HIV treatment and care services among the population and it can reignite progress towards the 95-95-95 goals and ensure that no one is left behind in the fight against AIDS.
Knowledge Mupembe, programmes lead Zimbabwe Civil Liberties and Drugs Network (ZCLDN) revealed during a media and science cafe on drug and substance use, organized by the Health Communicators Forum recently in Harare.
Mupemba added that there is an increased risk of HIV transmission among people who use and inject drugs. People who use drug as key populations at risk of HIV but acknowledges that there is need for tailored programming.
“Risky and unsafe sexual practices, drug overdose, sharing of needles and syringes including Bluetoothing, there is a continuation of risks from Drug Use to Drug Addiction to Drug Dependence, looking at adherence to ART.
Further drug use is still criminalized in Zimbabwe and the possession and use of illicit drugs attracts stiff jail penalties; there is the Dangerous Drugs Act and the Criminal Code.
“What is now needed in to reform the current drug control regime by decriminalizing drug use, create an enabling environment for the provision of evidence based harm reduction services to address HIV/AIDS among people who use and inject drugs.
Moreover he pointed out that fostering enabling environments can effectively address substance use and overdose promoting healthier individuals, families, and communities.
“There is need for policy reform; decriminalize drug use and possession there for implement harm reduction-friendly laws and regulations.
“Funding and Resources; allocate sufficient funds for harm reduction services so that everyone in any community will have access and its availability of services leaving no one behind and also providing resources for service scaling and sustainability in a manner to scale up drug prevention, treatment and harm reduction programs. This funding can be used to expand access to services, train healthcare providers, and develop new and innovative programs.
“Community Engagement, there by building trust and partnerships with drug user communities by involves them in service design, implementation and evaluation.
“Service Integration to a one stop centers which will offer comprehensive drug control strategies that focus on prevention, treatment, harm reduction and promoting a supportive environment for seeking help which will provide safe consumption from drop in centers in preventing over dose avoid sharing of syringe hence. More over there is need to include needle and syringe programs, HIV care, treatment, counseling and support,” he noted.
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