HIV/AIDS prevention

Injecting Drug Users are vulnerable and this information is not new. But despite adopting evidence based strategies, drug use is still considered a criminal offence not a public health issue. Under the Narcotic Controls Act of 1990, drug abuse is a punishable offence, and so they are the easiest target in our fight against drugs. They are persecuted like criminals. On the one hand, we have a policy that clearly identified the need of the drug users and a law that criminalises them. They are harassed, imprisoned regularly through Section 54. Just take your time and go through the survey of any NGO working in this field. Does any of the features bother to seek why this discrepancy between law and policy persists for over ten years? We need to ask these questions and judge our intentions about what we are actually doing. We all have the intelligence that if we are so keen to persecute the vulnerable groups they will be more hidden and more difficult to reach for prevention works and consequently more vulnerable. Despite that, the situation has not yet improved. Don't you think you should seek some thoughts on the matter from all the authorities concerned? Since 1998, CARE Bangladesh has been involved in harm reduction programmes for IDUs like, needle exchange, drop in centres, peer education, distribution of condoms and basic primary health care. But the legal issues surrounding the effective harm reduction programme still remain dubious. There are several sections in the Narcotics Control Act that can be utilised to launch a legal battle against such programmes. We have to consider this. It is not only time for reporting, we need to find the gaps and evaluate what we are doing. The people of Bangladesh at least have the right to know. There are other issues that can be discussed, why are we not utilising our own pool of skilled people within the government system? The public health culture is virtually absent in our county. For years, we are talking about STD treatment facilities, but why things have not changed? If you ever visit a STD treatment centre, you will find there is no privacy and they are not youth friendly. We all know that we don't need to hear it all over again, what we need to hear is why the situation has not changed. There is also lack of diagnostic facility. I had the opportunity to work in one of such departments, and I know what really the constraints are. Why we spend so much time on talking what should be done, why not spend some time why it has not been done. In Bangladesh, within the government pool of resources there are infectious disease specialists, virologists and microbiologists and, of course, the public health practitioners (in every medical college there are community medicine departments), why the government is not leading the way like it should? We have already identified the barriers but why are we not changing the situation? We need to ask these questions. Yes no doubt hundreds of NGOs are fighting at the forefront of our battle against HIV/AIDS, but we need to ask why still there are so many gaps between the policies and the situation at the field level? What has really happened?