Transcript 2 - ARASA
Evidence base to promote drug policy reform in Mauritius Steeve BATOUR Board Member, PILS Co-founding member, CUT ARASA Panel Discussion April 2014 Johannesburg Some details about Mauritius Population : 1,2 M inhabitants 2 Surface area about 2000km HIV Prevalence 1.02% A little bit of history 1996 : Civil society starts raising the alarm about HIV among PWIDs Early 2000’s: Exponential growth of HIV Infection within PWID HIV Incidence in PWIDs in Mauritius 2000-2005 1000 92% 921 900 800 700 600 87% 525 500 400 300 66% 200 100 0 225 2% 50 2000 7% 55 2001 14% 98 2002 2003 2004 2005 New HIV Cases PWIDs A little bit of history (contd) 2004: Platform created by Civil society to advocate for Harm Reduction Strategies in Mauritius. This platform will later be CUT (Collectif Urgence Toxida) 2006 : Launching of illegal Needle Exchange Program by CUT 2006 : Launching of Methadone Substitution Therapy by the Ministry of Health & Quality of Life (MOHQL) 2007 : Legal Framework for NEP through the HIV/Aids Act 2007 : Creation of National NEP Committee by MOHQL where CUT is invited to sit. 2009 : CUT launches premises and follow-up on NEP and advocacy on Harm Reduction 2010 : GFTAM allows upscaling of Harm Reduction Services 2011 : Methadone in Prisons Some data … IBBS 2009 2011 No of People Who Inject Drug 10,000 10,000 HIV Prevalence among PWIDs 49 52 HCV (Hepatitis C Virus) Prevalence among PWIDs 97 96 HIV Prevalence among female PWIDs 70 85 Some facts about drugs in Mauritius : HIV Prevalence Rate among other MARPS •Mauritius has highest rate of Opiate Consumption per capita in Africa MSM 20% FSW 29% •Drugs mostly injected in Mauritius : Opiates (Mostly Brown Sugar & limited black market Subutex®) •Presence of Heroin first documented in Mauritius in early 80’s Existing Harm Reduction Services today Needle Exchange Program Methadone Substitution Therapy HR Community services Mobile Caravan for MARPS Positive Points of Harm Reduction Services • High Coverage of services: 8000+ PWIDs reached through NEP 6200+ people on MST • No waiting list for MST • MST available in prison • NEP & MST has bridged gap between existing services and MARPS • Quality of life of service users increased (APMG evaluation report 2010) • Decrease in Drug seeking behaviour (APMG 2010) • Improvement of family environment • Quality of life of service users improved through more stable way of life Positive Points of Harm Reduction Services Progression of PWIDs from NEP to MST NEP visits MST CLIENTS 8000 5068 6000 4000 5893 3561 1994 2000 0 2009 2010 2011 2012 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 85,221 64,474 39,545 25,419 2009 2010 2011 2012 Positive Points of Harm Reduction Services Decrease in crime rates for drug related offences Reported cases 3000 2500 2650 2466 2046 2000 1641 1500 1295 1000 1085 500 0 2007 2008 2009 2010 2011 2012 Positive Points of Harm Reduction Services Decrease in HIV rates 1000 900 HIV Incidence Rate in Mauritius (2000-Oct 2013) showing PWID incidence rate 800 New HIV Cases 700 PWID Incidence Rate 600 500 400 300 200 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Challenges in Harm Reduction Services • MST : No take home doses, distribution points overflowed • S&D : Some community members do not like MST users to hang around their vicinity • S&D : Difficult for users to get a job (police records) • Psycho social support do not efficiently address needs of users • NEP do not offer wide variety of materials, (cookers, filters, etc not available), thus not addressing HCV transmission efficiently • Police harassment discourage NEP users from bringing back their used syringes/needles • Drug policies highly criminalising PWUDs • Discrepancies in laws (Dangerous Drugs Act v/s HIV/Aids Act) • Lack of comprehensive Harm Reduction services (ref MdM HR model) Effective Model of Harm Reduction Package Thank you for your attention ! www.pils.mu www.facebook.com/ONGPILS www.cut.mu www.facebook.com/Collectif.Urgence.Toxida