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Evidence indicates that detention of people who use drugs in compulsory centers in the name of treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based drug dependence treatment and support services. In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, drug policy reform to eliminate barriers to community-based drug dependence treatment and support services, and the integration of community-based drug dependence treatment in existing national health and social service systems. In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results. The need to accelerate national-level transitions to voluntary community-based drug dependence treatment and support services is compelling-on economic, medical, sustainable community development, and ethical grounds-as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based drug dependence treatment and support services across the region, as well as the steady scale-down of compulsory centers for drug users. Components of voluntary community-based drug dependence treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use drugs in Asia. [ABSTRACT FROM AUTHOR]

Presents information on the spread of human immunodeficiency virus (HIV) infection among injecting drug users (IDUs) in Asia. Special features of HIV; Distribution of injecting equipment; Education of HIV and injecting drug use; Prevention and treatment strategies; References.

Focuses on bringing the global HIV/AIDS epidemic under control. View that injection drug users (IDU) and their sexual contacts account for most new infections in regions such as Asia and eastern Europe; International initiatives to increase access to antiretroviral therapy; The problem of inadequate addiction treatment that could be avoided with opioid-substitution therapy in HIV prevention and treatment of IDU; Indication that WHO has not included methadone and buprenorphine on the Model List of Essential Medicines; Opinion that adding these drugs to the list would facilitate funding of integrated treatment systems that combine opioid-substitution therapy and HIV treatment; Criteria for adding drugs to the list.

Presents an editorial on the need to implement effective HIV interventions in Asian countries. The percent of HIV infected people in the region who were infected through the sharing of needles; Statistics on the expected number of HIV positive persons in India and China by the year 2010; Questions on how to get the governments to adopt known tactics to reduce the spread of the disease; Erroneous belief of some countries that harm reduction interventions go against the international drug treaties of the 1960's and beyond; Countries where the incident of disease transmission through the sharing of needles is the highest; Importance of Asian countries adopting harm reduction control methods.

Steady progress is being made towards understanding the use of drugs for non-therapeutic purposes. The associated problems are increasingly regarded as having psychological, biological and social dimensions. There is a growing acceptance that the hazardous consumption of alcohol and other drugs can both result from and exacerbate poor socioeconomic conditions. Sustained action to combat drug-related problems is needed on a broad front; there is no panacea.