US diplomats still object to the inclusion of harm reduction in United Nations counternarcotics declarations, though it's been adopted by virtually all UN agencies. And Obama has yet to tinker with Bush-era rules that ban the use of US foreign aid money to fund needle exchanges for drug users.
Experts on HIV/AIDS argue that needle exchanges, peer-led education, and substitute therapies such as methadoneoffer a proven way to prevent new infections among IDUs. But only a fraction of the $14 billion spent globally last year on tackling the disease went into such programs, says Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
The US government is the largest single contributor to the UN-backed fund. Mr. Kazatchkine says it faces a $4 billion shortfall in funding over the next two years, as recession-hit donors cinch their belts.
Handling dirty needles
In Thailand, which won praise in the 1990s for reducing HIV infections by promoting condoms in its sex industry, up to half of surveyed drug users test positive for the disease. Outside of sub-Saharan Africa, transmission via dirty needles accounts for roughly 30 percent of all HIV cases. In eastern Europe, Russia, and Asia, this practice is blamed for the majority of new infections, say health workers and UN officials.