Injecting Drug Use and Drug Led HIV in Nepal

Bijay Pandey

Recovering Nepal

Prevalence

• Drug Users: 70,000

• IDU: 25,000-30,000

• HIV prevalence among IDUs: 40%-70%

Coverage

• Coverage 8.6% (Nepal Country Report 2005/06)• Drug treatment and rehabilitation services: 30 to 35

centers• Harm reduction interventions: NSP (supported by

DFID, Global Fund, UNODC), Buprenorphine substitution• Program Strategy: Single sectored involvement-

primarily NGOs• Delivery Strategy: community outreach, NSP, DIC

centers, Primary Health Care, BCI, STI, VCT etc

Pilot Buprenorphine with MOHA/MOH/Youth Vision

Major challenges in scaling-up?

• Political Instability• Lack of national coordination committee• Policy and legal barriers• No strategic plan• Health infrastructure: Service, Attitude of service

providers• Technical capacity: Long term Planning • Resources (Human, Money, Materials): Donor

dependent• Others: Social Perception, Stigma and

discrimination

Vision for future

• Start & expand OS to cover 15% by by 2008, by end of 2011 achieve 75% coverage

• NSP: to cover 15% by by 2008, by end of 2011 achieve 75% coverage

• Scale-up Rehabilitation services for male/female IDUs

• Provision of condoms/ STI services for drug users & sexual partners

• Provision of ARV to Drug users

By Whom

• Multi-sector approach• Government Institutions, hospitals, medical

colleges• NGOs• Private sector

Need to enhance partnerships and cooperation

Summary

• 40%-70% HIV prevalence among IDUs• Low Coverage• Revisiting policies & structures• Costed Workplans• Improved advocacy• Training • M&E

Thank You