Central Asia and Eastern Europe

Subsections:

Page last updated June 9, 2020 by Doug McVay, Editor/Senior Policy Analyst.

16. Drug Users in Kyrgyzstan Prisons

"In Kyrgyzstan prisons, people who use drugs have no access to effective drug treatment in prison settings due to the low coverage of such services. With no alternatives, inmates often get involved in criminal activity in order to sustain drug use. Involvement in such gangs often continues after release, especially if an inmate has debts stemming from drug use87."

Merkinaite, S. "A war against people who use drugs: the costs" (Eurasian Harm Reduction Network (EHRN): Vilnius, Lithuania, 2012), p. 26.
http://www.harm-reduction.org/...

17. Prevalence of IDU-Related HIV in Prisons in Central Asia

"HIV testing within prison populations has been widespread in central Asia, reflecting sentinel surveillance and mandatory testing policies. HIV prevalence among prisoners ranges from 2% in Kazakhstan to nearly 7% in Tajikistan (figure 2). By the start of 2007, more than 25% of cumulative registered HIV cases in Kazakhstan were in prisoners, and in Tajikistan, a fifth of the registered HIV population are prisoners;32,64 these proportions reflect HIV-testing policies, criminalisation of illicit drug use, and high rates of risk behaviours among prisoners, both inside and outside prison settings.59 In central Asia, 5–25% of prisoners are estimated to have drug dependence43 and up to 70% share injecting equipment.32,69 In one study in Kazakhstan,36 the prevalence of syphilis among prisoners in temporary detention was 5%. The prevalence of tuberculosis among inmates is 60–100-times higher compared with the general population, with high tuberculosis mortality.64"

Claire Thorne, et al., "Central Asia: Hotspot in the Worldwide HIV Epidemic," The Lancet Infectious Diseases, 2010 Jul;10(7):479-88. doi: 10.1016/S1473-3099(10)70118-3
http://www.ncbi.nlm.nih.gov/pu...
http://www.thelancet.com/journ...

18. Needle and Syringe Programs Operating In Tajikistan, 2011

"As of the end of 2011, 49 needle and syringe programmes were operating in Tajikistan through the trust points, including 21 trust points for IDUs (based on the premises of treatment and prevention facilities) that were supported by UNDP within the framework of the implementation of GFATM grants, and 28 trust points supported both through GFATM grants and CARHAP/DFID, PSI, OSI, and Red Crescent Society projects. Geographically, NSPs are available in 28 sites of the 68 districts of the country.
"In 2011, 2,200,000 needles and syringes were distributed in the country, which translates into 88 needles/syringes per IDU (based on the total estimated number of IDUs in the country). Cumulatively, 15,871 clients were reached by harm reduction services in 2011, making up about 63% of the estimated number of IDUs in Tajikistan (National Coordinating Council on Prevention and the Fight against HIV, TB, and Malaria in the Republic of Tajikistan, 2012). Specifically, about 6133 IDUs were reached by needle and syringe programmes in 2011 (Burkhanova and Ibragimov, 2012). The provision of harm reduction materials to all programmes is done exclusively through GFATM funding, and at the present moment there are no alternative sources of funding, which jeopardises the future sustainability of harm reduction programmes in the country (National Coordinating Council on Prevention and the Fight against HIV, TB, and Malaria in the Republic of Tajikistan, 2012)."

Hasanov Kh.B., Muhabatov M.S., Makhsutov M.N., Chikalov Y.P., Murodova F.R., and Nurlyaminova Z.A. "2012 National Report on the Drug Situation in the Republic of Tajikistan (Drug situation in 2011)" (Dushanbe: National Centre for Monitoring and Prevention of Drug Addiction, Ministry of Health of the Republic of Tajikistan/Central Asia Drug Action Programme (CADAP)), pp. 36-37.
http://www.cadap.eu/filedepot/...

19. Availability of Harm Reduction Services in Central Asia

"With financial support from national Global Fund grants and cooperation from international organisations, prevention efforts are scaling-up across central Asia, largely concentrating on IDUs and female sex workers. Harm reduction efforts for IDUs have been impeded by legislative barriers and a lack of strong political support, including hard-line policing and punitive laws on drug use.34–36 However, Kyrgyzstan has made substantial progress in harm reduction, reflecting the explicit political support received and removal of some legal barriers.35,43 Some central Asian countries have achieved medium coverage of IDUs with low threshold services, mainly through Trust Points and outreach; for example, coverage has reached 61% in Kyrgyzstan and about 35% in Kazakhstan and services include provision of clean needles and syringes, and condoms and VCT or referral for HIV testing. However, coverage with needle and syringe exchange programmes (NEP) and opioid substitution therapy (OST) remains suboptimum in central Asia (table 4).83 Efforts are ongoing to scale-up harm-reduction activities and Kazakhstan now has a pilot OST programme, with a pilot planned in Tajikistan, although the pilot in Uzbekistan was recently closed by the government.35 In Kyrgyzstan, OST has been available since 2002 and recently became available to prisoners, along with NEP.43 A recent study suggested that awareness of HIV services among IDUs is highest in Kyrgyzstan at 70%, is around 50% in Kazakhstan, and lower than 10% in Tajikistan.34"

Claire Thorne, et al., "Central Asia: Hotspot in the Worldwide HIV Epidemic," The Lancet Infectious Diseases, 2010 Jul;10(7):479-88. doi: 10.1016/S1473-3099(10)70118-3
http://www.ncbi.nlm.nih.gov/pu...
http://www.thelancet.com/journ...

20. Opioid Substitution Treatment Availability In Tajikistan, 2011

"In 2009, the Government of Tajikistan reviewed and supported the request of the Ministry of Health of the Republic of Tajikistan regarding the introduction of a pilot project of opioid substitution therapy (OST), initially for 200 patients. In accordance with the resolution of the Government, the Ministry began to implement the project. In June 2010, the Ministry of Health, with financial support from the GFATM and UNODC, opened the first OST centre in Dushanbe, at the Republican Clinical Narcology Centre named after Prof. M. G. Gulomov. By the end of 2011, 102 patients, including 7 women, were receiving OST at that centre. The second OST centre was opened in the city of Khudjand, Sogd Province, in December 2010, with 52 patients (including 3 women) receiving OST there by the end of 2011. The third centre was opened in Khorog in June 2011, with 44 patients (including 1 woman) receiving OST there by the end of 2011 (Nidoev, 2012).
"In Dushanbe, the following eligibility criteria for the OST programme are reportedly being used: age over 18, the presence of an opioid dependence diagnosis, a confirmed history of injecting drug use, a history of failures in drug treatment, and the capability to provide informed consent.
"According to an evaluation conducted among OST patients in Dushanbe in October 2011, 94% of the participants in the programme reported improved family relationships; the number of employed patients rose to the level of 50%; the number of patients adhering to antiretroviral (ARV) therapy increased threefold; 98% reported a lack of legal problems in the past 30 days.
"The OST programme in Tajikistan continues to be funded through grants received from international organisations."

Hasanov Kh.B., Muhabatov M.S., Makhsutov M.N., Chikalov Y.P., Murodova F.R., and Nurlyaminova Z.A. "2012 National Report on the Drug Situation in the Republic of Tajikistan (Drug situation in 2011)" (Dushanbe: National Centre for Monitoring and Prevention of Drug Addiction, Ministry of Health of the Republic of Tajikistan/Central Asia Drug Action Programme (CADAP)), pp. 25-26.
http://www.cadap.eu/filedepot/...

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