Kenya moves towards a more sensible drug policy

Throughout Africa, there has been a general reluctance to link intravenous drug use with the spiralling rates of HIV infection that have plagued the continent since the 1980’s. By governments concentrating on the illegality of drugs, there has traditionally little provision and treatment made available to drug users, particularly intravenous drug users which has become far more common throughout the continent. This is partly because injecting drug use has been a relatively modern practice in many parts of Africa, but also because most African countries lack the necessary infrastructure to treat and handle any substantial volume of drug users. However, the Kenyan government has began to shift its policy.

Nicholas Muraguri, head of the “National AIDS and sexually transmitted infections control programme” said in a statement this week that “If we want talk about HIV prevention, then we cannot afford to ignore any group”, adding that the new policy they are forming to tackle the HIV epidemic would treat drug addiction as a health issue rather than a criminal justice issue. This new approach being taken by the Kenya government echoes the recent turnaround in policy by the US presidents plan for aids relief (PEPFAR) which recently amended its policy which used to exclude needle exchanges and opium substitution therapy programmes from its funding. This is a welcome move as Heroin has become increasingly popular in Eastern Africa and in some parts of Southern Africa, where by being situated along one of the major trafficking routes from central Asia through to Europe, new markets for heroin use have become an increasing concern, especially when there are such little provisions and treatments for heroin users. 

As these countries are now struggling to deal with the impact of such a drastic increase in intravenous drug users, there has also been a shift in the types of heroin available, from the less refined “brown sugar” to the more refined “white” heroin.  This shift in the type of heroin commonly available, the method of users has also shifted from non-injection to injection. Although there is still a lack of accurate data regarding levels of intravenous drug use, the injection of heroin has been documented throughout most of the continent, particularly in the east and north of the continent.  Most worryingly is the fact that the sharing of injection equipment in becoming increasingly common. In Kenya, 39% of drug users have reported sharing needles, although an accurate figure of users who regularly share needles is unknown.

Nevertheless, Intravenous drug users account for nearly 4% of new HIV infections nationally and about 6% in Nairobi and Coast provinces and as such it is commendable that the Kenyan has began to shift its policy. A recent study in the Lancet addressing this issue highlights how only 1% of HIV positive Kenyan who are intravenous drug users receive ARV’s (in 2008). The report claims that an increase in ARV coverage, coupled with effective opioid substitution and needle syringe programmes could avert up to 1800 new HIV infections by 2015. So far the Kenyan government has taken a small step, however it is a step in the right direction and one that it is hoped will be emulated throughout the rest of Africa.