East Africa: The Heroin Trade
In the last article I touched on the susceptible nature of West Africa to the trafficking of Cocaine. However, it is clear that the conditions that are allowing the drugs trade to flourish are not only located in this region. Poverty, corruption and limited government capacity are prevalent across many parts of the continent. In a similar way that has seen West Africa as the natural evolution of the transatlantic cocaine trade so we can look at East Africa and the development of the Heroin trade.
Internationally the focus has been for drugs coming from Latin America, with cocaine and Guniea-Bissau at the centre of much of the world's discourse on drugs in Africa. This has been driven by the heavy US focus on drugs from the South Americas monopolising the attention that should have been given to other drug trafficking and exporting regions. If West Africa can be considered favourable to the drugs trade, then East is exceptionally so. The political, economic and social context offered by ineffective policing and government are similar, if not more extreme than in the West of the continent. There is also an important key difference, the lack of international attention.
Recently there has been a considerable rise in seizures of Heroin in the region from 2009 - 2010, Egypt 159kg to 234, Kenya 8.5kg to 35kg and Tanzania a huge 7.9kg to 191kg. This growth pattern of seizures has been reportedly mirrored across East Africa. Considering the socio-economic fragilities of the countries involved, many are concerned about the deep lying effects drugs, their trade and the money associated will have on their societies. The ease at which drugs money can become embedded within government and allow criminal organisations to become established in society has the potential to greatly contribute to the instability the region already faces.
We must also consider that Heroin has a directly debilitating effect on society; being highly addictive it can threaten productivity, the breakup of families and to a degree contribute to societal breakdown. The major concern is the effects of needle sharing, with recent success in the fight against HIV the arrival of Heroin on the scene is worrying in a region ill prepared to educate and care for those addicted to drugs.
The reasons for the rise in drug trafficking to and through the region are apparent. Much like in the case of Cocaine in West Africa there has been a "ballooning" effect, where restrictions have caused traffickers to find new routes and markets. Afghanistan is the world’s biggest producer of opium poppies, where before 2009 40% of its Opium crop flowed through Pakistan then onto other destinations. However with a clamp down on terrorism and drugs in the region this has had a knock on affect on Opium trafficking, with some turning to East Africa as trade route less fraught with obstacles and the watchful eye of the international community. UNDOC estimates that around 45 tons or 10% of Afghan heroin was trafficked to Africa in 2009.
The use of needle sharing is a relatively new phenomenon for the East Africa, but it is part and parcel with the rise in Heroin use. Exact statistics are hard to come by; on the Island of Zanzibar estimates in heroin use are between 1% and 7% of the population which whatever way you look at it is a huge number. What is clear in the region as a whole is that drug use is on the rise. Somewhat easier to quantify and to a degree more important is the prevalence of Intravenous Drug Use (IDU) and HIV amongst drug users of the region. In Mauritius a study of female sex workers found that 74% were IDU, and one quarter of IDUs were sex workers. In costal Tanzania a survey of discarded syringes found that more than half were HIV contaminated, another study showed that needle sharing was rife. In Kenya the numbers are similar, 17% of coastal HIV is related to IDU compared to national average of 5%, much of the Heroin population is near the east coast relating to the natural trade route of drugs from the Middle East. Heroin injection now also appears to be occurring in most large towns of Kenya and Tanzania; a study of 336 heroin users in Nairobi, Kenya found that 44.9% were injectors. Of 101 current injectors, 52.5% were HIV positive five times great than those who didn't. All these figures show a tendency towards higher drug use and a resulting rise in HIV in the region.
The use of heroin by sex workers is an obvious worry in terms of HIV prevalence among the general population. An alarming practice called "flashblood" also takes place, a method of sharing heroin for those who cannot afford it where one user draws back their blood into the syringe after injecting heroin in order to give to a friend, these two examples show how easily the battle with HIV can turn against the region.
Considering past examples of failure when dealing with national drugs epidemics what is needed are user orientated harm reduction and education programmes that can help to relieve the debilitating social and health effects. However, a more measured harm reduction approach can be hard to implement, requiring an in-depth and on all fronts strategy tackling education, health care and a revised policing policy. A "War on Drugs" is far more direct, in that it deals with the dealers and users as the problem and thus requires a more simplistic approach. Of the two a harm reduction approach is most ideal, to avoid criminalising the victims of this international trade. However, the issue as ever is limited government capacity and an international obsession with "fighting" drugs.
However, steps are being taken at improving drugs policy in the region. Pioneering schemes such as Zanzibar’s drug rehabilitation centres or "safe houses" have been established by users seeking support from each other in getting clean. The Tanzanian government has initiated a needle exchange and education clinic, although this has come under criticism from civil society groups it is clearly required when considering a recent survey showed that 51% of IDU are HIV positive. In Kenya too government policy has shifted, the Kenya National Aids Strategic Plan targets IDU, also initiating a needle exchange programme. In both cases the governments are hoping to limit the spread of HIV amongst the IDU population and therefore the population as a whole. However, these developments are new and there are limitations, in both cases it is legal to buy clean needles from a pharmacist however some refuse to sell to suspect drug users and carrying an unused needle can be considered enough to warrant an arrest, this being especially true in coastal regions.