Re: Kerala NGO resumed Needle and Syringe Program (NSP)

July 4, 2006

Dear FORUM,

Tito 's (CSRD, Calicut, Kerala) mail really brings to focus on how

effective advocay need to be done to implement certain hard to understand harm

reduction programs.

I had been associated with SAHAI trust a FBO working among the

Injecting Drug users in Chennai for more than two years as a STI/

HIV physician.SAHAI trust had been working among the IDU in Chennai

for more than 8 years. SAHAI trust was basically working for the

rehabilitation of Drug users. From the year 2000 Sublingual

Buprenorphine substitution was given at two centres through EU

project. Success rates were better in that project , but due to

certain financial reasons the project was stopped in three years.

The project funded by FHI-USAID ( 2003 to 2006) on comprehensive

prevention / Care & support for IDU focussed mainly on risk

reduction .Needle syringe exchange(NSE) was given prime importance

for risk reduction among IDUs.

As lots of law & order problems were anticipated in carrying out the

NSEP, ground work had to be done with the Narcortics Control Bureau,

City police Commissioner & the Railway police Chief in Chennai.

Though the top level officials were sensitized, the actual

place where the problems were faced was among the police constables

& sub inspectors. Hence sensitization programs were conducted on a

regular basis for them. Counseling on safer injecting practices &

provision of new needles & syringes had drastically reduced the

opportunity of the IDUs to use the unsterile/ used needles & syringes.

Stabilized pattern of HIV prevalence was observed among

the IDUs for nearly three consecutive sentinnnel surveys in Chennai.

Occurence of over dosage death cannot be attribute to lack of NSEP.

Programs which work on the NSEP strategies should focus on

counseling the IDUs on safer drug usage & positive prevention among

their sexual & injecting partners. These NSEP programs should always

be carried out with the motive of encouraging IDUs to buy & use

disposable needles & syringes from the pharmacies, rather than

being dependent on the Outreach workers.

Hence, on a long run,this would really reduce the incidence of HIV among the

IDUs.

Dr.P.Mahalingam

Program manager ( care & support)

AIDS prevetion And Control Project( APAC) , Chennai.

e-mail: <pmahan76@...>

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