Scientific tool vs HIV

Sen. Tito Sotto recently went ballistic over news that the Dangerous Drugs Board (DDB) has green-lighted a program that will see the government distributing free syringes and needles to drug addicts in a barangay in Cebu City.

At first glance, the outrage seems justified. Giving addicts access to drug paraphernalia would only encourage them, and bury them deeper in their chemical-addled misery. Why is the government seemingly condoning their addiction, instead of clapping them in jail for possession of drugs and related paraphernalia?

But as in anything else that issues from a senator not exactly known for the intellectual and even factual rigor of his broadsides, the object of Sotto’s ire is more complex and nuanced than his knee-jerk condemnation makes it out to be.

The program is said to be part of a research study on how to prevent the further spread of HIV/AIDS. It is being implemented in Barangay Kamagayan, which has been designated as a “safe zone” and where, for the duration of the research, drug users and government health personnel taking part in the program will be exempt from arrest for possession of drug paraphernalia.

The 24-month “scientific and medical study” being undertaken by the Department of Health, Philippine National AIDS Council, the Cebu City local government and Population Services International, and funded by the World Bank and Asian Development Bank, is said to be aimed at determining the viability of other approaches to drug addiction and minimizing the harm associated with this behavior. In this case, Barangay Kamagayan has been identified as an area where drug addicts routinely share needles to inject themselves with drugs. The practice of using needles multiple times has also been shown to increase the risk of contracting HIV; there has been, in fact, a reported spike in HIV cases in the area, which makes it an ideal testing ground for the research study approved by the DDB.

The rapid rise in HIV infections nationwide, with some 21 new cases reported every day per DOH records, has made the Philippines one of only a handful of countries at risk of a full-blown HIV/AIDS epidemic if it is unable to address the problem on time. The 646 new cases reported last February is the highest number since the Philippines’ first case in 1984, according to the DOH. The numbers in six cities—Quezon City, Manila, Caloocan, Cebu, Davao and Cagayan de Oro—already exceed the national prevalence rate of 3.5 percent. Without greater awareness among the public, and more urgent action from the government to address this alarming trend in aggressive, efficient and innovative ways, the disease may reach “uncontrollable” levels, as the DOH has warned.

While HIV is spread primarily through unsafe sexual contact, it can also be contracted through the sharing of dirty needles during drug use. The research project in Cebu appears to be a methodical, controlled approach to mitigating the risk of HIV further compounding the addiction among users. This is not a wooly, unscientific method. “Harm reduction” as a public policy has proved to be effective in other countries such as Australia and the Netherlands, as a measure that complements more established civic programs such as increased law enforcement against drugs and their suppliers.

Sotto, however, thinks this “Western” strategy is misguided. Or in his words: “It’s as if we are saying that if we cannot stop a criminal from using a rusty knife, it would be better if the government gave killers clean and stainless knives so that nobody would die from tetanus if he gets stabbed.”

What’s wrong with that glib formulation? The assumption that drug addicts are criminals when they are victims that need to be helped—and that intervention for their kind needs time, which is why weaning them away from the harmful practice of needle-sharing would be a good start.

It’s a given, of course, that research studies like this, with their broad implications on public policy and social welfare, should be governed by strict and transparent parameters. If Sotto’s concerns were about the clinical foundations of the study, his diatribe against it would have better legs to stand on. But framing the discussion in fuzzy moral terms—the addict as criminal, addiction as a moral failing, and a program like this as an enabler of moral rot—attacks the cause of progressive, science-based thinking, the very thing the Philippines needs now in its battle against HIV.