Location: Kabul

Situation:
More than 90% of the opium sold in the world is produced in Afghanistan, where domestic consumption is growing. In 2009, there were an estimated 1.5 million people using drugs. The number of heroin injectors is thought to be growing fast, and this group represents the major risk factor in the transmission of HIV/AIDS and hepatitis. Faced with a repressive culture and a discriminatory healthcare system, Doctors of the World (DOW) is supporting a harm reduction programme.
 
Activities:
Since 2006, DOW has been developing an ambitious strategy of harm reduction amongst Afghan drug users. There are two parts to this work: the setting up of a prevention project and access to primary healthcare and treatment, as well as the creation of a resource and training centre for local actors involved in the struggle against HIV/AIDS. This health centre and refuge, which monitors the health of 230 drug users on a weekly basis, has been recognised as a model programme for the Middle East-North Africa region. In May 2009, DOW prescribed the first antiretrovirals in the country and set up the first self-help groups for people living with HIV/AIDS. Some 118,733 syringes and 34,295 condoms were distributed. 750 drug users are monitored within the scope of the programme.

Outlook:
From February 2010 DOW introduced methadone as a substitute treatment. The programme should extend to 120 patients by the end of the year. DOW plans to train local actors in harm reduction and HIV/AIDS. Finally, the programme will support the creation of an independent Afghan organisation involved in harm reduction.

Project start date: June 2006

End date: Ongoing