The two sides of opium

Afghanistan has a booming opium trade, which has increased seven-fold since 2002 and supplies an estimated 90 percent of the world's illegal heroin. Much of this goes to (or through) nearby Pakistan where injecting drug use is a main concern and HIV prevalence is rising. Recently, Pakistan's Health Minister expressed frustration at the Afghan government for not moving more effectively towards poppy eradication. The US eradication efforts since entering in 2002 have also been largely ineffective.

The WHO raises different concerns about Afghanistan's opium production: that it does not reach enough people worldwide for pain relieving purposes, causing a "world pain crisis". Opium is also the raw material for morphine. Developing countries as a whole only consume 6 percent of medical opioids yet by 2015 may have 10 million cancer cases. In the US, half of those suffering from chronic pain-most commonly AIDS and cancer patients-do not receive adequate pain relief. Pain relief worldwide is not only distributed unequally, but altogether insufficiently.

The Security and Development Policy Group (Senlis Council ), an international policy think tank with offices in Kabul, London, Paris and Brussels, has argued that the answer to Afghanistan's illegal drug trade is not poppy eradication, which: 1) deprives local farmers of a major source of income; 2) contributes further to the inadequacy of global pain relief; and 3) most likely will not eliminate the drug trade. Instead, it argues that the International Narcotics Control Board(INCB) license growing in Afghanistan. It is estimated that the price of buying the entire Afghan poppy crop would cost less than what the US is spending on eradication campaigns that have not worked.

The INCB's main function is to mediate exactly the dilemma that is presented in Afghanistan: balancing the medical needs of opioids while controlling illegal trafficking. The INCB has sent multiple missions to Afghanistan. They’ll outline their recommendations in their upcoming Annual Report to be released in February.

What will it say? Will it address only trafficking or also the need for more access to legal opiods?

Stay tuned.

Read more:
“There's a way to end Afghanistan's and the world's pain”

“Afghan drugs a worry as Pakistanis confront AIDS”

“Let a Thousand Poppies Bloom”

Parallel messages, similar results

A recent New York Times editorial on the ineffectiveness of Phillip Morris’ anti-smoking ads bears more than a little resemblance to current debates about abstinence-only education for teenagers.

We’ve all seen the Phillip Morris ads saying, “Think, Don’t Smoke” and recent ads target parents, telling them to warn their children against smoking. In short, “just say no”.

A recent research study published in the American Journal of Public Health found that the ads have had no beneficial effect on teenagers and that those aimed at parents actually had an encouraging effect on teenagers.

The study found a direct relationship between exposure to the ads and likelihood of smoking in the past 30 days.

The New York Times observed that “their theme—that adults should tell young people not to smoke mostly because they are young people—is exactly the sort of message that would make many teenagers feel like lighting up.” The Times also noted that the goal of the ads is not actually to prevent smoking for a lifetime, but to put it off until adulthood, and that the ads have no mention of the fact that smoking is addictive or even harmful.

Likewise with abstinence-only education. Nearly two-thirds of US high school seniors have had sexual intercourse and there were 822,000 reported pregnancies among women 15-19 years old in the year 2000. While there is no evidence to show that abstinence-only classes changes this, there is evidence to show that education about contraception and sexually-transmitted infections reduces risk-taking and pregnancy among teens (see PP, Kaiser, ACLU, Guttmacher). And if the goals of abstinence-only programs are the same as the anti-smoking ads—to delay intercourse until adulthood (i.e. marriage)—then we will still have rampant ignorance about STIs, protection, and reproductive health.

While the motivations of the two campaigns may be different (those behind the Phillip Morris ads are looking to keep sales (i.e. smoking) up while “avoiding a governmental crackdown” and those preaching abstinence-only arguably do want to keep teens from having sex), each scenario, through the evasion of straightforward conversation and disregard for proven studies, threatens young people with bitter ends: lung cancer and AIDS.

Signs of a new Congress: Questioning the roots of US HIV/AIDS policy

The Boston Globe reported yesterday on some important questions that Democrats are asking about President Bush’s faith-based initiatives:

• Have current faith-based initiatives violated the separation of church and state?
• Did the Bush administration really give 98.3 percent of the faith-based foreign-aid money to Christian groups? How does this affect, among other things, our foreign relations?
• What are the effects of such faith-based initiatives on our fight against AIDS?

Questions such as these are being articulated mainly by Representative Barbara Lee (D) from California and Representative William Delahunt (D) of Massachusetts.

Representative Lee is sponsoring a bill that would overturn a measure that requires that one-third of the money spent by the US government on AIDS prevention overseas go for "abstinence until marriage" programs. This is a $1 billion measure and many Democrats have suggested that the money could be better spent on other measures such as condoms. "When you look at what has been exposed and revealed, I think we have a factual basis to move forward with this," Representative Lee said.

Representative Delahunt, who will soon chair the International Relations subcommittee on Oversight and Investigation, said that if US-funded Christian groups work in Muslim-dominated countries, the effort could be "perceived to be proselytization and it can generate a harsh negative reaction that implicates and impacts in a negative way on America's image in the world and have significant consequence to our foreign policy goals."

Democrats are also attempting to repeal a measure that required US groups receiving faith-based funds to have a policy opposing prostitution. Many groups have said the pledge impedes their work with sex workers who are at high risk for HIV. Organizations have also raised a question of the constitutionality of the pledge as compelled speech. Two federal judges have ruled that the pledge is unconstitutional and the Bush administration has appealed these rulings. Read more.

Regarding the AIDS fight, Representative Tom Lantos, the California Democrat who will chair the International Relations Committee in January, said, "Our global HIV/AIDS policy should be about saving lives…It is inconsistent with this goal to place ideologically driven restrictions on the implementation of efforts to prevent spreading the virus."