For many years Afghanistan was protected from the HIV/AIDS pandemic that was sweeping across the world. Isolation at the hands of the Taliban government meant that migration to the Middle Eastern country was limited, and intravenous drug use was very rare.
But now that the Taliban have been ousted and the borders have been reopened, that has changed.
Two million refugees have returned to the country after years spent in camps, many bringing with them HIV/AIDS that they contracted while living in exile.
Afghanistan has long been one of the world’s leading suppliers of opium and heroin – it produces about 95% of the world’s heroin – and with the increase in the production and trade of these drugs there has been a marked increase in the number of intravenous drug users in the country.
Four years ago a UN study put the drug-using population at about 200 000. According to Afghan Counter-Narcotics Minister Khodaidad, the number has increased dramatically since then.
“More than 1.2-million people in Afghanistan are addicts. It’s a huge number and every year it increases,” he said in an interview with CNN in September.
Khodaidad explained that Afghan government is unable at this stage to stop the production of the drugs and does not have powerful enough enforcement agencies to prevent the trade.
But the UN says that the longer the drug trade isn’t policed, the quicker the problem will take a hold of the general population and the more common the practice of needle sharing will become – which in turn will cause HIV/AIDS infections to rocket.
With little information and education about the virus, few of these drug users are able to make informed decisions about the use of needles and experts predict Afghanistan’s HIV/AIDS problem is set to explode as a consequence.
Jean-Luc Lemahieu, head of the UN’s Office on Drugs and Crime (UNODC) in Kabul, told CNN that the country could not afford to delay its response to this issue. “We have seen, now, a few HIV/AIDS cases. Hopefully we can contain the problem, although it is unlikely, given the problems with the health structures.”
The UN has launched a programme to rehabilitate drug addicts wanting to get clean. It has established a detox centre in a renovated warehouse in Kabul which can accommodate 100 addicts at a time. The centre is the biggest of its kind in the country and provides users with a safe space to kick their habit with the support of therapy and counselling sessions.
But this programme won’t prevent new drug users from contracting HIV/AIDS. Current estimates put the number of HIV-positive people in Afghanistan at 2 000 but most experts agree that number is way off.
Afghan and international experts say that Afghanistan also faces the problems of countries emerging from conflict. A lack of education and government services, mass movements of people and a sudden influx of aid money and commerce will make combating the spread of the virus more difficult.
There are various organisations that run needle exchange programmes and education and awareness programmes, but the conservative Afghan culture does not encourage discussions about sex and safe sex, making it hard to educate people about the dangers of unprotected sex and the increased risk for men who have sex with men.
Stigma is also another major problem in the country and those who test HIV-positive face ostracism and even death if their communities discover their status.
All these factors contribute to the growing prevalence of HIV/AIDS in Afghanistan and currently the government health departments don’t have systems in place to respond adequately.