A tale of two cities: Durban ditches drug users while Tshwane becomes the first city in SA to pioneer and fund new ways to keep them safe.
Hundreds of people in the City of eThekwini could be at risk of contracting HIV and hepatitis as the metro cuts the only prevention programme for drug users.
The city’s health unit has closed the project run by the non-profit TB/ HIV Care Association, claiming that the programme poses a public health risk and breached municipal bylaws.
The closure follows a freak wave in January that caused more than 50 needles and syringes to wash up on Durban beaches. City authorities claim the incident is proof that the programme is unable to collect and dispose of the needles it hands out properly, placing the public at risk.
But almost 70% of the needles the association gives to drug users are returned, the organisation’s data shows.
In contrast, there is no evidence that any of the 5 000 needles distributed to diabetic patients at Durban’s Wentworth Provincial Hospital monthly are returned, according to a 2012 study published in the South African Medical Journal.
The hospital and association are not breaking any rules, the organisation argues.
“If that were the case, any pharmacist who sells a needle or syringe and does not account for its disposal would be breaching the same bylaw,” says the organisation’s spokesperson, Alison Best.
Experts say the city’s accusations are baseless and its decision to close the project has been a crushing blow for drug users – and national efforts to curb new HIV and hepatitis C infections among the group.
People in South Africa who inject drugs are 40% more likely to contract HIV than the general population, primarily because they’re at risk of sharing infected needles, a small, five-city study published in the International Journal of Drug Policy in 2016 found.
Meanwhile, programmes that provide people with clean needles to eliminate the need for dangerous sharing have been shown to cut HIV prevalence rates by almost half in just three years among British drug users, according to a 1995 study published in the journal AIDS.
Injecting drug users are also more at risk of contracting blood-borne virus hepatitis C. A 2005 study published in the journal Clinical Infectious Diseases found between 50% and 90% of injectors in the Untied States were also infected with the disease.
These statistics are why harm reduction programmes – or initiatives such as the one in Durban that seek to reduce the health risks associated with drug use – are also included in the latest national HIV and tuberculosis plan.
The TB/HIV Care Association programme has provided clean needles and HIV testing to more than 1 000 people since it opened its doors in Durban in 2015, the organisation’s data shows.