Substance maltreatment is a multi-facetted job that plagues a whole society, irrespective of different age classs and societal categories. The effects and the sum of injury caused to the person, the household and society are diverse. Mauritius, while being a little island of about 1.2 million[ 1 ]dwellers merely, far off from the taking powers of the planetary economic system, and niched at the bosom of the Indian Ocean has non been spared from this issue.
Harmonizing to the National Drug Control Masterplan 2004-2009[ 2 ], the age of induction to substance maltreatment in Mauritius starts from every bit early as 11 old ages because of equal or media influence. The principle of substance maltreatment is nevertheless non this simple. Sometimes, some people give in to the natural homo behavior which is seeking to happen the easiest flight from rough worlds and nuisances of day-to-day life, and resort to substance maltreatment.
Development of substance maltreatment in Mauritius
Substance maltreatment may hold become an dismaying phenomenon of late, but drugs have been present in Mauritius for a far longer clip. The usage of drugs has been recorded to hold started with every bit early as during the Gallic colonization[ 3 ]with illicit rum production by slaves. With the reaching of apprenticed laborers, Indians brought along with their civilization and traditions, hemps, while Chinese immigrants brought opium[ 4 ]. These drugs were largely utilised in a socio-cultural circumstance, by grownups without being a cause for serious concern. Sixtiess brought with it the Hippie Culture[ 5 ]to Mauritanian shores every bit good as new signifiers of drugs such as LSD[ 6 ], Mandrax[ 7 ]and other psychedelic drugs which became synonymous to ‘new highs ‘ to childs.
The 1970ss caused an wholly different tendency of substance maltreatment, as the state of affairs changed drastically from its socio-cultural to a more significantly worrying usage. A fundamental signifier of diacetylmorphine[ 8 ]known as “ Brown Sugar ” was introduced in Mauritius. Brown Sugar was smuggled through the airdrome, seaport and through postal packages.
The ”Amsterdam Affair ”[ 9 ]that broke out in 1985 was the ether of the range of the drugs job in Mauritius. As an effort to expose its willingness to go forth no rock unturned in the combat against drug trafficking, statute law was amended[ 10 ]and decease punishment was introduced for proven sellers. No drug seller have nevertheless been executed because of the thorny legal issues environing capital penalty. A sudden downward tendency was observed in 1987 and continued until 1990 after which indexs revealed a little addition in illicit trafficking and ingestion[ 11 ].
In 2003, the “ White Lady[ 12 ]“ was a psychoactive drug opted by most drug users. Post 2005, Subutex[ 13 ], which is usually used as intervention on those dependent on narcotic hurting slayers, and opiates, shortly became the most sought-after drug in Mauritius. A
Substance Abuse and Repercussions
Social Consequences
Significant societal effects include the decomposition of the household unit, with the emotional and psychological wellbeing of household members being disquieted. Substance maltreatment and delinquency go manus in manus ; as sometimes dependence and backdown syndromes overcome ground and push nuts towards larceny, force and similar such Acts of the Apostless to secure the fiscal agencies to obtain their needed dose. The 2009 World Drug Report[ 14 ]shows that figure of drug-related offenses has increased by 18 % from 2006 to 2007.
Health Consequences
Substance maltreatment affects the personal wellness of drugs nuts themselves. Withdrawal and apathy are a few of the psychological disfunctions they might confront. The impact of dependence can be far making. Cardiovascular disease, shot, malignant neoplastic disease, and lung disease can all be caused by drug maltreatment[ 15 ].
Because of needle sharing behavior[ 16 ], a well-established norm among IDUs as has been shown by the IDUs Respondent Driven Sampling[ 17 ], which is explained by the increased costs and low fiscal agencies of IDUs every bit good as Police Services uninterrupted still hunt of IDUs in ownership of drug gears, blood borne diseases such as AIDS or Hepatitis[ 18 ]are easy transmitted, reverberations of which is ruinous both for the IDU and society at big. IDUs who get affected by such blood borne diseases will frequently through a Domino consequence, affect their sexual spouses, while pregnant adult females who are IDUs run the hazard of polluting their unborn kids with such. Injecting drug usage is the cause for an increasing proportion of HIV infections in many parts of the universe, Mauritius included. It is estimated that between 11 and 21 million people worldwide inject drugs, and of those, between 0.8 and 6.6 million are infected with HIV[ 19 ].
Fiscal Impacts
Health services that have to be provided to drug nuts include intervention of diseases which may develop in drug nuts as a effect of substance maltreatment, every bit good as costs of rehabilitation services, which is frequently overlooked by most individuals. The cost of non-generic antiretroviral intervention per individual per annum may amount up to $ 1500[ 20 ], averaging to about Rs 50, 000 based on current exchange rates.
Fiscal effects on the economic system are sedate, with the parallel running of a black economic system with net incomes obtained from the illicit traffic, every bit good as with the effects of drugs abuse of members of the work force which reduces productiveness.
Conventional Approaches to Substance maltreatment
Mauritius has ratified the United Nations Drug Control Conventions[ 21 ]. It has besides ratified the 2000 Convention on Trans-National Organized Crime[ 22 ]and is besides signer of both the African Union[ 23 ]and the SADC Drug Control Protocol. Existing legal models that were used, and still are used to command drugs supply and demand decrease are:
The Dangerous Drug Act 2000[ 24 ]
The Pharmacy Act 1983[ 25 ]
The Financial Intelligence and Anti Money Laundering Act 2002[ 26 ]
Drugs Demand Reduction
Drugs demand decrease is one of the attack used to battle the substance maltreatment crisis at its nucleus. Drug demand decrease refers to policies and programmes directed towards cut downing the consumer demand for narcotic drug and psychotropic substances as covered by the three chief International Drug Control Conventions, as mentioned above. The National Agency for Treatment and Rehabilitation of Substance Abusers ( NATReSA ) is a parastatal organic structure under the auspices of the Ministry of Social Security, National Solidarity and Reform Institutions which was set up by an Act of Parliament in 1996[ 27 ]and it is responsible for all demand decrease activities in the state. By carry oning a figure of bar activities in the community, schools and the workplace, NATReSA uses instruction as its chief vehicular arm to seek to decrease the demand for drugs. It provides support to a figure of NGOs engaged in bar, intervention and rehabilitation work. The National Prevention Unit set up by the NATReSa in 2002 has set up a Demand Reduction Integrated Program, from which more than 25 parts have already benefitted boulder clay day of the month.
Supply Side Reduction
As to provide side decrease, the jurisprudence enforcement side is actively involved and a figure of establishments runing under the auspices of different ministries are responsible for drug control activities.
The Anti Drug Smuggling Unit ( ADSU )[ 28 ], the National Coast Guard and the Special Mobile Force are particular units of the Mauritius Police Force, working under the bid of the Commissioner of Police involved in drug control. The Passport and Immigration Office besides operates under the supervising of the Commissioner of Police and has a function in the showing of riders at the haven and airdrome while Custom Investigation and Intelligence Unit plays a notable function in the checking of containers and other baggage come ining the state. The Pharmacy Section of the Ministry of Health and Quality of Life is responsible for the issue of licences for the import of licit narcotic drugs and psychotropic substances.
Finally, Mauritius Post Services work in close cooperation with the above units to exert near control to vouch that drugs do non come in the state through letters and postal bundles and the Forest Department aids through its field work in woods, mountains and province lands, and is instrumental in observing cannabis cultivation.
Harmonizing to the 2010 World Drug Report[ 29 ], Mauritius is the state with the highest opiates ingestion prevalence in the African continent with an estimation of 1.9 % . This demonstrates clearly that conventional attacks to the Mauritanian drug job have non met outlooks in footings of efficiency in undertaking it. Alternatively, new factors borne due to a quickly altering society contributed to the rendering them inefficient – opening up of air spaces which while increasing benefits from the touristry and travel industry has besides increased the hazards of drugs being brought into the state by aliens, enlargement of the offshore sector through which big amounts of money theodolites through Mauritius, beginnings of which remain confidential to the offshore companies and the unfastened secret being that sometimes, portion of these monies go into the black economic system, financing drug minutess and poorness and harlotry which are cardinal conducive factors every bit good to the enlargement of the Mauritanian drug market among others. The escalation of drug usage became a cause for concern as the chief vehicle for substance maltreatment being through injection, this implied a heightened hazard of transmittal of blood borne diseases[ 30 ]among the IDU population and hence a greater figure of HIV positive and hepatitis instances amongst others.
An wholly new attack was therefore adopted to counter this contingency, known as the injury decrease attack. The injury decrease which consists of needle exchange plans every bit good as dolophine hydrochloride permutation therapy implied a wholly different position, the nucleus rule being acknowledging the being of a substance maltreatment issue in a community, which frequently is pig-headedly resisted by governments, therefore exposing the immense trouble in the execution of this method.
Over the old ages, legion observations have been made by journalists and Non-Governmental Organisations ( NGOs ) representatives on the structural alterations of the drug state of affairs in Mauritius, the distressing dimensions of the issue of substance maltreatment and its dealingss with transmittal of blood borne diseases. Harm decrease nevertheless, being a comparatively new construct in Mauritius dating merely back to 2006, remains a instead undiscovered way.
Hence, the intent of this thesis would be to convey focal point on Needle Exchange Programs ( NEPs ) as they are carried out in the Mauritanian context. While running through a general overview of the injury decrease attack, the principle behind it will be examined along with execution timeline of NEP in Mauritius. Policy facets will be reviewed and an analysis of the legal background of NEPs in Mauritius will be presented, which will dwell of a survey salient characteristics of the bing Torahs and NEPs and finally the NEP particular model which is the HIV/AIDS Act 06. NEP in prisons, being a delicate and problematic issue, will be considered and the chance of such in Mauritanian prisons discussed. The thesis will be concluded by measuring the Mauritanian NEP, and suggesting recommendations of possible ways to pitch more towards efficiency and best pattern with respects to Mauritian Torahs and needle exchange.
Preliminary Chapter: Understanding Harm Decrease
The Basic Concept
Harm decrease refers to policies, programmes and patterns utilized and applied with the aim of decreasing hazards associated with the usage of drugs by substance maltreaters[ 31 ]. Subdivided into needle exchange plans and dolophine hydrochloride permutation therapies, injury decrease is viewed as a far-reaching advanced attack to the job of substance maltreatment and its related hazards. The outstanding characteristic of this fresh method is the extremist displacement in focal point to the bar of injury caused by substance maltreatment, instead than on the bar of drug usage itself. This entails recognizing the being of a substance maltreatment job in society which in bend indicates the inability or sometimes even failure of concerned governments in undertaking the drug job.
This attack was frequently discussed in Mauritius after acknowledgment of the menace of HIV every bit good as other blood borne diseases which were distributing through shooting drug usage. ( RSA ( ? ? ) )[ 32 ]. Stakeholders including the National AIDS Secretariat[ 33 ]agreed that injury decrease does non sabotage but alternatively complements attacks seeking to forestall or diminish drug ingestion. It is based on the acknowledgment that many people throughout the universe continue to utilize drugs despite the best of attempts to forestall drug usage.
Rationale Behind Harm Reduction
Harm Reduction and Human Rights
The injury decrease attack to drugs is based on a strong pledge to public wellness and human rights. Harm decrease intercessions have found support among legion United Nations ( UN )[ 34 ]human rights mechanisms, specifically in context of HIV bar and the right to achieve the highest accomplishable criterion of wellness
International Covenant on Economic, Social and Cultural Rights[ 35 ]A ( ICESCR ) And Harm Reduction.
The Committee on the Economic, Social, and Cultural Rights[ 36 ]( CESCR ) has recommended[ 37 ]many times that States Parties scale up their injury decrease programmes in order to run into their duties under Article 12[ 38 ]of the ICESCR. In its Concluding Observations on Ukraine ( 2007 ) , the Committee stated that it was “ soberly concerned ataˆ¦the limited entree by drug users to substitution therapy, ” and recommended that the province party “ make drug permutation therapy and other HIV bar services more accessible for drug users ”[ 39 ].
In 2009, the UN Human Rights Council[ 40 ]adopted a declaration on human rights and HIV/AIDS that unambiguously provided support to harm decrease plans, including needle exchange. The declaration reflected past Committednesss[ 41 ]made at the General Assembly[ 42 ]in 2001 and once more in 2006. In 2010, the UN Commission on Narcotic Drugs[ 43 ]adopted a declaration more than of all time, endorsing the far-reaching bundle of intercessions for HIV bar intervention and among injecting drug users. Both ECOSOC and the UNAIDS Programme Co-ordinating Board ( will be explained in footer ) have besides endorsed these intercessions.
Article 15.1.b ( ( will be laid out in footer ) guarantees the right of everyone to profit from scientific advancement and its applications. In the context of shooting goaded HIV, this implies a right to profit from grounds based plans that can forestall, dainty and control HIV/AIDS and other drug related possible diseases. Harm decrease methods have been backed by extended scientific grounds base declarative mood of their effectivity at cut downing injecting-related hazards.
Research Based Rationale
Supply decrease has been used in Mauritius now, since many old ages and although being an expensive method to battle substance maltreatment, drug trafficking offenses and substance maltreatment is still good present in the Mauritanian society.
2002, 2003 to 2004 manner of transmittal of HIV and blood borne infections steadily shifted from heterosexual activities to shooting drug usage. ( annexed charts )
The 2009 Injecting Drug User HIV surveillance study was implemented by the AIDS Unit of the Mauritius Ministry of Health and Quality of Life ( MOH & A ; QL ) . HIV prevalence is 47.4 % . Hepatitis C prevalence is 97.3 % . ( Results of the study will be annexed as tabular array )
Presently, shooting drug usage comprises the majority of HIV infections in Mauritius. Whereas in 2002 shooting drug usage accounted for 14 % of all new HIV infections in Mauritius, this per centum increased dramatically to 92 % in 2005.[ 44 ]Although HIV prevalence among Injecting Drug Users appears to hold decreased bit by bit to 73 % in 2008, this per centum is still do for concern. The usage of non-sterile acerate leafs and panpipes and other shooting drug equipment is an highly efficient manner of HIV transmittal and remains a cardinal factor worsening the HIV epidemic among drug users worldwide.
Appraisal of population size of IDUs in 2009 has been rounded off at 10000.
Bad injection drug usage patterns 61.2 % of Injecting Drug Users reported shooting two to three times a twenty-four hours and 29.3 % reported shooting with a antecedently used acerate leaf in the past month
The Implementation of Harm Reduction In Mauritius
Harm decrease implemented in Mauritius under two plans: Methadone Substitution Therapy and The Needle Exchange Program
Methadone Substitution Therapy ( MST )
Methadone hydrochloride is an opioid ( will be explained in footer ) . Methadone is now chiefly used today for the intervention of narcotic dependence. Methadone ‘s effects can last up to 24 hours, thereby given merely one time a twenty-four hours in diacetylmorphine detoxification and care plans for the intervention of people dependent on diacetylmorphine and other opioids. ( beginnings will be provided in footer ) Methadone is normally available as a liquid and rummy with fruit juice.
MST plants by cut downing cravings and barricading “ highs ” from diacetylmorphine. It does non supply the euphoric haste. The drug user under MST will no longer see utmost highs and depressions that consequences from the degree of diacetylmorphine in the blood. ( beginning will provided in footer ) . Ultimately, the patient remains physically dependent on the opioid, but is freed from the uncontrolled, compulsive, and riotous behaviour seen in diacetylmorphine nuts. National Detoxification Centre For MST found at Cite Barkly. Program may be residential ( 15 yearss ) or day-care. Drug users are induced on dolophine hydrochloride under medical supervising and doses accordingly adjusted.
16 dolophine hydrochloride distributing points from which drug users, after holding gone through initial initiation receive their day-to-day doses of dolophine hydrochloride.
Needle Exchange Program
Forms portion of injury decrease scheme and is funded by the Government through the Ministry of Health and Quality of Life and partly by international administrations such as the Global Fund.
NGOs and Government through Ministry Of Health and Quality of life both carry out NEPs.
The plan offers a comprehensive bundle of services which include exchange of used acerate leafs, HIV guidance and testing, proviso of rubbers and intoxicant swabs and referrals for rehabilitation services ( where requested ) every bit good as other HIV-related services.
The Mauritian Needle Exchange Program
Execution of Needle Exchange Program In Mauritius
Having recognised shooting drug usage as the chief vehicle of blood borne transmittal, the purpose behind transporting out needle exchange plans is to transmissionA of HIVA and otherA viralA infectionsA ( HepatitisA BA & A ; A C ) A which travels through contaminated panpipes and equipments.
NEP protects the IDU, by guaranting proviso of safe, clean and unfertile injecting equipment, extinguishing hazard of transmittal of HIV and blood borne infections through sharing.
NEP protects non merely the IDU but besides IDU ‘s sexual spouse.
Needle exchange started in 2006 by two NGOs- Ki Nu ete and Prevention Information et Lutte contre lupus erythematosus Sida ( PILS ) on two sites – Batterie Casse and Baie Du Tombeau ( beginning will be cited in footer )
Adoption of HIV/AIDS Act in 2006 which provided legal model for NEP following which November 2007 saw authorities through the Ministry of Health And Quality of Life endorse NEP in Mauritius through the official launching of the NEP in Mauritius.
A 3rd NGO started NEP on a new site at Tranquebar in November 2007
In 2008, MOHQL called for stamps for new NGOS willing to take part in NEP, with merely one response and in February 2008 Idriss Goomany Centre ( IGC ) started Needle Exchange on a new site in Plaine Verte
March 2008 saw some of the non-governmental administrations set abouting needle exchange boulder clay day of the month regroup themselves under the auspices of one cardinal administration – Collectif Urgence Toxida ( CUT ) . CUT consists of Ki Nu Ete , PILS and Rapid IGC joined CUT for a limited clip period merely. In April 2008 two new sites for needle exchange were put into operation by CUT.
May 2008: functionary kick – off of authorities tally NEP It is deserving observing that Mauritius has pioneered authorities run needle exchange in Sub-Saharan Africa
As of date- 35 sites officially runing for Government run NEP and 17 sites for NGOs run NEP
Operation of the Mauritian Needle Exchange Program
Two chief methods of operation, NGO run NEP and Government Run NEP
Nongovernmental organization: street based needle exchange. Normally, two members of the NGO visit a fixed topographic point in the vicinity – the site, a certain figure times per hebdomad ( depending on the NGO in inquiry ) and have a figure of panpipes with them and an empty gallon. IDUs come to see them, conveying with them the used panpipes which are disposed in the gallon and are given new unfertile panpipes by the members. IDUs are assigned a ‘code ‘ when they visit the sites. It should be noted that this is non for designation intents of the IDUs but instead for monitoring and coverage intents ( Number of panpipes per IDUs, figure of IDUs sing each sitesaˆ¦ ) . Disposal of the acerate leafs is made after closing of sites for the twenty-four hours, by dropping them off at regional infirmaries, where they are burnt in the incinerators.
MOHQL: Mobile NEP through two operational trains. Two authorised wellness attention helpers and one qualified nurse per train ( identified by Ministry issed designation cards ) . Each train visit three sites daily, passing an norm of one hr and a half to two hours on each site. Work in coaction with equal leaders amongst IDUs who help ease smooth interacting between IDU crowds and the authorities staff.
The Needle Exchange Program in Mauritius and Other Policy Measures
Needle Exchange And Demand Reduction:
Demand decrease, focuses on detoxification and direction of backdown syndromes with the purpose of long term abstention. However, the consequences yielded are non the expected 1s as detoxification succeeds in taking people from the drug scene in the short term but the backsliding rates normally approach 100 per cent ( Fact Sheet Supply Demand And Harm Reduction, Burnet Institute Centre For Harm Reduction ) .
Needle Exchange And Methadone Substitution Therapy
Contrasting costs of supplying needle and costs of supplying dolophine hydrochloride
Return rate of panpipes ; and intervention follow-up statistics and backsliding rates for MST
Efficiency of both harm reducting plans in the sense that they would still be less even than proviso of antiretroviral intervention to an HIV positive individual ( proviso of non-generic anti-retroviral may come close $ 15000 )
The Needle Exchange Program and Its Framework In Mauritius
Adoption of the HIV/AIDS Act 2006
Needle exchange was carried out by NGOs even before the HIV/AIDS Act came into consequence. As such, they faced a legal hindrance in the sense that the pattern of needle exchange was inconsistent with the commissariats of bing Torahs which is the Dangerous Drugs Act at its subdivision 34 ( degree Celsius ) which made ownership of shooting equipment and drug paraphernalia a condemnable offense.
Following several commissions of assorted stakeholders including the MOHQL itself, constabulary officers, specially members of the ADSU and NGOs, it was agreed that there was a demand for a model to modulate the state of affairs of NEPs. HIV/AIDS Act 2006 was so adopted in 2006 with general consensus by members of parliaments ( remarks of few members from Hansard will be included here and lengthier plants will be attached ) and came into consequence in August 2007.
Purposes of HIV/AIDS Act 06 harmonizing to the act itself is “ to supply for steps for the bar and containment of HIV and AIDS ”
Analysis of this purpose – was a model truly required to supply for bar steps which are done chiefly through instruction, information and sensitisation, and containment which is already handled through supply-side decrease. This tends to take to the decision that the true motivation behind the HIV/AIDS Act was to supply a legal model for the NEP
A
Possession of Syringes and Needles and the HIV/AIDS Act 06
Article 2 of the International Convenant on Economic, Social and Cultural Rights besides requires legislative reform in order to make a legal and policy environment conducive to the graduated table up of these services and the remotion of barriers to entree and coverage to better handiness. Hence in line with this, Section 16 of the HIV/AIDS Act trades with the Possession of panpipes and acerate leafs in the context of NEP. It in fact through really expressed footings decriminalizes its ownership in the circumstance of the NEP.
This was important because:
ownership of a used acerate leaf and syringe may be used as circumstantial grounds to put other drug-related charges. For this ground some clients may be loath to return used equipment to NEP site.
fright of being arrested while in ownership of drugs and/or injection equipment can take IDUs to hotfoot injections, skip safer injection techniques ( e.g. , manus and tegument cleansing ) and to experience so dying that they can non shoot with truth. All of these effects can increase the hazard of injection-related jobs such as infections and tegument and soft-tissue harm
However – Section 34 ( degree Celsius ) has still non yet been repealed. Questionned by NGOs as to whether this is a best pattern.
Needle Exchange: Health and Safety Under the HIV/AIDS Act 06
Handling of used panpipes by forces involved under the NEP – conformity with Occupational Health and Safety Act – Applicable merely for Govt. Run NEPs
Section 10 Risk Assessment By Employment ( Will be showed in footer ) –
Is this carried out?
Section 35 Cleanliness – ( Will be showed in footer )
Analysis of whether the trains meet up with these demands
Section 37 Ventilation and Temperature ( Will be showed in footer )
Analysis of whether the trains meet up with these demands
Section 39 Sanitary Comfortss ( Will be showed in footer )
Analysis of whether the trains meet up with these demands
Section 40 Supply of imbibing H2O ( Will be showed in footer )
Analysis of whether the trains meet up with these demands
Section 41 Washing Facilities ( Will be showed in footer )
Analysis of whether the trains meet up with these demands
Section 45 Provision of First Aid Facilities
Analysis of whether the trains meet up with these demands
( All of the above would necessitate visits to the trains which have been planned but non yet carried out )
Offenses Under HIV/AIDS Act 2006 and the Needle Exchange Program
The lone offense which has been provided for under the HIV/AIDS act which relates to NEP is at subdivision 18 ( Provided for at footer ) which deals with non-authorised individuals and establishments transporting out needle exchange.
Aspect of confidentiality and NEP: Not cover with – Records of codification Numberss of clients, figure of clients per sites and all informations associating to NEP should be termed sensitive information and unauthorized storage, usage or distribution of such should be made an offense.
Issue Of Minors- Framework is mute on the issue of bush leagues as possible clients for NEP. Left to the discretion of forces involved in NEP – create an ethical v. moral struggle – should the hazard be run that the forces may allow their personal values affect their professional judgement? Explicit base should be taken by the model either doing it an offense to accept bush leagues as clients for NEP or non.
Obstacles To the Needle Exchange Program In the Mauritanian Society
Practical Hurdles and Logistic Hindrances to the Needle Exchange Program
One chief practical hurdle faced by NEP is struggles with jurisprudence enforcement officers chiefly those from the ADSU. Contrary to general belief there exists no legislative struggle, the HIV/AIDS Act through its subdivision 16 clearly decriminalises ownership of panpipes in the context of NEP as shown below- yet police surveillance and torment impedes the operation of NSPs operated both by non-governmental administrations and by the Government. Cases of constabulary apprehensions of outreach workers due to the ownership of panpipes have been reported although no formal proceedings launched. The ADSU make frequent unit of ammunitions on NEP sites, therefore detering people who inject drugs from go toing, every bit good as detering them from conveying their used acerate leafs to the NEP for safe disposal and to take clean unfertile panpipes every bit good.
IDUs become hostile to NEP forces, believing that they have been lured in a trap, and state of affairs can devolve rapidly ensuing in forces around NEP sites. Minor incidents merely have been reported and none have till now degenerated perilously, although if there is insisting on portion of ADSU officers to regularly demo up on NEP site, such an contingency is non to be discarded.
Section 16 Possession of panpipes and acerate leafs
A individual who is in ownership of a syringe or needle, in conformity with this Act, shall non, by ground merely of that ownership, be considered as holding committed an offense under the Dangerous Drugs Act.
There is a demand to accommodate jurisprudence enforcement officers with NEP patterns, which should and is being carried out through workshops and seminars every bit good as conferences clarifying the Torahs, and projecting off the confusion which hampers the smooth running of the NEP.
Sociological Issues and Needle Exchange Program
Society Remiss still remains one considerable societal concern. Despite modern times, where it is believed that people are more unfastened to fresh constructs and by and large more geared towards credence and non-discrimination, the construct of injury decrease specially needle exchange still remains really distorted for the huge bulk. Needle exchange equated with free distribution of acerate leafs to promote drug s injection.
IDUs remain a hard-to-reach and unstable population. They frequently show reluctance to put their trust in authorities tally plans.
NGOs face much troubles to seek to set up a “ web ” and have professional resonances with IDUs.
IDUs come normally live in unstable conditions and below the poorness lines. As such, bar of transmittal of diseases is non a precedence concern -inconsistent in the acerate leafs exchange and indulgence in acerate leafs sharing on and off.
This could be ruinous as needle sharing implies once more running the hazard of transmittal of HIV and other viral diseases which was well reduced through needle exchange.
The issue of “ white neckband ” IDUs. Not all injecting drug user is the hapless street vagabond, as the stereotypic description of an IDU by and large is projected. Many are professionals, respectable and high members of the society who are household individuals every bit good.
Since NEP is an outreach plan, it nevertheless is normally carried in vicinities where there is a known concentration of IDUs – hapless suburban countries, off the beaten way which are seldom frequented by the “ white neckband IDUs ” .
Therefore the job of NEP being even more unaccessible to them than to the stereotypic IDUs.
Needle Exchange In Prisons: A Controversial Issue
Needle Exchange In Prisons Around the World
In 1993 WHO issued guidelines on HIV infection and AIDS in prisons. They included the undermentioned paragraphs. “ All captives have the right to have wellness attention, including preventative steps, tantamount to that available in the community without favoritism, in peculiar with regard to their legal position or nationality. The general rules adopted by national AIDS programmes should use every bit to captives and to the community. “ ( beginning to be in footer )
In many states, needle exchange plans in the community have become an built-in portion of a matter-of-fact public wellness response to the hazard of HIV transmittal among people who inject drugs and, finally, to the general populace. Extensive surveies on the effectivity of these plans have been carried out, supplying scientific grounds that syringe exchange is an appropriate and of import preventative wellness step.
A 2002 Australian study concluded that needle exchange plans in that state had prevented 25,000 instances of HIV over a 10-year period and that the $ 150 million spent on the plans had resulted in a nest eggs of AUD $ 2.4 to 7.7 billion. ( survey to be elaborated upon in footer )
Because of the success of needle exchange plans in the community, calls to do unfertile acerate leafs available to captives have been made in many states. However, merely a smattering of states – Switzerland, Germany, Spain, Moldova, Kyrgyzstan, and Belarus – have established prison needle exchange plans.
In 1992 the first prison needle exchange plan in the universe was started in the Oberschongrun prison for work forces, located in the Swiss Guangzhou of Solothurn. The plan was initiated by Dr Franz Probst, a parttime doctor in the establishment. When the prison warden learned of the syringe distribution plan, instead than halt it, he was alternatively convinced by Dr Probst ‘s statements about the necessity of the plan as a public wellness intercession. As a consequence, the warden sought functionary blessing from prison governments to go on the plan. ( beginning to be cited )
The Mauritanian Prison: An Overview
Overpopulation ( statistics to be obtained and inserted and analysed here )
Guards to captives ratio
Etat des lieux – a physical description
The high prevalence of HIV infection and drug dependance among captives and detainees, combined with the sharing of shooting equipment, make prison a high hazard environment for the transmittal of HIV and other blood-borne viruses
Harmonizing to the Drug Control Master Plan, 70 % of all captives are functioning sentences due to a drug related offense
Execution Of Needle Exchange In Mauritanian Prisons: Feasibility and Associated Risks
Under international jurisprudence – [ United Nations General Assembly, Basic Principles for the Treatment of Prisoners, UNGA Resolution 45/111 ( 14
December 1990 ) , Article 5, ] individuals in detainment retain all rights except in so far as these are needfully limited by the fact of captivity. This includes the right to the highest come-at-able criterion of wellness. Consequently, it is recognised that people in prisons have a right to entree to equivalent wellness services and attention as individuals outside prisons, and that denial of such services is non a necessary or justified facet of captivity.
The Universal Declaration has the position of customary international jurisprudence as such is adhering on all provinces. Furthermore, provinces that have ratified or acceded to any one of the compacts, declarations, or charters as follows
International Covenant on Civil and Political Rights
International Covenant on Economic, Social and Cultural Rights
African Charter on Human and Peoples ‘ Rights
American Convention on Human Rights
hold recognized that they are lawfully bound to esteem, protect, and carry through the undermentioned human rights, among others:
aˆ? right to equality and non-discrimination
aˆ? right to life
aˆ? right to security of the individual
aˆ? right non to be subjected to torment or to cruel, inhuman, or
degrading intervention or penalty
aˆ? right to enjoyment of the highest come-at-able criterion of physical
and mental wellness
Sharing acerate leafs among endovenous drug users is a bad activity for the transmittal of HIV, due to the presence of blood in acerate leafs after injection. For people who inject drugs, imprisonment increases the hazard of undertaking HIV infection via needle sharing. Because it is more hard to smuggle acerate leafs into prisons than it is to smuggle in drugs, acerate leafs are typically scarce. As a consequence, captives who inject drugs portion and reuse syringes out of necessity. A needle may go around among ( frequently big ) Numberss of people who inject drugs, or be hidden in a normally accessible location where captives can utilize it as necessary. A needle may be owned by one captive and rented to others for a fee, or it may be used entirely by one captive, reused once more and once more over a period of months until it disintegrates. Sometimes the equipment used to shoot drugs is homemade, with needle replacements fashioned out of available mundane stuffs, frequently ensuing in vena harm, scarring, and injection-site and other infections.
The bar of HIV transmittal in prisons is largely hampered by the denial of authoritiess of the being of shooting drug usage and sexual intercourse in prisons, instead than by a deficiency of grounds that cardinal intercessions work. There is ample grounds that drug usage in general, shooting drug usage in peculiar and sexual intercourse between inmates are widespread in such establishments. Furthermore, there are informations bespeaking that the hazard of HIV infection in prisons is normally higher than in the general community: prisons are a bad environment for HIV infection. Once this has been accepted, authoritiess have a broad scope of programme options for forestalling HIV transmittal in prisons.
Hazards associated – ill will of captives who may utilize panpipes as arms ( the menace of HIV transmittal ) ; blackjacking officers and guards and fellow inmates
Ratio of guards to captives to low: Difficult to supervise and command distribution
Society Reaction – likely to be a extremely opposed undertaking
Lack of political will, and inordinate bureaucratism involved to set about such a undertaking
Recommendations
Needle Exchange as a Legal Duty
Needle exchange signifiers portion of steps which can be taken to forestall transmittal of HIV/AIDS. While for some states like Kenya, these bar of transmittal steps have been set as a legal duty in the concerned statute law associating to HIV/AIDS ( footer or annex the said statute law ) in most other states, the transmittal of HIV has been criminalised, either by reading of bing Torahs or through passage of new Torahs. Outlawing transmittal of HIV/AIDS entails bar steps as a legal duty since non set abouting such steps would connote a hazard by the a individual populating with HIV/AIDS of transmittal either through sexual contact or sharing of panpipes amongst IDUs or even mother to child transmittal.
One possible manner of traveling frontward with the needle exchange plan in Mauritius would be to hold needle exchange as a legal duty in Mauritius.
Dissentious issue ; which would trip argument as needle exchange as a legal duty would connote criminalization of HIV transmittal in Mauritius.
Human rights position –
Right of the person
Needle Exchange and Pharmacies as Authorized Institutions
