An taksa chhe zel tur a OST hman tel IDU te HIV laka ven ... - Unaids
An taksa chhe zel tur a OST hman tel IDU te HIV laka ven ... - Unaids
An taksa chhe zel tur a OST hman tel IDU te HIV laka ven ... - Unaids
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<strong>IDU</strong> <strong>IDU</strong> <strong>te</strong> <strong>te</strong> <strong>HIV</strong> <strong>HIV</strong> <strong>laka</strong> <strong>laka</strong> <strong>ven</strong> <strong>ven</strong> dan, dan, a a vei vei tawh tawh <strong>te</strong> <strong>te</strong> buaipui buaipui leh leh enkawl<br />
enkawl<br />
dan: dan: <strong>An</strong> <strong>An</strong> <strong>taksa</strong> <strong>taksa</strong> <strong>chhe</strong> <strong>chhe</strong> <strong>zel</strong> <strong>zel</strong> <strong>tur</strong> <strong>tur</strong> a a <strong>OST</strong> <strong>OST</strong> <strong>hman</strong> <strong>hman</strong> <strong><strong>te</strong>l</strong><br />
<strong><strong>te</strong>l</strong><br />
<strong>An</strong>net<strong>te</strong> Vers<strong>te</strong>r<br />
Department of <strong>HIV</strong>/AIDS<br />
Delhi, December 2006
► A tobul<br />
► UN leh WHO <strong>te</strong> hmalakna <strong>te</strong><br />
A riruang<br />
► Taksa leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna <strong>tur</strong> a <strong>hman</strong>rua <strong>te</strong><br />
► Opioid Substitution Therapy hmasawnna kawng a harsatna <strong>te</strong><br />
► A suihkhawmna<br />
Delhi, December 2006
<strong>IDU</strong> leh <strong>HIV</strong><br />
►<strong>HIV</strong> <strong>HIV</strong> kai thar 10% <strong>zel</strong> hi inchiun atanga kai a ni<br />
►<strong>HIV</strong> <strong>HIV</strong> kai thar 30% 0% <strong>zel</strong> hi sub-Saharan sub Saharan Africa pawn<br />
lama mi an ni<br />
►<strong>IDU</strong> <strong>IDU</strong> <strong>te</strong> zinga maktaduai 3 <strong>te</strong> hi <strong>HIV</strong> pai an ni<br />
►<strong>IDU</strong> <strong>IDU</strong> <strong>te</strong> zinga maktaduai 10 <strong>te</strong> hi <strong>HIV</strong> kai mai thei reng<br />
dinhmun ah an ding a<br />
►<strong>IDU</strong> <strong>IDU</strong> <strong>te</strong> kawppui <strong>te</strong><br />
►Hmei<strong>chhe</strong> Hmei<strong>chhe</strong> <strong>IDU</strong> in a fa a hrin <strong>te</strong><br />
Delhi, December 2006
UN Hmalakna <strong>te</strong><br />
► UNGASS chuan Drug Hman Tihtlemna thuchhuah a siam a<br />
(1998)<br />
► UN chuan Ruihhlo ngai<strong>te</strong> zinga <strong>HIV</strong> kaidarhna <strong>ven</strong>na <strong>tur</strong><br />
position paper a chhuah a (2000)<br />
► UNGASS chuan <strong>HIV</strong>/AIDS beihna thlawpna thuchhuah a<br />
siam a (2001)<br />
► UN General Assembly (2005, 2006)<br />
�� “Kum Kum 2010 ah chuan, <strong>HIV</strong> <strong>laka</strong> in<strong>ven</strong>na, inenkawlna leh<br />
chhawmdawlna <strong>te</strong> khawvel mipui tam zawk in an neih<br />
phak ngei theihna <strong>tur</strong>a, theihpatawpa hmala <strong>tur</strong> a<br />
intiamna"<br />
Delhi, December 2006
Kum 2010 a khawvel mipui tam zawk in a <strong>HIV</strong> <strong>laka</strong><br />
in<strong>ven</strong>na, Inenkawlna leh chhawmdawlna an neih na<br />
<strong>tur</strong> a rua<strong>hman</strong>na (WHO)<br />
►<strong>HIV</strong> <strong>HIV</strong> <strong>laka</strong> in<strong>ven</strong>na a Health sector <strong>te</strong> chanpual tih<br />
tam<br />
�� <strong>IDU</strong> <strong>te</strong> zinga <strong>HIV</strong> darhzau <strong>zel</strong> <strong>tur</strong> <strong>ven</strong>na <strong>tur</strong> a, an<br />
<strong>taksa</strong> <strong>chhe</strong> zual <strong>zel</strong> tu <strong>ven</strong> nana, <strong>HIV</strong> <strong>laka</strong> in<strong>ven</strong>na,<br />
enkawlna leh chhawmdawlna <strong>tur</strong> ram hrang hrangin<br />
rua<strong>hman</strong>na an siam <strong>te</strong> tihpuitling <strong>tur</strong>a tanpui leh<br />
ruihhlo ngai <strong>HIV</strong> pai <strong>te</strong>n enkawlna leh<br />
chhawmdawlna an neih ngei thiehna <strong>tur</strong> a<br />
rua<strong>hman</strong>na siam<br />
Delhi, December 2006
A thatlohna tihtlemna hi<br />
►Drug Drug in <strong>taksa</strong> tihchhiat <strong>zel</strong> <strong>tur</strong> <strong>ven</strong>na <strong>tur</strong> a thil thlak<br />
danglam <strong>te</strong> hi an ni a<br />
► mipui hriselna leh mihring dikna chanvo ngaihtuah<br />
chunga rua<strong>hman</strong>na<br />
►<strong>HIV</strong> <strong>HIV</strong> chungchang bik, mipui vantlang hriselna a a<br />
hlauhawm leh hlauhawm loh <strong>te</strong>hna bik atana<br />
rua<strong>hman</strong>na<br />
Delhi, December 2006
Ngun taka chhut a, ngaihtuah anih hnu ah<br />
► He <strong>taksa</strong> leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna <strong>tur</strong> a rua<strong>hman</strong>na hian<br />
<strong>IDU</strong> <strong>te</strong> zingah nundan hlauhawm a nung <strong>te</strong> tan a hlauhawmna<br />
a ti nep sawt tih hmuh a ni<br />
► <strong>IDU</strong> <strong>te</strong> zinga <strong>HIV</strong> a darh chak lutuk hi a <strong>ven</strong>, <strong>ven</strong>,<br />
thanmuan tir<br />
emaw a tihtlem theih ani tih hmuhchhuah a ni<br />
► http://www.who.int/hiv/pub/idu/idupolicybriefs/en/index.html<br />
Delhi, December 2006
Taksa leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna <strong>tur</strong> a<br />
rua<strong>hman</strong>na<br />
► Needle leh syringe programmes (NSP)<br />
► Opioid Substitution Therapy (<strong>OST</strong>) ruihtheihthil dang ngai<strong>te</strong><br />
enkawlna<br />
► Fehchhuah programmes<br />
► <strong>HIV</strong> <strong>te</strong>st leh counselling<br />
► STI <strong>laka</strong> in<strong>ven</strong>na leh enkawlna, enkawlna,<br />
condom hmuh awlsam zawkna<br />
► Hepatitis B <strong>laka</strong> in<strong>ven</strong>na leh viral hepatitis enkawlna<br />
► <strong>HIV</strong> enkawlna leh chhawmdawlna, chhawmdawlna,<br />
ART <strong><strong>te</strong>l</strong>in<br />
Delhi, December 2006
<strong>OST</strong> chungchangah WHO dinhmun<br />
► <strong>OST</strong> hi WHO in <strong>HIV</strong>/AIDS <strong>laka</strong> in<strong>ven</strong>na, in<strong>ven</strong>na,<br />
enkawlna leh chhawmdawlna<br />
zinga pawimawh tak a angaih a ni. ni<br />
► Hmalak tawh <strong>te</strong>: <strong>te</strong>:<br />
Injecting drug users (<strong>IDU</strong>) <strong>te</strong> zingah, zingah,<br />
<strong>HIV</strong> <strong>ven</strong>na leh<br />
enkawlna atana drug dependence treatment thatzia hmuh a ni tawh a<br />
► WHO/UNODC/UNAIDS position paper: paper:<br />
<strong>HIV</strong>/AIDS in<strong>ven</strong>na leh opioid<br />
dependence enkawlna atana substitution main<strong>te</strong>nance therapy <strong>hman</strong><br />
(2004)<br />
► Ruihhlo ngai<strong>te</strong> tana <strong>HIV</strong> <strong>laka</strong> in<strong>ven</strong>na leh chhawmdawlna rua<strong>hman</strong>na, rua<strong>hman</strong>na,<br />
chungchang a UNAIDS Commit<strong>te</strong>e of Cosponsoring Organisations Joint<br />
UNAIDS thuchhuah (2005) 2005)<br />
► <strong>HIV</strong> <strong>laka</strong>h in<strong>ven</strong>na tih changtlunna: changtlunna:<br />
UNAIDS Policy Position Paper<br />
(2005)<br />
► 2005 ah, Methadone leh buprenorphine <strong>te</strong> chu WHO Model List of<br />
Essential Medicines ah <strong><strong>te</strong>l</strong>h an ni<br />
Delhi, December 2006
WHO/UNODC/UNAIDS Position Paper,<br />
Policy Brief leh E4A Technical Paper<br />
Delhi, December 2006
Opioid Substitution Therapy (<strong>OST</strong>) hi<br />
► Uluk taka chawh a nih a, zawm that a nih chuan opioid<br />
dependence enkawlna atan chuan a tha ber a ni<br />
�� A <strong>te</strong>rm a rei zawk a- a tlem berah kum 2<br />
�� A eidan tawk chu methadone 60-120 60 120 mg leh buprenorphine 8-24mg 24mg<br />
a ni<br />
► Ruihhlo nghei tir thut ai hian, hian,<br />
ruihhlo ngai <strong>te</strong>n anmahni enkawl<br />
nan an thlang zawk a<br />
► WHO Model List of Essential Medicines ah a <strong><strong>te</strong>l</strong> bawk a ni<br />
Delhi, December 2006
Opioid Substitution Therapy thatna <strong>te</strong><br />
► <strong>HIV</strong> <strong>laka</strong> in<strong>ven</strong> nan<br />
�� <strong>HIV</strong> darh nasa <strong>tur</strong> a tihniam<br />
�� Ruihhlo a inchiuna leh himlo taka inchiuna a tihniam<br />
�� Mipat-hmeichhiatna<br />
Mipat hmeichhiatna himlo taka <strong>hman</strong>na <strong>te</strong> a tihniam<br />
► <strong>HIV</strong>/AIDS enkawl nan<br />
�� Ruihhlo ngai <strong>te</strong> zinga <strong>HIV</strong> pai <strong>te</strong> hriselna a titha<br />
�� Damdawi a enkawlna an zawmthat phah a,OI and ART <strong>te</strong> <strong><strong>te</strong>l</strong>in<br />
�� Directly Observed Therapy (DOT) tan kawng a sial. sial<br />
► A tangkaina dang <strong>te</strong><br />
�� Drug diklo taka <strong>hman</strong>na a titlem<br />
�� Overdose zat a tihniam<br />
�� Dan bawhchhiatna a titlem<br />
�� Taksa leh rilru a titha<br />
�� Sum leh pai dinhmun a chawisang<br />
Delhi, December 2006
<strong>OST</strong> hi khawvel pumah ram 58 ah <strong>hman</strong> a ni<br />
► Methadone main<strong>te</strong>nance treatment (MMT) hi ram 48 ah <strong>hman</strong> ani (pilot<br />
programme chhiar <strong><strong>te</strong>l</strong>in): <strong><strong>te</strong>l</strong>in):<br />
<strong>An</strong>dorra, Australia, Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Bulgaria,<br />
Canada,<br />
China, Croatia, Czech Republic, Denmark, Estonia, Finland, France, France,<br />
Germany,<br />
Greece, Hungary, Indonesia, Iran, Ireland, Israel, Italy, Kyrgyzstan, Kyrgyzstan,<br />
Latvia,<br />
Liech<strong>te</strong>ns<strong>te</strong>in, Lithuania, Luxembourg, Macedonia, Malaysia, Malta, Malta,<br />
Mexico, the<br />
Netherlands, New Zealand, Norway, Poland, Portugal, Romania, San Marino, Serbia<br />
and Mon<strong>te</strong>negro, Slovak Republic, Slo<strong>ven</strong>ia, Spain, Sweden, Switzerland, Switzerland,<br />
Thailand,<br />
Uni<strong>te</strong>d Kingdom (hmun ( hmun danga a ram <strong>te</strong> nen), nen),<br />
Uni<strong>te</strong>d Sta<strong>te</strong>s of America.<br />
► Buprenorphine main<strong>te</strong>nance treatment (BMT) leh detoxification (pilot<br />
programme <strong><strong>te</strong>l</strong>in) <strong><strong>te</strong>l</strong>in)<br />
ram 33 ah <strong>hman</strong> a ni: ni:<br />
Australia, Austria, Belgium, China (Hong Kong), Czech Republic, Denmark, Estonia,<br />
Finland, France, Germany, Greece, Iceland, India, Indonesia, Iran, Iran,<br />
Israel, Italy,<br />
Lithuania, Luxembourg, Malaysia, Netherlands, Norway, Portugal, Singapore, Slovak<br />
Republic, Slo<strong>ven</strong>ia, South Africa, Sweden, Switzerland, Ukraine, Uni<strong>te</strong>d Kingdom,<br />
Uni<strong>te</strong>d Sta<strong>te</strong>s of America, Uzbekistan<br />
Delhi, December 2006
2005 thlenga, thlenga,<br />
ram 58 <strong>te</strong> zing a data kan neihna ram 48, MMT.BMT phalna <strong>te</strong><br />
Region/Country<br />
E Europe & CAR (15)<br />
W Europe (21)<br />
Low/mid-income Low/mid income countries<br />
Global<br />
<strong>OST</strong> <strong>hman</strong> tlemna <strong>te</strong><br />
<strong>IDU</strong>s<br />
Est. ‘000s 000s (range)<br />
830 (555-1,045) (555 1,045)<br />
1,507 (1,351-1,667)<br />
(1,351 1,667)<br />
10,300<br />
13,200<br />
Delhi, December 2006<br />
Number in <strong>OST</strong><br />
(<strong>IDU</strong> <strong>IDU</strong> + non-<strong>IDU</strong>) non <strong>IDU</strong>)<br />
7,700-9,900 7,700 9,900<br />
519,000-540,000<br />
519,000 540,000<br />
48,000<br />
874,000 (859,000- (859,000<br />
889,000)<br />
Source: Aceijas, C, Gerlach, R, Wolfe, D Availability and scale of substitution treatment worldwide at the end of 2005: a review. Submit<strong>te</strong>d<br />
<strong>OST</strong><br />
coverage<br />
0.9-1.2% 0.9 1.2%<br />
34.4-35.8% 34.4 35.8%<br />
0.46%<br />
6.6%<br />
(10.5% for 48<br />
countries)
100<br />
90<br />
80<br />
70<br />
60<br />
50<br />
40<br />
30<br />
20<br />
10<br />
0<br />
Belarus<br />
Russia<br />
Substitution treatment coverage (% <strong>IDU</strong>s trea<strong>te</strong>d)<br />
<strong>IDU</strong> as % of <strong>HIV</strong> cases<br />
Estonia<br />
Latvia<br />
Ukraine<br />
Lithuania<br />
Poland<br />
Delhi, December 2006<br />
Finland<br />
Sweden<br />
Norway<br />
Uni<strong>te</strong>d Kingdom<br />
Germany<br />
Ireland
► <strong>OST</strong><br />
Thil hriatsual thin <strong>te</strong><br />
�� <strong>OST</strong> hian UN con<strong>ven</strong>tion a bawh<strong>chhe</strong> lo<br />
�� UN Sys<strong>te</strong>m ( WHO, UNODC leh UNAIDS <strong>te</strong> chhiat <strong><strong>te</strong>l</strong>in) <strong><strong>te</strong>l</strong>in)<br />
hian a thlawp a ni<br />
�� Mi <strong>te</strong> damdawi dang bawihah a uai bet lo<br />
�� Damdawi <strong><strong>te</strong>l</strong>lo a enkawlna <strong>te</strong> larna a dal lo<br />
Delhi, December 2006
<strong>OST</strong> in harsatna a tawh <strong>te</strong><br />
►Ram Ram hruaitu<strong>te</strong> leh vantlang thlawpna hmuh a har<br />
►Dan Dan lamah buaina a tawk fo bawk<br />
►Ruihhlo Ruihhlo ngai <strong>te</strong> enhranna leh thlei hranna<br />
�� <strong>OST</strong> mamawh tak tak <strong>te</strong> thliar hran<br />
�� Mipui <strong>te</strong> zinga a mamawh tak tak <strong>te</strong> leh thlei hranna tawk<br />
<strong>te</strong> – thingtlang mi<strong>te</strong>, lungin tang<strong>te</strong>, tang<strong>te</strong>,<br />
hnam tlem zawk <strong>te</strong> hnen<br />
thlen phak<br />
►Bultanna Bultanna <strong>te</strong> tak <strong>te</strong> <strong>te</strong> atanga thanlen<br />
Delhi, December 2006
Substitu<strong>te</strong> medications <strong>te</strong> Lakpenna<br />
► Inchiu a buaithlak fo<br />
► Hna a thawh leh thawhloh pawh the thlap lem lova, lova,<br />
<strong>hman</strong> phot <strong>tur</strong><br />
► Hmalak belh thiehna <strong>te</strong><br />
�� A enkawlna dang <strong>hman</strong> <strong><strong>te</strong>l</strong>, <strong><strong>te</strong>l</strong>,<br />
a bikin methadone emaw<br />
buprenorphine ruala naloxone <strong>hman</strong> <strong><strong>te</strong>l</strong>in emaw<br />
�� Enkawl lai mek <strong>te</strong> vil uluk lehzualin<br />
�� Damdawi sem dan enpui<br />
�� Dandawi ei chhung reilo zawk rua<strong>hman</strong><br />
�� Enkawltu doctor <strong>te</strong> inzir zau<br />
�� A <strong>hman</strong>gtu<strong>te</strong> hrilhhriat<br />
Delhi, December 2006
<strong>OST</strong> leh UA <strong>te</strong> tana hlenchhuah <strong>tur</strong> <strong>te</strong><br />
► <strong>OST</strong> hi opioid dependence atana, atana,<br />
zawi zawi an nghei theihna<br />
<strong>tur</strong> a, an mamawh tawk ang <strong>zel</strong> pe chunga enkawlna, enkawlna,<br />
ti a<br />
hrilhfiah a ni<br />
► <strong>OST</strong> a <strong>IDU</strong> <strong>te</strong> percentage<br />
40% tha lutuk<br />
Delhi, December 2006
<strong>IDU</strong> <strong>te</strong> tan ART<br />
►Ruihhlo Ruihhlo a inchiu thin(Injecting Drug User) <strong>te</strong> hi<br />
�� <strong>HIV</strong>/AIDS enkawlna ah hian lak<strong><strong>te</strong>l</strong> a ni lo fo thin<br />
�� ART dawng khat ber <strong>te</strong> an ni<br />
�� ART a intan tlai thin<br />
►Clinicians Clinicians <strong>te</strong>n a ART chawh an hreh chhan<br />
�� Chawh anih a, zawm that anih leh si loh hian, hian,<br />
<strong>taksa</strong> in a do<br />
ve tlat thei thin.<br />
Delhi, December 2006
<strong>HIV</strong> enkawlna leh chhawmdawlna <strong>IDU</strong> <strong>te</strong> tan<br />
► <strong>IDU</strong> <strong>te</strong> tana <strong>HIV</strong> enkawlna hi a hlawhtling<br />
► ART resistance levels hi <strong>IDU</strong> <strong>te</strong> leh <strong>IDU</strong> nilo <strong>te</strong> zingah a inang<br />
reng a.<br />
► <strong>IDU</strong> <strong>te</strong> hian <strong>IDU</strong> nilo <strong>te</strong> ang bawk in ART hi tha takin an zawm<br />
thei a<br />
► <strong>OST</strong> hian ART zawm that leh chelhzuina kawngah a pui a ni<br />
Delhi, December 2006
A Suihkhawmna<br />
► Taksa leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna <strong>tur</strong> (harm reduction) a, ram<br />
hruaitu<strong>te</strong> nena thawh ho<br />
► Taksa leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna atana <strong>hman</strong> <strong>te</strong> tih<br />
ngelnghen, ngelnghen,<br />
a bik takin NSP leh <strong>OST</strong> ah<br />
► Methadone leh buprenorphine <strong>te</strong> WHO Model List of Essential<br />
Medicines a <strong><strong>te</strong>l</strong>tir<br />
► Taksa leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> danna <strong>tur</strong> a sum thawh tipun leh<br />
<strong>OST</strong> tanpuinana Global Fund atangin sum hnar thar tha tak<br />
Delhi, December 2006
Tih<strong>tur</strong> <strong>hman</strong>hmawhthlak <strong>te</strong><br />
►<strong>OST</strong> <strong>OST</strong> a mamawh a piang <strong>te</strong>n an hmuh theihnan a<br />
tihchangtlun<br />
►<strong>OST</strong> <strong>OST</strong> pek leh tihchangtlun na <strong>tur</strong> rua<strong>hman</strong>na thar leh<br />
<strong>HIV</strong> <strong>laka</strong> indanna, indanna,<br />
enkawlna leh chhawmdawlna :<br />
�� <strong>HIV</strong> <strong>te</strong>st leh counseling, <strong>taksa</strong> leh rilru <strong>chhe</strong> <strong>zel</strong> <strong>tur</strong> dan, dan,<br />
condom,STI enkawlna, enkawlna,<br />
ART, opportunistic leh co-<br />
infections (TB, hepatitis B leh C <strong>te</strong> <strong><strong>te</strong>l</strong>in) <strong><strong>te</strong>l</strong>in)<br />
<strong>te</strong> enkawlna ,<br />
PMTCT …<br />
Delhi, December 2006
►Lawmthu Lawmthu sawina<br />
�� <strong>An</strong>drew Ball<br />
�� Martin Donoghoe<br />
Lawmthu<br />
►Hriatbelh Hriatbelh duh I neih chuan:<br />
http://www.who.int/hiv/pub/idu/idupolicybriefs/en/index.html<br />
►vers<strong>te</strong>ran@who.int<br />
vers<strong>te</strong>ran@who.int<br />
Delhi, December 2006
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