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OST-HIV Nepal

Background:

 

Like many other developing countries, illicit drug use is very common in Nepal. There is an ample supply of synthetic and psychotropic drugs from the southern broader to be abused. Use of opioids is growing in this country.

In Nepal more than 60,000 people are using illicit drug (CBS 2061).  Big sections out of this number are injecting drug users. The drug injecting behavior has different hazards. It has impacted on Social, economic, health and legal problems of the drug user, family members as well as society. Similarly, injecting drug users are at high risk of HIV infection. In addition to which the drug rehabilitations centers in Nepal reported HIV and other blood borne disease among the drug users frequently. These factful situations led to starting of the methadone maintenance program by Patan Mental Hospital in 1994 in Kathmandu, Nepal and continued till 2002. This program registered a total of 400 patients and provided services to about 180-200 patients per day. The evaluation of the program conducted after five years of implementation indicated that it was well accepted by patients and their families. However, due to lack of social support unit, other technical and psychosocial aspects the program was stopped in 2002. The MMT program was discontinued till May 2007, thereby endangering the lives of IDUs who were clients of the private practitioners. However, a high level of commitment by civil society and the government to roll out MMT in the country enabled a prompt reaction. UNODC (with support from different donors including GIZ) stepped in to conduct a needs assessment of the situation and developed a response in consultation with the Government, UN agencies, international donors and civil society for an emergency intervention to provide MMTP in Tribhuvan University Teaching Hospital [TUTH].

After the successful implementation in Kathmandu the MMTP was replicated to Patan and Pokhara to provide MMT services for drug user in the respective districts.  

 

A glimps of Clients Receiving Methadone in MMTPs (2011 July)

MMTP Sites

TUTH, Maharajgung

Western Regional Hospital, Pokhara

Mental Hospital, Lagankhel

 Particular

Total

Male

Female

Total

Male

Female

Total

Male

Female

Total Enrolled

570

557

25

228

219

9

148

141

7

Active Methadone users

173

160

13

108

104

4

128

126

2

Drop Out

20

19

1

1180

10

-

28

23

5

Methadone Users with HIV Infection

14

11

3

13

13

-

18

18

-

Methadone and ARV Users

9

9

-

6

6

-

8

8

-

Methadone Users having Hepatitis

17

15

2

11

10

1

20

20

-

 

Future Programme:

Further, considering the successful implementation of MMT in Kathmandu, Pokhara and Patan the government of Nepal has decided to extend the programme additional districts. For this, the NCASC has already secured funding, through the Global Fund. Using the Global Fund resources the NCASC will launch the MMTP in four more districts where the prevalence of injecting drug users is higher.  


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