Evidence base to promote drug policy reform in Mauritius Steeve BATOUR Board Member, PILS Co-founding member, CUT ARASA Panel Discussion April 2014 Johannesburg

Some details about Mauritius Population : 1,2 M inhabitants Surface area about 2000km HIV Prevalence 1.02% 2

A little bit of history 1996 : Civil society starts raising the alarm about HIV among PWIDs Early 2000’s: Exponential growth of HIV Infection within PWID

HIV Incidence in PWIDs in Mauritius New HIV Cases PWIDs

A little bit of history (contd) 2004: Platform created by Civil society to advocate for Harm Reduction Strategies in Mauritius. This platform will later be CUT (Collectif Urgence Toxida) 2006 : Launching of illegal Needle Exchange Program by CUT 2006 : Launching of Methadone Substitution Therapy by the Ministry of Health & Quality of Life (MOHQL) 2007 : Legal Framework for NEP through the HIV/Aids Act 2007 : Creation of National NEP Committee by MOHQL where CUT is invited to sit : CUT launches premises and follow-up on NEP and advocacy on Harm Reduction 2010 : GFTAM allows upscaling of Harm Reduction Services 2011 : Methadone in Prisons

Some data … IBBS No of People Who Inject Drug10,000 HIV Prevalence among PWIDs4952 HCV (Hepatitis C Virus) Prevalence among PWIDs9796 HIV Prevalence among female PWIDs7085 HIV Prevalence Rate among other MARPS MSM20% FSW29% Some facts about drugs in Mauritius : Mauritius has highest rate of Opiate Consumption per capita in Africa Drugs mostly injected in Mauritius : Opiates (Mostly Brown Sugar & limited black market Subutex®) Presence of Heroin first documented in Mauritius in early 80’s

Needle Exchange Program Existing Harm Reduction Services today HR Community services Methadone Substitution Therapy Mobile Caravan for MARPS

Positive Points of Harm Reduction Services High Coverage of services: PWIDs reached through NEP people on MST No waiting list for MST MST available in prison NEP & MST has bridged gap between existing services and MARPS Quality of life of service users increased (APMG evaluation report 2010) Decrease in Drug seeking behaviour (APMG 2010) Improvement of family environment Quality of life of service users improved through more stable way of life

Progression of PWIDs from NEP to MST Positive Points of Harm Reduction Services

Decrease in crime rates for drug related offences

Positive Points of Harm Reduction Services Decrease in HIV rates HIV Incidence Rate in Mauritius (2000-Oct 2013) showing PWID incidence rate

Challenges in Harm Reduction Services MST : No take home doses, distribution points overflowed S&D : Some community members do not like MST users to hang around their vicinity S&D : Difficult for users to get a job (police records) Psycho social support do not efficiently address needs of users NEP do not offer wide variety of materials, (cookers, filters, etc not available), thus not addressing HCV transmission efficiently Police harassment discourage NEP users from bringing back their used syringes/needles Drug policies highly criminalising PWUDs Discrepancies in laws (Dangerous Drugs Act v/s HIV/Aids Act) Lack of comprehensive Harm Reduction services (ref MdM HR model)

Effective Model of Harm Reduction Package

Thank you for your attention !