2. Drug Abuse in the Middle East R. Srinivasa Murthy Eastern Mediterranean Regional Office of World Health Organisation, Cairo, Egypt. R. Srinivasa Murthy Eastern Mediterranean Regional Office of World Health Organisation, Cairo, Egypt.

3. Illicit Drug Index-2005

4. DRUG ABUSE IS PUBLIC HEALTH PRIORITY

5. Scope of the Presentation:Scope of the Presentation: –Introduction to countries of Middle East –Drug abuse- production and supply –Drug abuse- Magnitude of the problem –Drug abuse- Health impact –Drug abuse- interventions –Drug abuse- Challenges

6. Countries of the Middle East Region ofRegion of –Contrasts, –Conflicts and –Challenges.

7. GNP in USD$ 1700 USD – 4000 USD 4000 USD – 9000 USD 1000 USD – 1700USD < 1000 USD(lowest $169) > 9000 USD( highest $28270)

8. Life Expectancy < 50 Years 50 – 65 Years > 65 Years

9. Adult Literacy Rate > 81% 65% - 80% < 64%

10. Less than 15 years < 40% > 40%

11. EMRO-Countries in Complex Emergencies and Post-Conflict situations

12. Doctors /10 000 population 10 - 20 2 - 10 > 20 < 2

13. Psychiatrists/100,000 0.4 1.6 0.15 1.0 0.10.2 1.3 3.4 2.0 0.1 0.04 1.00.5 1.0 2.0 0.8 0.1

14. Drug Abuse-Drug Abuse- Production and SupplyProduction and Supply

16. Evolution of Afghan opium poppy cultivation since 2000 2000 82,000 ha 2001 8,000 ha 2002 74,000 ha 2003 80,000 ha (+ 8%)

17. Tentative estimate of cannabis resin production and main source countries 7,400 metric tons

18. Magnitude of the ProblemMagnitude of the Problem

19. Source: World Health Organization, Eastern Mediterranean Regional Office, 2002 OMA BAH SUD IRA UAE MOR KUW PAK SAA IRQ OPT EGY JOR LEB SYR YEM TUN DJI 01020304050607080 % Risk Factors: Smoking prevalence among men in EMRO

20. Drug Abuse Pattern in the Region Opioids- Afghanistan, Bahrain, Iran, Pakistan, OmanOpioids- Afghanistan, Bahrain, Iran, Pakistan, Oman Khat- Djibouti, Somalia, YemenKhat- Djibouti, Somalia, Yemen Stimulants-Stimulants-

21. Regional Situation Age of starting drugs is decreasingAge of starting drugs is decreasing Injectable drugs is increasingInjectable drugs is increasing Women are using drugs more oftenWomen are using drugs more often Contribution to spread of HIV/AIDSContribution to spread of HIV/AIDS Majority of the drug abusers are not seeking treatmentMajority of the drug abusers are not seeking treatment

22. DRUG ABUSE IS PUBLIC HEALTH PRIORITY

23. Health ImpactHealth Impact

25. The Facts… in the EMR… cont’d

26. The Facts… in the EMR

27. Al Razi addiction treatment unit - % of admissions HIV positive

28. Regional InitiativesRegional Initiatives

29. Regional Initiatives High Recognition of the problem:High Recognition of the problem: –June 2005,Cairo,Egypt –High Level Arab Conference for Protecting the Youth from Substance Abuse –2 nd Inter agency Working Group on Young People and HIV/AIDS in MENA. –Youth in the Middle East

32. Innovative Regional Initiatives Specialised treatment facilities- Libya, Kuwait, Saudi ArabiaSpecialised treatment facilities- Libya, Kuwait, Saudi Arabia Prevention through Life skills education Eg. Egypt, Iran, OmanPrevention through Life skills education Eg. Egypt, Iran, Oman Harm reduction strategies- needle exchange, methadone treatment Eg. IranHarm reduction strategies- needle exchange, methadone treatment Eg. Iran Triangular clinicsTriangular clinics Public Mental Health EducationPublic Mental Health Education Involvement of Religious leadersInvolvement of Religious leaders

35. Regional Strategy for Substance Use and Dependence 1. Development of National policy- multi-sectoral with networking;1. Development of National policy- multi-sectoral with networking; 2.Increasing understanding of causes, consequences and care;2.Increasing understanding of causes, consequences and care; 3. Human Resource Development;3. Human Resource Development; 4.Wide range of services in Community;4.Wide range of services in Community; 5.Promotion of psychosocial wellbeing and prevention5.Promotion of psychosocial wellbeing and prevention

36. WHO ROLE RAPID- Reg. Adv Panel on Impact of Drugs-since 2002RAPID- Reg. Adv Panel on Impact of Drugs-since 2002 AdvocacyAdvocacy LegislationLegislation ResearchResearch Setting standards for care and HRDSetting standards for care and HRD Coordination with UNODC, UNAIDS, UNFPA,UNESCO,Arab LeagueCoordination with UNODC, UNAIDS, UNFPA,UNESCO,Arab League Models of PreventionModels of Prevention