national campaign against drug abuse (nacada) …attcnetwork.org/userfiles/file/greatlakes/archived...
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National Campaign Against Drug Abuse (NACADA) A th it i K
C t f S b t Ab T t t
(NACADA) Authority in Kenya
Center for Substance Abuse Treatment
C t f S b t Ab T t tCenter for Substance Abuse TreatmentSubstance Abuse Mental Health Services
AdministrationU.S. Department of Health & Human Services
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Global Drug Trafficking
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NACADA AuthorityNACADA Authority
•Federal authority (2006) with mandate is to co ordinate public•Federal authority (2006) with mandate is to co-ordinate public education campaigns against drug and substance abuse,
collaborate with other stakeholders to curb drug abuse in youth and facilitate the setting up of rehabilitation centersand facilitate the setting up of rehabilitation centers
•To co-ordinate the implementation of the national action plan on reducing drug abusereducing drug abuse
•To play an effective role in the development, setting up and expansion of drug treatment programs for the rehabilitation ofexpansion of drug treatment programs for the rehabilitation of
drug dependants
•Advise on the best practices and licensing of drug treatment p g gprograms
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2009 Household Survey of Drug and Alcohol Use and Abuse in Kenya
• Quantitative sampling of 4,200 households in 140 cluster areas as well as qualitative interview of key informants– Nairobi, Mombasa , coastal islands and providences– Focus groups with addicts in rehab, interviews with recovering
addicts and treatment programs• Use of drugs and alcohol
– 33.6% of all respondents ever consumed alcohol tobacco, glue, tamboo, khat , cannabis (bhang), heroin, cocaine, , ( g), ,
– 47.8% of elderly (50 and older) consumed alcohol or drugs– 16.9% children (12-17yrs)– 61% male61% male– 18.9% female– 2.6% population used heroin
M i l i N i bi d M b• Mainly in Nairobi and Mombasa• 3.3% of 18-28 yrs old -5.5% of males and 0.8% females
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Description of Treatment Services
• There are about 75 treatment centres in the Country, both private and public. They deal with all drugs, p p y g ,ranging from alcohol, tobacco, khat, bhang, heroin and cocaine.HIV i i t l t i d t t t• HIV is an integral component in drug treatment, hence harm reduction is now an acceptable model of operation
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Geographic Mapping of Injection drug Users
• National STI/AIDS Control Program and National AIDS Control Council
• June 2012919 IDU t id tifi d• 919 IDU spots identified – 35% on the coast with 35% of the IDU population– 16% in Nairobi with 19% of the IDU population
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Kenya Site Locations forHIV Outreach with Heroin Users
• Nairobi: Central Transport Route, easy access and trafficking of herointrafficking of heroin– Estimated population- 3 million– Estimated HIV prevalence- 9.9% – Estimated heroin addicts -10-15,000
• Mombasa: Major East African commercial port of• entry primary access and trafficking of drugs• entry, primary access and trafficking of drugs.
– Estimated population – 1 million– Estimated HIV prevalence- 12.8%– Estimated heroin addicts-10-15,000
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PEPFAR Kenya Targets
• Annually reach:• 4 000 drug users with outreach4,000 drug users with outreach• 2,000 drug users with HIV testing• 750 with care and rehabilitation• 200 with antiretroviral treatment for HIV+ drug users
• Work with NACADA to develop drop-in centers for IDU for outreach and HIV testing
• Methadone treatment programs for rehabilitation• Methadone treatment programs for rehabilitation
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Kenya IDU drop-in centers
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Kenya IDU drop-in center
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Mathari slums
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Mathari HospitalMajor East African commercial port ofentry, primary access and trafficking of drugs
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Women’s Treatment Center in Mathari
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Evidence- based Documents
• Ministry of Medical Services
• Standard Operating Procedures for Medically Assisted Therapy for Opioid Drug Users
• National Guidelines for Comprehensive Services for HIV Prevention for Injection Drug UsersHIV Prevention for Injection Drug Users
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Achievements in opioid treatment
• 1) Kenya National Guidelines for HIV Prevention and ) yManagement of People Who Use Drugs (PWUD)
• 2) Standard Operating Procedure for NSP• 3) Standard Operating Procedure for MAT• 4) Draft Policy for HIV Prevention among People Who Inject
DrugsDrugs• 5) Draft Policy for HIV Prevention among Most At Risk
Populations( MARPS)• 6) Capacity building of health care workers, law enforcement
agencies and civil society organisations.
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Impacts of the Developments
• Recognition of opioid dependence as an urgent public health priority.p y
• Decriminalization of opioid dependence• Acceptance of harm reduction strategies as means of curbing
HIV AIDs among people who inject drugs• Collaborations between governmental and non-governemental
organizations in addressing the opioid problemorganizations in addressing the opioid problem
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Challenges
• Prevalence of opioids abuse, particularly at the Coast and in capital city Nairobicapital city, Nairobi.
• High HIV Prevalence among the male IDUs at 17% and even much among the female IDUs at 44.5%
• Limited funding for programs.• Lack of Monitoring and evaluation of the interventions
L t k f i b PWUD• Low uptake of services by PWUDs• Resistance by certain members of the society, particularly
religious leaders who are of the opinion that NSP and MAT isreligious leaders who are of the opinion that NSP and MAT is only perpetuating drug use
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Recommendations for the way forward
• The sharing of best practices with countries that haveThe sharing of best practices with countries that have succeeded.
• The Government’s commitment to curb HIV AIDs and drug abuse should be enhanced
• The Vibrant civil societies should be supportedInstitutions of higher learning that can be encouraged to churn• Institutions of higher learning that can be encouraged to churn out more professionals
• Africa, and Kenya in particular, offers a fertile ground for the , y p , gexpansion of harm reduction strategies. This should be exploited by the American Association of Opioid Dependence
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THANK YOU!OUKARIBUNI KENYA!KARIBUNI KENYA!