By Ben Blanchard

BEIJING, May 14 (Reuters) - Asian countries need to wake up to the threat of HIV transmission via intravenous drug use and spend more money on needle exchanges and other programmes or risk a rapid rise in new cases, a U.N. health official said on Monday.

Around one-third of new infections worldwide, excluding sub-Saharan Africa, are from injected drug use.

Asia has about 6 million users, and most new HIV cases are blamed on dirty injecting equipment, according to the United Nations.

But less than one-tenth of Asian users have access to prevention services, UNAIDS Asia Pacific Regional Director Prasada Rao told Reuters in an interview.

"If you look at comprehensive interventions, which means giving the option of both needle exchange and drug substitution, I think very few countries are doing it," he said by telephone from a conference in the Polish capital Warsaw.

"They have to prioritise interventions among intravenous drug users and the aim is for at least 80 percent coverage by 2010," Rao added.

"That requires enormous scale up in terms of resources and also in creating an environment where drug users can come out and access these services. Because in most of these countries they are still criminalised, and police raid them and catch them.

"It needs a change of attitude and a change of legislation relating to drug use. Because most often they don't distinguish between the supplier of drugs and the ultimate victim who is the user," he said.

HARM REDUCTION

Injecting drug users can also easily pass on HIV to the general population, so it is essential to reach them, Rao said.

"Most of them are young people, and they have sexual partners," he said. "So it ultimately gets into the general population as an epidemic if you don't control it at the injecting drug user level."

The global cost of such "harm reduction" programmes as providing clean needles is estimated at just $200 million a year, the official said.

"We're not spending even half that. It is less than $100 million throughout the world," Rao said. "It is a very small amount of money, but even that, governments are still not putting into ideal programmes."

"In some cases, they think it's not really important. In some cases they think these people are not in the mainstream of society so can be ignored. I think the governments are not sensitive enough to the problem of young people and how they get into injecting drug use," he added.

"The important relationship between injecting drug use and HIV -- still many governments are not realising it."

Bright spots include China, which has started both needle exchanges and drug substitution work, as well as Indonesia, while India has also started on the right path, Rao said.

He singled out Thailand, though, for doing lamentably little.

"Thailand is a glaring example. A country which has done so well at prevention sexually has not started any good programme for injecting drug users even though over 30 percent of new infections in Thailand are among injecting drug users."

AlertNet news is provided by