Conclusion
The challenges raised by drug use in South America have spawned proposals ranging from simply cracking down on drug users to the concerted use of a plurality of actions aimed at minimizing demand for illicit drugs and reducing the harms resulting from such consumption, focusing on education and public health. Countries like Brazil and Argentina have offered the
World, and especially the other developing countries, invaluable lessons on how to combine public policies with respect for the autonomy of social movements. Despite the deep economic and social crisis faced by Argentina in the late 1990s, the main prevention projects were slowed down, but not discontinued. Both countries have subsequently introduced policies guaranteeing universal access to antiretroviral medicines, including access for a sizeable number of drug users (Aceijas et al., 2006). Universal access has been proposed but implemented with some difficulties in other South American countries. Initiatives aiming to reduce drug related harm have been relatively cautious in the other South American countries, with some successful, but still limited initiatives, in countries such as Uruguay and Colombia.
The best practices in South America in the field of drug use and HIV/AIDS prevention and management, such as in some localities from Brazil and Argentina, comprise a broad range of HIV prevention programs ranging from HIV testing and counseling, education, behavioral and network interventions, drug use treatment, needle exchange and expanded syringe access, as well as interventions aiming to reduce transition to injection and other harmful practices. In common with drug users across the world, those in South America, face several clinical conditions in addition to HIV/AIDS, including other blood-borne/sexually transmitted infections (Caiaffa et al., 2006). In the main urban areas of South America, violence and the constant violation of basic human rights have been unacceptably high and brutal with frequent mass murders and torture.
In the near future it will be increasingly difficult, if not impossible, to ameliorate the living conditions of people who use illicit drugs and/or live with different clinical conditions, such as HIV/AIDS and hepatitis C, without reversing current unacceptable levels of structural violence and disrespect for human dignity which prevail across South America. The best efforts of community leaders, non-governmental organizations and well intentioned public health officials have been thwarted by the sheer violation of human rights and intimidation of community members, activists and health professionals by gangs, corrupt policemen and paramilitaries. In my opinion, sound public health policies must be necessarily complemented by a fundamental reform of drug policies and the implementation of broad public policies aiming to ameliorate the untoward consequences of dire poverty, discrimination, and criminalization.
