In Hanoi, Linking Health with Human Rights

Anand Grover, the United Nations special rapporteur on the right to health, told the conference this week that drug users should not be treated as criminals.

"The criminalization of these practices actually hinders the right to health of all persons, including these groups. I think there's a serious need to decriminalize these practices," said Grover. Some countries in Asia, including Vietnam, have traditionally sent heroin addicts to mandatory treatment centers, often for years.

In China, experts estimate there may be 350,000 people in these sorts of centers. Human rights organizations say they violate the rights of addicts, and studies show almost all addicts resume using heroin after they are released.

Now Vietnam and China are trying a new approach: methadone and buprenorphine, two drugs that, taken every day, eliminate the craving for heroin.

Dr. Nguyen To Nhu is the Vietnam program director of Family Health International, which helps run some of the first methadone clinics in Vietnam. The clinics, funded in part by the United States, opened last year, and treat 1,600 addicts.

She says almost none have gone back to heroin.

"Very good adherence rate, 95 percent. Five percent drop out, the majority because of death due to AIDS," said Dr. Nhu. In China, methadone clinics began five years ago, and there are now about 500. At the Hanoi conference, Dr. Zhai Xiaomei of the Chinese Academy of Medicine called for the decriminalization of drug abuse in China, saying it harms the health of drug users.

"We should treat them as patients, not just as law offenders, because from the scientific fact, they are patients," said Dr. Zhai. The problem, she and some colleagues say, is that China's law enforcement officials still want to treat drug use as a criminal problem. But they say Chinese leaders have embraced methadone treatment and decriminalization.

The U.N. 's Grover says the move toward treatment rather than punishment does not have to conflict with Asian cultural attitudes, or even with China's and Vietnam's Communist ideologies. "One of the good things about the Communist parties is they base a lot of their policies on what they call scientific socialism. So science is a very strong element," said Grover. "So I hope they look into evidence, and not just go by political ideology of various countries." The conference, which wrapped up on Thursday, also covered issues such as protecting the rights and health of those infected with HIV and those whose health and livelihoods are affected by climate change.