To Protect and Serve

Open Society Foundations - Recent studies from Ukraine, for example - a country I visit often in my role as UN Special Envoy - have estimated that fear of police is the single greatest factor associated with needle sharing among people who inject drugs, and that the elimination of police violence could reduce new HIV infections among people who use drugs in Odessa by as much as 19 percent.

Fifteen years ago, public health wisdom told us that the so-called concentrated HIV epidemics—confined among networks of sex workers, men who have sex with men, and people who use drugs, rather than generalized to large populations—should be easiest to contain. Today it is with these HIV epidemics concentrated among vulnerable groups that we see the least progress. Whether in Eastern Europe, where the majority of all HIV infections remain concentrated among people who use drugs and sex workers, or countries like Senegal or Tanzania with generalized HIV infection but with sub-epidemics and sharply higher prevalence of HIV among vulnerable groups, measures that we know work have failed to reach the most vulnerable. Laws, policies, and law enforcement are three important reasons why.

It is surprising that HIV donors and experts have not spent more time supporting these forms of “smart law enforcement,” or on engaging with other development efforts that aim to support police professionalization and retraining.

This volume—which includes case studies from six low- and middle-income countries on how HIV and law enforcement professionals and communities worked together to increase accessibility of health services for sex workers and people who use drugs—offers a corrective. (Foreword to the report "To protect and serve" by  Michel Kazatchkine, the UN Secretary General’s Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, and former Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, a member of the Global Commission on Drug Policy, and Chair of the Board of the Robert Carr Civil Society Networks Fund)

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