Did the Taliban's Opium Eradication Campaign Cause a Decline in HIV Infections in Russia?

Abstract

We offer a new hypothesis for why HIV infections fell rapidly after 2001 in Russia: the Taliban's opium eradication campaign in Afghanistan reduced the supply of heroin, causing use to fall and, thus, transmission of HIV to fall. We present evidence of the impact of the eradication campaign on the heroin market and show that the fall in HIV infections happened simultaneously in Russia and surrounding countries soon after the eradication campaign. We also show that the decline in HIV infections only occurred in injecting drug users, while other risk groups were unaffected. Limitations to our analysis are discussed.

RÉSUMÉ

Est-ce que la campagne d’éradication de l'opium des Talibanes a causée une diminution des infections du VIH en Russie?

Nous proposons une nouvelle hypothèse qui explique pourquoi les infections du VIH ont diminué après 2001 en Russie: la campagne d’éradication de l'opium des Talibanes en Afghanistan a réduit l'offre d'héroïne, causant une chute de sa consommation et une chute subséquente de la transmission du VIH. Nous présentons des preuves de l'impact de la campagne d’éradication sur le marché d'héroïne et nous montrons qu'après l'implémentation de la campagne, les infections du VIH en Russie et plusieurs pays voisins sont tombées simultanément. Nous montrons aussi qu'il y eut une réduction dans les infections du VIH seulement pour les consommateurs de drogues injectables, alors que d'autres groupes à risques ne furent pas affectés. Des limitations à notre analyse sont discutées.

RESUMEN

¿Es la política de prohibición de cultivo de opio la causa de la dismunición de infecciones de VIH en Rusia?

Proponemos una nueva hipótesis para explicar la disminución de infecciones de VIH en Rusia después del 2001: la política de prohibición del cultivo del opio realizada por los Talibanes en Afganistán. Mencionada política ha reducido la oferta de heroína, el consumo de ésta y la subsecuente trasmisión del VIH en Rusia y países vecinos. La reducción de infecciones se observa solamente en el grupo de consumidores de drogas inyectables, los otros grupos de personas en riesgo no fueron afectados por la política. Los límites de nuestro análisis son discutidos.

Keywords :

• heroin supply
• HIV transmission
• Afghanistan
• Russia
• illicit drug markets

Notes

2 Opium production estimates are from UNODC (2003) Table 2.1.1 and UNODC (2010) Table 13.

3 Italy and France are the other two.

4 For a few countries, the UNODC (2008) has estimated purity levels for 1 year (2005 or 2006). However, these estimates have large ranges making even the one data point uninformative. For example, Canada's heroin purity is reported as ranging from 1% to 100%.

5 Price data are on page 9 of UNODC (2005).

6 Gibson et al. (2003) show that there was an increase in heroin prices in Australia at this time. Although it is believed that the Golden Triangle is the only significant supplier of heroin to Australia, it is possible that the drop in opium production in Afghanistan diverted heroin from Southeast Asia toward Central Asia and Europe, who were suffering a heroin shortage and high prices. If this is the case, then the heroin shortage in Australia was indirectly caused by the fall in opium production in Afghanistan.

7 Eastern countries include: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Tajikistan, Turkmenistan, and Uzbekistan. Not all countries have data for every year. The Russian Federation and Ukraine were included as part of Eastern Europe in the data, but we have taken them out as they would otherwise dominate the results with their much higher numbers of HIV infections. HIV infections for the Russian Federation and Ukraine are shown separately in Figure 2 and Figure 6.

8 Data are unavailable on drug treatment in Estonia. Data on hepatitis B and C and drug treatment are available from the European Monitoring Centre for Drugs and Drug Addiction.

9 Central European countries include: Albania, Bosnia & Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Hungary, Macedonia, F.Y.R., Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, and Turkey. Western European countries include: Andorra, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, Netherlands, Norway, Portugal, San Marino, Spain, Sweden, Switzerland, and the United Kingdom. Not all countries have data for every year.