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Harm Reduction: Drug use and HIV

The Secretary of State for International Development (Hilary Benn): I am placing in the Libraries of both Houses copies of the new Government paper "Harm Reduction: Tackling Drug use and HIV in the Developing world." This paper is published by DFID today in conjunction with seven other Government Departments: the Cabinet Office, the Department for Culture, Media and Sport, the Foreign and Commonwealth Office, the Department of Health, HM Treasury, the Home Office and the Department for Work and Pensions.

Drug injection with contaminated needles and syringes is one of the major means of transmission of HIV and hepatitis C in Europe, Asia and Latin America. It is also driving HIV transmission in North Africa and the Middle East and is becoming an increasing problem in Africa. 1 For example, in Kenya, Nigeria and South Africa, injecting drug use appears to be higher than has previously been realised.

The paper primarily focuses on the prevention of drug-related harm, rather than the prevention of drug use per se. This includes reducing different kinds of harm whether health, social and economic. In the context of HIV and other blood borne diseases, harm reduction aims to reduce the health and social consequences of injecting drugs.

There is substantial evidence about the effectiveness of harm reduction in preventing HIV infection among Injecting Drug Users (IDUs), especially needle and syringe exchange programmes from many countries. For example in the UK and Australia HIV infection rates among Injecting Drug Users are much lower (less than 2 per cent.) than in countries without or with insufficient programmes.

Harm reduction programmes as part of a comprehensive plan for HIV prevention, treatment and care could save millions of lives every year.

The Government view harm reduction as an important part of the overall HIV prevention strategy in countries with serious HIV epidemics among Injecting Drug Users, as well as in countries without serious HIV epidemics where harm reduction helps maintain low prevalence rates. We are working across Government to address this issue and have jointly agreed next steps. These are outlined in the paper, and cover: 1) the UK Government's understanding of harm reduction in the context of HIV; 2) the international approach for harm reduction; and 3) DFID's support and approach for harm reduction in developing countries.

DFID's approach focuses on piloting, or assisting in the national implementation of harm reduction including needle and syringe programmes, safer injecting, substitution therapy, social marketing of condoms, and peer education through government partners, and international and local NGOs.

1 UNAIDS, Report on Global AIDS Epidemic, Geneva, Switzerland, July 2004.
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In implementing the approach set out in this paper we will continue to work in partnership with developing country Governments, international agencies and donors, civil society, the pharmaceutical and biotechnology industries, the broader private sector and the research community.


Integrated Kent Franchise

The Secretary of State for Transport (Mr. Alistair Darling): I am announcing today that Govia has been awarded the contract to run the integrated Kent rail franchise from 1 April next year.

The contract my Department has signed commits Govia to introducing the high speed commuter trains that will use the channel tunnel rail link to serve the south-east from 2009.

Journey times for passengers who wish to travel from Ramsgate and east Kent, through the Medway towns and Thames Gateway to the centre of London will be reduced. It will be the first high speed commuter service this country has seen. In 2012 Govia will provide the flagship Olympic Javelin rail service that helped London secure the Olympic games. This will link St. Pancras and Stratford in less than eight minutes.
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In addition Govia has committed to improve performance, invest around £76 million in passenger and staff facilities, oversee the construction of two depots in East Kent to maintain the new and existing fleet of trains and add a number of off peak services to the current timetable. The franchise contract is for eight years with the final two years dependent on service performance achieving preset targets.

There has been significant investment in the franchise region in recent years. The taxpayer has invested more than £600 million in new rolling stock in Kent in the last three years. In addition, Kent has seen £93 million of investment in power supply, stations, depots and related infrastructure. Some £250 million will be invested in the new high speed trains.

The total subsidy for IKF is £585 million over the eight years. It is therefore justifiable for the new operator to increase fares by 3 per cent. above inflation from January 2007 for five years to ensure there is fair balance between the taxpayer and fare paying passenger.

I am satisfied that the competition for the franchise has resulted in a contract that represents very good value for taxpayer. It is a tough contract on which Govia will be expected to deliver. It will help support the new housing and economic opportunities in the Thames Gateway area and region beyond.