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While only 3.5%–5.7% of 15–64 year olds are reported to have used illicit drugs at least once, between 10% and 15% of them are estimated to develop dependence or a pattern of harmful use. Globally, however, the Eastern Mediterranean Region reports the highest prevalence rates of drug dependence and harmful use. Similarly in our Region, drug use disorders account for the loss of 4 DALYs (disability-adjusted life years) and 9 deaths per 1000 population, compared with the loss of 2 DALYs and 4 deaths per 1000 population globally. According to the data WHO collected from countries for the WHO ATLAS on resources for prevention and treatment of substance use disorders, the median prevalence of drug use disorders in the Region is 3500 per 100 000 population, and that of injecting drug use is 172 per 100 000. Another worrying development is that the age of first use for many substances, and for alcohol, is decreasing. Many individuals initiate use when they are under 19 years of age. Results from countries participating in the global school-based student health survey show that 5.2% had used drugs in the last 12 months, while 11.8% had used alcohol in the last 30 days.
Of course, these figures can neither capture nor quantify all the dimensions of the burden imposed by drug use, especially the suffering of family members and relatives of persons abusing drugs, and the cost for society and communities.
Drug use and its disorders are among the top 20 risk factors to health worldwide, and among the top 10 in our Region. Drug use disorders are associated with increased risk of development of many other diseases and health conditions, including HIV infection and AIDS, hepatitis, tuberculosis, neuropsychiatric disorders and cardiovascular diseases. They are also one of the major contributing factors in injuries, violence, criminal behaviour, suicide and social exclusion, differentially affecting the younger and marginalized strata of a society.
Ladies and Gentlemen,
There is a growing body of evidence regarding effective interventions available to prevent drug use and to manage drug use disorders. According to the recently published WHO ATLAS on substance use – Resources for prevention and treatment of substance use disorders, countries of the Eastern Mediterranean Region report the highest number of programmes focusing on drug prevention, ranging from community to school and workplace- based programmes. However, population coverage of these programmes is relatively low and only three countries have prevention programmes for prisoners. No country has any
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prevention programme for pregnant women. Similarly opiate substitution, screening and brief interventions are only available in about 21% of the countries in the Region. However, more than 40% of the countries have a community-based needle/syringe exchange programme in place. While there is evidence as to which components are essential for the effectiveness of such programmes, evidence of the effectiveness of the programmes implemented in the Region is still patchy, at best.
Ladies and Gentlemen,
WHO Regional Office for the Eastern Mediterranean and Mentor Arabia has a relationship going back to 2006, when we signed a bilateral memorandum of understanding to collaborate on issues of drug abuse, and a multilateral memorandum of understanding involving also the United Nations Office on Drugs and Crime, Dubai Police and the Right Start Foundation for the Guardians of the Future project. I am therefore particularly pleased that Mentor Arabia is taking this timely initiative to set up an Arab research resource information centre, involving a wider array of partners and stakeholders.
I feel that the overall effectiveness of this initiative will be enhanced if we can collectively and thoughtfully address the issues of whether prevention of drug abuse should focus only on specific and proximal causes; or whether it should focus on the broad spectrum and distal causes, such as employment and educational opportunities and childhood development; on identification of the most prevalent harms caused by drugs in our Region;
and on which strategies have the strongest evidence of effectiveness and cost–effectiveness This is all the more important in light of the current developments taking place in the Region. The increasing calls for the involvement and empowerment of citizens present us with a range of complex problems which call for technically prudent, ethically acceptable and culturally sensitive approaches to the issue of drug abuse.
I thank you for inviting us to join hands in this initiative and assure you of our full and continued collaboration.
