The Battle for Harm Reduction Continues in Budapest

May 14, 2015
The HCLU’s Drugreporter has warned that rates of hepatitis-C infection among injecting drug users in Budapest almost doubled between 2011 and 2014 – in a period when access to harm reduction programs rapidly decreased. Government politicians are still denying the reality, and accuse harm reduction advocates of exaggerating the problem.

The Hungarian Civil Liberties Union (HCLU) obtained public data from the National Centre for Epidemiology (OEK) about the results of the annual national testing campaign they conducted in 2014. We submitted a freedom of information request, because the data had not been published for a year, even though the government received the information in September. We suspect the data were kept back for political reasons. From the answer, we learned that between March and May 2014, over 600 injecting drug users were tested for hepatitis-C and HIV, at 19 harm reduction service locations. Two people tested positive for HIV, and 279 tested positive for hepatitis-C. While rates of hepatitis-C infection had remained stable between 2006 and 2011, they increased sharply between 2011 and 2014. This means that the prevalence of HCV among injecting drug users rose from 34 percent to 60 percent. 

There are two probable explanations for this trend. First, the number of people injecting new psychoactive stimulants grew rapidly after 2009. These drugs are injected more frequently than either heroin or amphetamine (10-15 times a day). Second, the supply of harm reduction services was unable to meet the growing demand for sterile injecting equipment. The number of clean needles distributed by services decreased by almost 40 percent between 2011 and 2012. In 2014, the two largest needle and syringe providers were closed down, as a result of political attacks and a lack of financial resources. These two programs alone provided 55 percent of the needles provided by needle and syringe programs in Hungary. Thousands of injecting drug users in Budapest are now not covered by any harm reduction or treatment services. This means that this year's testing program will not yield reliable results about the hepatitis and HIV epidemics, because without needle and syringe programs, the National Centre for Epidemiology will be unable to reach drug users.

In a press release, we called upon decision-makers to recognise the epidemic and take urgent steps, especially in terms of expanding harm reduction programs. We also pointed out that, while individual districts may have local drug coordination bodies and drug strategies, Budapest as a city has no council, strategy, or budget to tackle drug problems. Opposition members on the Budapest council agreed, and are currently preparing a resolution on this issue.

In addition, we asked the drug coordination council of Budapest's district 8, where the largest needle and syringe program was closed last August, to give us access to the minutes of their meetings. Our aim was to see whether the district had made any efforts to provide care for people who use drugs, after the closure of the needle and syringe program. They denied our freedom of information request, so we are now suing the council.

Televised debate between Orsolya Ferencz, politician from the ruling party, and Peter Sarosi, HCLU's Drugreporter

Angered by our litigation efforts, the mayor of the district addressed an angry open letter to the head of HCLU's Drugreporter, accusing him of “fighting for free drug distribution”. HírTV, a news chanel, invited us to take part in a live debate with a Conservative politcian, Orsolya Ferencz. Ms. Ferencz denied that there was an epidemic, and claimed that the research of the National Centre for Epidemiology was biased, because it was conducted via needle and syringe programs which falsified the data. It is not easy to fight those who do not respect scientific evidence, not to mention human rights.   

Peter Sarosi