In Malaysia, over half of all HIV infections are transmitted through sharing contaminated needles and syringes. To combat the spread of the epidemic, the government in 2006 spearheaded 'harm reduction' interventions (pdf) which included a program where people who inject drugs are provided unused needles and syringes in exchange for used injecting equipment. Those who are addicted to opioids such as heroin, the most commonly used illicit substance in Malaysia, can also enroll in rehabilitation for synthetic opioid replacement therapy. Synthetic opioids, taken orally, help stabilize the opioid cravings of patients, thus enabling them to work. The move to introduce harm reduction in Malaysia revealed something that caught people by surprise—many of the fishermen from port city on the east coast of peninsular Malaysia use drugs.
|More information on the World Bank-AusAID partnership in worldbank.org/unlockingpotentialreport|
Making a difference for people, he
The bow of the open aluminium boat jumped from wave to wave, cutting deeply into the white-topped wave crests and adding salt spray to the rain that was showering us constantly with wind-blown pin prick-like strikes. The helmsman then turned towards the shore, slowly bringing the boat into shallow water beside a small wooden pier, where we were able to climb gingerly ashore.
The helmsman was Wilson, Team Leader for the Solomon Islands Rural Development Project (RDP) in the Western Province, and he was accompanied by Lottie, the RDP Project Manager. RDP is a Solomon Islands government project supported by the World Bank, Australia, the European Union and the International Fund for Agricultural Development. Graham (my colleague on this mission) and I were in the Solomon Islands as part of an evaluation of the World Bank's work in the Pacific, funded by the Australian Agency for International Development (AusAID). The RDP had been selected as a case study project for us to visit.
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When I think of HIV/AIDs, symbols pop into my mind: the red looped ribbon and the free condom. They’re actually a good representation of what Thailand is doing best to combat the epidemic- massive information campaigns and the 100% Condom Program which saw the dramatic decline of HIV/AIDS among sex workers.
However, those symbols faded in my mind after I visited an old, impoverished part of Bangkok and met the people who currently are the most vulnerable to HIV/AIDS- the injection drug users.
HIV/AIDS and other blood-borne diseases are transmitted when needles are shared. Under influence, many users are also likely to have unprotected sex. There are programs called ‘harm reduction’ where drug users are provided with clean needles, syringes, and condoms to avoid transmission. Condom distribution is easy but needles are another issue.
Roads are not sexy. You don’t see glossy ads pleading for people to sponsor a road. You don’t see the construction of a road moving global audiences to tears. There are no celebrities, concerts, wrist-bands for the road. I guess that is because for most people in the developed world, we take roads for granted.
Recently I spent some time around Kerema, which although only 350 km from the country’s capital, feels as one of the most remote and cut-off places in Papua New Guinea. Kerema is the Gulf’s provincial capital and, with its surrounding villages, it has been cut-off from the rest of the country due to a mere 67 km of mostly un-passable road. Under the Roads Maintenance and Rehabilitation Project, the World Bank has been supporting the Government of Papua New Guinea to restore the road. Today, the Bank’s Board of Executive Directors approved the second phase of this project, which will see the rest of the road restored and paved to a proper national standard.
|Hayleen Dusaru is the Moli clinic's registered nurse|
I recently spent almost a week calf deep in mud, shooting around islands, and speaking to beneficiaries and community helpers of the Solomon Islands Rural Development Program (RDP). The trip was an illuminating and uplifting opportunity to get out into rural areas and meet the people that are experiencing the direct benefits of one of the World Bank’s most dynamic projects within Solomon Islands.
Terms like ‘bottom up approach’ and ‘grass roots focus’ are catch-cries that are often heard but not always followed within development projects. However, spending some time in villages that are controlling the funds and direction of infrastructure projects and seeing clear and sometimes astounding benefits from them reinforces the principle that this program is not offering simple lip-service or superficial checklists of community involvement. This is really what community direction of projects looks like. (The Country Manager in Solomon Islands, Edith Bowles, has blogged about this program before, read her views on its agricultural aspects and on the effects of the islands’ remoteness.)
Big news: the World Bank has launched an open data site with more than 2,000 financial, business, health, economic and human development statistics. Until now, most of this had been available only to paying subscribers.