VZCZCXRO0301
PP RUEHDBU RUEHPW RUEHSL
DE RUEHBUL #1910/01 1981525
ZNR UUUUU ZZH
P 171525Z JUL 09
FM AMEMBASSY KABUL
TO RUEHC/SECSTATE WASHDC PRIORITY 0220
RUCNAFG/AFGHANISTAN COLLECTIVE
RUEKJCS/OSD WASHDC
RUEKJCS/JOINT STAFF WASHDC
RHMFISS/CDR USCENTCOM MACDILL AFB FL
RHEFDIA/DIA WASHDC
RUEKJCS/OSD WASHDC
INFO RHEHAAA/WHITE HOUSE WASHDC
RHMFIUU/DEPT OF JUSTICE WASHINGTON DC
RHEHOND/DIR ONDCP WASHDC
RUEABND/DEA HQS WASHINGTON DC
RUEKJCS/CJCS WASHINGTON DC

UNCLAS SECTION 01 OF 02 KABUL 001910 
 
DEPT FOR INL, INL/AP, SCA, AF 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: SNAR KCRM PREL PINS IR AF
SUBJECT:  AFGHANISTAN/COUNTERNARCOTICS:  DRUG DEMAND REDUCTION (DDR) 
- UNODC WANTS BACK IN THE GAME 
 
¶1.  (SBU) SUMMARY:  On 16 July, the head of the Health and Human 
Development Section of UN Office on Drugs and Crime (UNODC) Gilberto 
Gerra and Afghanistan Country Directory Jean Luc Lemahieu called on 
Coordinating Director for Development and Economic Affairs (CDDEA), 
Ambassador Wayne to discuss the current Drug Demand Reduction 
(DDR)/HIV situation in Afghanistan and to push for more resources 
directed towards community based, mobile treatment teams under UNODC 
auspices. They expressed concern over what they thought was an 
uncoordinated and ineffective effort at clinic-based treatment and 
the separation of current DDR and HIV programs. With funding, UNODC 
could initiate programs reaching the street-level addict with both 
DDR and HIV prevention to break the connection between intravenous 
drug use and HIV transmission. In many ways, the new UNODC proposals 
appear similar to previously existing Afghan DDR programs that UNODC 
discontinued two years ago.  It is clear that UNODC will look to the 
USG, and INL in particular, for funding for these new projects.  END 
SUMMARY. 
 
¶2.  (SBU) CDDEA Wayne hosted visiting UNODC head of Health and Human 
Development Gerra and Country Director Lemahieu in his office on 16 
July. Gerra is in Afghanistan to access the current DDR/HIV programs 
in place and formulate UNODC's proposals to reenter the sector after 
pulling out in 2007 due to lack of funding. They laid out what they 
see as the main deficiencies in the sector-a reliance on 
residential, clinic-based treatment, lack of coordination between 
GIRoA ministries, and few programs targeting the linkage between 
drug addiction and HIV.  Lemahieu and Gerra proposed training small, 
community based teams that could reach addicts at "street level". 
They maintained that with a few months of training, these teams 
could operate by providing in-home, outpatient care to a larger 
number of addicts then could clinic based treatment and at a lower 
cost. The key to this treatment would be the use of methadone, which 
they claimed has just recently become widely available in 
Afghanistan. (Note: Methadone has long been legal in Afghanistan but 
only recently did Ministry of Public Health give permission to 
import it in limited quantities.) Although they initially called 
clinic-based training ineffective, they were quick to note the good 
work done by Colombo Plan, an International Organization funded by 
INL that runs 16 DDR clinics in Afghanistan. Gerra and Lehahieu 
commented that the current Colombo Plan operations should continue 
to cater to the worst cases but any new funding should be directed 
towards their proposal. 
 
¶3.  (SBU) Lemahieu stressed that need for better coordination in 
general and between GIRoA ministries in particular. Ministry of 
Public Health (MoPH), Ministry of Counternarcotics (MCN), Ministry 
of Justice (MoJ) and Ministry of Interior (MoI) all have roles to 
play but not the will or means to pursue effective programs in 
coordination with one another. For example, MoJ is in charge of 
prisons, which have an endemic addiction problem, but no money for 
treatment or medicine. They asked for the U.S. Embassy's backing in 
putting pressure on GIRoA to increase coordination and develop a 
unified model of intervention and treatment. Lemahieu and Gerra 
pointed to recent events at the Russian Cultural Center - a 
notorious opium den that was cleared out by MoI forces, who moved 
the drug addicts removed to an abandoned factory hastily converted 
to a makeshift treatment facility by MoPH - as an example of what 
increased coordination could accomplish. They thought that programs 
to continue treatment for the Russian Cultural Center addicts plus 
programs to address drug abuse in jails could be started for $500K. 
Ambassador Wayne remained noncommittal on funding but sympathetic to 
the dire need. 
 
¶4.  (SBU) Their last point of emphasis was the need to better 
integrate HIV/AIDS programs with DDR. As they pointed out, a recent 
report showed that 8-9% of drug users were HIV positive, and with 
intravenous drug use being one of the key vectors for HIV, the need 
to address the drug side of the equation was imperative. They noted 
that it was not a question of money as HIV/AIDS programs were well 
funded through the World Bank and Global Fund, but more an 
unwillingness on the part of the major donors to link the problems 
together. 
 
¶5.  (SBU) COMMENT:  The UNODC proposals, while short on specifics, 
indicate a clear desire by UNODC to reestablish a role in supporting 
DDR programs in Afghanistan, after effectively walking away from 
this area two years ago. The idea of mobile, community based 
treatment teams appear to be similar to the former UNODC programs, 
 
KABUL 00001910  002 OF 002 
 
 
which were later taken over by INL and converted to clinic based 
treatment with in-home programs. INL currently funds approximately 
60% of UNODC's worldwide budget, and it is not surprising that UNODC 
continues to look to the USG and INL in particular to fund the new 
proposals as well.  INL will continue to look for ways to work with 
UNODC, but as with most health related topics, the devil will be in 
the details. 
 
EIKENBERRY