Korsang awaits NACD licence, halts needle exchange project.

ASENIOR official with the national drugs bureau insists a local organisation that distributes clean needles to injection drug users will be allowed to continue its work – even after the NGO suspended its programme when its licence expired at the New Year.

Korsang, an NGO that works with street drug users in Phnom Penh, suspended its needle exchange programme Friday – sparking concern that HIV transmission rates among drug users could skyrocket if the situation is left unchecked.

However, Moek Dara, secretary general of the National Authority for Combating Drugs (NACD), which wields approval power over the licence, insists the NGO has not been barred from distributing clean needles.

“We haven’t stopped them from providing needles,” Moek Dara said Sunday.

“If representatives from Korsang said that we stopped the programme, did they receive any letter of confirmation from [authorities] to stop?”

Korsang officials said the group has received no formal word on its programme, but they suspended needle distribution because its licence was no longer valid.

“We’re just waiting for the NACD licence. We have put in our request,” Korsang Director Taing Phoeuk said Sunday. “They haven’t given us any information at all.”

Mith Samlanh licensed

At the same time, the only other organisation in Cambodia permitted to distribute clean needles to drug users, Mith Samlanh, did have its licence officially renewed.

“I don’t understand the circumstances as to why Mith Samlanh had its licensing approved and why Korsang has not,” said David Harding, international coordinator for drugs programmes with Friends International who provides technical support to Mith Samlanh.

The confusion comes within weeks of a controversial NACD-led programme in which drug users were taken from the street and administered a 10-day treatment of a little-known Vietnamese detoxification medication called Bong Sen.

Rights groups said drug users were coerced to participate – allegations denied by NACD officials – and officials with the United Nations and US embassy expressed “concern” over use of the unproven drug.

Before the trial, however, NACD officials approached both Korsang and Mith Samlanh, asking for its clients to participate.

“We sent letters to two drug treatment organisations to cooperate with us by sending their people to join our service,” Neak Yuthea, director of the NACD’s Legislation, Education and Rehabilitation Department, said in an interview December 21, the day the Bong Sen trial ended.

“But only one organisation, Mith Samlanh, replied, telling us that they did not have people for the trial.

“Korsang did not reply. They complained to [international groups], claiming that authorities were forcing them into the trial,” Neak Yuthea said then.

“We did not force anyone. There is no reason for us to bring people to die or joke with people’s lives.”

When contacted Sunday, Neak Yuthea declined to comment.

A World Health Organisation official said he believed Korsang and the NACD could sort out any apparent tensions.

“I think fundamentally it’s a communication issue that can be overcome,” said Graham Shaw, technical officer on drug use with the WHO.

“Mith Samlanh has done a lot to make sure local residents and authorities are aware of their harm-reduction programmes,” he said. “Korsang has not done much in that regard.... If people don’t understand something, they can become fearful of it.”

In the meantime, there is concern that the apparent loss of Korsang’s needle and syringe programme could see drug user HIV transmission rates spike if left unresolved.

“We’re already at a 24 percent HIV prevalence rate among injection drug users,” Shaw said. “If that was unchecked for another year, it could quite easily hit 50 percent.”

Starting today, Mith Samlanh, which is still licensed to continue its needle exchange operations, will coordinate with Korsang in an attempt to fill the gap left by the suspended programme, Harding said.

But with Korsang distributing more than 12,000 clean needles in the last year through its outreach and drop-in centre programmes, it could be a challenge.

“It’s going to be hard,” Harding said. “We’re talking about Mith Samlanh’s reach increasing by over two-thirds. It’s going to be tough.”

ADDITIONAL REPORTING BY CHHAY CHANNYDA