Switzerland, HIV, and the Power of Pragmatism: Lessons for Drug Policy Development, Joanne Csete and Peter J. Grob, 23 Int. J. of Drug Pol. 82 (2012)

This article reviews Switzerland's evolving drug policies over the past thirty years in an effort to demonstrate the relationship between public health services and reduced HIV prevalence among drug users. It traces changes in the Swiss government's attempts to curb drug use in the 1980s through rigorous policing to the development of a more balanced national drug policy in the 1990s and early 2000s. The authors outline the effects of drug reform on HIV transmission and treatment for injection drug users (IDUs) and consider the replicability of these Swiss policies to other countries.

Drawing on interviews with public health workers, government officials, and civil society representatives, the authors detail the shift in Swiss drug policy from strict drug policing in the 1980s to the development of needle exchange and harm reduction programs in the 1990s and into the 2000s. The authors note that alongside new drug policies, there occurred a dramatic transformation in the number of HIV infections related to drug use; in 1985, an estimated 68 percent of new HIV infections in Switzerland were linked to drug injection; in 1997, that figure was about 15 percent, and in 2009 approximately 5 percent.

The authors conclude that the Swiss authorities effectively changed the tide of the HIV epidemic in Switzerland in large part by establishing a public health-centered approach to national drug policy. While they acknowledge that other countries may not have the resources or amenable cultural and political traditions for identical programming, the authors rightly note that others can learn from Switzerland's evidence-based strategy for addressing the complex relationship between drug dependence and HIV infection.