asked the Minister for Health if he will respond to the vital questions posed by the "Today-Tonight" programme on 12 May 1987 on AIDS; if he will expedite a scheme of needle exchange and more readily available methadone to drug addicts as a preventative measure against the spread of the AIDS virus among addicts; and if he will make a statement on the matter so as to allay public disquiet.

196.

asked the Minister for Health if his attention has been drawn to the serious problem relating to the interaction between drug pushing, the use of needles for drug abuse and the AIDS disease in inner city Dublin, as reported recently on radio and television programmes; the action, if any, he is taking in the light of these developments; and if he will make a statement on the matter.

I propose to take Questions Nos. 2 and 196 together. I am very conscious of the interaction between drug pushing, intravenous drug abuse and the spread of the AIDS virus.

The situation in relation to drug pushing is being constantly monitored by the Garda Síochána and they are taking all steps open to them to curb this problem.

Intravenous drug abuse and the spread of the AIDS virus are clearly very closely linked and the Government's recent public information programme specifically addressed this problem. I did, however, recognise that drug addicts are not particularly receptive to general campaigns and that special measures were required to get the message into the drug community.

The AIDS information booklet and a special poster specifically directed at intravenous drug abusers were circulated to all voluntary drug agencies as part of the programme. In addition the poster has been erected at several sites in the inner city of Dublin.

However, I realise that, in relation to intravenous drug abusers, one-to-one contact and education remains the most important and realistic way of motivating personal behavioural changes. Having consulted the National Co-ordinating Committee on Drug Abuse it was agreed that a meeting should be urgently convened for personnel currently working on a one-to-one basis with intravenous drug abusers. That meeting has been held and the Central Strategy Committee on AIDS have been examining these suggestions, my Department will be responding on these to the relevant agencies in the very near future.

While the establishment of programmes of needle exchange and methadone maintenance for drug addicts was not advocated at the meeting it was considered that research done in other countries in relation to both of these topics should be examined to see if either would be appropriate in the Irish context.

In relation to free needles the situation is that no other country has yet got a general policy on their distribution to intravenous drug abusers. Some countries, including the United Kingdom, have experimental programmes in operation and will be evaluating the results over the coming months. Information on these pilot projects should, therefore, be available quite soon and it would seem prudent to await these results before making a positive policy decision on this matter.

Countries have also diametrically opposed views on the value and, indeed, ethics of methadone maintenance programmes. Many people regard methadone maintenance as a form of social management rather than medical treatment and find it very objectionable on that basis. It must also be remembered that methadone is a very potent and addictive drug in its own right.

However, both the National Co-ordinating Committee on Drug Abuse, and the Central Strategy Committee on AIDS, will be closely monitoring developments in other countries in relation to both of these issues.

Does the Minister agree that the highest risk group in the AIDS crisis here are the intravenous drug users and those in intimate contact with them? Does the Minister agree that for some time the use of infected needles has been the most common means of transmission of the virus among drug users and that it has meant transmission of very dangerous proportions? Does he agree also that this is a matter of extreme urgency because a virtual AIDS epidemic faces intravenous drug users here? In the course of a reply to a recent question the Minister informed me that there are at least 3,000 drug users in Dublin.

The Deputy is embarking on a speech. We should have finality in respect of these supplementaries.

Does the Minister feel that such a dangerous position requires immediate and urgent action? Does he agree that a pilot scheme, based on similar schemes in Britain under which needles are made available to drug users should be introduced?

I want to assist the Deputy in eliciting information but he may not proceed indefinitely. I have asked for finality.

In responding to my questions will the Minister set a time limit on when he will make a decision in this regard?

On the question of numbers, the Department's HIV testing programme shows that 369, or 19 per cent of those tested intravenous drug abusers, are infected with the virus. On the question of the use of needles I should like to tell the Deputy that no other country has yet adopted a general policy in relation to the distribution of free needles to intravenous drug abusers. Some countries, including the United Kingdom, have got experimental programmes in operation and will be evaluating those results in the coming months. Information on those pilot projects should be available quite soon but it is too early to make a positive policy decision on the matter. For instance, the question of legal liability pertaining to the distribution of free needles will have to be considered. It is felt by some professionals that the distribution of free needles would not necessarily make irresponsible drug addicts become more responsible. It should be noted that the Pharmaceutical Society of Ireland have left it to individual pharmacists to decide whether to supply needles in different circumstances.

The Minister referred to his recent publicity campaign and I should like to ask him if he accepts the criticism of it, that it is too narrow in a moralistic sense and does not, with the necessary emphasis, relate to the real problem in Dublin and elsewhere in Ireland which is the number of drug users who are affected by the virus and present a real threat to other people.

Surely that is more appropriate to the next question.

The Minister referred to his publicity campaign in the course of his reply.

Questions, including the next question on the Order Paper relate to this matter.

I do not accept that the AIDS information programme is too narrow in a moralistic or in any other sense. I am pleased to report to the House that at a recent meeting of the Ministers for Health of the other 11 countries of the European Community, it was unanimously agreed by all 12 that the public information campaign should be directed at the whole population and not specifically at those most at risk, the homosexual population and the intravenous drug abusers.

Arising from the Minister's original reply, while I welcome his indication that the review committee in the Department are moving towards a position where they are trying to develop a policy of one-to-one contact with drug users and the drug community who are most at risk, I should like to ask if the Minister has funds available — should a decision of that kind be made — for the deployment of sufficient numbers of workers to undertake the task?

The Government's public information campaign directed at drug abusers first appeared in the AIDS information booklet, in the newspaper advertisements to which I referred and by way of special posters in treatment centres and certain locations throughout the city. At the launch of the AIDS campaign, it was stated that drug addicts are not especially receptive to a general campaign and that special measures are required. Some of those special measures have been taken since the launch of the campaign. The National Co-ordinating Committee on Drug Abuse has been set up and is chaired by my colleague, the Minister of State, Deputy Leyden. They met on 5 May 1987 and considered what extra steps might be required to educate the intravenous drug community in regards to AIDS. As a direct result of that meeting, a special meeting took place on 13 May with drug counsellors, social workers and others who work with the drug community from the Eastern Health Board and from the organisations working with drug abusers in the Eastern Health Board area. I have a list of the organisations represented if the Deputy wishes to see it. At that meeting a wide-ranging discussion took place during which several matters were raised which might improve the delivery of information on AIDS and drug abuse generally to persons not yet addicted to hard drugs and to hard drug abusers. These measures include the need for improved structures co-ordination between the Department, the health boards and the voluntary agencies and the need for additional resources, mainly trained personnel. The Department will be responding shortly to the organisations on these points and as the campaign will be carried on mainly by people who are already working with drug abusers the question of extra funds does not arise.

3.