In Asia, economic, social and political instability is similarly paving the way for increases in drug production, injecting drug use, sex work and cross border migration - all recognised factors in the spread of HIV. Shifts in trade, transportation and communication networks across Asia are also facilitating the spread of drug injecting, needle-sharing and consequently, of HIV (Suwanwela & Poshyachinda 1986).

Drug use lies behind the bulk of the HIV/AIDS epidemics in China, Malaysia and Vietnam, accounting for a respective 69 per cent, 77 per cent and 66 per cent of infections in these countries, estimates indicate (Kin, 1995). In Myanmar, prevalence rates amongst IVDUs is at 60 - 70% since 1992 and in Thailand 38% of all HIV infections are as a result of injecting drug use (Suwanwela & Poshyachinda 1986). Despite this, in many Asian countries, it was still poorly addressed in the national HIV/AIDS plan of most affected Asian countries with India, Malaysia, Myanmar and Nepal only gave "inadequate" attention to the drug use issue in their AIDS plans (Kin 1995). Moreover, HIV/AIDS was not addressed in the national drug plan of affected countries, such as China, Malaysia, Myanmar and Nepal. Indeed, only Vietnam addressed the issue in its national drug plan.

In countries that promise a mandatory death penalty for drug importation and trafficking it is no surprise that harm reduction for current drug users is a rather political topic. While it is not unlawful to carry syringes and needles in nearly all countries, the police still arrest people for the possession of injecting equipment in India, Malaysia, Myanmar and Nepal. Only one affected country, Vietnam, has a needle and syringe exchange available, although India and Nepal have limited programmes (Poshyachinda 1993).

Policy-makers are also currently against substitution therapy in all countries except Thailand, Vietnam and Hong Kong, although some, such as India and Nepal, are considering it. Hong Kong, which has an extensive number of methadone clinics, has only a low HIV infection rate (Poshyachinda 1993). Most countries in this region, including India, Malaysia, Nepal and Myanmar have treatment which is abstinence-oriented, with a 1961 convention on narcotics, which calls for drugs only to be used for certain purposes such as medical reasons, still influencing many countries.

Methamphetamine became a widely used drug in SE Asia, particularly Thailand around 1998. In Thailand it is known as 'Yaba' and abuse in 2001 had reached epidemic proportions, with Thai authorities estimating that over 2.5 million people were regular users (Poshyachinda 1992).