KUNDA DIXIT CLOUDS, BUT NO RAIN: The evening sun breaks through clouds in the mountains of central Nepal as a parched land waits for rain. Meteorologists say the monsoons arrived in eastern Nepal this week, but precipitation throughout Nepal has been 50 per cent below normal.

The prevalence of infectious diseases among intravenous drug users is rocketing because the fear of stigma and poor support services are discouraging users from seeking help.

Political instability, low literacy levels, poor awareness and a lack of voluntary counselling and testing services mean infection figures are only likely to increase.

Among drug users in Nepal, 61.4 per cent inject drugs, 29 per cent of whom share needles. An estimated 6,557 intravenous drug users (IDU) are living with HIV or AIDS, which is about 10 per cent of the total 70,000 people living with HIV/AIDS, according to UNAIDS.

In Kathmandu, about 30 per cent of all people living with HIV/AIDS inject drugs. They are also vulnerable to the incurable Hepatitis C, for which 94 per cent of drug users in Kathmandu have tested positive.

The market for heroin and opium is also on the rise in Nepal with most narcotics being smuggled over the border. The Narcotic Drugs Control Law Enforcement Unit seized 105.6kg opium and 10kg heroin last year. In the first six months of this year it has already seized 225kg of opium and six kg of heroin.

The prevalence of HIV among IDUs in 2003 was 51 per cent. Given the limitations of Nepal's public health surveillance system, the actual number of infections is thought to be much higher.

Although Nepal was the first country in Asia to establish a harm reduction program with a needle exchange service for IDUs, it has failed because of limited coverage and a short supply of syringes.

A survey conducted by Central Bureau of Statistics in 2007 reported there are 46,309 hard drug users in Nepal with around 50 per cent of them aged 15 to 29.