In short, there is much to be applauded in the progress already achieved in addressing this crisis. However, we must be prepared to move forward and build on these accomplishments. Despite clear indications of an escalating problem since the mid-1980s and the use of a variety of approaches to address it, the spread of HIV among drug users is increasing, as is the incidence of hepatitis and tuberculosis. Epidemics continue to emerge among new populations. Continuing marginalization and stigmatization of drug users, especially those who inject, and those who are HIV positive or have AIDS, remain barriers to progress.
Leadership is in question, from key community levels up to the federal government.