Day 5- Thursday, April 29
Day 5, the final day of the International Harm Reduction Conference highlighted several important themes within Harm Reduction. Damon Barrett chaired a session called “Harm Reduction for Producer Nations? Farmers’ perspectives on the war on drugs.” This was the first-ever session at a harm reduction conference on the topic of harm reduction approaches to involving countries that provide the bulk of the world’s supply of heroin and other drugs, especially engaging with farmers who grow and cultivate the drugs.
In another session on harm reduction in Asia, Fabio Mesquita from the WHO outlined the new WHO 5 year strategy for harm reduction, which highlights to urgent need to scale up evidence-based harm reduction interventions and to improve on provision of quality, evidence-based, and voluntary drug treatment for people who use drugs. Mesquita also noted the urgent need to develop effective approaches to deal with the growing epidemic of amphetamine use in Asia. The challenges of scaling up will be enormous, as he pointed out that we need ‘many more organizations delivering more services to many more people.’ And Robert Power outlined some of the main drug challenges in the Pacific island nations, reminding us of the diversity of drug patterns in the region, as more and more people who use drugs switch away from heroin and towards other drugs.
One session dealt with the issue of how to improve the behavioral and epidemiological surveillance typically used on harm reduction programs. Dagmar Hedrich gave a presentation on behavioral and HIV trends among drug users in several European countries, showing some very promising trends including a general reduction in both needle sharing and the incidence of HIV among IDUs in many EC countries. Martin Donoghoe presented on the nine year history of harm reduction efforts in Ukraine, highlighting the positive impact that program has had, especially to reduce needle sharing, increase condom use, and to stabilize and begin to reduce HIV incidence.
In one of the final sessions of the conference, Evan Wood gave a presentation outlining how the debates around global drug policy are usually sorely lacking in scientific evidence. Wood showed how the debate on drug policy is often dominated by ideological agencies rather than objective researchers drawing on scientific evidence. He announced the recent establishment of the International Center for Science in Drug Policy, whose mission is to address this problem.
Margaret Hellard gave a presentation on Hepatitis C, pointing out that it’s preventable, treatable, and curable. Current harm reduction interventions (i.e. NSPs) are mostly failing to prevent the spread of Hepatitis C. She called for programs to push forward to experiment with higher coverage models, integrated with substitution therapy, based on some early evidence from the Netherlands that higher coverage harm reduction projects may be able to reduce the spread of Hepatitis C. She emphasized that the scientific evidence indicates that current injecting drug users are able to be compliant on their Hep treatment and have successful treatment outcomes, just as with the general population.
Annette Verster presented the WHO’s perspective on harm reduction’s challenges in the next generation. She highlighted the critical importance of improving the quality of drug treatment, but also remaining engaged with the criminal justice organizations that run forced “treatment” centers, in order to help redress urgent health problems facing inmates in the centers. She also highlighted the need for operational research to help us understand how to scale up quality harm reduction interventions in the next generation.
The PSI team at this year’s International Harm Reduction Conference concludes the week feeling inspired by the good work that many organizations are doing – including PSI in 10 countries – to help protect people who use drugs from serious harms of drug use. But we also leave the conference humbled by how much is yet to be done, especially the scale up of high quality interventions to reach out to much higher numbers of people who use drugs. Next year’s conference will be held in Beirut; the conference is being taken to the Middle East and Africa region to help support the spread of harm reduction to a part of the world currently experiencing a troubling growth in both drug use and HIV. PSI will be there as part of our commitment to playing a role in helping address the problem that one-third of all new HIV infections outside sub-Saharan Africa are related to risky drug use.
Rob Gray
PSI IDU Technical Expert
Harm Reduction Fact Sheets
Building Capacities of IDUs in China
Changing Behavior of IDUs in Mexico
Research Tools for IDU Evidence-based Programming
Cross-sector Programms Enhance Harm Reduction in China
Consistent Condom Use and Risky Drug injecting Behavior among Sex Workers in Vietnam
Multimedia
The HIV prevalence rate among injecting drug users (IDUs) in Yunnan Province, China is more than 28%.
This is the story of Feng Yu, a former IDU, who is now the director of Kangxin Home for recovering IDUs in Yunnan Province. At Kangxin, Feng yu regularly organizes small group activities for recovering IDUs who have started methadone maintenance treatment (MMT).
With funding from U.S. Agency for International Development (USAID), PSI started providing financial and technical support to Kangxin Home in 2009.
Images courtesy of John Rae Photography.
38% of injecting drug users (IDUs) in Thailand are HIV-positive. This is largely due to sharing injecting equipment and a lack of access to health services and information.
PSIs Ozone Drop-in Center, a branded network of peer educators and drop-in centers run by PSI/Thailand. At the centers, IDUs can access health services, information, clean injecting equipment and condoms, in a confidential, trusting environment. More than 800 IDUs are currently being served by the centers.
P’Boy, a recovering drug user, is a peer educator for Ozone Drop-in Center. He provides referrals to the center and HIV counseling and testing. He distributes sterile injecting equipment and educates his peers about the risk of HIV infections. On an average day, P’Boy meets with about 50 current and recovering drug users.
