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International provision of harm
reduction services is under threat
from a funding crisis and lack of
political will, according to a report
from Harm Reduction International
(HRI), the International HIV/Aids
Alliance and the International Drug
Policy Consortium (IDPC).
Funding has been falling
‘dangerously short’ of estimated
needs for some time and is set to
deteriorate further, says the
document, the result of changes in
donor policies and neglect on the part
of national governments. The report
urges international donors, UN
agencies and national governments to
take action, stressing that ‘there can
be no “Aids-free generation” without
targeted efforts with and for people
who inject drugs’.
Around 40 per cent of new
infections are the result of unsafe
injecting practices in middle-income
countries – particularly in Eastern
Europe and Asia – where around three
quarters of people who inject drugs
live. However, changes in Global Fund
funding policy ‘threaten to
significantly reduce’ harm reduction
allocations in these countries, says the
report. Major international donors like
the US and UK are also withdrawing
aid from many of these countries
because of their middle-income
status. Of the 15 countries prioritised
by UNAIDS for harm reduction
programmes, only Kenya is still
classed as a low-income country
according to World Bank definitions.
‘Donors are retreating from these
countries under the premise that they
are wealthy enough to resource their
own HIV responses,’ the report states.
‘Yet national governments are often
unwilling to invest in services for key
populations, leaving existing
programmes under threat and scale-
up impossible.’ It cites the example of
Romania, where many programmes
closed following the end of Global
Fund support and where a
subsequent rise in HIV transmission
through unsafe injecting has been
reported. ‘Underpinning many of
these resource gaps lies a
fundamental inhibiting factor: harm
reduction services for people who
inject drugs are often politically
unpopular,’ it adds.
Around $2.3bn is needed next year
alone to fund HIV prevention among
people who inject drugs, according to
UNODC estimates, but only around 7
per cent of that has been invested by
international donors so far. National
governments are also choosing to
prioritise ‘ineffective drug law
enforcement’ over harm reduction, even
in countries with high drug-related HIV
transmission rates, the report says. ‘Just
one tenth of one year’s drug
enforcement expenditure (estimated to
exceed $100bn globally) would fund
global HIV prevention for people who
inject drugs for four years,’ says HRI.
The funding crisis for harm
reduction at www.ihra.net
PSYCHOACTIVE SURVEY
A consultation on new psychoactive substances
has been launched by the National Assembly for
Wales’ health and social care committee,
looking at issues like awareness, legislation,
service capacity, partnership working, data
collection and international evidence. The
committee is looking for submissions from both
individuals and organisations and the
consultation, which has been welcomed by the
BMA, runs until 26 September. ‘Our members
are increasingly seeing problems as a result of
these substances,’ said BMA Welsh secretary
Richard Lewis. ‘Health and education services
need to have a consistent way of monitoring
these changes as new products are coming
out
all of the time.’
Consultation at
www.senedd.assemblywales.org
ACMD ADDITIONS
Nine new members have been appointed to the
Advisory Council on the Misuse of Drugs,
including DrugScope chief executive Marcus
Roberts and professor of neuropharmacology
at the University of Reading, Ben Whalley.
‘Their considerable experience and expertise
will further strengthen our council,’ said ACMD
chair Les Iversen.
CONTINENTAL COMPARISONS
A Europe-wide overview of the history and
availability of residential provision in different
national drug treatment systems has been
published by EMCDDA. Among the areas
looked at in
Residential treatment for drug use
in Europe
are coverage, organisational
structure and treatment components.
Available
at www.emcdda.europa.eu
A BRIEF WORD
More than 100 people attended a training and
networking event in Monmouth last month to
promote ‘Have a Word’, the national alcohol
brief intervention training programme for Wales.
‘The “Have a Word” training has enabled over
6,000 people in Wales to identify hazardous and
harmful drinkers and provide advice to reduce
alcohol-related harm,’ said the Kaleidoscope
Project’s alcohol service team leader and
training coordinator, Tom Damsell. ‘By working in
collaboration with Public Health Wales to deliver
the training and by putting on events like this, I
hope that in a few years time alcohol brief
intervention training will be commonplace and
fewer and fewer problem drinkers will be slipping
through the net into alcohol dependency.’
SENSITIVE SUBJECTS
A briefing to help ensure that pupils receive
relevant alcohol and drug education in the
context of cultural differences has been
published by Mentor ADEPIS.
Making it
inclusive: alcohol and drug education in
multicultural settings
sets out the key
requirements for ‘culturally sensitive’ teaching.
Available at mentor-adepis.org
A set of new pledges has been announced by the
government as part of its ‘responsibility deal’ with
the alcohol industry. They include an end to the sale
of super-strength drinks in large cans and more
‘responsible’ displays and promotions in shops.
There is also a commitment to promoting lower-
alcohol products in pubs and bars, and making sure
that house wines below 12.5 per cent are always
available. Initial funding of £250,000 from the drinks
industry to provide alcohol education programmes in
schools has also been announced.
The responsibility deal was launched as a
partnership between the government, the industry and
the voluntary sector, alongside similar arrangements
with the food industry and others, and originally
announced in the 2010 public health white paper (
DDN
,
6 December 2010, page 4). Controversial from the start,
it was branded ‘the worst possible deal for everyone
who wants to see alcohol harm reduced’ by Alcohol
Concern (
DDN
, April 2011, page 4), with the charity
refusing to sign up – along with the Royal College of
Physicians, the British Medical Association and the
British Liver Trust – despite government claims that the
arrangement would deliver ‘faster and better’ results
than legislation.
Other organisations including Cancer Research and
the Faculty of Public Health later withdrew from the
responsibility deal network following the government’s
announcement that it was not planning to introduce a
minimum unit price (
DDN
, August 2013, page 4), and
although the government has said the aim is to remove a
billion units of alcohol from the market, a recent report on
the progress of the deal found that the reduction so far
had been a quarter of that (
DDN
, May, page 4).
‘Alcohol-fuelled harm costs taxpayers £21bn a year.
It is therefore right that the alcohol industry is taking
action to help reduce this burden, without penalising
those that drink responsibly,’ said home secretary
Theresa May of the new arrangements. ‘The
government welcomes the progress the alcohol
industry has made so far in responding to the
challenge we set them. We now look forward to seeing
the positive impact of these pledges and continuing to
work with industry to explore what else can be done to
tackle alcohol abuse.’
‘As responsible businesses, we are determined to
play our part and have set out a whole new programme
of voluntary actions in response to the challenge set by
the home secretary,’ said Portman Group chief executive
Henry Ashworth. ‘Working in partnership with business
is a great way to get positive change happening quickly
in towns and cities throughout the UK.’
4 |
drinkanddrugsnews
| August 2014
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Round-up
NEWS IN BRIEF
‘New pledges’ announced
as part of alcohol deal
Funding fears for harm reduction