Basic HTML Version
bined and pharmaceutical companiesmaking their drugs affordable in poorer countries.
‘HIV was a brutal teacher,’ she told delegates. ‘We learned that mass
incarceration for drug possession – far from discouraging drug use – was the place
where HIV, hepatitis C and drug use were allowed to flourish. Our approach has to
be more comprehensive.’
It was also vital to consider harms ‘beyond the public health approach’, she
said. These included the increased power of criminal organisations, which not only
challenged weaker states but had actually come to threaten democracy and the
rule of law in many parts of the world.
‘Mass incarceration is a huge waste of public resources, and human rights
violations are justified by the war on drugs,’ she said. It also remained vital to fight
for and finance harm reduction measures, and ensure they were accepted and
understood by the public.
‘We are all committed to achieving these aims,’ she told delegates. ‘And you are
saving lives.’
THE HEAVY COST OF CUTBACKS
HARM REDUCTION IS A ‘GLOBAL BEST-BUY’
‘We all know why we need to worry,’ said David Wilson of the World Bank, in a
session on financing harm reduction. ‘If we look at the prevalence of injecting,
there are very high rates in Eastern Europe and Central Asia. The picture is
alarming, but we all know what works.’ The gaps in needle and syringe
programmes (NSPs) coverage globally, however, were profound. ‘Since 2010 we’ve
actually seen NSPs scaled back in countries in Eastern Europe and Asia.’
The Global Fund was the largest harm reduction funder, and responsible for
more than half of the funding coming to the region, he said. ‘But harm reduction is
cost-effective in every region, and the return on investment is very positive.’ Total
future returns were estimated at up to $8 per dollar spent, and the more
interventions were scaled up the more cost-effective they became, he stressed,
with figures from Australia showing an estimated yield of $27 per dollar invested.
‘Inaction is costly,’ he told delegates. ‘And it’s not the equivalent of doing
nothing. Wherever we can, we need to get upstream before infections start.’ The
returns accrued to the whole of society, however. ‘It’s a global best-buy for public
health and development money.’
Nonetheless, the trend for investment in HIV prevention for people who used
drugs was going the wrong way, Daniel Wolfe of the Open Society Foundations
International Harm Reduction Development Programme told the conference. ‘The
Global Fund is also likely to be a lot less global and a lot less prevention-focused
14 |
drinkanddrugsnews
| July 2013
Harm Reduction International |
Vilnius, 2013
www.drinkanddrugsnews.com
RECLAIMING
HARM
REDUCTION
HRI EXECUTIVE DIRECTOR RICK LINES
EXPLAINS THE REASONS FOR MOUNTING
THE EVENT IN EASTERN EUROPE
‘Eurasia is one of the regions that’s been most severely
hit by the HIV epidemic related to injecting drug use,’ says HRI executive director
Rick Lines of the decision to stage this year’s conference in Lithuania – the first time
the event has been held in the Baltic States, and its first time in Eastern Europe
since 2007.
‘It’s also a region where the harm reduction response is underdeveloped,’ he
says. ‘There are high levels of need and a lot of countries with generally poor harm
reduction services, severely repressive drug laws and human rights violations
against people who use drugs. Having the conference in the Eurasian region was an
important way to call attention to these issues.’
Lithuania is also home to HRI’s partner organisation, the Eurasian Harm
Reduction Network. ‘They approached us with a proposal to hold the conference
here and they’re a fantastic organisation so we jumped at the chance,’ he says.
This year’s theme is the
Value/s of harm reduction
, with a focus on two key
issues. The first is the economic case – the fact that harm reduction ‘not only saves
lives but is also a very cost-effective public health intervention’, he states.
‘But we also wanted to focus on the values, because one of the things we’re
seeing is the pushback against harm reduction by conservative governments
pushing a recovery agenda. Even five years ago the anti-harm reduction lobby was
trying to argue against the scientific basis of harm reduction, but you rarely hear
that now. Instead they try to frame harm reduction as this kind of morally suspect,
very clinical response that doesn’t value people and sees them as simply receptors
of services. So it’s also about reclaiming the moral, ethical and philosophical basis
of harm reduction.’
THE RIGHT TO LIFE
HUMAN RIGHTS SHOULD NEVER BE SACRIFICED TO THE ‘WAR ON
DRUGS’, SAID MINISTERS
‘If you break stereotypes,’ Lithuania’s health minister Vytenis Povilas Anriukaitis
told delegates, ‘you break down walls.’
Human rights included the right to live, to have opportunities and to
acknowledge that people are equal, he said. ‘We must always remember that. It’s
predetermined positions that destroy people’s lives –we have to fight for leadership.’
Human rights were not invalidated by drug use, former president of
Switzerland Ruth Dreifuss told the conference. Lithuania was playing a pioneering
role in harm reduction in Eastern Europe, she said, with HIV rates ten times lower
than in some neighbouring countries. However, the ‘ticking timebomb’ of hepatitis
C meant that adequate coverage of services was vital.
Ensuring that services were accessible and affordable for all was challenging, she
said. International solidarity was essential, with financing from states and NGOs com-
Last month saw the 23rd International Harm Reduction Conference take
place in Lithuania.
DDN
reports on a gathering of activists, policy makers
and service users from across the globe.
‘Harm reduction
is cost-effective
in every region...’
DAVID WILSON
SAFE FROM HARM