Monday at AIDS 2012: Two sessions in the main conference illustrated the challenges of scaling up harm reduction in a world-wide context. In a session on HIV, Drug Use and Human Rights, Jeffrey Lazarus analysed the amount the Global Fund has spent on harm reduction between 2002 and 2009. The Global Fund is the single largest financial supporter of harm reduction around the world, giving close to $582 million to harm reduction services since 2002.
The majority of this funding, around 95%, went to Eastern Europe and Asia, with very few countries in Sub-Saharan Africa receiving funding for harm reduction. As Lazarus noted, accessing monies through the Global Fund is a country-driven process, and this means the Global Fund must provide greater technical support, advocacy, and political commitment to ensure that adequate harm reduction funding flows to African nations where injection drug use is on the rise.
In other presentations, researchers used their data to illustrate many of the tenets of CDPC policy and to underscore what many people in the harm reduction field already know. Police-violence in Thailand marginalizes people who use drugs resulting in higher rates of HIV transmission; the recent scale-up of the enforcement against people who use drugs in France threatens to undermine that country’s successes at eliminating the transmission of HIV; despite extensive external funding, the implementation of opioid substitution therapies (OST) in the Ukraine is still hampered by government indecision; and stigma against drug use in China leads to lower than recommended dosing of people on methadone, an underlying factor in low OST program retention rates.
Joanne Csete from the Open Society Foundations examined the balance between a public health and a law enforcement approach to illegal drug use in Ghana, Nigeria, South Africa and Tanzania. Findings from the research project argue conclusively that where countries include harm reduction in their national drug strategies, programs follow. As Csete illustrated, Tanzania has undertaken a comprehensive public health approach to drug use and has moved to scale up its harm reduction efforts. Though the link between political support and programs might seem obvious, there’s a lesson for Canada here. Harm reduction is the missing piece in Canada’s national “anti-drug strategy” promoted by the Harper government. At AIDS 2012 the message from global NGO’s is clear: harm reduction limits the transmission of HIV and saves lives. What do you say Canada – isn’t it time to get on board with what many countries around the world already know? To do less is to risk moving backwards on gold standard policies that ensure the safety of all Canadians.