Harm reduction conference closes in Thailand

Da: “” 10 April 2003 Chiang Mai, Thailand

Every day, it becomes more urgent for governments to provide efficient and practical measures to help injecting drug users lead healthy lives, such as increased access to treatment and harm reduction programmes.

Harsh and even violent policies to force individuals to change only succeed in turning the war on drugs into a war on drug users. That was the message from representatives of the International Federation and its partners at a symposium on ‘Harm reduction: humanitarian principles in action’, which came at the end of the 14th International Conference on the Reduction of Drug-related Harm in the Thai city of Chiang Mai today.

The Federation was one of the sponsors of the conference, which was attended by some 750 people including medical professionals, scientists, sociologists, therapists, counsellors and HIV and drug policy activists from all over the world.

“The scientific evidence is clear: harm reduction works. ‘Social evil’ policies, condemnation, harrassment and even incarceration of drug users do not,” said Bernard Gardiner, head of the International Federation’s HIV/AIDS unit. “What is urgently needed are treatment programmes for those who want to stop using drugs and effective harm reduction programmes to stop people from dying.
The stigmatization and discrimination of injecting drug users, particularly those who are HIV-infected, continues to spread the virus around the world, also among the groups who consider themselves at low-risk,” he added.

Drug-related harm reduction is a new focus of the International Federation with a limited number of Red Cross and Red Crescent Societies around the world involved in activities such as needle and syringe exchange programmes. But regional Red Cross Red Crescent conferences in Europe and Asia-Pacific last year encouraged members to take the global campaign against HIV-related stigma and discrimination to its next logical step and scale up harm reduction activities.

The Federation’s symposium in Chiang Mai sought to explore the link between humanitarian values such as the Red Cross Red Crescent’s seven fundamental principles and advocacy to create a supportive climate for harm reduction programming. Dr. Massimo Barra – creator of the “Villa Maraini”, an Italian Red Cross foundation that assists injecting drug users, and a board member of the Global Fund to fight AIDS, Tuberculosis and Malaria – reminded participants that most injecting drug users were already a disenfranchised population at high risk of HIV infection.

They also faced high levels of stigmatization, discrimination and even incarceration. Support to these groups is imperative, he said. “If we react in ways that aggravate the suffering, then we are perpetuating an attitude that goes against the concept of humanity and human rights – as well as against the interests of each nation.

Easier access to clean needles and syringes, drug substitution and treatment programmes is a humanitarian gesture and fully in line with our Fundamental Principles,” Barra told the symposium. Although many countries are already providing quality services to address problem drug use, other governments have instituted policies that hinder practical harm reduction work.

A number of Red Cross and Red Crescent societies in Europe, Africa, Asia and the Americas are already running harm reduction programmes or involving injecting drug users in HIV prevention programmes. One is the Iranian Red Crescent, which has a harm reduction programme in the prisons of Tehran.

The programme includes distribution of syringes, disinfectant materials and condoms, as well as encouraging addicts to move from injecting drugs to sniffing or oral consumption in an effort to reduce the risk of HIV-infection through shared needles. “We believe that every new infection we prevent can compensate for the cost of providing free syringes for 2,500 people,” said Dr. Alireza Salehi, under-secretary general for Treatment and Rehabilitation of the Iranian Red Crescent Dr. Lise Grivois, health adviser to the French Red Cross and member of the International Federation’s health commission, said the Red Cross and Red Crescent had a duty and a mandate to help the most vulnerable people and this included injecting drug users.

“Based on the principles of humanity and neutrality, the Red Cross Red Crescent cannot stay out of the field in which some of the most vulnerable people are struggling for their lives,” she said. “Who is more vulnerable than the person who is on the verge of losing or has already lost his dignity, his health, his social and family standing?”

The Italian Red Cross has been involved in substance abuse treatment and harm reduction for a quarter of a century through the Villa Maraini. Dr. Fabio Patruno, a psychologist and one of the founders of the foundation, said it did not wait for people to come to it. “We try to bridge the gap by seeking contact with the hard-to-reach drug users. We seek them in courtrooms, police stations and on the streets to provide them with care and assistance in any way possible, every day of the year,” he said, explaining how Villa Maraini staff deliver sterile syringes, condoms and information on safe sex, where to get a meal, a place to sleep or a bath.

“Helping someone to get a clean and safe syringe is an act of solidarity, not of complicity,” Patruno added. Julian Hows, board member of the European chapter of Global Network of Positive People (GNP+), a partner organization of the Federation in the global campaign against HIV-related stigma and discrimination, also took part in the symposium. Hows, who has lived with HIV for the past 15 years, described the impact the partnership with the Red Cross and Red Crescent had had on GNP+ and its members.

“During our initial discussions with the Federation back in 2001, we realized that the Red Cross people certainly could talk the talk – but would they walk the walk?” he said. “We decided that they would – and they have. Our self-help manual, Positive Development, has found a much wider audience in Red Cross and Red Crescent Societies around the world.

Another positive outcome of this partnership is that it has created a new resource for many of our partner organizations and it has changed the lives of many individuals who are living with HIV/AIDS.”
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