Highlights from the 12^th International Harm Reduction Conference

Monday 2 April 2001, New Delhi

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PROBLEM DRUG USE IS A GLOBAL ISSUE

NGOs, UN agencies, government officials and drug users reach consensus on scope and complexity of drug use 

The launch yesterday of the 12^th annual International Harm Reduction Conference marked a new consensus on the understanding and conception of problem drug use the world over Law enforcers, policy makers, treatment practitioners and community activists alike agreed no country is exempt from the issue-drug use is no respecter of national boundaries. And despite deep ideological and cultural differences as recently as two year ago, all acknowledged the multi-faceted character of drug dependence and called for more comprehensive responses.

“The international community has recognized that problem drug use can’t be addressed by supply reduction alone,” said Renate Ehmer, Regional Representative from the UN Drug Control Programme. “We need comprehensive strategies which is why the UNDCP supports the full range of proven interventions from needle exchange programmes to equipping young people to innovate their own responses to marginalisation.”

Shri Roja, the Indian Minister of State for Health and Family Welfare, demonstrated what national governments can do to realize these objectives. “One of the most effective strategies policy makers can adopt is a political attitude that goes beyond the moral boundaries of judgemental public perceptions,” he said. “It is critical we respond to the complex social factors in problem drug use.”

Luke Samson, Conference President and Director of the host drug project SHARAN, explain how the agenda for harm reduction is now being realized in grassroots practice. “Harm reduction is not just a strategy, but a human response. We mush be award that by ourselves we cannot address the problem from lack of human and material resources. We need to work with the community in partnership.”

But though harm reduction now receives widespread support and continues to mature and develop, Werasit Sititrai, Deputy Director of UNAIDS, left delegates in no doubt of the challenge ahead. “We have enough knowledge about how to prevent the spread of HIV, but we have not achieved enough. We have successful and committed projects, but coverage is patchy and interventions have not achieved a cumulative effect.”

Perhaps the reality on the ground was best reflected in the observation of Pat O’Hare, Executive Director of the International Harm Reduction Association, that drug users’ lives haven’t changed that much from ten years ago. “They are still denied their rights and access to basic health care,” he said.

To that end, John Francis, a key stakeholder in SHARAN and himself a drug user like the majority of his professional colleagues, underscored the role of the first IHRC to be held in Asia. “We must take the conference to the drug users who can’t be here because they don’t have the means to attend. We need to be looking for real outcomes that will make a practical impact on drug users’ lives.”

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sound bites

“We wanted to support the IHRC in Delhi to bring the urgency of the drug problem to the doorstep of the Indian government. We don’t want to reach the point where we have to declare a national crisis.” N Saxena Chair, Rusan Phamaceuticals, sponsors to the 12^th IHRC.

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Follow-up sessions

The role of community development in delivering harm reduction will be developed in a key plenary session, Community Development and Harm Reduction, Tues 09 15 in Convention Hall  B.

The urgency of developing more strategic coverage will e addressed in joint UNDCP/UNAIDS roundtable HIV Prevention, Drug Control and Health Promotion. Weds 14.10 in the Ruby Room.

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Network News is produced by the Media Committee; Gieera Ahuja, Sundar Daniel, Cedric Fernandes, Richard Francis, Vicky Loverseed, Mamoj Misra, Timothy Moore, Rowena Young (Co-Ordinator). The Mieia Committee can be contacted via the media room in the foyer to the convention suite.

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Safer injecting rooms: the next step in harm reduction? 

Needle exchange programmes and substitute prescribing have for over a decade formed the medical backbone to harm reduction efforts. But now drug agencies are responding to the wider issues around injection drug use by providing supervised environments for the process of injection itself. 

“A safer injecting room is a legal facility that enables drug users to consume drugs they have bought themselves in a stress-free environment which is hygienic and reduces the likelihood of taking risks.” Explained Robert Broadhead from the University of Connecticut, USA. 

Though professionals share a concern that there has not been sufficient evaluation to judge whether the practice delivers results, early findings suggest safer injecting rooms (SIRs) work. 

Jo Kimber from the University of New South Wales, Australia, studied 15 SIRs in Switzerland, Spain, Germany and the Netherlands. According to her drug workers and policy makers should be encouraged by the assessments of frontline staff who reported.

A reduction of overdoses and deaths;

Reductions in blood borne viral infections;

Reductions in discarded needles and injecting in public; 

Dane van der Hoe, a Dutch drug user representative, said drug users welcome SIRs, but that there was a widespread feeling they could be more user-friendly. He called for a more chilled out atmosphere, food and hospitality-and resident dealers. Without access to “proper drugs at proper prices’ he felt SIRs would fail to attract users and undermine their potential.

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News-in-brief 

If proof were needed that ‘when drugs come in through the front door (metaphorically), common sense can fly out of the window’ (Pat O’Hare), witness the experience of Santa Cruz drug users ‘zine’ Junkphood. 

Drawing heavily on graphic comics for inspiration, the magazine successfully communicates critical health advice to teenagers and young people. But when one local teenager overdosed and died, a recent edition demonstration how to inject safely was blamed for inciting drug abuse. 

Junkphood is currently banned by the police from being distributed in the vicinity of the incident. 

For further details contact Emily Ager at emil.ager@lycos.com

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FINDINGS 

Just how widespread is problem drug use” 130 countries now report injecting drug use. Near to 100 have HIV among injecting drug users (IDUs). WHO 

New incidents of HIV among IDUs can quickly develop to epidemic proportions without early strategic responses. For example, the first cases of HIV among this community in Manipur in north-east India were detected in October 1989. within ten years, 70% of this population were coming to terms with the disease. 

A recent study conducted by John Hopkins University, USA, revealed that of 200 respondents, 45% of Delhi’s drug dependents inhect and 77% do not use condoms. HIV rates among IDUs stand at;

• 10% in Mumbai;
• 20% in Chennai;
• 20% in Kolkata;
• 80% in Imphal; 

Eastern European countries are experiencing the fastest growth in drug-related  HIV prevalence. Current figures suggest there are over 700,000 IDUs in Russia alone. More than 80,000 are thought to be infected with HIV. WHO 

The salience of drug-related social exclusion in contemporary life is acknowledged in this year’s World Health Day, 7 April. Celebrated in almost every country, this year it is dedicated to raising awareness of substance dependence and mental health