Thai drugs activists made their position clear at the start
of the conference (p9519)
Thailand’s Public Health Minister, Dr. Sudarat Keyuraphan,
addressed the conference's opening ceremony on Sunday (p9520)

Red Cross and Red Crescent delegates to the conference come
from a dozen countries, representing National Societies and
Federation staff on three continents (p9521)
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Harm reduction conference opens
with call for better treatment
7 April 2003
by Omar Valdimarsson in Chiang Mai
The 14th International Conference
on the Reduction of Drug Related Harm, co-sponsored by the International
Federation, has begun in the Thai city of Chiang Mai. The tone was
on Sunday set when members of the Thai Drug Users Network greeted
the arrival of Thai Public Health Minister Dr. Sudarat Keyuraphan
with protests against the Thai government’s drugs policy.
The activists held placards and banners criticising their government’s
controversial campaign to rid Thailand of drugs in the space of three
months. Since the campaign was launched at the end of January, more
than 2,000 people suspected of drug dealing or drug use have been
killed, most of them gunned down in the street. Human rights groups
accuse the police and military of carrying out these killings, while
the government says they are mostly the result of inter-gang warfare.
“We are here to respond to the deplorable health and human rights
situation of drug users in our country, and in particular the current
climate of fear caused by the extra-judicial killing of people allegedly
involved with drugs,” the drugs activists stated.
“Many of our friends have also died because of a lack of health
information or the denial of care and treatment. We are rejected by
our families and friends and discriminated against in the legal system;
society treats us as criminals, not as human beings.”
The Thai drugs activists are demanding a role in the development of
programmes and policies related to drug use, harm reduction and treatment
for addicts. Current practice in this normally very tolerant country
prevents active drug users from accessing health care and treatment,
including anti-retroviral treatment for those infected with HIV.
The Thai Drug Users Network is one of a number of activist groups
and networks taking part in this conference, in addition to a number
of international organizations and non-governmental organizations.
The conference is organized by the International Harm Reduction Association,
in partnership with the Asian Harm Reduction Network and Thai authorities.
The International Federation is one of the sponsors of the conference.
The Federation has echoed the cry of the activists by urging governments
to stop treating people who are at high risk from HIV/AIDS as ‘social
evils’. It believes the stigma, discrimination and marginalization
faced by such groups must be addressed urgently if global efforts
to combat the AIDS pandemic are to succeed. Eastern Europe and parts
of Asia are today experiencing alarming rates of HIV infection through
shared injecting drugs equipment such as needles.
“The only way to reverse this trend is for governments to implement
policies that see a deliberate shift from social exclusion to social
inclusion of injecting drug users. Reach out to them and make their
practices safe. Providing clean needles is a start,” said Dr
Massimo Barra, founder of an Italian Red Cross foundation that assists
injecting drug users, and board member of the Global Fund to fight
AIDS, Tuberculosis and Malaria.
“We need greater recognition worldwide that by ostracizing and
marginalizing groups of people, they are made especially vulnerable
to disease,” Barra stated on the eve of the conference. “By
being singled out as deserving punishment, the unsafe practices of
injecting drug users are being driven underground, resulting in a
public health disaster.”
Studies show that needle exchange programmes have reduced high-risk
behaviour among injecting drug users by as much as 80 per cent, with
an estimated 30 per cent or more reduction in HIV infection rates.
“There is clear scientific evidence that needle exchange programmes
work. They help contain the HIV/AIDS pandemic and in a very cost effective
way,” said Bernard Gardiner, head of the International Federation’s
HIV/AIDS unit. “Evidence is also clear that these programmes
do not promote drug use. On the contrary, they are associated with
decreased drug use.”
Among the countries with extensive experience of harm reduction policies
is the Netherlands, where the first needle exchange programmes were
instigated two decades ago. Its government is one of the main funders
of the International Harm Reduction Association.
“Our national drugs policy has been drafted in partnership between
law enforcement, public health and civil society and has proven to
be effective,” said Dr Jacob Mol, Dutch deputy ambassador to
Thailand. “Not only has drug related harm in the Netherlands
been brought back to very low levels but also, when compared to other
countries in the region and beyond, drug use levels in our society
are at a moderate or low level.”
Mol said that reaching out to those who “have been caught in
a trap of drug use or abuse is decisive and needs our compassion and
support. I am very pleased that the International Federation of Red
Cross and Red Crescent Societies has recognized this.”
Several Red Cross and Red Crescent societies around the world are
already implementing harm reduction programmes, including those in
Italy, Croatia, Latvia, Portugal and Spain, in collaboration with
governments or other organizations.
The Vietnamese and Chinese Red Cross Societies have begun to include
injecting drug users in their HIV/AIDS prevention programmes, while
in West Africa, the Nigerian Red Cross is similarly planning to expand
its existing environmental sanitation programme in prisons to include
HIV education and advocacy.
“Harm reduction is a new concept in Nigeria and, in fact, large
parts of Africa,” says Dr. Moses Aderanti, director of health
for the Nigerian Red Cross and a member of the Red Cross/Red Crescent
delegation in Chiang Mai. “I hope to be able to learn much about
how others are conducting their harm reduction programmes and then
adapt some of that to our situation – and use our prison programme
as an entry point.”
On the last day of the conference, Thursday, the International Federation
is organizing a symposium on ‘Harm Reduction: Humanitarian Principles
in Action’, open to all 750 conference delegates. Its aim is
to explore the link between humanitarian values, such as the Red Cross
Red Crescent Fundamental Principles, and advocacy – for legal
reform and more effective strategies - to create a supportive climate
for harm reduction programming.
Related links:
Reducing the impact of HIV/AIDS
14th International
Harm Reduction Conference, Chiang Mai
Press Release: Federation calls
on governments to end “social evil” policies that fuel
HIV/AIDS
News Story: Belarus Red Cross taking
steps towards harm-reduction
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