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31st August 2009
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IHRA Launches Online Document Collection on Overdose
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 On August 31st 2009, IHRA launched the fifth in a series of online document collections – this time focusing on the extent and prevention of overdose. These “50 Best” collections have been created by IHRA in order to provide free, accessible harm reduction resources on its website. The idea is to highlight a selection of documents, papers and resources which best summarise the evidence-base, reasoning and justification for particular harm reduction interventions and approaches. These resources can then be used by other researchers, policy-makers, advocates or anyone interested in the field.
This latest collection is designed to improve knowledge and discussion on the important topic of overdose, and this collection has been launched to coincide with International Overdose Awareness Day which, since 2000, has been aiming to build awareness about this key issue and to remember friends, peers, family members and colleagues who have died or are suffering from a permanent injury due to an overdose. The document collection is the result of several months of literature searches and research by IHRA – inspired by the Eurasian Harm Reduction Network (EHRN) – with the guidance of an International Reference Panel.
Overdose is a risk for all psychoactive drug users. For example, longitudinal studies indicate that between 1% and 3% of heroin users die each year, with overdoses accounting for an (increasing) majority of these deaths in many countries. Evidence also suggests that in excess of 40% of heroin injectors have experienced a non-fatal overdose and as many as 70% have witnessed an overdose event. Research has also found that injecting drug users are 15 times more likely to overdose than those who use non-injecting routes of administration, and overdose is especially common for those who use combinations of different drugs.
Overdose is, however, a fundamentally preventable harm. In many ways, overdose prevention is a quintessential harm reduction approach. For heroin overdoses in particular, a ‘cure’ exists through emergency medication called ‘naloxone’ – yet this is a shamefully underused intervention around the world given its potential to save lives.
The online document collection from IHRA covers seven sub-categories – Overviews; Guides and Policies; Epidemiological Research; Risk Factors and Risk Environments; Naloxone Research; Naloxone Programmes; and Other Prevention Research and Interventions. It aims to provide an introduction into the topic of overdose for a broad range of audiences - including policy makers, practitioners, communities, international organisations and researchers. Wherever possible, links are provided to the papers and articles that are featured, with most of the documents freely available to download online.
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Previous ’50 Best’ collections from IHRA cover HIV prevention and care for injecting drug users, tobacco harm reduction, alcohol harm reduction, and the role of policing in harm reduction for illicit drugs. All of these collections are available to view and search on the IHRA website, and more collections are being planned over the next 12 months.
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26th August 2009
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ICAAP Calls for Stronger Commitment to Universal Access
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More than 3,000 health experts, advocates and activists from over 60 countries gathered in Bali, Indonesia in August 2009 for the 9th International Congress on AIDS in Asia and the Pacific (ICAAP). The event aimed to discuss efforts towards universal access to HIV/AIDS treatment, care and support – including for people who use drugs – and called for a strengthened commitment from governments and donors despite the pressures of the global economic crisis. The theme for the event was ‘Empowering People, Strengthening Networks’.
The goal of universal access was set in the ‘Declaration of Commitment’ adopted at the UN General Assembly Special Session on AIDS in 2001, and reaffirmed by a ‘Political Declaration’ in 2006. The UNAIDS Executive Director, Michel Sidibe, told delegates in Bali that “more than 1,000 people become infected with HIV in Asia each day”, and urged that “We must transform the AIDS response in Asia so that it works for people, and especially for people who have been marginalised and without a voice” – including sex workers, men who have sex with men, and injecting drug users. He added that “most infections could have been averted if only we had invested in reaching populations at higher risk and their partners – at a cost of less than half a US dollar per person”.
The Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Professor Michel Kazatchkine, also addressed delegates and said “it is time for the G20 – which is 85 percent of the world’s economy – to come into the circle of donors” in order to help expand the global AIDS funding. He pointed to countries such as Brazil, China, Mexico and South Africa, who “play more political leadership roles [and] have to enter into the global solidarity effort when it comes to health”.
The ICAAP event also featured discussions on key topics such as the decriminalisation of drug use, the high rates HIV and hepatitis C co-infection, compulsory treatment in Asia, and youth leadership on HIV issues. There was also a meeting of AIDS Ambassadors to discuss the mobilisation of funds and commitments, and accountability in the global responses to HIV. A pre-congress forum was also held for people who use drugs to discuss issues such as the decriminalisation of drugs, the human rights of people who use drugs, and issues around drug policy reforms.
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24th August 2009
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Latin Judges Agree Statement on Drugs and Human Rights
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In July 2009, at CLAT 5 (the 5th ‘Latin’ conference on harm reduction) in Portugal, an international group of high-profile judges released an important statement claiming that “drug policies have proved an outright failure” and have “created an illegal market of unknown macroeconomic proportions”. The statement expresses frustrations that the global response has led to criminal courts around the world being inundated with minor cases while the higher-level suppliers, money-launderers, traffickers, dealers and offenders remain untouched.
The statement was signed – among others – by a member of the Supreme Court of Portugal, two members of a Supreme Court from Italy, a member of the Supreme Court of Cantabria (Spain), a senior judge from Spain, and two Court of Appeal Judges from Brazil. It states that “using the penal system in reality violates the right to access to health” for people who use drugs and that “the prohibition of consumption through the repression of drug possession ostracizes drug users”. It calls for the concept of harm reduction to be expanded from public health to the “reduction of violence exerted by government or state agencies over the population”.
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 Click here to view the full statement [PDF:50KB]
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19th August 2009
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Harm Reduction 2010 Call for Submissions
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The online system for submitting abstracts to present at Harm Reduction 2010: IHRA’s 21st International Conference is now open – and will close on November 1st 2009. All delegates who wish to present at the conference – either orally or with a poster – are encouraged to make submissions about innovative harm reduction services, new or ground-breaking research, effective or successful advocacy campaigns, or key policy discussions or debates. In order to submit an abstract, you must first register for the conference and create a new user account. Once you have done this, simply click on the ‘your submissions’ link and follow the instructions.
This year, the Programme Committee is particularly keen to receive submissions that relate to the conference theme – Harm Reduction: The Next Generation. This theme will reflect upon two and a half decades of harm reduction experience (including substantial scientific evidence showing that harm reduction works), but will also explore what is needed to move on to the next twenty years. This includes questions such as:
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- How adequate are the models of harm reduction that have been developed?
- Is the ‘comprehensive package’ of harm reduction for HIV sustainable in low and middle income countries?
- How can we expand harm reduction to cater for all psychoactive drugs?
- How can harm reduction be ‘scaled up’ in terms of coverage, quality and integration into health systems?
- How does harm reduction intersect with, and change, drug control systems?
- What new opportunities are there for harm reduction in terms of human rights, security, development and other sectors?
- How can we better empower and engage young people, who are both directly and indirectly affected by drug use around the world?
- How can harm reduction better serve new populations, especially in regions such as Africa and Latin America?
- How can we better support non-injecting drug users and move beyond a focus on opiates?
- How can harm reduction overcome new challenges, such as the need to improve global resourcing?
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In order to assist delegates, the conference organisers have created a short guide which includes information about choosing a topic, writing and formatting an abstract, choosing a title, and submitting the abstract.
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Click Here for the ‘Guide for Developing and Submitting an Abstract’ [PDF:165KB]
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18th August 2009
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UN Economic and Social Council Endorses Harm Reduction
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In July 2009, the United Nation’s Economic and Social Council (ECOSOC) adopted a resolution related to the work of the Joint United Nations Programme on AIDS (UNAIDS). The resolution was agreed at an ECOSOC meeting in Geneva focusing on the social determinants of health. It contains an explicit supportive reference to harm reduction – the first official mention of harm reduction by this senior UN body.
The resolution “[r]ecognizes the need for UNAIDS to significantly expand and strengthen its work... to support increased capacity and resources for the provision of a comprehensive package of services for injecting drug users including harm reduction programmes”. The resolution was supported by 31 Member States (and was not opposed during the meeting), and follows on from another recent endorsement of harm reduction by the UNAIDS Programme Coordinating Board. This resolution is further evidence of the expanding acceptance and credibility of harm reduction approaches at the international level.
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ECOSOC was one of the original UN bodies established under the United Nations Charter in 1945. It co-ordinates the work of a number of specialised UN agencies, programmes and commissions – including UNAIDS. The ECOSOC meetings serve as the central forum for discussing a broad range of issues such as standards of living, employment, economic and social progress, and health problems. Crucially, however, ECOSOC is also the ‘parent’ body of the central drug policy forum in the UN – the Commission on Narcotic Drugs. Unlike ECOSOC, CND which has yet to make an official, explicit endorsement of harm reduction, due in no small part to an over-reliance on consensus which has allowed a minority of Member States (including Japan, Russia and the USA) to actively oppose harm reduction during discussions and in the wording of resolutions. It will be interesting to see whether the ambiguous and incongruous position of CND changes now that harm reduction has been formally endorsed by ECOSOC as well as the UN General Assembly (the chief organ of the United Nations comprising all 192 Member States), and the Office of the High Commissioner for Human Rights.
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Click here to view the ECOSOC Resolution [PDF:27KB]
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7th August 2009
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Liverpool 1990 and Sao Paulo 1998 Added to Conference Archive
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Over the past two years, IHRA has been developing an online conference archive for the previous international harm reduction events. We are pleased to announce that this archive now includes resources from the inaugural event – the 1st International Conference on the Reduction of Drug-Related Harm in Liverpool, England in April 1990 – and also from the 9th International Conference on the Reduction of Drug Related Harm in Sao Paulo, Brazil in March 1998.
The Liverpool 1990 archive is of particular interest as our next event – Harm Reduction 2010: IHRA’s 21st International Conference – will be returning to Liverpool to reflect upon the past two and a half decades of harm reduction, and look forward to the challenges and approaches for ‘Harm Reduction: The Next Generation’ (the 2010 conference theme). After months of searching, we have finally been able to obtain a copy of the original conference programme and abstract book from 1990, and the archive page for this event currently includes a detailed overview, scanned items from the original programme, the official conference report, photographs, and links. The 1990 conference was organised in response to world-wide interest in the ‘Mersey Harm Reduction Model’ in the late 1980s, as Liverpool was one of the first cities in the world to develop and implement a comprehensive harm reduction approach. It attracted over 350 delegates and included presentations from the UK, Australia, the Netherlands and the USA.
Since 1990, these conferences have been crucial to the promotion and development of harm reduction research, debate and best practice around the world. They have been held in seventeen cities across five continents, and become the main international meeting point for all those interested in harm reduction. The addition of the Sao Paulo 1998 archive page means that detailed conference reviews are now available for the last twelve events. The 1998 page includes a detailed overview of the event, scanned items from the original programme, photographs, and information about the 1998 IHRA Awards.
IHRA will continue to develop this conference archive over the coming months. In order to maintain and develop this resource, we ask all IHRA members and friends to send us any information that you may have from any of the past events – including photographs and presentations. If you have any information that you would like to share, please contact Jamie Bridge.
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3rd August 2009
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Harm Reduction in Prisons: The Moldova Model
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The Open Society Institute’s International Harm Reduction Development programme (IHRD) has released a new report which describes the development and implementation of prison harm reduction programmes in Moldova. The report – by Jeff Hoover and Ralf Jürgens (the 2009 International Rolleston Award winner) – is based on research, site visits and interviews with prisoners, pre-trial detainees, NGO staff and prison officials during 2007 and 2008. It aims to share the experiences, successes and challenges from Moldova, and to provide recommendations for policy-makers and advocated in other countries wishing to start similar programmes.
In many countries, the prevalence of HIV and hepatitis C among prisoners who use drugs is notably higher than among people who use drugs outside of prisons, and significantly higher than among the general population. Despite this, however, the global coverage of harm reduction interventions in prisons is generally poor. According to IHRA’s Harm Reduction Policy and Practice Worldwide report, 84 countries around the world support harm reduction, yet only ten have needle and syringe exchange in prisons, and only 37 have opioid substitution therapy in prisons. The risk of being infected in prison – specifically through the sharing of contaminated injecting equipment – is therefore high.
The report – entitled ‘Harm Reduction in Prison: The Moldova Model’ – is available to download for free in English and Russian. Paper copies are also available by contacting Roxanne Saucier and specifying how many you require and in which language.
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