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24th September 2009
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Tasnim Azim Joins IHRA Board of Directors
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IHRA is pleased to announce that Tasnim Azim has been appointed onto the IHRA Board of Directors. Tasnim has been working in the field of HIV prevention in Bangladesh for more than ten years, and currently heads the HIV/AIDS Programme at the International Centre for Diarrhoeal Disease Research in Dhaka. She works closely with harm reduction services in Bangladesh, has worked on projects in Nepal and Bhutan, and has worked as a consultant for the likes of UNAIDS, the World Health Organization, the World Bank, and Family Health International.
Speaking about her appointment, Tasnim said, “When I started working on HIV in Bangladesh in 1997, it became immediately apparent that it was among injecting drug users that HIV would first appear. Since then, I have been researching on drug use and HIV and have used this evidence to influence programme design. IHRA has always been a strong force in bringing the issues of harm reduction forward and has greatly influenced my thinking in this field. I am therefore honoured to be invited onto the Board”.
The IHRA Board of Directors is the governing body of IHRA, and comprises individual experts in the field from around the world. Each Director is elected into a three-year term by the IHRA members at the Annual General Meetings. As IHRA is a registered company and a UK charity, Tasnim has been appointed as both a Director and a Trustee using a special provision which allows the Board to temporarily fill vacant positions. The appointment lasts up to the next IHRA Annual General Meeting (which will take place at Harm Reduction 2010: IHRA’s 21st International Conference), where she will be required to stand for election as normal.
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24th September 2009
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Hep Chat: A Radio Show on Hepatitis and Harm Reduction
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Hep Chat is a ground-breaking weekly radio programme in Australia that focuses specifically on hepatitis C and harm reduction. It is the weekly programme of Hepatitis C Victoria and is possibly the only radio show in the world to cover these issues in such detail. The programme aims to give a voice to people living with hepatitis C and allow them to ask questions and tell their own stories. The programme also aims to raise the profile of these issues and to help coordinate existing services and resources around hepatitis C.
As the on-going transmission of hepatitis C around the world is inextricably linked with drug use, Hep Chat actively argues that this must be seen as a predominantly health issue and that people with, or assumed to have, hepatitis C must have the same human rights as the rest of the community. As a result, Hep Chat has also become a forum for discussing some of the broader, more political issues around discrimination, harm reduction and drug law reform. Hep Chat takes the view that policies should be based on the greatest available scientific evidence, and that the people who are directly affected by these issues must have their voices heard and their rights respected and protected.
Hep Chat is broadcast by 3CR Radio in Melbourne every Thursday at 10.30 AM (local time). Since 2006, the show has also been made available online through web-streaming. Since 2007, it has also been archived and made available through a series of podcasts. These online resources have made Hep Chat accessible for a worldwide audience.
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21st September 2009
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IHRA Release Position Statement Defining Harm Reduction
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After months of discussion and consultation with partners, the International Harm Reduction Association (IHRA) Board of Directors and staff have released a detailed position statement defining the term ‘harm reduction’. The statement outlines a set of underlying principles which best describe this approach, and offers the following definition:
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‘Harm Reduction’ refers to policies, programmes and practices
that aim primarily to reduce the adverse health, social and economic
consequences of the use of legal and illegal psychoactive drugs without
necessarily reducing drug consumption.
Harm reduction benefits people who use drugs, their families and the community.
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The term ‘harm reduction’ came to prominence after the emergence of HIV in the 1980s, but the underlying principles of the approach can be traced back much further. However, as the approach developed gradually and in several places at once, there has always been an element of debate regarding an exact definition. More recently, this has led to concerns that some organisations may ‘hijack’ the term to justify interventions and policies which would not normally be classed as harm reduction. Therefore, IHRA is offering this definition of harm reduction – which applies equally to policies, programmes and practices, and to all psychoactive drug use (including controlled drugs, alcohol, tobacco and pharmaceutical drugs).
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 Click here to view the IHRA Position Statement in PDF format [PDF:370KB]
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The IHRA Board of Directors is the governing body of IHRA, and comprises individual experts in the field from around the world. Each Director is elected into a three-year term by the IHRA members at the Annual General Meetings.
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18th September 2009
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New IHRA Report: From Evidence to Action
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Among the many notable events happening in and around Harm Reduction 2009: IHRA’s 20th International Conference in Bangkok were the highly publicised keynote speeches by Professor Michel Kazatchkine (Executive Director of the Global Fund to Fight AIDS, TB and Malaria) and Craig McClure (Executive Director of the International AIDS Society). Both speeches were highly motivating, moving, passionate and visionary – and each received a standing ovation from delegates. To permanently record these two excellent orations, IHRA has combined them into a new publication entitled ‘From Evidence to Action: Reflections on the Global Politics of Harm Reduction and HIV’.
Both speeches were articulate calls from senior international policy makers for increased global attention to harm reduction, increased funding for harm reduction interventions, and increased respect for the human rights of people who use drugs. Both speakers also questioned the logic of drug prohibition and noted the multiple ways in which the ongoing criminalisation of drugs results in human rights abuses and the spread of HIV. By formally publishing the text from both of these speeches, IHRA hopes to make them accessible for harm reduction advocates around the world. The report can be widely quoted and referenced, and will be of interest to a range of audiences in the drugs field.
In his Opening Session speech (the ‘Rolleston Oration’) on Monday 20th April 2009, Professor Kazatchkine told delegates that “human rights must continue to be at the forefront of everything that we do” and told them that “By embracing harm reduction, you are on the right side of history”. He stressed the importance of continued advocacy and evidence-building in the face of the “wilful blindness” of some countries and organisations, and the need for spending on harm reduction to be proportionate to need. He also assured delegates that the Global Fund – already the largest international donor for harm reduction – will consider increasing resources for harm reduction and a “demand mobilisation strategy” to increase requests for harm reduction funding from the bottom-up.
In the Closing Session on Thursday 24th April 2009, Craig McClure reflected upon five years at the International AIDS Society (who manage the International AIDS Conferences), and the politics surrounding harm reduction and HIV. He told delegates that, globally, “Blatant and wilful denial of the evidence can only be based on deep-seated fear. Fear drives the global war on drugs. Fear drives abuse by doctors and others in the medical system of people who use drugs and the continuing use of so-called ‘treatments’ that might more accurately be called ‘torture’”.
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Click here to view the ‘From Evidence to Action’ report [PDF:210KB]
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17th September 2009
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September 2009 Article of the Month
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Oviedo-Joekes E, Brissette S, Marsh DC, Lauzon P, Guh D, Anis A & Schechter MT (2009) Diacetylmorphine versus Methadone for the Treatment of Opioid Addiction. New England Journal of Medicine, Volume 361 (8), pages 777 – 786.
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This paper presents the results of the North American Opiate Medication Initiative (NAOMI) – a clinical trial from Canada which began in 2005 to assess the benefits of heroin prescription for people who use drugs who have not responded to alternative treatments. Around 65 countries currently provide opioid substitution treatments – but normally in the form of methadone or buprenorphine. It has been documented that a significant portion of severely dependent people do not respond well to these treatments, raising the issue of how to successfully treat these individuals. Studies and services from countries such as Germany, Switzerland and the United Kingdom suggest that prescribing diacetylmorphine – the active ingredient of street heroin – can be an effective solution, and this new paper lends further support to this claim.
Published in the prestigious New England Journal of Medicine, this randomised controlled trial directly compared the provision of injectable diacetylmorphine with the provision of oral methadone for 226 opioid-dependent patients who had not benefited from at least two previous attempts at treatment. The trial was conducted in two Canadian cities – Montreal and Vancouver. After 12 months, “patients assigned to receive injectable diacetylmorphine were more likely to stay in treatment and to reduce their use of illegal drugs and other illegal activities than patients assigned to receive oral methadone” – although both treatments demonstrated positive impacts. The authors concluded, therefore, that injectable diacetylmorphine was more effective than oral methadone. However, due to the inherent increased risks of injecting and an identified risk of overdose or seizure, this treatment should be delivered in settings where medical support is available.
Historically, doctors in the UK have been able to prescribe heroin or morphine, and this was the basis of the so-called ‘British System’ from the 1920s to the 1960s. However, this treatment has recently received heightened attention around the world. In May 2009, following a multi-city trial, the German Parliament voted in favour of this treatment as a therapeutic option for severely dependent opiate users who had not benefited from any previous treatments. In Britain (where very few doctors prescribe diacetylmorphine despite being allowed to), a recent multi-site Randomised Injectable Opioid Treatment Trial (RIOTT) demonstrated that it is possible to engage and retain ‘hard-to-treat’ drug users. This trial also reported reduced use or abstinence from ‘street’ heroin, reduced spending on illicit drugs, reduced criminal activity, and improvements in physical, mental health and social functioning. In Switzerland doctors have been prescribing heroin to patients since the 1990s, citing a major reduction in crime and improved rehabilitation success rates, and recently approved a nationwide programme. The Netherlands and Spain also provide – and have positively evaluated – this treatment, and Denmark is expected to begin soon.
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16th September 2009
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New Human Rights Resource Guide Launched for Practitioners and Advocates
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As the health and human rights movement continues to grow, the Open Society Institute has launched a new online resource guide for practitioners and advocates – www.equalpartners.info. The guide covers the basic concepts and resources in health and human rights, and provides information on international treaties and enforcement mechanisms that can be applied. It contains chapters on human rights in terms of patient care, HIV/AIDS, harm reduction, palliative care, sexual health, minority communities, and mental health – each of which seeks to answer the following questions:
1. How are these human rights issues?
2. What work is the Open Society Institute doing on these issues?
3. Which are the most relevant human rights standards?
4. Which are the effective human rights programmes?
5. Where can you find additional resources on these issues?
6. What are the key terms related to these issues?
The guide states that “Harm reduction goes hand in hand with advocacy to ensure a range of human rights for people who use drugs” including access to information and protection against disease and overdose, protection against cruel or inhumane treatment, protection against violations of privacy (such as forced testing), and freedom of association and political participation. The guide also highlights some of “
The Good News” in terms of harm reduction and human rights – including the provision of needle exchange services in Brazil (which have contributed to a 20% drop in HIV among injecting drug users), and a range of successful human rights challenges for people who use drugs.
This online guide aims to provide essential tools for advocates to generate pragmatic, rights-based solutions to urgent health threats. The full online guide is available in English and Russian, and certain chapters are also available in Romanian, Spanish and Thai (with more languages to follow). The guide can be viewed online or downloaded.
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15th September 2009
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IHRA Launch ‘Addicted to News’ Media Guidelines
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 IHRA – in partnership with the European Opiate Treatment Association (EUROPAD), the South Eastern European Adriatic Addiction Treatment Network (SEEAnet) and Schering-Plough – have created a set of media guidelines to assist in the reporting of constructive, accurate and responsible information in the field of opioid dependence. This initiative aims to help opioid dependent patients by reducing media stigmatisation and inaccuracies in this emotive area.
A large number of patient advocacy groups, healthcare professionals, government agencies and pharmaceutical companies are working towards changing the treatment and policy landscape for patients with opioid dependence – including through research and development of medicines, and the delivery of harm reduction interventions. To support this work, it is essential that we help journalists to better understand the issues around opioid dependence, strike a balance in their reporting to avoid stigmatisation, and help encourage a different perspective which communicates positive messages about drug treatments.
Guidelines such as these have already been used in other therapeutic areas – such as mental health and HIV – to try and prevent sensationalist reporting which can create a backlash against the affected population. As stated in the guidelines, ‘It is essential to recognise the potentially damaging effects of inaccurate media stories on patients, their families and the medical personnel treating them, as well as the potential negative impact on access to treatment’. This includes coverage which wrongly depicts patients as criminals, uses stigmatising terms (such as ‘drug abuser’ or ‘junkie’), or categorises treatments as street drugs rather than medicines. According to the guidelines, “It is our role to remove this stigma; a key part of which is to aim for wider recognition that there are effective medical treatments for opioid dependence – it is a medical not a moral issue”.
The guidelines – entitled ‘Addicted to News: A guide to responsible reporting on opioid dependence and its treatment’ – will be formally launched at an interactive workshop as part of the UK National Conference on Injecting Drug Use at the Radisson Hotel in Glasgow, Scotland on Monday 26th October. The workshop will include media training, mock interviews and refreshments. Please contact Jemima Warrack for more information.
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Click here to view the ‘Addicted to News’ guide [PDF:1MB]
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Click here to view a flyer for the ‘Addicted to News’ workshop [PDF:1MB]
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14th September 2009
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IHRA Begins New Anti-Death Penalty Project
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In September, IHRA began a new three year programme of work on the issue of the death penalty for drugs. Funded through a grant from the European Commission, this programme builds and expands upon existing work initiated in 2007, when IHRA released its Death Penalty for Drug Offences report.
That report found that of the 64 countries retaining the death penalty, approximately half had legislation applying capital punishment to drug-related offences. It also reported that “the number of countries expanding the application of the death penalty to include drug offences has increased” over the past twenty year – a marked contrast to the general decrease of countries allowing the death penalty overall during that same period.
The report argued that the application of the death penalty for drug offences was contrary to Article 6(2) of the International Covenant on Civil and Political Rights (ICCPR), which states that such punishment may only be applied to the “most serious crimes”. This new project will focus on tracking and monitoring the global status of the death penalty for drugs. It will also advocate at the international level for human rights impact assessments to be applied to all drug enforcement funding and technical assistance that is given to countries which retain the death penalty.
Joining IHRA to work on the first phase of this project is Patrick Gallahue, who joins our team as a Human Rights Analyst with responsibility for the global monitoring of the death penalty for drug offences. Patrick recently completed a Masters degree in International Human Rights Law at the Irish Centre for Human Rights, and will be coordinating a team of four regional rapporteurs in Asia and the Middle East and North Africa who will be assisting us in collecting information. This data will be compiled and published in early 2010.
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Click here to view IHRA’s ‘Death Penalty for Drug Offences’ report [PDF:598KB]
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10th September 2009
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MENAHRA Announce 1st Regional Harm Reduction Conference and Call for Submissions
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The Middle East and North Africa Harm Reduction Association (MENAHRA) is pleased to announce the First Regional Conference on Harm Reduction, which will take place on the 16th, 17th and 18th November 2009 in Beirut, Lebanon. This ground-breaking event will showcase the latest harm reduction research, developments and interventions from across the region. The conference will help to define, explain and promote harm reduction strategies from across the Middle East and North Africa, and to promote harm reduction interventions to an audience of around 300 local and regional practitioners, advocates, academics and policy-makers.
In order to create a programme which truly represents best practice and current activities across the region and internationally, MENAHRA is keen to receive submissions for presentation during the conference. This is an ideal opportunity to present innovative harm reduction services, relevant research, advocacy efforts, and key national or regional policy discussions. Submissions should be no more than 300 words long (in English) and emailed to info@menahra-conference.org before 30th September 2009. In your email, please also include your name, country, job title, organisation and contact details, and a brief (100 word) summary of your background.
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The Middle East and North Africa Harm Reduction Association (MENAHRA) was established in 2007 in partnership with IHRA and the World Health Organization (WHO) – and with funding from the Drosos Foundation in Switzerland. It comprises a central secretariat in Lebanon and three sub-regional ‘Knowledge Hubs’ in Iran, Lebanon and Morocco. The MENAHRA network aims to establish a forum for the promotion, exchange and dissemination of information and experience on harm reduction across the region. It also works to represent issues from the Middle East and North Africa at the international level, to strengthen collaborations between stakeholders in the region, and to directly fund harm reduction projects.
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