Stigmatisation, criminalisation blamed for hampering utilisation of Harm Reduction services
The 2024 Global State of Harm Reduction Report has highlighted stigmatisation and criminalisation of people who use drugs as some of the major barriers to the mainstreaming and utilisation of Harm Reduction services in most countries. The report further laments that these barriers have undermined the political and financial support needed to implement and expand Harm Reduction services.
‘Despite some countries making a slight improvement in increasing the availability of Harm Reduction services and incorporating Harm Reduction policies in their national policies since the Global State of Harm Reduction report in 2022, criminalisation and punitive responses to drug use remain dominant in most places. These approaches undermine Harm Reduction efforts and continue to fuel stigma and discrimination, and deter people who use drugs from seeking vital and life-saving services. This key contradiction must be addressed for meaningful progress to be made,’ reads the report in part.
It further observes that the number of international Harm Reduction donors remains small, leaving Harm Reduction vulnerable to their shifting priorities. Domestic funding for Harm Reduction is said to be even more fragile, and a lack of data prevents civil society from being able to monitor levels and hold governments accountable, leaving people who use drugs facing multiple intersecting vulnerabilities that impede their access to Harm Reduction services.
‘This includes women, LGBTQIA+ people, Indigenous people, migrants and people in prison. In addition to stigmatisation because of their drug use, these groups are already marginalised and discriminated against. This results in them being particularly underserved. Young people who use drugs also face additional barriers to accessing services. Language can also be a significant barrier for migrants who need access to Harm Reduction services. Interpreters and multicultural mediators are needed to ensure migrants who use drugs can access Harm Reduction services,” it says.
The report further adds: ‘Punitive drug policies have led to the overrepresentation of people who use drugs in prisons, where access to Harm Reduction services is even more inadequate. An estimated one-third to half of people in prison have a history of drug use. Many people continue or start injecting drugs while in prison, and high-risk behaviours such as sharing paraphernalia and unsafe tattooing also increase in prison and other closed settings. Despite the evident need for Harm Reduction services in prisons, they are typically even less likely to be available than they are outside prison.”
A Ghanaian Harm Reduction activist, Samuel Hanu, has since pleaded with governments in Eastern and Southern Africa governments to stop funding punitive approaches to drugs and instead invest in Harm Reduction.
In his presentation at the 4th Harm Reduction Exchange (HRE) in Nairobi, Kenya, on Wednesday the 27th of November, 2024, Hanu, who works with The Harm Reduction Alliance in Ghana, also recommended investment in holistic Harm Reduction programmes with specific gender-sensitive services and interventions to meet the needs of women who use and inject drugs.
“Such programmes must consider creating safe spaces where women feel secure, respected and free from judgement or discrimination. Governments also involving female peers in the programmes can be an effective way to foster trust and encourage participation,” he said.
Hanu’s presentation was titled: ‘How Science-Led Innovation and Regulation are Changing the Harm Reduction Landscape.’ He commended emerging technologies including digital applications that allow the provision of real-time counselling services to persons who use drugs, and to artificial intelligence (AI), which helps in predicting high-risk populations and targeted interventions.
Knowledge Action Change Consultant, Chimwemwe Ngoma, emphasised the need for science-led regulation to guide national efforts to reduce harm. Ngoma said there is a need for unconventional approaches that prioritise public health over punitive taxation. He gave examples of these as: “Efforts that encourage smokers to switch to SNPs, through subsidies, proportional taxation, and education campaigns.”
This year’s conference was held under the theme: ‘Enabling Innovation in Harm Reduction Through Science-led Regulation and Policymaking.’
