Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Cresent Societies - 7 April 2003
Omar Valdimarsson in Chiang Mai
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 û 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 û for legal reform and more effective strategies - to create a supportive climate for harm reduction programming.
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