The International Harm Reduction Association (IHRA) are hosting their annual conference in Liverpool, UK, from April 25th -April 29th and I’m looking forward to attending to learn more about where we’re at with harm reduction 21 years after harm reduction policies were first started, and what needs to happen now to improve the effectiveness and rollout of harm reduction initiatives worldwide.
I recently discussed the aims and achievements of the IHRA with Professor Gerry Stimson, who has been executive director of the IHRA since 2004. The host venue for the IHRA meeting this year, Liverpool, introduced groundbreaking needle exchange services in 1985 that have since become a model for programmes worldwide. Gerry pointed out that nowadays 90 countries support (or at least tolerate) harm reduction services, such as needle exchange, but also drew my attention to this recently published systematic review which revealed that coverage of harm reduction is still poor: for instance, worldwide, just 2 needles per drug user per month are available. An estimated 15.9 million people worldwide inject drugs. With up to 10% of all new HIV infections occur through injecting drug use and more than 3 million people who inject drugs living with HIV the potential for harm reduction to mitigate the burden of HIV alone would therefore seem huge.
Harm reduction is a complex term that the IHRA defines as “policies and programmes which attempt primarily to reduce the adverse health, social and economic consequences of all psychoactive substances to individuals drug users, their families and their communities”. Types of programmes specific to HIV alone range from needle and syringe programmes , opioid substitution therapy and other drug treatments, HIV testing and counselling, antiretroviral therapy and condom provision. The IHRA, which is a not-for-profit NGO seeks to promote evidence-based harm reduction policies and practices on a global basis for all psychoactive substances (including illicit drugs, tobacco and alcohol). Medical journals like PLoS Medicine clearly have a role to play in publishing studies that evaluate harm-reduction strategies, and delineate the burden of diseases attributable to or exacerbated by drug harms, with both quantitative and qualitative evidence required for progress to be made.
Gerry is stepping down as Executive director of the IHRA later this year. I asked him what the highlights of his tenure at this growing NGO were. He told me that when he joined the IHRA he wanted to help to mould it into an organization which could live up to its promise. Specifically he has helped IGRA to develope advocacy work, using a human and health rights framework to advance harm reduction as a right to health.
With an opening lecture from Michel Sidibé, Executive Director of UNAIDS and sessions on the challenges for harm reduction in the future, evidence in harm reduction, harm reduction poliies around the globe, insights from qualitative research, and mental health and drug use, the conference promises to be a facinating experience. Gerry mentioned that the attendees are incredibly diverse, ranging from those representing drug users, to law enforcement officials, frontline workers, researchers and policymakers. I’m looking forward to it.