Values of Harm Reduction

Harm reduction refers to a set of measures that aim to reduce the harms associated with the use of drugs, including HIV, TB and viral hepatitis. Harm reduction has public health, human rights and socio-economic value. It is evidence-based, rights affirming and cost effective.

Harm reduction has public health value and refers to policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs. Harm reduction benefits people who use drugs, their families and the community. Harm reduction is strongly supported by the WHO, UNAIDS and UNODC as an evidence-based approach to HIV prevention, treatment, care and support for people who inject drugs (PWID).These 3 UN bodies have defined a comprehensive package, which includes 9 interventions to address HIV/AIDS among PWID. Only when these services are accessible to people who inject drugs, through appropriate delivery methods and throughout all countries in the region, will we truly begin to control the spread of HIV, Hep C and TB in EECA.

The harm reduction approach to drugs is based on a strong commitment to public health and human rights. The International Federation of the Red Cross and Red Crescent Societies states that the harm reduction programs exemplify human rights in action by seeking to eliminate hazards faced by people who inject drugs. People who use drugs do not forfeit their human rights, including the right to the highest attainable standard of health, to social services, to work, to benefit from scientific progress, to freedom from arbitrary detention and freedom from cruel inhuman and degrading treatment.

A major World Bank study in 2012 found that scaling up four key interventions - NSP, OST, ART and HIV counselling and testing (HCT) for people who inject drugs would lead to massive reductions in HIV prevalence among people who inject drugs: it also found that, these interventions are evidence-based, rights affirming and cost effective. Most harm reduction approaches are inexpensive, easy to implement and have a high impact on individual and community health. In the time of economic austerity, benefit is maximised when low-cost/high-impact interventions are preferred over high-cost/low-impact interventions.

People who use drugs are always somebody’s son or daughter, sister or brother or father or mother. The compassion that underlies harm reduction extends to the families of people with drug problems and their communities. 

Comprehensive Package of Services for People Who Inject Drugs (PWID)

According to UNODC, WHO and UNAIDS Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users (“the Technical Guide”), the implementation of a package of nine interventions is essential. This package consists of harm reduction interventions with a wealth of scientific evidence supporting their efficacy and cost-effectiveness in preventing the spread of HIV and other harms:

  1. Needle and syringe programs (NSPs)
  2. Opioid substitution therapy (OST) with methadone and buprenorphine, including psychosocial support for OST clients, and other drug dependence treatment
  3. HIV counseling and testing, including rapid testing by NGOs where possible
  4. Antiretroviral therapy (for PWID who are living with HIV), including adherence assistance
  5. Prevention and treatment of sexually transmitted infections
  6. Condom programs targeted specifically at PWID and their sexual partners
  7. Targeted information, education and communication materials and campaigns for PWID and their sexual partners
  8. Vaccination, diagnosis and treatment of viral hepatitis (including HAV, HBV, HCV)
  9. Prevention, diagnosis and treatment of tuberculosis

 

Watch
"Fund Harm Reduction" video
HCLU video: Michel Kazatchkine, the UN Special Envoy for HIV/AIDS in Eastern-Europe and Central-Asia, addressing the issue of HIV increase
OSF video about harm reduction values
HCLU video: Harm Reduction Conference in Vilnius 2013