On 25th July, 2012, Harm Reduction International (HRI) launched The Global State of Harm Reduction 2012: Towards an Integrated Response to coincide with the 19th International AIDS Conference, Washington DC, USA. The Global State of Harm Reduction compiles data on international developments for HIV prevention among people who inject drugs, such as the availability of needle and syringe exchange programmes and opioid substitution therapy. It is the only independently produced account focusing on this aspect of the epidemic.
The report found that injecting drug use has been documented in 158 countries, yet approximately half of those have no programmes to prevent HIV via unsafe injecting practices. Even in countries that have programmes in place to varying degrees, reach and effectiveness are severely undermined by lack of coverage of services, and a decreasing level of donor support. Since 2010, programmes have been severely scaled back in countries with some of the highest HIV burdens among people who inject drugs. For example, the number of needle syringe programmes in Russia dropped from 70 in 2010 to only 6 in 2012. Such developments significantly limit progress toward global commitments to halve HIV transmission related to unsafe injecting by 2015 or to achieve universal access to HIV prevention, treatment, care and support for people who inject drugs. In his foreword to the publication, Michel Sidibe (Executive Director, UNAIDS) points out that, ‘The need for legal reform aligned with HIV prevention and treatment, complemented by the meaningful involvement of people who use drugs in service and policy formulation and implementation, has never been more imperative than it is now for achieving the goal of universal access.’ He also echoed the sentiment of the CAHR programme by stating that responses should be rooted in ‘scientific evidence and sound human rights principles’, and should ‘support, not punish’ those affected.
The present, third edition of the report also explores key issues for developing an integrated harm reduction response, such as building effective harm reduction services for women who inject drugs, limited access to harm reduction services by young people, drug use among men who have sex with men, global progress toward drug decriminalisation and sustainability of services in challenging environments.
The launch was chaired by Ani Shakarishvili (UNAIDS Country Director, Ukraine), and speakers included David Wilson (Global AIDS Program Director, World Bank), Rick Lines (Executive Director, HRI), Claudia Stoicescu (Public Health Analyst, HRI), Robin Pollard (Operations Coordinator, YouthRISE), Adam Bourne (London School of Hygiene and Tropical Medicine), Anya Sarang (President, Andrey Rylkov Foundation) and Elie Aaraj (Executive Director, Middle East and North Africa Harm Reduction Association). Over 100 delegates attended the event.