Dear readers – this was another momentous moment for the PUDs history book. As previously mentioned, the new US HIV/AIDS ambassador was at UNAIDS, and Mat Southwell sat down to chat…here’s what happened.
Meeting between Harm Reduction NGOs and the new US Delegation at UNAIDS PCB
In his inaugural speech to the UNAIDS PCB yesterday, Michel Sibide, the UNAIDS Executive Director, reminded us how even after Pandoras box was opened, and many miseries were inflicted on the world, there remained hope.
Along with many other marginalised populations, the drug using community has held its breath as first President Obama stood for office and was then elected as the first black President of the United States of America. I remember getting up at 7 am to hear the results and finding myself in tears filled with hope that a country that had opposed harm reduction was changing.
The Commission on Narcotic Drugs (CND) was a coming of age event for INPUD. We showed the depth of expertise in our community as 30 people who use drugs from around the world came together to call for a peace in the War on Drugs. However, the US Delegation at CND didn’t become overnight champions for harm reduction and we wondered whether this was just the unavoidable confusion that comes with the changing of the guard or whether our hopes had been overinflated.
During his speech, Michel notified the meeting that the new US administration had worked hard to ensure that the new US AIDS Ambassador, Dr Goosby, would be in post in time to take part in the meeting. When Dr Goosby subsequently arrived, the welcoming applause highlighted the sense of expectation that exists more broadly in the AIDS community.
Over lunch I was invited to attend a meeting that had been arranged with Dr Goosby and his team by Allan Clear from the US Harm Reduction Coalition. Vitaly Djuma from the Russian Harm Reduction Alliance and few other NGO representatives were also present. We met with the full US team including representatives from PEPFAR and other parts of the Department of State.
The meeting was wide ranging covering the US approach to harm reduction generally and in particular Dr Goosby recognition of needle exchange and opiate substitution therapies as science-based HIV prevention interventions. We discussed the US’s historic concerns surrounding the use of the term harm reduction and the misperception that it is equivalent to legalisation. Dr Goosby identified the limits of the US position; clarifying that the US did not support heroin prescribing or consumption rooms.
We talked about the limitations placed on compliance with ARV treatments when OST are not present.
We further discussed the need to include the voices of people who use drugs in the discussion of policy and practice. Dr Goosby acknowledged the importance of engaging people who use drugs in order to inform and guide the implementation and review of interventions with our community.
After the official meeting, we had an informal discussion with members of the US delegation. This included a frank conversation about the role of drug user organisations. While the US accept the need to engage people who use drugs, they have been more hesitant about engaging drug user organisations. The perception for some is that we are hard core legalisers who don’t reflect the wider diversity within our community. I clarified that we had been working very hard to reflect the pluralism within our community. I stated my own position as a legaliser and acknowledged that these views are held by many of our community. However, I highlighted that our movement includes people who inject drugs, drug treatment advocates and ex-drug users.
I highlighted the important role that people who use drugs can play in championing the cause of HIV prevention and harm reduction services. I particularly highlighted the challenges faced by people who use drugs living in the USA who do not receive financial support to engage in international advocacy because they are from the leading developed world country. I stressed that people who use in drugs in the US often live in marginalised situations that can be equivalent to situations faced by some in the developing world.
We concluded by agreeing to establish a communication channel between the harm reduction movement and the US delegation when problems or points of difference arise. This won’t limit our ability to speak out publicly in the interests of our community but it reflects the normal diplomatic practice that exists between NGOs and progressive countries.
It is important to understand that this is the beginning of a conversation. We need to be realistic that we will continue to have points of difference with the US. However, we do have clear areas where we share common interests and have common concerns. The major change is that the US are willing to talk to different stakeholders even where differences exist. I confirmed our ability to work with partners on areas of shared interests while respecting areas of difference. This is the beginning of a journey with a significant international partner. We need to continue demonstrating our ability to operate as a constructive, reflective and informed partner in international affairs.
Hope continues even if it is tempered by an awareness of how far the international community has to go to meaningfully engage our community and to address the impact of the AIDS and Hepatitis C pandemics within our community.