Alliance for Public Health took an active part in 25th Harm Reduction International Conference, which was held in Montreal on 14–17 May 2017. This is a key conference for harm reduction experts, researchers, activists, and members of vulnerable communities – people who use drugs, sex workers, and men who have sex with men. For four days, the capital city of the only French-speaking province of Canada celebrating its 375th anniversary became a think tank, summing up the results and defining the key agenda for future years. The conference was attended by over 1,000 delegates from more than 70 countries of the world. 40 sessions, 25 dialogue spaces, 8 workshops, 26 video and film sessions, over 20 exhibition halls, 3 award ceremonies – they all clearly demonstrated the global harm reduction trends and formed a diverse program for community activists and harm reduction experts.
Alliance for Public Health played an active role in the conference, delivering four oral and six poster presentations.
Anton Basenko, the Country Focal Point: PITCH Project as a Board Member of the International Network of People Who Use Drugs (INPUD), representing the Eurasian region and the ENPUD, delivered a speech at the traditional INPUD meeting, which always precedes the conference, presenting the position of the PUD community and defining clear messages for the global community on harm reduction issues. “Two years, which passed from the previous conference in Kuala Lumpur, were very challenging both for the INPUD and for our region, – he said. – But today, reporting on the previous years, we have an honor to welcome the new board, the new executive director and the new strategy, to which the EECA PUD community addresses its problems, needs and proposals, being confident in real support from the side of our international brothers and sisters.”
Presentations at the conference demonstrated the successful experience of Alliance in harm reduction. In particular, Pavlo Smyrnov, Deputy Executive Director: Program shared the successful experience in implementing the biggest in the region harm reduction program, covering approximately 250,000 drug users. Besides, Pavlo Smyrnov presented harm reduction as a platform to scale up access to HIV care for PWID as well as best practices of the Alliance for Public Health, including Community Initiated Treatment Intervention (СІТІ) and Optimized Case Finding (OCF), which received positive feedback and prompted numerous questions from the audience on the possibility to implement such approaches in other countries. It is good to know that the experience of Alliance and Ukraine has been again recognized at the international level. Pavlo Smyrnov’s presentation was preceded with a speech delivered by Annette Verster, representative of the WHO headquarters, who on several slides gave the example of Ukraine in the context of availability and highest quality of data on the cascade of services and the national estimates on key populations: “I would like to thank Ukraine as the work of WHO is based exactly on such adequate country data as only having reliable data along the cascade we can clearly understand where the world is on its way to the global 90-90-90 targets”.
An important topic discussed at the conference was drug policy reform and decriminalization of drug users. Pavlo Skala, Associated Director: Policy and Partnership in his presentation “Police and Harm Reduction” presented the most recent developments and effective approaches in cooperation with the national police at the responsible stage of its reformation. Invaluable experience of Alliance in conducting all-Ukrainian testing of representatives of defense and law enforcement agencies for viral hepatitis C (over 4.5 thousand people were tested for HCV in 2015), further use of self-testing using rapid tests during educational workshops for police officers in combination with demonstration of new awareness-raising harm reduction videos (developed by the UNODC Office in Ukraine in cooperation with civil society organizations implementing harm reduction programs), along with the interest of the audience to the ways of responding to challenges in the spread of HIV and HCV epidemics in the east of Ukraine sparked a big interest in the conference participants.
Another highlight of the conference was presentation of the activities of the National Substance Abuse and OST Hotline as an effective human rights, advocacy and awareness-raising mechanism – the experience of activities implemented by members of the PWID/OST community with support of the Alliance was presented by Svitlana Tkalya, head of a partner self-organization of OST patients and parents – Hope and Trust NGO. This is the only Ukrainian implementing partner organization, which won the right to make an oral presentation at the conference. Even Australia and the UK are looking closely at such experience in the context of launching similar mechanisms in the peer support format.
The posters presented by Alliance representatives and its partners at the conference were also very interesting and informative:
- Positive dynamics or the real situation with the drug users’ criminalization level in Ukraine? (Pavlo Skala, Natalia Kravchenko, Andriy Tolopilo)
- Access to HCV treatment for key populations in Eastern Europe and Central Asia (Ludmila Maistat, Natalia Kravchenko, Pavlo Skala)
- Increasing the impact of harm reduction programs in response to HIV and HCV epidemics through integrated approach of testing with linkage to care and treatment (Natalia Kravchenko, Ludmila Maistat, Pavlo Skala)
- Strategy to scale up access to HCV testing and treatment for PWIDs in Ukraine (Pavlo Skala, Ludmila Maistat, Natalia Kravchenko)
- Implementation study informs innovative intervention for adolescents who use drugs in Ukraine (Iana Sazonova, Vyacheslav Kushakov, Iryna Zharuk)
- “On the way to NSP in prisons.” Implementation of harm reduction services based in probation service, Ukraine (Anton Basenko, who was in the focus of attention during all days of the conference, in particular attracting greetings and questions from representatives of the Ministry of Health and Social Services (Quebec) and the Correctional Service Canada as Canada is the country that gives multimillion support to reform the penitentiary system of Ukraine).
Besides, the conference included a side event “Future Proofing Harm Reduction” focused on sustainable development goals. One of the speakers at this event was Marina Braga, Senior Manager: International Technical Support. She presented the project for adolescents who use drugs implemented by Alliance and its partners with support of the Elton John AIDS Foundation. “Harm Reduction International 2017 demonstrated that even in such a progressive country in terms of access of people who use drugs to services and their quality as Canada there are issues and challenges, which makes the community of activists build bridges between stakeholders and call high public officials to quickly respond to changes in the drug scene and recent scientific developments,” – underlined Marina.
Alliance representatives had an opportunity to promote Harm Reduction Academy – an international training course to educate harm reduction experts, the next cycle of which is scheduled for September 2017.
The conference allowed summing up the existing experience and expertise, defining challenges as well as new trends which would influence the development of drug policy and harm reduction in the nearest years. The topics which are gaining momentum or are among the new trends are access to HCV treatment among PWID, gender approaches, new drugs and changes in the global drug scene (synthetic opioids (fentanyls) and stimulants (e.g. mephedrone) and their consequences (overdose, diseases, mortality), new forms of naloxone and new consumables for harm reduction among people who use non-injecting drugs, new internet-based harm reduction approaches, “chemsex” (using injecting and non-injecting substances in sexual context), addiction therapy with ibogaine and other psychedelic substances (ayahuasca and others). Crisis with the “boom” of opioid overdoses and deaths caused by the spread of such dangerous synthetic substances as fentanyl and carfentanyl in Canada made the Canadian PWID community turn their backs to the Canadian Minister of Health, Jane Philpott, at the opening ceremony of the conference with “They Talk We Die” banners, calling to urgently solve the problem.