US drug czar John Walters is in Europe this week to "combat so-called 'harm reduction' policies," his new blog announced, while at the same time some 50 groups from around the world have signed onto a Human Rights Watch letter denouncing the war on harm reduction and the US attack on needle exchange programs in particular. To add fuel to the fire, both the New York Times and the Washington Post criticized Bush administration policies in the field in editorials over the weekend.
In a consensus statement on harm reduction, the task force came out four-square against the approach. "We support a policy of no use of illegal drugs or destructive use of legal drugs. Rational drug policies which recognize that the temporary use of measures to reduce harm with the goal of ultimate abstinence are fundamentally different from so-called 'harm reduction' drug policies which accept the inevitability of drug use," the statement read. "The phrase 'harm reduction' and its obvious meaning has been hijacked and cynically employed by those whose goal is to legalize drugs. They use the obvious, universal desire to reduce harm to promote the legalization of drugs. Drug legalizers use the phrase to gain the sympathy of well-meaning people and government officials... We support the International Narcotics Control Board (INCB) position on so-called 'harm reduction' that does not support stand alone needle exchange programs and so called 'safe' injecting rooms because such policies encourage drug use and violate UN Conventions."
If Walters and his crowd are "pushing back" against harm reductionists, well, the harm reduction community is pushing back, too. Citing recent moves by the US to stop United Nations agencies from promoting harm reduction strategies such as needle exchanges for the prevention of HIV infections, scientists, researchers, and public health advocates Wednesday released a letter to the UN Commission on Narcotic Drugs urging it not to capitulate to US pressure. "Silencing the UN on needle exchange is deadly diplomacy," said Jonathan Cohen of Human Rights Watch's HIV/AIDS Program. "The United States should be encouraging proven HIV prevention strategies, not attacking them."
"The fastest growing epidemics in the world are being driven by injection-drug use, and provision of sterile injection equipment is among the most important, proven strategies to contain them," said Kasia Malinowska-Sempruch of the Open Society Institute, another of the letter's signatories. "It is reprehensible that the US would try to compel the UN to keep silent about one of the best studied and most effective HIV prevention measures."
Despite complaints from conservative moralists that such programs aid and abet drug use, needle exchanges have been endorsed as an effective means of HIV-prevention by leading scientific, public health, and medical associations in the United States, including the American Medical Association, the American Public Health Association, and the National Academy of Sciences. The World Health Organization has also endorsed syringe exchange.
Those same moralists also oppose HIV-prevention through sexually explicit messages, instead advocating an abstinence-based "just say no" approach. "Whether it's sex or drugs, the US is exporting an abstinence-only agenda to countries hard hit by HIV/AIDS," said Joanne Csete, executive director of the Canadian HIV/AIDS Legal Network. "If governments do not stand up to this bullying, millions will pay the price."
Human Rights Watch, the Open Society Institute, and the Canadian HIV/AIDS Legal Network were among the 334 organizations and individuals who signed onto the letter delivered Tuesday to the UN Office on Drugs and Crime. "We write to express concern about US efforts to force a UNODC retreat from the support of syringe exchange and other measures proven to contain the spread of AIDS among drug users," the letter said.
The Washington Post and New York Times were critical of the administration effort to harm harm reduction as well. In a Sunday editorial titled "Deadly Ignorance," the Post accused the administration of "undermining the global battle against AIDS" with its opposition to needle exchange, and singled out Rep. Mark Souder (R-IN) for special mention.
A day earlier, the Times, in an editorial titled "Ideology and AIDS," accused the administration of "contributing to suffering and death" by opposing harm reduction programs. Blaming "right-wing" lawmakers with a moralistic agenda, the Times wrote that, "Washington's antipathy toward needle exchanges is a triumph of ideology over science, logic and compassion. The United States should help pay for these important programs. If it cannot bring itself to do so, it should at least allow the rest of the world to get on with saving millions of lives."
With the moralist right on the move and the harm reduction community mobilizing, the battle has been joined. Much is at stake.