As the eventful 24th Harm Reduction Conference entered its final day, I feel a great sense of pride that we have arrived where we are, but at the same time sad that in some countries harm reduction is not on the agenda, and In others such as England it has slowly been dismantled. Harm reduction in England was described to me recently by one of the early UK pioneers as a "cottage industry".
On the other hand, there was a tremendous enthusiasm in the air in Kuala Lumpur. Harm reduction's tentacles have spread far and wide. The International Rolleston Award was won by Edo Augustin from Indonesia, and Abdur Raheem Rejaey won the Carol and Travis Jenkins Award. The truth of the matter, however, is that scale up has not really happened in the majority of countries. Then there is the shameful situation in the USA in which the Federal Government won't fund needle and syringe programmes.
In our host country, Malaysia, thanks to the Malaysian AIDS Council, winners of the National Rolleston Award and the many brave activists, many of whom were at the conference protesting about the lack of Hep C treatment, in the last 10 years harm reduction programmes have dramatically reduced the incidence of HIV among people who use drugs.
Despite this, drug policy in Malaysia continues to include imprisonment of people who use drugs, judicial corporal punishment, and compulsory detention, which make harm reduction service delivery more difficult.
This brings me back to my take home message. Mass incarceration, the stigmatisation and marginalisation of people who use drugs added to the denial of the basic human right of access to the same quality of health care will never be eradicated under the prohibitionist regime. This won't happen until prohibition is repealed, until drugs are legalised.
If you believe in harm reduction, you must believe in reducing all of the harms. Not to believe that is cognitively dissident. You cannot reduce all of the harms in a prohibitionist world. If you don't believe it, maybe it is because, deep down, or maybe not so deep down, you believe that drug use is wrong.
If you believe in harm reduction, you must believe in getting rid of all criminal and administrative sanctions for the production, sale, possession and consumption of drugs. Drug policy reform is harm reduction.