‘Harm Reduction 2009: Harm Reduction International’s 20th International Conference’ took place in Bangkok, Thailand from the 20th to 23rd April, and – despite the city being under a ‘state of emergency’ due to disturbances – brought together an incredible 1,000 delegates from 80 countries around the world, including many from Thailand and other Asian countries. Particular thanks for this achievement must go to the four Conference Partners - the Asian Harm Reduction Network (AHRN), Population Services International (PSI), the Raks Thai Foundation, and the Thai Red Cross Society.
The four days were filled with sessions, presentations, meetings, events and workshops – discussing and debating the latest research findings, best practice guidelines, policy developments and advances in harm reduction programming worldwide. The conference theme was ‘Harm Reduction and Human Rights’, and this was a recurring issue throughout the programme – from sessions which specifically documented some of the human rights violations committed in the name of drug control, to discussions about international advocacy, the United Nations’ work, and drug treatment. In particular, there was a lot of focus on the current situation faced by many people who use drugs in Asia – often characterised by poor access to harm reduction services and detention in compulsory ‘treatment’ centres. This was highlighted as early as the Opening Session on Monday 20th April by a dignified protest by Thai drug users and their allies, in which they called for “treatment not torture” while Seree Jintakanon from the ‘12-D’ network people working on drug issues in Thailand delivered a rallying speech.
The Opening Session also included a Thai drum display, a formal welcome from Mom Rajawongse Sukhumbhand Paripatra (the Governor of Bangkok), a speech from Professor Gerry Stimson (Executive Director of Harm Reduction International), and a keynote address from Professor Michel Kazatchkine (the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Professor Kazatchkine emphasised the need for drug policy reform and the decriminalisation of drug use as part of a public health approach – a point that was raised throughout the conference. This statement of intent from a senior international policy maker was received with a standing ovation from the delegates and attracted a great deal of media interest from around the world. The Opening Session speeches also highlighted the huge discrepancy which exists between the identified resources that are needed for global harm reduction, and the current level of global funding – an issue which gained much attention during the rest of the conference.
The Opening Session was followed by a Plenary Session on ‘Injecting Drug Use and HIV: A Comprehensive Review of the Situation and Response in Asia’ (which included a presentation from Anand Grover, the UN Special Rapporteur on the Right to Health), a lunchtime session organised by the Global Fund (who also hosted a ‘Dialogue Space’ throughout the week to allow delegates to meet key international leaders), 12 Concurrent Sessions (on a range of issues including hepatitis C, harm reduction donors, policing, drug law reform, alcohol harm reduction, research and opiate substitution treatment), poster presentations, workshops and the opening of the 6th International Drugs and Harm Reduction Film Festival.
The second day of the conference - Tuesday 21st April – opened with an engaging Plenary Session which further discussed the conference theme of ‘Harm Reduction and Human Rights’ and included presentations from the UN Special Rapporteur on Torture and representatives of the UN Committee on the Rights of the Child, the International HIV/AIDS Alliance and Lawyers Collective HIV/AIDS Unit in India. This was followed by the first Major Sessions of the conference – a session on tuberculosis services organised by the World Health Organization, a session on compulsory drug treatment organised by the United Nations Office on Drugs and Crime and the International Harm Reduction Development programme, and a session on methamphetamine use in Asia.
The Tuesday afternoon included a lunchtime session and Concurrent Session dedicated to harm reduction developments in the host country. The conference was well timed for Thailand in that it came during discussions about a new national harm reduction policy – and just before a major national grant from the Global Fund. There were also Concurrent Sessions on poverty, integrated services, prisons, young people, harm reduction in Asia, drug-related deaths, and sex work – as well as more workshops, poster presentations and film screenings.
In a change from the usual Harm Reduction International conference structure, Wednesday 22nd April opened with two sets of Major Sessions covering issues such as young people, legal interventions, research, employing drug users, and risk environments. There was also a panel discussion featuring some of the leading parliamentarians from across Asia - organised by the Asian Forum of Parliamentarians on Population and Development and supported by UNAIDS. These sessions were followed by a ‘Lunchtime Lecture’ (another first for Harm Reduction International conferences) by Dr Ethan Nadelmann, the Executive Director of the Drug Policy Alliance in the USA, who discussed the potential implications of their new Presidency for harm reduction and global drug policies.
The Wednesday afternoon included Concurrent Sessions on needle exchange, qualitative research, women, psychosocial interventions, drug user organisations in Asia, children and families, human rights violations, and tobacco harm reduction. The conference party also took place that evening with delegates enjoying a poolside dinner, the presentation of the 2009 Harm Reduction International Awards, and a wonderful performance from ‘Kormix’ – a hip hop group of Khmer drug users from Korsang– Cambodia’s only harm reduction programme. Korsang brought a delegation of around 30 staff, peer educators and people who use drugs to the conference, and were given a $1,000 donation at the party by the Conference Consortium for their wonderful work.
The final day of the conference – Thursday 23rd April – opened with two sets of Major Sessions on issues such as drinking patterns in Asia, engaging law enforcement agencies, gender issues, the war on drugs, and nursing. There was also a panel discussion on the recent ‘UN High Level Segment’ on Drug Control, which reflected on the disappointing meeting in Vienna and the implications and future directions for international drug policy advocacy - organised by the International Drug Policy Consortium. These sessions were followed by the third and final Plenary Session, which focussed on methamphetamine use – a phenomenon which is increasing across the globe (and especially in Asia), and for which the harm reduction field must develop appropriate and effective responses. This session was organised by the Global ATS Working Group and included four of the best presentations from the ‘1st Global Methamphetamine Conference’ in Prague in 2008.
The conference then closed with the presentation of the 2009 Film Festival Award and the 2009 Bonnie Devlin Memorial Scholarship, a brief summary of proceedings from Professor Nicholas Crofts (the appointed conference rapporteur) and an impassioned keynote address from Craig McClure, the Executive Director of the International AIDS Society. After five years in his current position, Mr McClure reflected on the politics surrounding harm reduction, the global responses to HIV, and the evolving status of injecting drug use within these responses. He told delegates that the Russian Government’s refusal to legalise methadone and introduce adequate needle exchange programmes was allowing an HIV epidemic in the country to go unchecked, and that, globally, “Blatant and wilful denial of the evidence can only be based on deep-seated fear. Fear drives the global war on drugs. Fear drives abuse by doctors and others in the medical system of people who use drugs and the continuing use of so-called ‘treatments’ that might more accurately be called ‘torture’”.
Overall, Harm Reduction 2009 highlighted how far harm reduction has progressed and where there are still huge challenges to be overcome. The event brought together health workers, law enforcement, human rights activists, people who use drugs, frontline workers, policy makers and researchers. Around half of the delegates were attending an international harm reduction conference for the first time, which vindicated Harm Reduction International’s decision to hold this year’s event in Asia and in Thailand, and showed that new people were becoming engaged with this field. In total, there were over 60 sessions across the four days – showcasing over 200 presentations and 250 posters exhibitions. Crucially, there was a great sense of energy and enthusiasm throughout the event. There were countless discussions and meetings to improve partnership working and advocacy across Thailand, Asia and the rest of the world – and plenty of work to do before the next event in England in April 2010!