Public Health and Harm Reduction Strategies in Latin America

In order to keep up with the constant social, cultural and political transformations within the drug policy and harm reduction debates, the panel began with a few questions such as: How are harm reduction techniques adapted to the Latin America and Caribbean reality? What experiences can be found in the region?

To answer these questions, Luciana Temer, Secretary of Development and Welfare for Sao Paulo, Brazil, presented details of the implementation of the Open Arms Program (Bracos Abiertos) which aims to reduce crack use in Brazil. “We built a space for users with the goal of improving and evaluating their health and welfare,” said Temer. “Our offer of reintegration, including bathrooms, food, clothing, and paid work, provided certain acceptance on the part of user,” she said. “Drug abuse is a social problem, which does not mean that might not be completely met by the health services provided, and rather illustrates the need for this type of support to correct the problem,” she said.

Then Nuria Calzada, Project Coordinator for Energy Control, a risk and harm reduction program within the NGO Welfare and Development Association (ABD) of Spain provided the background on their experience in risk reduction work in public spaces, including nightlife spaces. “You need to go where users are, where drugs are being consumed,” said Calzada. “Our perspective is based in science, but also in human rights, including the right to health, privacy, the right to leisure and the right to education”.  “Harm reduction implies that abstinence is not the only way, but that we take a pragmatic approach, doing what we can to minimize the impact of drugs.”  She also asserted that “responsible drug use is possible, because there are many ways to relate to them, from the safest to the most problematic. Responsible use means that the person has the necessary means to achieve the effects you want, and avoid the potential risks that might arise from that use.”  She also stressed that the success of Energy Control is based on its communication “beginning with language of respect, which accepts consumption as a reality, and adapts the message according to the sector of the population to which it is addressed.”

Bibiana Restrepo Lizcano, manager of social life and mental health with the Ministry of Health and Social Security of the Mayor of Pereira, Colombia, presented details of the needle exchange in the city and noted that “harm reduction is not just to deliver what users need in order to be safe, you also need to generate an entire educational campaign, awareness and expertise, in order to influence the way in which drugs are used, so it is the right way and able to minimize the impact. ”

In addition, she plotted the challenges that exist for the development and implementation of harm reduction programs. “In principle, it is difficult to get space and sensitize the responsible officials in order to get permission to carry it out. After the implementation, it is important to continue evaluating so you can improve service to consumers, and access to these projects and programs,” she said.

Meanwhile, Lidiane Malanquini, Project Coordinator with Axis Public Security and Territorial Development NGO Networks da Maré in Rio de Janeiro, Brazil, spoke about the alternative spaces of socialization. “We provide safe spaces in the favelas in northern Rio de Janeiro, seeking to empower mainly crack users. Through alternative spaces of socialization, it can empower the perception of those actors who live in Maré, who have been involved in the realization, implementation and evaluation of public policies. Thus it is that we operate as a dialogue with the country’s institutions to guarantee the rights of people who use drugs.”

Juan Radhames de la Rosa Hidalgo, Executive Director of Open House, Dominican Republic noted that “the war on drugs is a source of political domination. In the Dominican Republic, we have had a policy that is consistent with this view, we have a policy that is absolutely contrary to human rights.” “In the Dominican Republic need to quickly establish policies to reduce risks such as drug substitution, it is urgent to supply appropriate treatment given the social conditions associated with the use of heroin, and generate changes in the law, analyzing the contributions of science to the drug policy debate, which are centered on the human being, taking into account the inalienable rights of individuals,” he said. “It is necessary to create ample opportunities for advocacy, awareness and sensitization of the general population, in order to for the public and organized social movements to take on the issue of drug policy” Radhames said, regarding the impact of the conference on the country.

Vanessa Brito Uziely Rosario, Manager Operations Center Integral Orientation and Investigation (COIN) moderated the panel.