First do no harm

There's been a lot of traffic among the chattering classes here as a result of the news that Indonesia was among 13 countries that voted against the inclusion of the words 'harm reduction' in a footnote to the draft Political Declaration from the 52nd Session of the Commission on Narcotics Drugs (CND) in Vienna. As a result, apparently harm reduction is not mentioned in the draft political declaration, not even in a footnote.

This has confused everyone, because as I noted in my recent prisons report, the policy of the Indonesian government (as usual, whoever that is?) strongly supports harm reduction. Indeed, Michel Sidibe, the new Executive Director of UNAIDS in a speech to a donor conference on harm reduction on 28th January, praised Indonesia for its support: "It is extremely heartening that countries with huge populations like Indonesia and China are seriously embracing the harm reduction challenge, at the full scale. Indonesia for example is aiming to ensure that needle and syringe exchange covers 70% of injecting drug users by 2010, up from the baseline of only 10%, and that methadone treatment reaches 30% of users." He must be feeling like the rug has been pulled out from under him!

Ibu Naf, the AIDS Commission Secretary quickly confirmed that this does not reflect a change in policy: "Don't worry. We're still working in accordance with the ruling of the Coordinating Minister of Peoples' Welfare [he's also the chair of the AIDS Commission]. We can continue to use the term, and continue, indeed increase, our efforts as laid out in the national work plan for AIDS."

But activists are wondering if they may still use the term 'harm reduction.' Of course, that raises the question why we use an English term for this. When we translated the Asia Harm Reduction Manual ten years ago, we went to great efforts to achieve a consensus on the Indonesian translation of 'harm reduction'. A very late final agreement meant we had to make many last moment changes only a couple of days before we went to the printers.

Pandu Riono notes that the Coordinating Minister's ruling clearly has not reached all those concerned, particularly in Vienna. We need to do a much better job of communicating, he says. Prof. Wirawan wondered if the Indonesian delegation in Vienna was aware of this ruling, but Ibu Naf confirmed that they knew. But she notes that the CND is primarily made up of law enforcers and diplomats. They would refer to the narcotics law, which does not mention harm reduction.

Actually they are in good company. As the international activists have only just noticed, back last November, Antonio Costa, the head of UN body concerned with drugs (and a UNAIDS co-sponsor), claimed harm reduction has been appropriated by "a vocal minority. This kind of harm reduction can prevent the spread of blood-borne diseases. But it does not solve the underlying problem, and can even perpetuate drug use."

It seems we all need to do a better job of communicating...

Babé