Harm Reduction Works: Putting People First
One of my friends in Manipur recently ventilated his feelings that his ethnic group is being killed by drugs, insurgents, regular clashes and low fertility rate. Drugs, however, were the first and foremost reason.
In India, National AIDS Control Organization (NACO) reports that there are approximately 177,000 people who inject drugs (PWID) in India, although other studies suggest that the numbers could be much higher. The Government’s approach towards this crucial issue has only been either criminalization or through HIV prevention. Beyond jailing users, the Government has limited itself to implementing only some basic harm reduction services such as needle & syringe exchange, and Opioid Substance Therapy (OST).
What is left out in the Government harm reduction strategy is one of the most important component of a person’s life the PEOPLE in it! Reaching out to the families of PWID, as well as their peers, is important as they play a central role in their lives. By creating linkages between the traditional harm reduction services and family/peer counselling we can help sustain changes in the behaviour patterns of PWID.
Alliance India’s Hridaya programme, the Indian component of the five-country Dutch government-funded Community Action on Harm Reduction (CAHR) initiative, has taken this important facet into consideration and has collaborated with the Government of India through NACO to expand and strengthen harm reduction services for PWID, family members and their close contacts within the government-supported Targeted Interventions (TIs) for HIV prevention.
Since its inception in 2013, the project has provided services to 12,128 PWID and 64,193 close contacts in Bihar, Haryana, Uttarakhand, Manipur, and Jammu & Kashmir. A whole gamut of services have supplemented the offerings of the TIs, including reaching out to the families of PWID, sexual & reproductive health services, social entitlement linkages, family meetings, and other referral linkages including hepatitis C testing.
To understand the impact of the programme, an impact assessment was undertaken, and India HIV/AIDS Alliance has recently published the findings in a new report. This document describes how the lives of PWID have been changed by improved access to harm reduction services. There has been significant reduction in injecting with used equipment and increase in condom usage during intercourse with commercial sex partners. One notable finding was that 91% of respondents, as compared to 74% previously, had not sold or lent their injecting equipment in the 30 days prior to the study.
As the close of Hridaya approaches, the value of the programme’s additional services should be looked at closely. It is vital that harm reduction services are not seen only through the lens of HIV/AIDS but as a broader issue with a holistic approach that considers the range of needs of PWID. When this happens will we see reductions not only in HIV among PWID communities but also in drug dependency.
The author of this post, Viswanathan A, is the Manager: Strategic Information at India HIV/AIDS Alliance in New Delhi.