Opening remarks by Robert Tickner on the occasion of the 9th Anex Harm Reduction Conference
Tuesday June 7 and Wednesday June 8
Dear friends and colleagues,
Firstly allow me to thank you, on behalf of Australian Red Cross and the International Red Cross and Red Crescent Movement, for giving me this opportunity to share with you our experiences in the area of harm reduction.
This is also a great opportunity to exchange views and ideas and I hope all participants will walk away from the conference with information that will help us all learn more about harm reduction and a better understanding of all sides of the argument.
May I say at the outset that I am new to Australian Red Cross, having taken the CEO role less than 4 month ago. I have however arrived to the organisation at a very exciting time in its 90-year history. For the very first time Australian Red Cross is moving to deliver national services and programs in a much more cohesive way under the leadership of the national Board.
This reform process, creates for the first time the concept of 'national functions', and will mean that although the important work of State/Territory Divisions will continue, in respect of the national functions (ranging from fundraising, marketing, communications, national community services, human resources, finances and many others) that we will be speaking with one national voice. This will mean a more powerful national voice for the organisation as a whole and a capacity to deliver more effective services on the ground.
I speak about this reform process because I would argue that all of us delivering critical services to vulnerable people have an obligation to relentlessly drive efficiencies in our organisations.
The not-for-profit sector which many of us come from have an obligation to the people we serve not only to champion high ideals but to also be pacesetters in good management practice to ensure that we ensure that the highest level of resources are available to benefit people on the ground.
During this 9th Annual Conference on Harm Reduction we will hear from a very diverse group of international and local speakers addressing the prevention of drug related harm. You will see from your program however, that this is no closed shop for ideas and viewpoints; you will also consider the views of those who criticise the notion of harm reduction, those who argue that it is anything but a benign approach.
In the course of the 2 days you will travel the seemingly great divide between the pivotal importance of the worker-client relationship in drug and alcohol services to the development of drug use policies and testing protocols by the Australian Football League.
Importantly your conference will also consider the benefits of primary health care to intravenous drug users and others who find themselves marginalised and on the street.
Throughout these presentations you will consider diverse community relationships: relationships with those in detention facilities, with sex workers, with injecting drug users and with people living with HIV/AIDS.
What will you take from these two days as you return to workplaces and apply the shared knowledge you have gained?
Some very useful lessons, strategies and contacts that's for sure. But we will also better understand the importance of working within a holistic harm reduction framework, particularly with marginalised members of the community.
However, recent research tells us that emergencies resulting from drug and alcohol use amongst even the very young in the not-so-marginalised 'middle class' group are on the rise -- often because the difference between life and death can simply be the fear of reporting an illegal activity or the ramifications of revealing a substance use to family and friends.
Australian Red Cross makes its own contribution to responding to these needs, using a harm-reduction framework. Our Save-a-Mate program addresses this group as part of its youth focus, but also targets people in correctional facilities, sex workers, rehabilitation clients, remote indigenous communities, culturally and linguistically diverse groups, school children and patrons of pubs, clubs and venues.
The Save-a-Mate program aims to reduce harm by training key target groups how to prevent, recognise and respond to emergencies resulting from alcohol and other drug use at parties, raves, in nightclubs, at events and in the street because, the majority of substance use emergencies are witnessed, and regardless of how the community may feel about drug use, the unnecessary loss of life is a tragic waste.
This approach is reflected in strategies implemented across the International Red Cross and Red Crescent Movement, which applies humanitarian, public health and human rights rationales in developing strategies for harm reduction.
For example, the humanitarian rationale identifies vulnerable groups such as intravenous drug users who are often stigmatised and who experience high levels of incarceration. Whilst this rationale is too often frustrated when key issues become entangled in political, religious and moral debates; it is central to the Red Cross and Red Crescent Movement's Mission and to its Fundamental Principles of Humanity, Impartiality and Neutrality.
It is from this perspective that the Movement has developed Guiding Principles for harm reduction programs which include:
- the active involvement of injecting drug users
- the protection of human rights
- early intervention
- adequate coverage of affected population
- responses developed from accurate base line data
- humane and compassionate response
- concerted effort at all levels to successfully implement harm reduction
- working modalities outside of traditional settings including outreach work and peer education.
This approach has been further advanced within our region at the Manila conference in 2002, where 46 Red Cross/Red Crescent National Societies from the whole Asia-Pacific region participated. These NS collectively adopted the so-called Manila Action Plan, which sets the agenda for the region in the area of harm reduction, and calls for all Red Cross and Red Crescent organizations to develop appropriate harm reduction responses. The work on this is far from over, but we are moving ahead and through our program we are working with individual National Societies to understand the particular issues they are facing in their communities and develop appropriate responses.
As you would expect, for a global organisation such as ours and particularly for our country-based colleagues, the selection of interventions is influenced by a number of factors based on prevailing social, political, cultural and economic conditions and the strategies utilized to implement those interventions reflect this.
Strategies developed by National Societies take into consideration local legal frameworks that can be adapted to allow comprehensive responses. They also reflect the level of awareness about the underlying problems that cause harm and lead to stigmatization and discrimination and the extent to which a multi-sector approach is possible. Finally, those strategies also ensure there are resources at a local level and they are be based on reliable baseline information.
An excellent example of the way in which the Movement is successfully applying harm reduction strategies is emerging in the Xinjiang region of far north western China, where a partnership between the Red Cross Society of China and the Australian Red Cross is delivering an HIV/AIDS Prevention and Care Program.
In Yinning city, which borders with Kazakhstan, rates of HIV/AIDS are as high as 80% amongst injecting drug users.When the Positive Peer Education program commenced in 2002, awareness of issues surrounding safe injecting, safer sex and HIV transmission reflected this alarming statistic.
As the program progresses we are seeing an increased demand in the community for advanced training in home based care for people living with HIV/AIDS. Simple, basic literature on home based care has been produced and a new initiative in partnership with the Yinning Health Department is involving Red Cross volunteers trained in safe collection of discarded needles.
This element was particularly successful -- needle collection activities, which are undertaken by Red Cross volunteers in 2 sites in Yinning city, resulted in some 11,120 needles being collected in just 6 months!
Today, three years into the project the positive or affected volunteer peer educators have reported an increase in their self esteem and increased respect from their local community, which in itself is very encouraging. Even better, we are seeing a shift in attitude towards injecting drug users and people living with HIV/AIDS and importantly; increased willingness to talk openly about the issues.
Which brings me to my final message- the idea of harm reduction may be perceived as controversial, but for the Red Cross there are two guiding principles which we will use to determine our involvement.
The first is that our engagement is guided by sound public health and humanitarian principles - this is a genuine crisis and it has real and devastating humanitarian consequences for those involved. The second is that our activities will not be guided by populism or by political, religious or other debates. The body of evidence clearly shows that harm reduction is a genuine, well-recognised and effective public health approach that helps save lives.
Research shows harm reduction reduces the spread of HIV without increasing drug use. Guided solely by the needs of those affected, we will continue to promote and facilitate harm reduction strategies in a bid to fulfil our Red Cross / Red Crescent mission, which is to alleviate human suffering.
I wish you well for a wonderfully successful conference!