Future Proofing Harm Reduction in Montreal

At the 25th International Harm Reduction Conference, Mainline organised a packed side event called ‘Future Proofing Harm Reduction’, together with AFEW, AidsFonds, INPUD and others. The rationale behind the side event was the need we see to promote harm reduction as a broad approach- not just as a set of HIV-related interventions.

Most harm reduction programmes are funded by HIV prevention programmes. However, harm reduction is much more than the prevention of blood-borne diseases like HIV and Hep C. Instead, care for vulnerable people, including women and minors, but also overdose prevention, interventions for non-injectors and access to other forms of care are extremely important. These needs are not addressed by most harm reduction programmes. At the same time, globally, funding for HIV has been decreasing. These and other challenges – such as repressive governments and decreasing space for civil society – threaten the sustainability of harm reduction.

The aim of this side event was to illustrate the need and to look at potential solutions. The Netherlands is one of the pioneers in harm reduction interventions and, despite the small size of the country, one of the world’s biggest governmental donors of harm reduction programming. Dutch SRHR Ambassador Lambert Grijns chaired the event, reflecting the Dutch moral and financial support for addressing this issue.


Five speakers highlighted some of the key challenges in harm reduction today. For example, Valentin Simionov illustrated how HIV prevalence among injecting drug users in Romania increased drastically when harm reduction funding was ended abruptly, without a national government willing to take over. Janine Wildschut, from AFEW International, explained how governments in Central Asia become more repressive, with community organization closing down as a result. 


The second half of the side event addressed the opportunities of future proofing harm reduction, particularly by framing harm reduction within the agenda of the United Nations’ Sustainable Development Goals. These ambitious goals include ending poverty, improving health, promoting gender equality and many others. 

Many harm reduction activities, such as programmes for pregnant users in Kyrgyzstan, or interventions for people who smoke methamphetamine in Indonesia, already contribute to the targets set by the UN. So far, most organisations do not realise this yet. 

The event showed that organisations need to start thinking creatively about how to embed harm reduction in other themes besides HIV prevention. A new narrative is needed, and novel approaches are sought in order to ensure harm reduction stays future-proof. Because without a harm reduction approach that safeguards people’s human rights, that enables access to male and female users equally and that ensures a continuum of care for people who use drugs, governments won’t be able to achieve their targets under the sustainable development goals (SDG’s). 

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