International Harm Reduction Day, which was commemorated on Tuesday, May 7, is dedicated to promoting harm reduction as an evidence-based approach to managing and minimising the negative social and physical consequences associated with various human behaviours.
This is particularly in the context of drug use and sexual health.
This observance aims to raise awareness about harm-reduction principles, advocate for harm-reduction policies and practices and celebrate the successes of harm reduction around the world.
It seeks to shift the focus from punitive responses, to drug use towards compassionate, health-focused solutions.
Harm reduction encompasses a range of public health strategies designed to lessen the risks and adverse outcomes associated with drug use and other high-risk activities.
These strategies include needle exchange programmes, opioid substitution therapy, safe consumption spaces, sexual health services and accessible information on safe practices.
By prioritising health and human dignity, harm reduction aims to reduce the incidence of drug-related harm, such as the spread of HIV and hepatitis C among injecting drug users, and to improve the overall well-being of individuals and communities.
Professor. Harry Hausler, the head of TB HIV Care, believes that people often turn to drugs because they are hurting or have experienced trauma.
He argues that treating them with kindness and respect and protecting their health and rights, is a better response than judgement or punishment.
"Harm reduction is really all about looking after people in a caring way. It means helping them to lessen the danger that comes with drug addiction. This includes dangers from using needles to inject drugs. We're here to support them as they try to get better."
This approach to drug addiction started in the 1980s in the UK. A clinic in Merseyside began giving clean needles and syringes to people who inject drugs. This was to stop the spread of HIV that occurs when needles are shared.
Since then, harm reduction has become an essential part of the worldwide plan to stop HIV from being a major health problem by 2030. According to Prof. Hausler, it also plays a significant role in South Africa's 2023 to 2028 strategy to combat HIV, TB and sexually transmitted infections.
“There’s no doubt that harm reduction reduces infection and onward transmission of HIV,” explains Prof. Hausler. “But it also reduces hepatitis C and other infections, as well as harm caused by blunt or dirty needles, like painful abscesses and sores.”
Despite their potential to save lives, harm-reduction programmes often meet strong resistance from local communities, particularly when they involve giving clean needles to drug users.
According to Prof. Hausler, organisations dedicated to harm reduction, such as TB HIV Care, do much more than just hand out needles and syringes.
With financial support from the Global Fund, through the Networking HIV & AIDS Community of Southern Africa (NACOSA) and additional backing from the US President's Emergency Plan for Aids Relief (PEPFAR), through the Centres for Disease Control and Prevention (CDC), they're working on a comprehensive health-care programme for injecting drug users.
This programme includes safe spaces for people to prevent overdose, treatments that help reduce the cravings and withdrawal symptoms from opioids like heroin, and plenty of support for mental and emotional health.
"Harm reduction means reaching out to drug users on their own terms, connecting them with medical care, and providing emotional and psychological support to cut down on their loneliness – especially those who are homeless. Our goal is to help them get their health back on track and lead productive lives," he said.
Meanwhile, Nikita Van Vuuren shared her powerful story of overcoming heroin addiction with the help of TB HIV Care's harm-reduction programme, calling the drug "the devil itself" and discussing the tough battle against addiction.
She highlighted the programme's role in treating individuals with dignity, providing support and offering a way to stabilise through Opioid Agonist Therapy (OAT) until they can quit.
Now a peer educator at TB HIV Care, Nikita helps others facing similar struggles, valuing every day she can make a difference. The team, including Prof. Hausler, views harm reduction as essential and a fundamental human right, underlining its impact on recovery and rehabilitation.
“We will continue to advocate for needle syringe programmes and OAT programmes – not only as a way to prevent HIV but as part of a complete package of health and psychosocial services so we treat people who inject drugs with dignity and compassion and provide the support they need to reintegrate with society,” said the team.