Harm Reduction in Africa

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Harm Reduction in Africa

• Lanre Onigbogi MD, MPH
• Department of Community Medicine, University
  College Hospital, Ibadan, Nigeria

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Compendium

• Contributory factors to HIV/Hep B disease spread
  in Sub-saharan Africa.
• Need for new and innovative approaches in dealing
  with emerging problems.
• The importance of networking in the development
  of harm reduction methods.
• The Sub-saharan Harm Reduction Network
  (SAHRN)-prospects and pursuits.

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Sub-saharan Africa and new challenges

• Longstanding issues that have assisted in
  fuelling transmission of HIV and Hepatitis
  infections in Sub-saharan Africa incude
• Alcohol abuse
• Tobacco smoking
• Non-injecting drug use
• Injecting drug use

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Sub-saharan Africa and new challenges

• Public health systems in Sub-saharan Africa have
  been burdened by these issues over the past three
  decades.
• They have increased in importance with time.
• The renewed emergence can be linked to new
  technologies boosting illicit drug production and
  new drug smuggling routes.

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Need for harm reduction methods

• Recently, there have been reports of increased
  drug use among African youth.
• Adoption of western lifestyles and the erosion of
  traditional family values in many African
  countries have been found to be contributory.
• This has necessitated the adoption of more
  practical methods in dealing with the problems of
  illicit drug use.

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Need for harm reduction methods

• Many youth, especially those involved with the
  street are at risk of drug-related harms such as
  violence, overdose, HIV or Hepatitis B infection.
  
• The majority of these harms can be reduced
  through focused education, provision of safer
  means of using drugs during the rehabilitation
  period and implementation of youth-friendly drug
  laws.

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Need for harm reduction methods

• Harm reduction initiatives will be beneficial
  because Sub-Saharan Africa currently faces the
  challenge of discouraging the diffusion and
  spread of injection drug use.
• Present laws and methods mainly succeed in
  driving drug use underground without addressing
  the harm to individuals and families who are
  already victims.

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Importance of networking

• Most Sub-saharan African countries share similar
  experiences of civil strife, conflicts, lack of
  economic opportunities and weak governmental
  institutions.
• Many researchers on the continent have worked
  extensively in other fields that are related to
  harm reduction.
• However, civil society involvement in harm
  reduction issues have been minimal or
  non-existent.

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Importance of networking

• Networking will help Sub-saharan Africa to
  develop harm reduction methods that are
  culturally acceptable and relevant.
• It will also mobilize individual, institutional
  and national interest in the adoption of harm
  reduction methods.
• The harm reduction message on the continent must
  go beyond rhetoric and tokenism!

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Importance of Networking

• Collaboration should be between the North and the
  South as well as between countries in the South.
• Collaboration should also involve all interest
  groups UN agencies, NGOs, governments, research
  organizations.
• Interest groups and drug user organizations must
  not be left out.

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Importance of networking

• Current harm reduction efforts on the continent,
  where they exist, focus on the direct and the
  hidden harms associated with the use of illicit
  substances.
• Harm reduction programs must however also focus
  on commercial sex workers, youths and children on
  the street/children of the street.

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Importance of Networking

• There is the need to widen the involvement of the
  NGO community in the development of the harm
  reduction agenda.
• NGOs have been major catalysts for a lot of
  recent development in health care in Africa.
• There is also a need plan the expansion of harm
  reduction methods to other components of public
  health on the continent.

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Importance of Networking

• Sub-Saharan Africa Harm Reduction Network (SAHRN)
  provides a great framework for achieving this
  goal on the African continent.
• SAHRN comprises researchers, clinicians and
  advocates and was inaugurated in October 2007.
• If the HR message in Africa will have its desired
  impact, SAHRN must be nurtured and supported by
  individual governments and international
  agencies.

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• Thank you for listening