Harmonizing public health and public safety in a politically conservative environment
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www.aids2014.org Harmonizing public health and public safety in a politically conservative environment Joëlle Rabot Field Coordinator Collectif Urgence Toxida (CUT) Mauritius
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Harmonizing public health and public safety in a politically conservative environment. Joëlle Rabot Field Coordinator Collectif Urgence Toxida (CUT) Mauritius. Setting the scene. Mauritius & its socio- political environment regarding drug use HIV epidemic in Mauritius - PowerPoint PPT Presentation
Transcript of Harmonizing public health and public safety in a politically conservative environment
www.aids2014.org
Harmonizing public health and public safety
in a politically conservative environment
Joëlle Rabot Field Coordinator
Collectif Urgence Toxida (CUT)Mauritius
www.aids2014.org
Setting the scene• Mauritius & its socio-political environment regarding
drug use• HIV epidemic in Mauritius• Public health approach : The introduction of Harm
Reduction(HR) strategies • The current situation• Opportunities for harmonisation• Key Challenges• The way forward for better harmonisation
www.aids2014.org
Mauritius & its socio-political environment regarding drug use
• Population : 1,2 M inhabitants• Surface area about 2000km2 • Generally speaking, drug use is
tackled with a repressive approach
• General population still conservative about drug use
• Politicians usually use populist ‘ tough on drugs’ approach
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HIV epidemic in MauritiusMauritius has a concentrated epidemic with a prevalence
of 1.02% in the general population• First case detected in 1987• 5863 detected cases (up to end of March 2014) • 70.5% of new transmission is related to injecting drug use.• There is an estimation of 10,000 People Who Inject
Drugs(PWIDs)population in Mauritius • Integrated Biological & Behavioural Surveillance(IBBS) survey, 2011)
HIV Prevalence Rate among KAPS (IBBS, 2011)
PWID 52%MSM 20%FSW 29%
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1996 : Civil society starts raising the alarm about HIV among PWIDs
Early 2000’s : Exponential growth of HIV Infection within the PWID population
Public Health approach : Introduction of Harm reduction strategies
A little bit of history
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2000 2001 2002 2003 2004 20050
100
200
300
400
500
600
700
800
900
1000
50 5598
225
525
921
2% 7%14%
66%
87%
92%
New HIV Cases PWIDs
HIV Incidence in PWIDS in Mauritius2000-2005
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Public Health approach : Introduction of Harm reduction strategies
A little bit of history (Contd)2004: Platform created by Civil society to advocate for Harm Reduction Strategies in Mauritius. This platform will later be CUT (Collectif Urgence Toxida)
2006: Launching of illegal Needle and Syringe Program(NSP) by CUT & Methadone Substitution Therapy(MST) by the Ministry of Health & Quality of Life (MOHQL)
2007: Legal Framework for NSP through the HIV/Aids Act
Creation of National NSP Committee by the govt where CUT is invited to sit.
2009 : CUT opens its premises and follows-up on NSP and advocacy on Harm Reduction
2010: Global fund allows upscaling of Harm Reduction Services
2011: MST in Prisons
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Public Health approach : Introduction of Harm reduction strategies
• About 40 NSP sites• 2540 PWIDs registered• Different model of intervention
used ( Fixed/Mobile/Backpack)
Needle and Syringe
Programme
• About 6000 people on MST• Introduction of MST in prison
Methadone Substitution
Therapy
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The Current Situation
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
100
200
300
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1000
New HIV Cases
PWID Incidence Rate
HIV Incidence Rate in Mauritius (2000-2013) showing PWID incidence rate
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26502466
2046
16411295
1085
0
500
1000
1500
2000
2500
3000
2007 2008 2009 2010 2011 2012
Reported cases
Decrease in crime rates for drug related offences
The Current Situation
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Opportunities for harmonisation• Legal Framework available for NSP• Harm reduction present in national strategies
and supported by the Global Fund• HIV/Aids National coordinating body has created
an enabling environment for Harm Reduction• Private sector implication• Policy Dialogue between Govt and NGOs• Availability of data through recent research• Training of Police force & Legislators
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Key Challenges• No National Drug Control Master Plan since 2009
• Clash between the repressive approach of the system and public health approach
• Repressive approach – Behaviour of KAPs are criminalised
• High level of stigmatisation towards KAPs– Police Harassment at service delivery
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The Way towards better harmonisation
• STRENGTHEN ADVOCACY– with media, partners, users, Community, Govt, police, CSRs, etc– For a National Drug Control Master Plan based on the 4 pillars approach
that should also include : • Legal reviews• Drug policy reform• Recognition of HR approaches in strategic plans of law enforcement
– For the ongoing training of police, media, partners, users, CSRs on HR and the inclusion of an HR module in the police force curricular
• RESEARCH FOR ADVOCACY– Need of data to strenghen arguments based on evidences
• POLICY DIALOGUE– Promote representation of KAPs on platforms that can enable more
harmonisation– Better implication and representation of civil society in commitees such as
the CCM, HR Committee , etc
Nathalie
whay 2 seperate pts?
Nathalie
what about drug policy reform?presentation do not show how harmonisation is being made. "increase Policy dialogue" is vagueHow do we plan to harmonize more??Maximize ADVOCACY work with : media, partners, users, Gov, police, CSRs, etcResearch for advocacyPolicy dialogue : active implication on various committees : CCM, HR Committee, etc.Promote representation of KAPs on platforms that can enable more harmonisationADVOCATE FOR WHAT :Creation of NDCMP based on 4 pillar approach that should also include : Legal reviewsDrug policy reformRecognition of HR approaches in strategic plans of law enforcement
