Drug use has been a feature of political rhetoric in Rwanda for years. President Kagame has stated in the past that drug use is “wasting” the lives of young people, and the country has historically relied heavily on incarceration and criminalisation to prohibit drug possession and trafficking as part of its anti-delinquency initiatives. What has often been missing from these discussions is the voice of those that use drugs and are fighting for harm reduction.
As a result of this environment, drug-related harms have grown in the African nation: according to the government’s 2020 HIV statistics, around 2.7% of all Rwandans aged 15 to 49 are HIV positive, over four times the global average of 0.6%. Women are more likely to be affected at 3.7% as opposed to 1.7% in men. Independent research has also confirmed that people injecting drugs in Rwanda were estimated to have HIV rates three times higher than the national average.
Regardless of the evidence, the Rwandan government has denied that certain drug using behaviours exist in the country. The 2030 vision document for ending HIV transmission stated that injecting drug use “is not present” in Rwanda; people injecting drugs are not even acknowledged as a key population in the government’s HIV statistics. This is despite existing evidence which highlighted the existence of hundreds of people injecting drugs in the capital of Kigali alone, and how a lack of access to harm reduction equipment meant needle sharing was common practice.
Seeking to address a lack of health-based tools and representation, PARUDA (People Against Risks of Using Drugs Association) was formed. PARUDA is a Rwandan network of people involved in harm reduction operating out of Kigali providing support for this marginalised group. Originally established by Burundian refugees who were displaced after civil unrest and conflict, it is now composed of both Rwandan and Burundian members. Its goal is to provide comprehensive support focused on global health, including prevention of HIV, TB, hepatitis, and other transmissible diseases. This includes harm reduction services like condom distribution, HIV testing, and risk-reduction education to mitigate the spread of infections. PARUDA hopes to foster community empowerment through advocacy and peer support, particularly for vulnerable groups such as women, youth, people living with HIV (PLHIV), and those previously incarcerated.
Operating in a criminalised environment, however, means that PARUDA and others who use drugs still face many challenges. Harm reduction is not recognised in Rwanda’s national health strategies, limiting the range of possible interventions that can be used to reduce drug-related harms. This also impacts financing, particularly around stockpiling sterile equipment and essential medications.
Another key factor that PARUDA will be up against is the lack of public knowledge on how to support people using drugs, should they face any problems. If someone’s family member or child is using drugs, their options for support are limited; those with money will put them through expensive rehabilitation; those without may be placed under psychiatric care, or in rehabilitation centres that fix “delinquent” behaviours in people for undetermined periods of time. For those with even less luck, they face a future behind bars.
Taking the first steps
PARUDA’s ultimate hope is to achieve financial stability, strengthen their community, and advocate for policy changes that will improve the lives of people using drugs in Rwanda.
So far, they have already conducted two activities with authorisation from the Rwandan government. The first was an educational intervention, teaching community members about the potential dangers from drug use, as well as how to use safer practices to prevent the spread of bloodborne viruses. This included sharing living experiences from sex working PARUDA members. The second was the distribution of condoms for men who have sex with men, with the aim of raising awareness about drug use-related risks and reducing the transmission of communicable diseases.
While PARUDA would ideally move towards decriminalisation as an end-goal, it is one currently too far for the Rwandan context. For now, the group is focused on growing its community within the capital before considering national level work. The priorities at the moment are financing and relationship building.
With a long journey still ahead of them, PARUDA is focused on securing approval from the government to freely organise meetings with their community so they can discuss and exchange harm reduction information and resources without the fear of arrest or repercussions.
In the future, PARUDA hopes to join as many regional and international networks to ensure they learn from other similar communities and understand how they can grow, thrive, and best advocate for their future.
Building a positive political relationship
While PARUDA is still growing, it has ambitions to change Rwandan drug policies from the outside. This may not be too far fetched: the nation has a history of non-governmental organisations influencing public opinion and political direction. In 2010, activists and organisations mobilised to prevent the criminalisation of same-sex relations and activism, demonstrating how civil society can successfully work with politicians to frame certain issues like LGBT rights as aligned with the state’s current vision for the country.
With drug use, something that has been continuously criminalised and stigmatised in modern day Rwanda, organisations like PARUDA may struggle to convince political elites of their value. There are, however, some inroads that the organisation can make based on existing commitments. Rwanda’s 2030 HIV vision document outlines its proposed activities to end HIV transmission: this includes condom distribution and better education and prevention efforts. PARUDA is expertly positioned to represent this ignored group, protect their community while achieving the nation’s HIV goals.
With PARUDA already registered in the Rwandan Development Board, the public body accelerating development through private enterprises, they are working towards their goals. And while there is a long road ahead for PARUDA, building a community that represents the interests of those using drugs is key for securing better health and a positive future for their community.
