“You Cannot Promote Safety Through Prejudice”: An Interview with Marinella Kloka On Harm Reduction in Greece
Marianella Kloka, one of the leading figures of the Greek harm reduction movement.
Marianella Kloka is one of the leading figures of the Greek harm reduction movement, and is currently the advocacy officer at the Praksis NGO. We interviewed her about how the government and civil society in Greece have responded to the threat of an HIV epidemic among people who use drugs. Read her inspiring thoughts, and watch our video about people, drugs and harm reduction in Greece!
Drugreporter: How and why did you get involved in harm reduction?
Marianella Kloka: Back in 2011, when I was working mainly with people in Greece who were living with HIV/AIDS, an HIV outbreak hit people who inject drugs in central Athens. Before that time, we had about 4-6 positive HIV diagnoses per year among drug users.
The Chair of OKANA (National Organisation Against Drugs), Mrs Malliori, formed an NGO/Agency working group, in order to implement, as quickly as possible, harm reduction practices such as needle and condom distribution, rapid HIV testing, and direct links into care services.
It was then that I started to read about the comprehensive package written by UNAIDS, WHO, and UNODC, and to closely follow any meetings with international or European bodies which might help Greece, and the NGO sector where I was working, to devise a plan to combat the epidemic.
DR: What does harm reduction mean to you?
MK: The use of substances which produce different effects on human consciousness is a practice with a long history. Kikeon, for example, is the mushroom drink which played a key spiritual role in the mysteries of Eleusis.
It's important to consider why and how people use drugs. As I understand it, harm reduction is a way of making drug use safer. It allows those who are attracted by it to enjoy their drug use, while making it safer, both for the people who use them and for those who are close to them. It’s also a way of not losing people to overdose.
Personally, I think that people who use drugs should be fully aware of the effects – both positive and negative – of every substance they consume. You cannot promote safety through prejudice or supposedly “moral” judgemental attitudes.
DR: Greece has witnessed a huge HIV epidemic among people who use drugs since 2008. What were the reasons for this sudden increase in new infections?
MK: I think two of the reasons are the major factors which led us to an HIV epidemic. First, the lack of harm reduction services tailor-made for the needs of people who were using drugs before the outbreak. I'm talking about the long waiting list for OST programmes, the lack of needle and syringes distribution/exchange, the lack of condom distribution programmes; I think it's fair to say that people who use drugs were generally neglected. For years, there was a hidden Hepatitis C epidemic, but nobody seemed to care.
The second factor was the economic crisis, which brought cheap and harmful drugs to the market, some of them injectable. The same crisis caused pharmacists to stop giving out free syringes in downtown Athens. For a time, pharmacists were the most consistent way of providing syringes to drug users.
DR: How did the government respond to the HIV epidemic?
MK: The government invited the relevant European bodies to a joint mission in Greece.
The World Health Organisation (WHO) Europe, European Centre for Disease Prevention and Control (ECDC), European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), and the European Union Agency for Fundamental Rights (FRA) responded positively. There were many meetings and the partners formulated some proposals, which were, in part, implemented by the Greek Ministry of Health.
But then, in spring 2012, we entered an election period, and a huge error occurred: a Ministerial Decree forced women who use drugs to get tested for HIV, and they were then put in jail for “deliberately transmitting HIV and producing bodily harm”. Zoe Mavroudi did a very nice and to-the-point documentary on this.
The Minister of Health, Andreas Loverdos, together with the Minister of Public Order, Michalis Chrisohoidis, based a large part of their electoral campaign on this, claiming that they cared about public health issues. The move was a big mistake, despite the fact that they managed to get re-elected. Re-election is one thing – how history records your name is also important. At least, it matters to me and to a big part of civil society.
Half of the women who were prosecuted during those first days are now dead. At least now this decree has been overturned by the present government, although more action needs to be taken concerning legislation on harm reduction in Greece.
DR: The first drug consumption room, opened in Athens, was open for only a very short time. Why did the government decide to suspend it?
MK: This is a case which confirms my last point. Conservative circles inside governments can’t seem to understand the vital role that a DCR plays, both for drug users and for broader society. They refuse to understand that if we have DCRs, we can make open drug scenes vanish. We will lose fewer people from overdose. They think that the political risk of allowing a DCR outweighs the deaths of drug users. I believe that there is no excuse for the politicians in charge to not change the legal framework to allow DCRs to operate in Greece.
DR: How could we convince the public about the usefulness of harm reduction? How do you see the future?
MK: I believe we need to work on several issues: a) the way that we try to implement harm reduction for people who use drugs, based on public health criteria; b) we need to change the way people feel towards drug use and morality; and c) we need to understand that this is a debate which is gaining ground at a global level, and we must never quit working methodically on it.
Another factor is important: people who use drugs must be directly involved, every step of the way. After all it's their lives we're talking about.