Thai harm reduction campaign
On the 24th June 2011 more than 100 harm reductionists lobbied the Ministry of Public Health in Bangkok for greater leadership over a harm reduction strategy in Thailand. The campaigners gathered “to protest the lack of evidence-based, community-based, and voluntary approaches for dealing with harms related to drug use, such as HIV, viral hepatitis, and overdose,” said Jirasak Sripramong, manager of a health education centre for intravenous drug users (IDUs).
Thailand has suffered from a threatening HIV and viral hepatitis epidemic since the 1980s due to the unrestricted transmission amongst IDUs. Whilst in 2002 new policy was introduced to treat drug users as “patients, not criminals,” frequent police clampdowns on drug consumption and possession is considered by many harm reductionists to hinder the development of a successful public health initiative. Karyn Kaplan, of the Thai Treatment Action Group (TTAG) explains that “It’s really hard for us to implement life-saving services like HIV counselling and needle/syringe programs (NSP) when the police are empowered to walk into our centers and arrest who they like.” Safety and confidentiality of drug users often conflicts with national drug laws and Thai police have been criticised for its interference in campaigners work to promote rights to healthcare for drug users. “We need the Ministry of Public Health to stand up and be a vocal and effective national leader on harm reduction, and to help us do away with laws and policies that actually increase harm to drug users and society at large,” said Paisan Suwannawong, former Chairman of the Thai Network of People Living with HIV/AIDS and member of the Thai Drug Users’ Network (TDN).
Another recent health issue in Thailand is that of recreational methamphetamine consumption, which is set to reach 1.1million (1 in 60 citizens) in 2011, following a growth in 100,000 users over the previous six years. Unsurprisingly, children too are affected by emerging use and trade in methamphetamines. In June the minister of Public Health Jurin Laksanawisit announced 6700 children aged between 7 and 17 were rehabilitated in 2011 so far and children as young as five have been used as mules. Although the prime minister-designate, Yingluck Shinawatra has promised to defeat “a new war on drugs” within 12 months, human rights organisations worry it will duplicate the violence seen under the 2003 strategy. That is when former Prime Minister Thaksin Shinawatra (brother of Yingluck) ordered a list of suspected dealers who were to be dealt with “decisively and without mercy.” Furthermore, popular support was strong for the crackdown, even though later findings confirmed over half of the 2500 deaths during the three month period were considered extra-judicial killings. In fact, Sunai Phasuk of Human Rights Watch said many of those killed in 2003 had been “victims of personal revenge or sloppy categorisation”. One particular couple were shot dead after acquiring a suspicious wealth; it later surfaced that they were lottery winners. The rise in methamphetamine use has been accredited to shifts in societal values, the global economic downturn in 2008, and political instability; however the harm reduction campaign promotes an increased focus on reducing its effects (rather than causes) through education and rehabilitation programmes.
Following the UN International Day Against Drugs on 26th June, hopefully the Ministry of Health considers the open letter from advocates and moves forward with the suggested cross agency cooperation and involvement of existing and ex- drug users in harm reduction policy development and programming.