US Harm Reduction Pioneer Awarded by Japanese Goverment

On April 29, the government of Japan announced the awarding of the highly prestigious “Order of the Rising Sun, Gold Rays with Neck Ribbon” to Dr. Robert G. Newman in recognition of his distinguished contribution to promoting academic exchanges in the field of health between Japan and the United States.

The former president of the Beth Israel Medical Center, Dr. Newman is an internationally renowned expert in methadone treatment. A perhaps lesser-known fact is that he has simultaneously been committed to serving the Japanese community, opening up a medical facility for Japanese people residing in New York, and launching a clinical training program for Japanese physicians at the Beth Israel Medical Center. The training program was expanded in 1997 when he became the president of Continuum Health Partners, Inc., a corporation that oversees several large hospitals in New York. Over the past 23 years, approximately 150 Japanese physicians have benefited from the training program, and they are now leading major academic institutions and hospitals in Japan.

I am not a physician who participated in his training program, but I believe my personal experience helps speak of his inspirational effort to advocate a humane, evidence-based drug policy. It was in the fall of 2005 when I first met Dr. Newman in Tokyo. At that time, I was interested in working for an international organization focused on HIV/AIDS and was putting together applications for a master’s degree in international relations at US universities. One day, a friend of mine (and my mentor for life), Prof. Masayoshi Tarui, who is working with an HIV/AIDS advocacy organization in Tokyo, received an email from Dr. Newman. Apparently, Dr. Newman obtained the contact through his network of Japanese physicians in New York and told Prof. Tarui that he was visiting Tokyo for a vacation in the coming days. He stated that he would like to meet with people who may be interested in advocating harm reduction to the Japanese government and shared his concern that Japanese delegates to the UN had been strong opponents of harm reduction.

Intravenous drug use was - and still is - believed to be uncommon in Japan, and none of the HIV/AIDS advocates in the country had ever recognized a need for needle and syringe programs domestically, or had paid attention to what their government was saying about harm reduction at UN meetings. Therefore, Dr. Newman’s request was a real bolt out of the blue. Moreover, back then, even non-injecting drug use had rarely been discussed in the context of HIV/AIDS in Japan. There was little communication between those working in HIV/AIDS and drug addiction fields. Nonetheless, Prof. Tarui managed to find and make an appointment with a peer-based organization that supports recovery from drug addiction in Tokyo, and he invited me to join the meeting with Dr. Newman and help translate for him. I was nervous because I knew nothing about drugs, and felt this nervousness reflected back toward me from people at that organization. However, Dr. Newman turned out to be such a good ice breaker that I believe everyone enjoyed the meeting. While the meeting did not meet his original objective of finding advocates for harm reduction to the Japanese government, it provided an important opportunity to let the two separate fields engage in a dialogue and learn about each other and issues at the international level.

A year later, I found myself starting a graduate program at Columbia University in New York. While my schedule for the first semester was mostly packed with mandatory coursework, I wanted to take at least one class that had “HIV” in its title. Lo and behold, only one such class was held in that particular semester, focusing on HIV prevention for people who inject drugs. It was co-taught by Dr. Newman and Dr. Kasia Malinowska-Sempruch, the then-director of International Harm Reduction Development Program at Open Society Foundations. Although my knowledge on the subject was still minimal, I recognized Dr. Newman’s name and consulted with him about taking the class. He wholeheartedly welcomed me, and I decided to enroll.

I don’t think I was a bright student in the class because as someone who had never lived in an English-speaking country, I always had to spend more time consulting a dictionary than critically reviewing the assigned readings. However, Drs. Newman and Malinowska-Sempruch were very patient with me, and the class turned out to be incredibly instrumental for my academic career today. It led me to pursue another master’s degree in public health, got me a research internship with UNAIDS focusing on harm reduction in Thailand, and led me to complete my PhD by undertaking one of the first community-based research projects involving people who inject drugs in Bangkok, Thailand.

Dr. Newman’s visit to Japan not only had a profound impact on me but also on the Japanese HIV/AIDS community. Prof. Tarui, for one, has since been committed to raising awareness about the link between HIV/AIDS and drug use. In 2012, he and his colleagues successfully obtained funding through the Japanese Ministry of Health, Labour and Welfare’s Sciences Research Grant to conduct the first of its kind research on drug use among people living with HIV/AIDS in Japan. While this is ongoing, their preliminary findings indicated that approximately 40 percent of a sample of HIV/AIDS care providers in Japan had ever been asked by their patients for medical advice on their illicit drug use. However, the majority of these healthcare providers had difficulty responding to it primarily due to a lack of knowledge about addiction medicine. On the other hand, the research team also found that community-based social workers and peers working for people living with HIV/AIDS and those working for people who use drugs have increasingly come to collaborate and share knowledge and resources in recent years. These findings shed light on issues that have long been neglected, and they represent a key milestone for future research and advocacy efforts in this area.

In sum, Dr. Newman is highly deserving of the honor given his extraordinary contribution to the health field in Japan. If I had not met with him in Tokyo in 2005, I would have followed a completely different path from the one that I am on now and love. I’m sure many people out there who had an opportunity to interact with him feel the same way I do. Thus, I have no doubt I am not alone in offering my warmest congratulations to him for receiving this decoration.

To find out more about Dr. Newman’s contribution to Japan, see the website of the Consulate-General of Japan in New York.

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Kanna Hayashi is a Postdoctoral fellow at the University of British Columbia, Canada.