Harm Reduction in Africa Lanre Onigbogi MD, MPH Department of Community Medicine, University College Hospital, Ibadan, Nigeria

Compendium Contributory factors to HIV/Hep B disease spread in Sub-saharan Africa. Need for new and innovative approaches in dealing with emerging problems. The importance of networking in the development of harm reduction methods. The Sub-saharan Harm Reduction Network (SAHRN)-prospects and pursuits.

Sub-saharan Africa and new challenges Longstanding issues that have assisted in fuelling transmission of HIV and Hepatitis infections in Sub-saharan Africa incude: Alcohol abuse Tobacco smoking Non-injecting drug use Injecting drug use

Sub-saharan Africa and new challenges Public health systems in Sub-saharan Africa have been burdened by these issues over the past three decades. They have increased in importance with time. The renewed emergence can be linked to new technologies boosting illicit drug production and new drug smuggling routes.

Need for harm reduction methods Recently, there have been reports of increased drug use among African youth. Adoption of western lifestyles and the erosion of traditional family values in many African countries have been found to be contributory. This has necessitated the adoption of more practical methods in dealing with the problems of illicit drug use.

Need for harm reduction methods Many youth, especially those involved with the street are at risk of drug-related harms such as violence, overdose, HIV or Hepatitis B infection. The majority of these harms can be reduced through focused education, provision of safer means of using drugs during the rehabilitation period and implementation of youth-friendly drug laws.

Need for harm reduction methods Harm reduction initiatives will be beneficial because Sub-Saharan Africa currently faces the challenge of discouraging the diffusion and spread of injection drug use. Present laws and methods mainly succeed in driving drug use underground without addressing the harm to individuals and families who are already victims.

Importance of networking Most Sub-saharan African countries share similar experiences of civil strife, conflicts, lack of economic opportunities and weak governmental institutions. Many researchers on the continent have worked extensively in other fields that are related to harm reduction. However, civil society involvement in harm reduction issues have been minimal or non-existent.

Importance of networking Networking will help Sub-saharan Africa to develop harm reduction methods that are culturally acceptable and relevant. It will also mobilize individual, institutional and national interest in the adoption of harm reduction methods. The harm reduction message on the continent must go beyond rhetoric and tokenism!

Importance of Networking Collaboration should be between the North and the South as well as between countries in the South. Collaboration should also involve all interest groups – UN agencies, NGOs, governments, research organizations. Interest groups and drug user organizations must not be left out.

Importance of networking Current harm reduction efforts on the continent, where they exist, focus on the direct and the hidden harms associated with the use of illicit substances. Harm reduction programs must however also focus on commercial sex workers, youths and children on the street/children of the street.

Importance of Networking There is the need to widen the involvement of the NGO community in the development of the harm reduction agenda. NGOs have been major catalysts for a lot of recent development in health care in Africa. There is also a need plan the expansion of harm reduction methods to other components of public health on the continent.

Importance of Networking Sub-Saharan Africa Harm Reduction Network (SAHRN) provides a great framework for achieving this goal on the African continent. SAHRN comprises researchers, clinicians and advocates and was inaugurated in October 2007. If the HR message in Africa will have its desired impact, SAHRN must be nurtured and supported by individual governments and international agencies.

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