1. Dr Nicholas Thomson Nossal Institute for Global Health 6th HAARP Consultation and Coordination Forum, Siem Reap, April 2012

2.  What does this mean in the context of harm reduction?  How do we actually do it?  What are some of the factors that “enhance the enabling environment”?

3.  We understand the importance of an enabling legal and policy environments in the context of drug use and HIV……….(HAARP’s Legal and Policy Review)  The same discussion is being had for all HIV prevention among Key Affected Populations  UNESCAP High level meeting, Universal Access, UNDP Global Commission on the Law and HIV  National and Global Policy Debates and Civil Society issues based movements

7.  What else are critical components of the enabling environment?  Best practice, evidenced-based comprehensive programs ultimately funded by the state

8.  It’s the intersection of law enforcement and HIV programs and the people they work with that ultimately dictates how “enabling” the enabling environment is

9.  We haven’t been able to influence law enforcement agencies : why not?  How can we work with police to reinvigorate their ability to become significantly better harm reduction program supporters and indeed public health actors?

10.  Multiple (and substantiated) reports of rights violations  Really, really high rates of lifetime history of arrest, incarceration, re-arrest and further incarceration of drug users and sex workers

12.  Action orientated; reactive rather than proactive  Achievement measured according to arrests=promotion  Extension of conservative state approaches  Discouraging of innovation and creativity  Police see a “war on drugs” as their national security duty

13.  How many of us have tried working with police on a regular and ongoing manner?  How many of us have really tried to understand the operational culture of policing?  How do we create an enabling environment where the police are fully engaged in their role in HIV prevention?

15.  We have started a series of research projects to understand the dynamics of the enabling environment  UNESCAP Best Practice  Law Enforcement and Harm Reduction Research Network

16.  Examined enabling environments across the Asia Pacific  Case studies included if actions taken by either civil society, government or police (in isolation or separately) had contributed to a “BETTER ENABLING ENVIRONMENT”  Measured by: decreasing prevalence of HIV risk behaviour, uptake in service delivery

17.  Community mobilisation in AVAHAN projects in India  Efforts to enhance communication between police and drug user networks in Indonesia  Significant engagement between the Blue Diamond Society in Nepal with the police  Sex worker led interventions with police in Thailand (SWING) and Fiji  Human rights policing efforts in Indonesia  Harm reduction training curriculum in Cambodia, Malaysia and Yunnan

18.  Less brutality experienced by sex workers in Fiji leading to increase condom use  Female sex workers reform police practices in southern India  Workplace policies on HIV in the police department in Nagaland  But how can we scale up LE and HIV program partnerships?  And how can we monitor the implementation and success?

19.  1) The Importance of LEADERSHIP  Leadership from both police and civil society  We need people who can meet regularly and represent the views of their organisations.  Respectful and collaborative leadership

20.  2) Importance of growing of Civil Society Networks  Case examples highlight that building civil society networks and their ability to collectively represent themselves made significant impacts on police practices towards them  The role of paralegal services, rights documentation etc

21.  3) The importance of police operational, educational and cultural reform  Development of harm reduction and HIV prevention curriculum (role of police)  Without police reform progress difficult  Police need to feel supported in their reform efforts

22.  4) The Importance of formal and informal communication channels between police and civil society and HIV programs  National and local task forces  Key actors from both sectors knowing each other

23.  5) Addressing Structural Drivers  Violence, intimidation  Employment and education  Policy and practices  Scaled up programs  Program design that specifically prioritises a Law Enforcement Advocacy and Partnership plan

24.  6) The need for monitoring and evaluation of the enabling environment  What are the variable of interest?  Decrease incidence of police harassment  Increase in service uptake

25.  The role of harm reduction programs on policing practices  Laos, Vietnam and Cambodia  What have we found????

26.  The involvement of law enforcement is critical to the success of harm reduction programs at all levels – regional, national and local.  There is a pressing need for law enforcement agencies and authorities to share ownership of harm reduction.  Police must be engaged early by harm reduction programs; not as a subsidiary but as a core partner.  There need to be multi-sectoral structures among all key agencies involved at all levels, so that working relationships can be established and maintained.

27.  Have a long history going back to original design of Asia HIV/AIDS Regional Project (ARHP)  Police trainings  Sustained involvement: Takes time  Working with Yunnan Police Academy (almost 15 year relationship  HAARP cross border work pioneering Law Enforcement and Public Health cooperation cross border…………We need to document lessons!!

28.  “We heard about the program from our bosses but we were never approached by anyone running the program to inform us about how it would work”  Program design, police liaison officers?

29.  Law Enforcement & Harm Reduction Network (LEAHRN)  www.leahrn.org www.leahrn.org  Special Edition of the International Harm Reduction journal and dissemination events in Thailand, Laos, Cambodia and Vietnam  Policing and Public Health, LEPH 2012: The First International Conference on the Intersection of Law Enforcement and Public Health, Melbourne November 11-14, 2012 "Working Together, sharing success"www.Policing-and-Public-Health.comwww.Policing-and-Public-Health.com

30.  For more information on our growing Law Enforcement and Public Health Program  Email: nthomson@jhsph.edu