eThekwini Demand
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Delegates of the SA Drug Policy Week 2018, a high-level gathering of local, regional and international and local experts on drug policy, have duly noted the background events that lead to the suspension of the needle and syringe programme due to an apparent by-law infringement.
We are outraged at this ill-informed, unconstitutional and life-threatening decision by the eThekwini Municipality to suspend the needle and syringe services for people who inject drugs and call for the following:
Cape Town
12 October 2018
We are outraged at this ill-informed, unconstitutional and life-threatening decision by the eThekwini Municipality to suspend the needle and syringe services for people who inject drugs and call for the following:
- The immediate reinstatement of the needle and syringe services.
- A delegation of officials and politicians from the city should visit needle and syringe programmes in appropriate countries.
- The municipality must engage in constructive dialogue with the community of people who use drugs, service providers, policy and treatment experts.
- The municipality must take guidance from the City of Tshwane in regard to their management and support of the needle and syringe programme, which includes their funding of the programme.
Cape Town
12 October 2018
Background
TB/HIV Care provides people who inject drugs with sterile needles and syringes in order to prevent the sharing needles and the re-use of needles. The aim of this is to prevent the spread of communicable diseases. In providing sterile needles and syringes, TBHIV Care also plays an important role in educating people who inject drugs on the safe disposal of needles and syringes. This service, provided by TBHIV Care has prevented the onward transmission of blood-borne diseases like HIV and hepatitis B and C.
TB HIV Care not only provides an essential services to people who are already injecting drugs, but also provides essential preventive services at the Umbilo Drop-In Centre and through their mobile clinics. In these spaces, all people who use drugs, or who are at risk of using drugs, are provided with free basic health services such as HIV testing, TB and STI screening, and psycho-social services. These services have been offered in Durban since 2015, after a study revealed a large existing population of people who inject drugs in eThekwini.
In May 2018, following a moral panic that emerged when a number of needles and syringes were washed up on the Durban beach front, the eThekwini Municipality instructed TBHIV care to halt its needle services. Despite having no evidence to support this, TBHIV Care was deemed to be responsible for this incident despite the well-known and publicised fact that the nearby public hospital has a very poor record of medical waste disposal. Without proper investigation or consultation, the instruction to halt services was issued on the basis of non-compliance by-laws that the organisation had previously not been asked to comply with. TBHIV Care has been non-defensive in its response: it recognised that some of the needles and syringes found may be from negligent beneficiaries, and has now followed all the requirements to compliance. TBHIV Care has now suspended its needle and syringe services since May 2018, and the Municipality has provided no feedback to date on the compliance application or the requests to reinstate services in the interim.
The impact of the suspension has been dramatic. People who inject drugs are now sharing needles and syringes and re-using blunt needles. There is a high level of anxiety amongst this group of already vulnerable people as well as a rapid increase in primary health care problems such as burst veins and open wounds resulting from the re-use of unsterile needles. This suspension is also harmful to the general public, as it has resulted in a lack of services for the safe disposal of injecting paraphernalia. This can only be seen as denial of the fundamental right of all to the highest standards of health care.
This action by the eThekwini Municipality stand in stark contrast to the rights enshrined in the South African Constitution and the recommendations of the National Strategic Plan 2017-2020. It also goes against the guidance from the World Health Organisation (WHO),the UN Office on Drugs and Crime (UNODC), the Joint UN Programme on HIV/AIDS (UNAIDS), the Global Fund to Fight AIDS, Tuberculosis and Malaria, USAID and many more.
TB HIV Care not only provides an essential services to people who are already injecting drugs, but also provides essential preventive services at the Umbilo Drop-In Centre and through their mobile clinics. In these spaces, all people who use drugs, or who are at risk of using drugs, are provided with free basic health services such as HIV testing, TB and STI screening, and psycho-social services. These services have been offered in Durban since 2015, after a study revealed a large existing population of people who inject drugs in eThekwini.
In May 2018, following a moral panic that emerged when a number of needles and syringes were washed up on the Durban beach front, the eThekwini Municipality instructed TBHIV care to halt its needle services. Despite having no evidence to support this, TBHIV Care was deemed to be responsible for this incident despite the well-known and publicised fact that the nearby public hospital has a very poor record of medical waste disposal. Without proper investigation or consultation, the instruction to halt services was issued on the basis of non-compliance by-laws that the organisation had previously not been asked to comply with. TBHIV Care has been non-defensive in its response: it recognised that some of the needles and syringes found may be from negligent beneficiaries, and has now followed all the requirements to compliance. TBHIV Care has now suspended its needle and syringe services since May 2018, and the Municipality has provided no feedback to date on the compliance application or the requests to reinstate services in the interim.
The impact of the suspension has been dramatic. People who inject drugs are now sharing needles and syringes and re-using blunt needles. There is a high level of anxiety amongst this group of already vulnerable people as well as a rapid increase in primary health care problems such as burst veins and open wounds resulting from the re-use of unsterile needles. This suspension is also harmful to the general public, as it has resulted in a lack of services for the safe disposal of injecting paraphernalia. This can only be seen as denial of the fundamental right of all to the highest standards of health care.
This action by the eThekwini Municipality stand in stark contrast to the rights enshrined in the South African Constitution and the recommendations of the National Strategic Plan 2017-2020. It also goes against the guidance from the World Health Organisation (WHO),the UN Office on Drugs and Crime (UNODC), the Joint UN Programme on HIV/AIDS (UNAIDS), the Global Fund to Fight AIDS, Tuberculosis and Malaria, USAID and many more.