Pubdate: Sun, 01 Jun 2003
Source: Winnipeg Free Press (CN MB)
Copyright: 2003 Winnipeg Free Press
Contact:  http://www.winnipegfreepress.com/
Details: http://www.mapinc.org/media/502
Author: Lloyd Axworthy
Note: Lloyd Axworthy is a former Canadian foreign minister and senior 
Manitoba MP. He is now CEO of the Liu Centre for the Study of Global Issues 
at the University of British Columbia.

The View From The West

A WALK ON THE EAST SIDE

ON the corner of Main and Hastings in Vancouver's Eastside sits the 
Carnegie Community Centre, housed in a wonderful old structure originally 
erected as a library and similar to the Carnegie building on William Avenue 
in Winnipeg.

A few nights ago, I was walking in the alleyway behind the centre and 
watched in "shock and awe" as small clusters of drug-users engaged in 
various acts of shooting up. Especially graphic was the sight of one young 
woman leaning against the back of the building while plunging a needle into 
her jugular vein, her neck deeply scarred from frequent past injections.

I was in the area, accompanied by staff members of VIDUS (the Vancouver 
Injection Drug User's Study) to assess allegations by Human Rights Watch 
investigators of police abuse during a recent crackdown on the Eastside 
drug trade. As a Canadian board member for Human Rights Watch, I had been 
called by Vancouver Mayor Larry Campbell to discuss this report, and 
thought it wise to see for myself what was going on in what has been called 
the drug capital of Canada.

It was an eye-opener in several ways, and raised for me a serious question 
of Canadian public-health policy that has both domestic and international 
implications.

Certainly, public-health issues have been very much in the news of late. 
SARS, mad cow disease and West Nile virus have received blanket media 
coverage, reminding us all of the vulnerabilities of living in an age when 
diseases hatched in far-off parts of the globe become a direct menace to 
our own population.

But what this preoccupation with exotic global health issues overlooks is 
other, more widespread and lethal public-health threats, also global in 
nature, which endanger far more Canadians and which suffer neglect and 
general indifference from the public and policymakers alike. The research 
staff at VIDUS have complied a series of studies that point to an explosive 
increase in the incidence of HIV infection among the nearly 10,000 
drug-users on the Eastside, particularly affecting women, young people and 
aboriginals. But, as the study notes, "this health crisis is not unique to 
Vancouver. Many North American cities are currently experiencing ongoing 
HIV epidemics as a result of injection drug use."

Combine that with the deadly human toll taken by drug overdose and other 
health problems among users and you have a potent killer of Canadians 
occurring every day, with little outcry or attention paid. This public 
indifference is all the more surprising at a time when there is serious 
debate about the costs of health care. It is estimated that the lifetime 
medical costs of an HIV-infected drug-user total $150,000. The combination 
of health and enforcement-related costs from drug use is in excess of $5 
billion annually.

One would think that those numbers alone would spur efforts at prevention 
and treatment. Quite the opposite, and the situation is an indictment of 
faulty, if not deadly, public policy that applies the wrong responses or no 
response at all.

Dr. Martin Schechter, head of the Department of Health Care and 
Epidemiology at the University of British Columbia, cites cancellation of 
federal social-housing programs, community release of mental patients 
without proper funding of care facilities, cutbacks in provincial treatment 
programs, a freeze on funding for Canada's AIDS strategy and over-reliance 
on law enforcement as major factors in the escalating pathology of drugs 
and HIV in Canada.

The issue of over-reliance on police methods to control the problem is 
particularly unsettling. A report from Canada's Auditor General says that 
of the $454 million spent on our national drug strategy, $426 million (94 
per cent) is spent on enforcement, with no discernible evidence that these 
interventions generate any benefit. Police officers on the Eastside defend 
the current community-enforcement effort -- part of Mayor Campbell's 'Four 
Pillar' drug strategy supported by Ottawa and the B.C. government -- as 
bringing a greater sense of security to the area. But they do admit it is 
not a solution to the basic problem.

VIDUS fieldworkers on the Eastside say there are many successful prevention 
strategies in Europe involving efforts to better educate potential users 
and offer safer services to existing users, such as safe injection sites. 
This contrasts with the North American emphasis on police power and the 
courts. They felt Canada seems to identify more with the U.S. approach of 
trying to limit supplies rather than controlling demand, and that we were 
quite conservative in our overall strategy. But they say the underlying 
culprit is a general shrinkage of services such as housing, community care 
and poverty alleviation targeted to marginal groups in our population.

Previously on these pages, I have written that our cities represent the 
frontier for determining Canada's global future. It's where we can develop 
a smart agenda to cope with and master many problems of economic growth and 
sustainable development. It appears that cities are also the battleground 
for confronting a social crisis and demonstrating that we can still be a 
caring society.

As we debate how to deal with terrorism, devote billions to erecting border 
controls, sign on to missile-defense projects and anguish over the global 
transfers of strange viruses -- all in the name of security -- let's 
remember that real security begins at home. A walk on the Eastside of 
Vancouver, and many other places like it throughout our country, should 
remind us that we have a "human security" crisis in our midst.
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MAP posted-by: Keith Brilhart