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. - --- MAP posted-by: Keith Brilhart