Pubdate: Thu, 02 Nov 2017
Source: Ottawa Citizen (CN ON)
Copyright: 2017 Postmedia Network Inc.
Authors: Sandra Ka Hon Chu and Richard Elliott
Page: A7


Does Trudeau back harm reduction or not, ask Sandra Ka Hon Chu and
Richard Elliott

Implementing needle and syringe programs in federal prisons could
prevent numerous new HIV and Hepatitis C virus infections each year,
saving tens of millions of dollars.

Five years ago, we started a constitutional court case, because it was
clear that, despite the evidence, the previous government would never
agree to implement these health services in federal prisons.

But the Trudeau government has repeatedly declared its commitment to
harm reduction and evidence-based policy, to Charter rights, and to
the health and welfare of vulnerable Canadians. Prison-based needle
and syringe programs reflect all of these.

So why is this government still dragging its feet?

During the last election, the federal Liberal party agreed in writing
that there is "compelling evidence" for such programs.

Indeed, that evidence shows that in Canadian prisons, injection drug
use is common, injection equipment is scarce and therefore shared, and
HIV and HCV are rampant. Government figures indicate federal prisoners
have rates of HIV and HCV many times higher than in the Canadian
population as a whole. Meanwhile, rates of HIV and HCV among
Indigenous prisoners - and Indigenous women in particular - are higher

Just as they do outside of prisons, needle and syringe programs in
prisons reduce the harms of drug injection (including HIV and HCV
infections and overdose), without leading to increased drug use or
jeopardizing the safety of prisoners or prison staff. They increase
referrals to drug treatment programs, and further virtually eliminate
the risk of accidental needle-stick injuries in the workplace. First
introduced in Switzerland 25 years ago, such programs now operate in a
growing number of countries.

Factor in the ballooning costs of HIV and HCV treatment, and the
fiscal case for sterile needles is also compelling. And finally,
remember that the vast majority of prisoners are eventually released.
Good prison health is good public health.

The Correctional Service of Canada (CSC) has known all this for years.
It also knows that access to sterile injection equipment is a
necessary part of the solution. Nearly 20 years ago, CSC's own study
group urged the implementation of needle exchange programs.

Eleven years ago, the Public Health Agency of Canada advised CSC that
the evidence supporting such programs was definitive. Two years ago,
the Canadian Agency for Drugs and Technologies in Health found the

Implementing prison-based needle and syringe programs has been
recommended by the Correctional Investigator of Canada, Canadian Human
Rights Commission, Canadian Public Health Association, Canadian Nurses
Association, Canadian and Ontario Medical Associations, World Health
Organization, UNAIDS and UN Office on Drugs and Crime.

The government's ongoing deadly disregard of the evidence is not only
negligent public health practice, it also violates human rights standards.

Prisoners have a right to the same standard of health care as is
available in the community.

And denying prison-based needle and syringe programs is discriminatory
in its impact, harming women and racial minorities

The Trudeau government has reinstated harm reduction as a key pillar
of Canada's federal drug strategy. The prime minister has instructed
the attorney general to resolve outstanding litigation that is not
consistent with the government's values or the Charter. And numerous
current and former Liberal cabinet members and MPs support harm
reduction, including in prisons.

Despite all this, this government has so far failed to

Delaying the implementation of prison-based needle and syringe
programs is an enormous waste of public money, not only to defend
against our lawsuit but to treat prisoners and members of the broader
community with HIV and hepatitis infections that can be prevented.

If this government is serious about public health and human rights,
including for some of the most vulnerable people in Canada, it must
commit - now - to establishing needle and syringe programs in all
federal prisons without delay and with a firm deadline. Because it's

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Sandra Ka Hon Chu is director of research and advocacy and Richard 
Elliott is executive director with the Canadian HIV/AIDS Legal Network, 
which is one of the co-applicants in the ongoing court case.
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