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Harmonizing public health and public safety in a politically conservative environment

Harmonizing public health and public safety in a politically conservative environment. Joëlle Rabot Field Coordinator Collectif Urgence Toxida (CUT) Mauritius. Setting the scene. Mauritius & its socio- political environment regarding drug use HIV epidemic in Mauritius

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Harmonizing public health and public safety in a politically conservative environment

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  1. Harmonizingpublic health and public safety in a politically conservative environment Joëlle Rabot Field Coordinator Collectif Urgence Toxida (CUT) Mauritius

  2. Setting the scene • Mauritius & its socio-politicalenvironmentregardingdrug use • HIV epidemic in Mauritius • Public healthapproach : The introduction of HarmReduction(HR) strategies • The current situation • Opportunities for harmonisation • Key Challenges • The wayforward for better harmonisation

  3. Mauritius & its socio-politicalenvironmentregardingdrug use • Population : 1,2 M inhabitants • Surface area about 2000km2 • Generallyspeaking, drug use istackledwith a repressiveapproach • General population still conservative about drug use • Politiciansusually use populist ‘ tough on drugs’ approach

  4. HIV epidemic in Mauritius Mauritius has a concentratedepidemicwith a prevalence of 1.02% in the general population • First case detected in 1987 • 5863 detected cases (up to end of March 2014) • 70.5% of new transmission isrelated to injectingdrug use. • There is an estimation of 10,000 People WhoInjectDrugs(PWIDs)population in Mauritius • IntegratedBiological & Behavioural Surveillance(IBBS) survey, 2011)

  5. Public Healthapproach : Introduction of Harmreductionstrategies A little bit of history 1996 : Civil society starts raising the alarm about HIV among PWIDs Early 2000’s : Exponential growth of HIV Infection within the PWID population

  6. HIV Incidence in PWIDS in Mauritius2000-2005 New HIV Cases PWIDs

  7. Public Healthapproach : Introduction of Harmreductionstrategies A little bit of history (Contd) • 2004: Platform created by Civil society to advocate for Harm Reduction • Strategies in Mauritius. This platform will later be CUT (Collectif • UrgenceToxida) • 2006: Launching of illegal Needle and Syringe Program(NSP) by CUT & • Methadone Substitution Therapy(MST) by the Ministry of Health & • Quality of Life (MOHQL) • 2007: Legal Framework for NSP through the HIV/Aids Act • Creation of National NSP Committee by the govt where CUT is • invited to sit. • 2009 : CUT opens its premises and follows-up on NSP and advocacy on • Harm Reduction • 2010: Global fund allows upscaling of Harm Reduction Services • 2011: MST in Prisons

  8. Public Healthapproach : Introduction of Harmreductionstrategies

  9. The Current Situation HIV Incidence Rate in Mauritius (2000-2013) showing PWID incidence rate

  10. The Current Situation Decrease in crime rates for drug related offences

  11. Opportunities for harmonisation • Legal Framework available for NSP • Harmreductionpresent in national strategies and supported by the Global Fund • HIV/Aids National coordinating body has created an enabling environment for Harm Reduction • Private sector implication • Policy Dialogue betweenGovt and NGOs • Availability of data throughrecentresearch • Training of Police force & Legislators

  12. Key Challenges • No National Drug Control Master Plan since 2009 • Clash between the repressiveapproach of the system and public healthapproach • Repressiveapproach • Behaviour of KAPs are criminalised • High level of stigmatisation towardsKAPs • Police Harassmentat service delivery

  13. The Way towards better harmonisation • STRENGTHEN ADVOCACY • with media, partners, users, Community, Govt, police, CSRs, etc • For a National Drug Control Master Plan based on the 4 pillarsapproachthat should also include : • Legal reviews • Drug policy reform • Recognition of HR approaches in strategic plans of law enforcement • For the ongoing training of police, media, partners, users, CSRs on HR and the inclusion of an HR module in the police force curricular • RESEARCH FOR ADVOCACY • Need of data to strenghen arguments based on evidences • POLICY DIALOGUE • Promote representation of KAPs on platforms that can enable more harmonisation • Better implication and representation of civil society in commiteessuch as the CCM, HR Committee , etc

  14. Thankyou for your attention www.cut.mu jo.rabot@gmail.com www.facebook.com/Collectif.Urgence.Toxida

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