Arresting HIV: The Importance of Law Enforcement and Harm

Reduction Program PartnershipsDr Nicholas Thomson

Nossal Institute for Global Health

6th HAARP Consultation and Coordination Forum, Siem Reap, April 2012

What does this mean in the context of harm reduction?

How do we actually do it?

What are some of the factors that “enhance the enabling environment”?

Enhancing the enabling environment?

We understand the importance of an enabling legal and policy environments in the context of drug use and HIV……….(HAARP’s Legal and Policy Review)

The same discussion is being had for all HIV prevention among Key Affected Populations

UNESCAP High level meeting, Universal Access, UNDP Global Commission on the Law and HIV

National and Global Policy Debates and Civil Society issues based movements

Enabling the Legal and Policy Environment

What else are critical components of the enabling environment?

Best practice, evidenced-based comprehensive programs ultimately funded by the state

But its only part of the “enabling environment” equation

It’s the intersection of law enforcement and HIV programs and the people they work with that ultimately dictates how “enabling” the enabling environment is

But to create an enabling environment……..

We haven’t been able to influence law enforcement agencies : why not?

How can we work with police to reinvigorate their ability to become significantly better harm reduction program supporters and indeed public health actors?

Understanding the dynamics between law enforcement and HIV programs

Multiple (and substantiated) reports of rights violations

Really, really high rates of lifetime history of arrest, incarceration, re-arrest and further incarceration of drug users and sex workers

How is our perception shaped?

Action orientated; reactive rather than proactive

Achievement measured according to arrests=promotion

Extension of conservative state approaches Discouraging of innovation and creativity Police see a “war on drugs” as their national

security duty

How do we understand police culture?

How many of us have tried working with police on a regular and ongoing manner?

How many of us have really tried to understand the operational culture of policing?

How do we create an enabling environment where the police are fully engaged in their role in HIV prevention?

There must be a better way?

We have started a series of research projects to understand the dynamics of the enabling environment

UNESCAP Best Practice

Law Enforcement and Harm Reduction Research Network

Understanding the factors that create an enabling environment

Examined enabling environments across the Asia Pacific

Case studies included if actions taken by either civil society, government or police (in isolation or separately) had contributed to a “BETTER ENABLING ENVIRONMENT”

Measured by: decreasing prevalence of HIV risk behaviour, uptake in service delivery

Enabling environment exploration

Community mobilisation in AVAHAN projects in India

Efforts to enhance communication between police and drug user networks in Indonesia

Significant engagement between the Blue Diamond Society in Nepal with the police

Sex worker led interventions with police in Thailand (SWING) and Fiji

Human rights policing efforts in Indonesia

Harm reduction training curriculum in Cambodia, Malaysia and Yunnan

Some examples

Evidence of effectiveness? Less brutality experienced by sex workers in Fiji

leading to increase condom use Female sex workers reform police practices in

southern India Workplace policies on HIV in the police

department in Nagaland

But how can we scale up LE and HIV program partnerships?

And how can we monitor the implementation and success?

1) The Importance of LEADERSHIP

Leadership from both police and civil society

We need people who can meet regularly and represent the views of their organisations.

Respectful and collaborative leadership

What are the key factors

2) Importance of growing of Civil Society Networks

Case examples highlight that building civil society networks and their ability to collectively represent themselves made significant impacts on police practices towards them

The role of paralegal services, rights documentation etc

Civil Society

3) The importance of police operational, educational and cultural reform

Development of harm reduction and HIV prevention curriculum (role of police)

Without police reform progress difficult

Police need to feel supported in their reform efforts

Police Reform

4) The Importance of formal and informal communication channels between police and civil society and HIV programs

National and local task forces Key actors from both sectors knowing each

other

Communication

5) Addressing Structural Drivers

Violence, intimidation Employment and education Policy and practices Scaled up programs Program design that specifically prioritises a

Law Enforcement Advocacy and Partnership plan

Addressing the Structural Drivers

6) The need for monitoring and evaluation of the enabling environment

What are the variable of interest? Decrease incidence of police harassment Increase in service uptake

Monitoring and Evaluation

The role of harm reduction programs on policing practices

Laos, Vietnam and Cambodia

What have we found????

Law enforcement and harm reduction research network

Principles of police and harm reduction programs The involvement of law enforcement is critical to the

success of harm reduction programs at all levels – regional, national and local.

There is a pressing need for law enforcement agencies and authorities to share ownership of harm reduction.

Police must be engaged early by harm reduction programs; not as a subsidiary but as a core partner.

There need to be multi-sectoral structures among all key agencies involved at all levels, so that working relationships can be established and maintained.

Have a long history going back to original design of Asia HIV/AIDS Regional Project (ARHP)

Police trainings Sustained involvement: Takes time Working with Yunnan Police Academy (almost

15 year relationship HAARP cross border work pioneering Law

Enforcement and Public Health cooperation cross border…………We need to document lessons!!

The Role of HAARP

Communication??????

“We heard about the program from our bosses but we were never approached by anyone running the program to inform us about how it would work”

Program design, police liaison officers?

Thank You Law Enforcement & Harm Reduction Network

(LEAHRN) www.leahrn.org

Special Edition of the International Harm Reduction journal and dissemination events in Thailand, Laos, Cambodia and Vietnam

Policing and Public Health, LEPH 2012: The First International Conference on the Intersection of Law Enforcement and Public Health, Melbourne November 11-14, 2012 "Working Together, sharing success"www.Policing-and-Public-Health.com

For more information on our growing Law Enforcement and Public Health Program

Email: nthomson@jhsph.edu

Contact