Theme: Models of Care Year: 2024
Background: Latin America (LA) presents particular drug use patterns compared to the global trends. In LA, injection drug use and opioid prevalence are notably scarce, centered on smoking or snorting stimulants like cocaine or methamphetamine. Resulting in a lack of interventions and funding for People Who Use Drugs (PWUD), especially in the HIV or HCV response. For this reason, LA has cultivated a distinctive approach to comprehend and implement harm reduction programs.
Description of model of care/intervention: Full Spectrum Harm Reduction (FSHR) embodies an approach grounded in human rights and social health, prioritizing communities living in the most vulnerable conditions. Extending beyond conventional clinical and healthcare methodologies, this model originates from popular education and participatory action research. Its development lacks specific manuals, as it is more of a pragmatic and bioethical approach towards drug use and PWUD. LA’s harm reductionists perceive themselves not merely as healthcare providers, but as catalysts for political and social transformations.
Effectiveness: Assessing the effectiveness of FSHR proves challenging. An evaluation in 2016 of the “With Open Arms” program in Sao Paulo found that interventions such as housing, job opportunities, and counseling reduced drug use and improved the health of drug users. At least 15 government institutions and many social organizations coordinated this project. However, political shifts in 2017 led to program closure.
Conclusion and next steps: In LA, Harm Reduction transcends the sanitary perspective to a human rights imperative. We understand HR as an “Ethics of Care”, shifting from biomedical interventions to a broader community and political approach to mitigate inequality and exclusion. Essential measures include legal and institutional reforms to counteract the harms associated with the criminalization and discrimination of PWUD. Simultaneously, tailored interventions for non-injection and stimulant drug users, incorporating housing, education, and employment opportunities, are crucial.
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