Am Johal

VANCOUVER, Canada, Aug 23 2006 (IPS) — Three former mayors of Vancouver have joined current Mayor Sam Sullivan in calling for Canada’s Conservative minority government to renew the exemption which allows North America’s first legal safe injection site to operate for users of heroin and other addictive drugs.

The three-year exemption is set to expire on Sep. 12 if the federal cabinet does not support the Health Canada recommendation to proceed with the exemption.

The safe injection site has been in operation for three years as part of a pilot project designed to address an overdose and HIV/AIDS health epidemic that has plagued Vancouver’s Downtown Eastside neighbourhood for almost two decades.

Drugs are not provided, but the facility offers supervised injections with sterile needles, including emergency medical care if a user overdoses. Clients can also obtain information about addiction treatment and other health services.

Over 2,000 people have overdosed in British Columbia since 1990 and the HIV/AIDS rate among injection drug users in the Downtown Eastside neighhbourhood specifically had reached close to 25 percent at one point.

British Columbia Premier Gordon Campbell, also a former mayor of Vancouver, has publicly stated his support for the site.

Health studies supporting the positive impact of the health facility, known as Insite, have been widely published in international medical journals, including the Lancet and the British Medical Journal. The city’s “Four Pillar” approach to dealing with drug addiction includes prevention, enforcement, treatment and harm reduction.

Kerstin Stuerzbecher, a director at the Portland Community Health Society (PCHS), which manages the site with the Vancouver Coastal Health Society, told IPS that, “The site has reached its main objectives by providing the highly marginalised access to health services. In our view, there’s no question that the site should continue along with the whole Four Pillars strategy. We’ve managed to stabilise a health care crisis the past few years.”

Dr. Dan Small, another director with the PCHS and a medical anthropologist, says that the site has shown positive effects from an empirical perspective in the main areas of the study, and that there is no reason to treat addicted human beings like lepers.

“There has been a decrease in public disorder in both the residential and business areas. There has been a decrease in overdoses and a decrease in communicable diseases,” he said.

Small views the government’s upcoming decision as a fundamentally Canadian one of whether the country will support the evidence on the ground or will take an ideological approach to the drug issue.

“This site has been thoroughly studied and documented by the most prestigious medical journals in the world and they have deemed it a success,” he told IPS. “We have wide support to continue even from Health Canada.”

Small views this as an historic decision that will take politics out of healthcare in favour of a more evidence-based approach. Small cites the American Psychiatric Association decision of 1971 to label homosexuality as a disease as an example of the medical establishment being driven by political agendas rather than by scientific evidence.

“We hope the prime minister works with us, rather than against us,” he said. “I hope I can feel proud as a Canadian that we not only follow our conscience in treating people in the shadows of life with dignity, but that we take the evidence as presented and allow it to drive public policy rather than take a knee-jerk ideological approach to drug addiction. Do we really want to create a health care disaster again?”

Small says that those who operate and work there would find it difficult to close the doors of the site from a moral perspective.

Community groups have also been deeply critical of Prime Minister Stephen Harper for not having attended the International AIDS Conference in Toronto, where the U.N. special envoy for HIV/AIDS, Stephen Lewis, openly called for an extension for the site. Former U.S. President Bill Clinton, also an attendee at the conference, gave words of support for the health intervention as well.

Dr. Thomas Kerr, a researcher with the BC Centre for Excellence in HIV/AIDS and a professor at UBC Faculty of Medicine said, “This site has gone through rigorous scientific review with the publication of results in over 20 peer-reviewed journals. This site has clearly produced benefits based on the criteria that it was set to be evaluated against.”

Kerr cites the decrease in overdose deaths, rate of communicable diseases, increase in users seeking treatment and a reduction in public disorder as examples that the site is doing what it set out to accomplish.

“In our view, the benefits of the safe injection site are robust based on the evidence,” he told IPS.

Prime Minister Harper has publicly expressed concerns about encouraging drug use at the site and has been widely viewed as dragging his feet on the issue by not clearly supporting the exemption. Many supporters of the Conservative Party are not in favour of the site. Other critics have charged that the prime minister views the site as a project initiated by the former Liberal government.

Community groups have also expressed concerns that U.S. lawmakers were lobbying Harper not to approve the exemption for the site, which has been open since September 2003. The cabinet may make a decision as early as the end of this week.

Larry Campbell, a former provincial coroner and former mayor of Vancouver and now a senator, who spearheaded the site under his tenure at City Hall, told IPS, “Obviously the site should stay open. The prime minister and the health minister are intelligent people and I would hope they respond favourably to the research that has been done the last three years rather than allowing their other political interests to derail the project.”

A call seeking comment from the federal health minister was not returned.