THE TORIES FIDDLE WHILE INTRAVENOUS HIV SOARS

The Needles And The Damage Done

The Tories will face an intravenous HIV epidemic if they continue to
dismantle harm-reduction projects warn AIDS Conference scientists

The two women were near perfect representatives of Vancouver's two
solitudes: Gillian Maxwell, immaculately tailored and perfectly
coiffed, with the muted English accent common to so many of the
Pacific city's upper class, and Diane Tobin, old, slouched, missing
two front teeth, a veteran of the city's drugs- and AIDS-scarred
Downtown Eastside neighbourhood. Both were delegates at the XVI
International AIDS Conference, held this week in Toronto, and both
had come to deliver a single message: inSite - Vancouver's supervised
injection site, a three-year pilot project giving drug users a place
to safely do drugs, get counselling and enter detox - must be kept open.

Reading the testimony of a 20-something drug user she called "Linda,"
Tobin said, "InSite kept Linda alive. Now she's on the road to
recovery, thanks to the care she received there. Don't close it,
'cause it'll kill a lot of people."

Her plea came minutes after Dr. Thomas Kerr, a Vancouver scientist,
reported that the 16-booth clinic in the heart of the Downtown
Eastside has had scientifically incontrovertible benefits, including
a drop in needle sharing, an increase in people going to detox and,
despite the fears of many in the city, a decrease in local crime and drug use.

"It is the single most successful project I've ever been involved
with," said Dr. Julio Montaner, Kerr's boss and incoming president of
the International AIDS Society, the world's leading group of HIV/AIDS
scientists. "It has overwhelmingly demonstrated to be tremendously
valuable at managing infections, preventing ODs and saving scarce
health care resources."

Established in 2001, inSite is Canada's leading example of harm
reduction, a philosophy aimed at preventing HIV transmission by
treating drug use and the sex trade less as criminal acts and more as
a public health concern. It prioritizes needle exchange, methadone
and safe-injection sites over police crackdowns and jail time. It was
meant to address the city's explosive outbreak of HIV in the
mid-1990s, now ranked as the worst epidemic in the Western world.

Not surprisingly, harm reduction doesn't seem particularly popular
with Canada's federal Tories.

Despite the solid scientific evidence - and the support of many
community members including the chief of police - the Tories have
refused to say if they will renew inSite's licence or shutter it when
the pilot project expires on Sept. 13.

"The review is underway, and when we make a decision, we'll announce
it," said Eric Waddell, a spokesman for Health Minister Tony Clement.

Not that the IV drug problem - or the refusal of policy makers to
support innovative, evidence-based programs over the traditional
reflexes of stigma and discrimination - is unique to Canada. While
the HIV epidemic in the Western world stabilizes in many at-risk
groups like gay men, more and more new cases are the result of
needle-based drug use. The former Soviet Union, for example, is
suffering an explosive outbreak of AIDS thanks to drug use, with the
vast majority of last year's 200,000 new cases a result of dirty
needles, police repression of addicts and cheap smack from Afghanistan.

"In public health, if a pilot project works, you expand it," Chris
Beyrer, one of the world's top experts on the HIV pandemic, told
Hour. "We have to implement the prevention plans we know work."

One of Beyrer's colleagues was more blunt. Following Kerr's
presentation of inSite's success, Stephanie Strathdee looked at
Steven Fletcher, a Tory MP and parliamentary secretary to the Health
Minister, and warned: "If the Conservatives close inSite, they will
have blood on their hands."

That was echoed by Tobin, the Vancouver activist. Asked what she will
do if inSite is closed, she sighed and said calmly: "I'll start goin'
to a lot more funerals."