Reid Gary, Aitken Campbell
The Centre for Harm Reduction, The Macfarlane Burnet Institute for Medical Research & Public Health, GPO Box 2284, Melbourne 3001, Australia.
Int J Drug Policy. 2009 Jul;20(4):365-70. doi: 10.1016/j.drugpo.2008.10.004. Epub 2008 Dec 20.
China's initial response to drug use and HIV was largely ineffective but has improved with recent government endorsement of harm reduction interventions. This paper examines the views of senior key informants inside China who articulated core needs and objectives for the development of a harm reduction advocacy strategy.
Thirty-nine key informants (KI) were interviewed, representing 19 stakeholder bodies selected from the Chinese government public health sector, public security sector, international agencies such as WHO, UNODC and UNAIDS, and international non-government organisations.
The concept of harm reduction is widely understood and considered valid. Support for harm reduction is increasing, but KIs perceived an imbalance between the rapid expansion of methadone maintenance treatment programs over needle and syringe programs and other interventions. Challenges for harm reduction identified by KIs included: policy inconsistencies; lack of skilled resources, training programs and technical capacity; poor coverage of interventions; and gaps in the sharing of information. KIs suggested numerous ways to strengthen the capacity of the government and communities to reduce drug related harm.
Increased acceptance of harm reduction in China, particularly among public security, implies a new level of optimism towards addressing the HIV epidemic among drug users, and parallels an impressive expansion of harm reduction interventions. Nevertheless, scaling up a response to the ongoing dual epidemic of drug use and HIV remains an enormous challenge. With appropriate technical education and training, ongoing advocacy, and a cohesive, coordinated multi-sectoral effort, the capacity of the government and community to adopt, support and promote measures to reduce HIV and other drug related harm would be markedly strengthened.
中国最初应对吸毒和艾滋病的措施大多成效不佳，但随着政府近期对减少伤害干预措施的认可，情况有所改善。本文探讨了中国国内高级关键信息提供者对于制定减少伤害宣传战略的核心需求和目标的看法。
对39名关键信息提供者进行了访谈，他们代表了从中国政府公共卫生部门、公安部门、世界卫生组织、联合国毒品和犯罪问题办公室、联合国艾滋病规划署等国际机构以及国际非政府组织中挑选出的19个利益相关方团体。
减少伤害的概念得到广泛理解且被认为是有效的。对减少伤害的支持在增加，但关键信息提供者认为美沙酮维持治疗项目的快速扩张与针头和注射器项目及其他干预措施之间存在不平衡。关键信息提供者指出的减少伤害面临的挑战包括：政策不一致；缺乏专业资源、培训项目和技术能力；干预措施覆盖不足；以及信息共享存在差距。关键信息提供者提出了许多加强政府和社区减少与毒品相关伤害能力的方法。
在中国，特别是在公安部门中，对减少伤害的接受度有所提高，这意味着在应对吸毒者中的艾滋病流行方面有了新的乐观程度，同时也伴随着减少伤害干预措施的显著扩展。然而，扩大对持续存在的吸毒和艾滋病双重流行的应对措施仍然是一项巨大挑战。通过适当的技术教育和培训、持续的宣传以及协调一致的多部门努力，政府和社区采用、支持和推广减少艾滋病毒及其他与毒品相关伤害措施的能力将得到显著加强。
