Department of Political Science, University of Vienna, Vienna, Austria.
Global Commission on Drug Policy, Geneva, Switzerland.
Harm Reduct J. 2024 Sep 20;21(1):172. doi: 10.1186/s12954-024-01067-x.
Europe has been at the forefront of harm reduction since its inception. These important early steps were in large part a response to the dramatically expanding HIV epidemic, and investing in these innovative interventions early and robustly had a transformative effect. This brought about not just pioneering services but also pioneering policy changes. However, while Western Europe and Member States in the European Union often have been at the vanguard of harm reduction innovation and vocal advocates for public health and human rights-based drug policy reform, the situation has been much different in the "wider" WHO European region, which also includes Eastern and Southeastern Europe as well as Central Asia. This is a result not just of limited budgets for health, but also of punitive laws and policies and persistent stigma and discrimination. Even as harm reduction has demonstrated huge successes in Europe, there is a need to move forward a wider array of services to respond to an evolving and increasingly complex drug situation in Europe. Instead, it is a lack of political will and of political courage that is holding back the establishment, expansion, and deepening of these essential, lifesaving interventions. Responding proactively and effectively to this changing drug situation will require redoubled investment in public health and harm reduction approaches.
欧洲自成立以来一直处于减少伤害的前沿。这些重要的早期步骤在很大程度上是对 HIV 疫情的急剧扩大的回应，早期和强有力地投资于这些创新干预措施产生了变革性的影响。这不仅带来了开创性的服务，也带来了开创性的政策变革。然而，虽然西欧和欧盟成员国通常在减少伤害的创新和宣传公共卫生以及基于人权的药物政策改革方面处于领先地位，但在世界卫生组织的“更广泛”欧洲区域情况则大不相同，该区域还包括东欧、东南欧和中亚。这不仅是由于卫生预算有限，还由于惩罚性的法律和政策以及持续的污名化和歧视。即使减少伤害在欧洲取得了巨大的成功，也需要进一步推广一系列服务，以应对欧洲不断变化和日益复杂的毒品形势。相反，阻碍这些至关重要的拯救生命的干预措施的建立、扩大和深化的是缺乏政治意愿和政治勇气。要积极有效地应对这种不断变化的毒品形势，就需要在公共卫生和减少伤害措施方面加大投资。
