What does the legislation say?
The provision of sterile injecting equipment among people who are dependent on injectable drugs
November 2018
Legislation
1
World Health Organization, 2012. WHO, UNODC, UNAIDS technical guide for countries to set targets for universal
access to HIV prevention, treatment and care for injecting drug users–2012 revision.
2
Brooner, R., Kidorf, M., King, V., Beilenson, P., Svikis, D. and Vlahov, D., 1998. Drug abuse treatment success among
needle exchange participants. Public Health Reports, 113(Suppl 1), p.129.
3
Riley, E.D., Wu, A.W., Junge, B., Marx, M., Strathdee, S.A. and Vlahov, D., 2002. Health services utilization by injection drug users participating in a needle exchange program. The American journal of drug and alcohol abuse, 28(3), pp.497- 511.
4
Tookes, H.E., Kral, A.H., Wenger, L.D., Cardenas, G.A., Martinez, A.N., Sherman, R.L., Pereyra, M., Forrest, D.W.,
LaLota, M. and Metsch, L.R., 2012. A comparison of syringe disposal practices among injection drug users in a city with versus a city without needle and syringe programs. Drug and alcohol dependence, 123(1-3), pp.255-259.
November 2018
Legislation
- ACT No.70 of 2008 (Prevention of and Treatment for Substance Abuse Act), Chapter 3 lists harm reduction as one of the three broad categories of intervention prescribed by the Act to “combat substance abuse.”
- Harm reduction is defined by ACT 70 as: “the holistic treatment of service users and their families, and mitigating the social, psychological and health impact of substance abuse;”
- Part II of the Minimum Norms and Standards, item 34 states: “Out-patient services must be evidence-based and holistic in nature and must be presented as a comprehensive package of services which must include any one or a combination of the following: (a) Education for the service user and the service user's family about the dangers of substance abuse and other related health problems; (b) life and social skills training; (c) harm reduction activities; and (d) access to self-help and mutual help support groups.”
- From the above, it is clear that there is a duty to provide: “evidence based, holistic comprehensive package of harm reduction services that mitigate the social, psychological and health impact of substance abuse”
- The “evidence-based” response to mitigate the impact of substance abuse for people who inject drugs is the WHO Comprehensive Package of Services for People Who Inject Drugs(1). While the package is primarily an HIV Response, and not specifically a ‘treatment for substance abuse”, it must be noted:a. the Constitutional Court has ruled in Soobramoney v Minister of Health (KwaZulu-Natal) 1998 (1) SA 765 (CC) and Minister of Health v Treatment Action Campaign (No 2) 2002 (5) SA 721 (CC) that the state has a duty to prioritise major public health needs and that HIV/AIDS is “the greatest threat to public health in our country.” b. As such, needle and syringe programmes clearly mitigate the harm of injecting drug use. c. Needle and syringe programmes assist people who would never have considered treatment to access treatment their dependence.(2) (3)
- Access to needle and syringe programmes reduces the number of used syringes discarded in public spaces. (4) If there are no syringe programmes, people who inject drugs will still inject drugs, but they will have: a. No means of disposing of their used needles in an appropriate way, b. They will have reduced contact with health and treatment services
- It follows from the above that the stopping of needle and syringe programmes would contradict the terms of Act 70 of 2008.
1
World Health Organization, 2012. WHO, UNODC, UNAIDS technical guide for countries to set targets for universal
access to HIV prevention, treatment and care for injecting drug users–2012 revision.
2
Brooner, R., Kidorf, M., King, V., Beilenson, P., Svikis, D. and Vlahov, D., 1998. Drug abuse treatment success among
needle exchange participants. Public Health Reports, 113(Suppl 1), p.129.
3
Riley, E.D., Wu, A.W., Junge, B., Marx, M., Strathdee, S.A. and Vlahov, D., 2002. Health services utilization by injection drug users participating in a needle exchange program. The American journal of drug and alcohol abuse, 28(3), pp.497- 511.
4
Tookes, H.E., Kral, A.H., Wenger, L.D., Cardenas, G.A., Martinez, A.N., Sherman, R.L., Pereyra, M., Forrest, D.W.,
LaLota, M. and Metsch, L.R., 2012. A comparison of syringe disposal practices among injection drug users in a city with versus a city without needle and syringe programs. Drug and alcohol dependence, 123(1-3), pp.255-259.
National Support
| letter_of_support_from_ndoh_for_tb_hiv_care.pdf |
| letter_of_support_ethekwini_district_health.pdf |
| sanac_letter_of_support_for_stepup_project_tbhiv_care.pdf |
| doh_nsp_hcv.pdf |
| wc_gov_step-up_project_letter__4_.pdf |
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