Structural Barriers To Effective Harm Reduction Implementation

"In the Global State of Harm Reduction 2020 we reported on the wave of reflection on racism and colonialism that followed the murder of George Floyd by a police officer in Minneapolis, United States. These shifts have continued to influence thinking about drug policy and harm reduction globally.^{13,14,15,16,17}

"In November 2021, a group of advocates and academics published a paper detailing the ways in which drug policy has been used to uphold colonial and racist power structures around the world.15 Over recent years, this has been a theme of advocacy and research carried out by many organisations in different countries, including Bolivia, Brazil, Indonesia, South Africa and the United States.^{13,14,18,19,20,21,22}

"The implementation of harm reduction continues to be affected by racism and colonial structures. Black, Brown and Indigenous people who use drugs have less access to harm reduction services.¹⁵ Direct and structural racism makes it harder for Black, Brown and Indigenous people to access services, it results in Black, Brown and Indigenous communities being targeted by drug law enforcement agencies and disproportionately detained or imprisoned, and means the needs of these communities are often deprioritised or ignored.²³ People who are migrants or refugees face particular challenges, to the extent that experiencing migration can be a major detriment to a person’s health.²⁴"