MUSSE

Professor Nick Crofts, Senior Research Fellow at the Nossal Institute for Global Health, University of Melbourne.

The Guest Column is an opportunity to look at issues from a different perspective. Opinions expressed are those of the contributor.

Professor Nick Crofts, Senior Research Fellow at the Nossal Institute for Global Health, University of Melbourne, writes on ‘Public health in action – creating alliances to stop HIV/AIDS epidemics in Asia’.

How do we pull together research and public health action? How do we transfer our knowledge across cultural divides, not only between countries and ethnicities, and not only across the research and action divide, but between very different social sectors with very different world views and priorities? The Nossal Institute for Global Health at the University of Melbourne is engaged in tackling exactly these challenging questions – in some of the most challenging social and political environments.

The injecting of illicit drugs, especially of heroin, is widespread across Asia, and the sharing of needles and syringes makes this a major driver of the HIV/AIDS epidemics in most Southeast Asian countries. Australia pioneered effective HIV prevention among injecting drug users – strategies grouped under the term ‘harm reduction’ – and has been more effective than any other country in limiting HIV spread.

Harm reduction is a life-saving and proven public health strategy, yet only a small proportion of drug injectors in this region have access to vital services such as needle exchange or methadone programs. This is very much due to the illegality of drug use, and to the competing pressures confronting law enforcement authorities, especially police, in dealing with issues of drug use.

To stop HIV in Southeast Asia, a profound change in approach is needed – a move from law enforcement as the only way of dealing with drug users to a broad social policy of harm reduction, effective drug treatment and real social reintegration. To do this, we need to form alliances with police, and we need to know what influences law enforcement policy and practice in Southeast Asia regarding harm reduction. How are high-level harm reduction programs having an impact on law enforcement?

The Nossal Institute for Global Health is undertaking a program of research and development to explore these questions. With one of AusAID’s first Australian Development Research Awards, one Nossal Institute four-year research project, Harm Reduction and Law Enforcement in Southeast Asia: What Works and What Doesn’t, began in April 2007, and is being conducted with research partners in Vietnam, Cambodia and Laos, with the support of Victoria Police.

This is but one example of working to cross the multifaceted cultural divides which characterise international and public health; many more are going on at the Nossal.

For more information visit: www.ni.unimelb.edu.au