FDS Insight Magazine Nov - Dec 2022

14 in the securitisation and militarisation of public health, which had a heavy impact on people who use drugs. Nevertheless, harm reduction services, particularly those led by the community of people who use drugs and civil society, adapted to ensure they could still operate throughout the COVID-19 pandemic, for example, by increasing access to take-home OAT and naloxone. It is essential that community and civil society – which in many cases were the frontline of the COVID-19 response – are included in international conversations about pandemic preparedness, notably the proposed Pandemic Treaty. Economic, political, humanitarian, and environmental crises have also put harm reduction at risk. In Afghanistan, the Taliban retook control of the country in August 2021, which has had a significant impact on harm reduction service provision. Russia’s invasion of Ukraine in February 2022 has caused Europe’s largest movement of refugees since the Second World War and put harm reduction services in Ukraine and neighbouring countries under immense pressure. Community and civil society organisations have continued to provide harm reduction services during this economic and humanitarian crisis. In Lebanon, the COVID-19 pandemic and a major explosion in the port of Beirut led to economic crisis and shortages of essential OAT medications in 2021. A coalition of national, regional and global civil society and community-led organisations reached an agreement with pharmaceuticals company Ethypharm and the Lebanese government to import a donation of buprenorphine to mitigate the impact of the shortage. In Sri Lanka, economic and political crises resulted in shortages of essential medicines and limited the operations of essential health services, including harm reduction. Climate crisis and extreme weather, including flooding, wildfires, droughts and heatwaves, have created acute public health disasters across the globe which have affected vulnerable populations, including people who use drugs, people in prison and detention and people experiencing homelessness. Since May 2022, the world has faced another public health challenge in the form of an ongoing outbreak of monkeypox. The outbreak has particularly affected gay men and other men who have sex with men. Within days of the outbreak being confirmed, the harm reduction movement and LGBTQI+ communities were already responding with advice on harm reduction and avoiding infection. The community and civil society organisations that make up the harm reduction movement have met all of these crises with compassion, dedication and resilience. With or without the support of the state, civil society and peer support groups have mobilised to ensure that as many people as possible continue to access lifesaving and life-enhancing harm reduction services.