Reflections on IDPC drug policy workshop in Kunming, Yunnan Province, China

In November 2013, we worked with IDPC to organise a workshop on harm reduction and drug policy advocacy for civil society actors in China. In preparing for the workshop, we wanted to involve people who use drugs who were already actively engaged in representing their communities in service delivery and advocacy. To make sure we invited community representatives that could engage effectively in drug policy advocacy in China in the near future, we did a lot of internal planning.

It is not an easy task to identify workshop participants from around 2 million people who use drugs in China. We finally decided to design a questionnaire which could help us to evaluate the understanding and attitudes of respondents towards current drug policies in China. At the beginning of September, with the help of our local partners from Yunnan, Sichuan, Beijing, Guangxi, and Guangdong, we distributed questionnaires to 89 people who use drugs or who are methadone clients. We collected and analysed their feedback and identified 12 individuals who expressed clear, assertive ideas about the reforms needed for existing policies and regulations in order to improve the quality of life and health for people who use drugs. We invited them to participate in the workshop.

The community representatives we invited agreed to take part in the workshop, and worked passionately to achieve the workshop objective of developing a civil society advocacy strategy for China. They developed a shortlist of challenges to harm reduction policies, coverage and accessibility, and selected three issues to focus future advocacy on in the short term:

• Getting access to takeaway methadone doses—to address problems associated with only being able to access methadone doses at designated clinics
• Easing travel restrictions for registered people who use drugs—to reduce the extent of police monitoring and ‘supervision’, which includes random urine testing, and
• Reducing stigmatisation and discrimination by health officials and service staff, and police—to improve the accessibility of harm reduction services.

The workshop itself turned out to be a very successful one. Gloria from IDPC shared with participants about the international drug control system, effective drug policies, harm reduction advocacy, and drug policy advocacy. Her presentation gave them another perspective on policy advocacy. Professor Li Jianhua from the Yunnan Institute for Drug Abuse (YIDA) presented on the diagnosis and treatment of opioid dependence. During his presentation, he emphasized again and again that drug dependence is only a health problem and should not be regarded as a criminal act. He also mentioned that the use of the Chinese word to refer to drugs ”毒品” (poison) is a key reasons preventing the general population from accepting people who use drugs in China. He himself preferred to use the Chinese word “药物” (medicinal drugs) to refer to drugs. Professor Li’s opinions on drug use were warmly welcomed by the participants and some of them who had previously held uncertain attitudes about drug use all claimed that they now found new confidence in participating in drug policy advocacy.

Mr. Zhang Bo, also from YIDA, shared the successful implementation of methadone maintenance treatment (MMT) services in Yunnan and his future expectations. In the past ten years, YIDA has established 68 MMT clinics and 82 service sites in villages and townships in Yunnan. By the end of 2012, the number of people on MMT in Yunnan reached 14,929 and over 85% of the clients had received HIV/HCV/TP (for syphilis) tests. Despite the impressive results, Zhang Bo still expects to scale up MMT services and try innovative ways of management (such as piloting take-home methadone programs and providing psychological support and counselling services to MMT clients) in the near future.

And speaking of methadone, there is one more thing to mention. With the help of YIDA, for the first time in China’ history, a local MMT clinic in Kunming agreed to send methadone doses to the workshop venue so that the 7 methadone clients participating in the workshop did not have to waste time and money to travel to the MMT clinic for their dosage. This gave us all more reason to hope that the controls over access to methadone would gradually ease in the future—which is another joint goal of IDPC and ACC for harm reduction and drug policy advocacy.

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