 Thank you very much for all these very inspiring presentations from extremely difficult environments. I hope you have many questions to the presenters. So please, if you have a question, you see that mic. So please form a line behind that. And please just tell your name and where you come from. So I'm Rafi Baba Khanian. I'm from active New York. I'm a co-founder of the Crystal Math Working Group. And also on the border of housing works in New York. I wanted to ask a couple of things. I think in one of your slides you talked about mapping 17 different. How did you do that? What mechanisms did you use to do that? Okay. So it was a reasonably informal process. So we first worked in a classroom setting to do what's called a pre-mortem or a pre-practice where you go out and work through strategically what you're going to do. So firstly we have security teams who make the environment secure and remain spotters during the actual event in cases either police or vigilantes or people try to rob us. Then the drug users have a team leader and then they just... It's very informal. They just go in and start talking to drug users. In this first phase they were introducing themselves as a group of drug users, explaining what they were doing, asking people what their stories were like. We had a series of questions we wanted to test, like there was a lot of transitions going on from injecting to non-injecting. There was a lot of police violence. There was a local force detox centre. So it was very conversational. And then they gathered that information. And then they worked in two separate teams covering two different areas. And then when they came back we then documented... Because they didn't want me to go out with them because I would prove a distraction on the process. So when they came back we then documented it by getting them to tell the stories of what had happened. And then they also then picked up, in fact Haji particularly, they picked up as an advocacy case somewhere with acute appendicitis under a bridge. And in that case we then actually got involved in advocacy to try to save his life. And it actually led to the drug users asking me after the needs assessment, please don't send us out again if we can't do something, we can't bear it. And that's why we started doing wound care interventions just so they can offer something alongside the consultation. But that's how you were able to identify these distinct kind of user groups. Well we knew, we did that in the classroom beforehand, so we basically got the drug users to sit down and say, where do you think the groups are? So then we came up with the areas where somewhere drug users were living, somewhere they were using, and then they went out to try to hit those areas. Interesting. I just want to make one comment which is that obviously the situation among urban gay men in New York is different, but the level of knowledge about shooting up is, the whole thing that you're talking about with the syringes, it's the same thing that we have. The knowledge of, well I say like the knowledge of the most marginalized young opiate user is so much greater about how to properly inject them, the most highly educated crystal meth user in New York. I mean it's just a community knowledge that is there that goes from one person to another and then the level of denial and shame that prevents the other. Absolutely. Thank you very much. Thanks very much. My name is Robert Power from Australia, I'm from the Planet Institute in Australia. Thank you everyone for a fantastic session. I mean it's probably one of the best sessions by a long way. But my question goes right back to what Peter said at the very beginning. You kind of said we have public health, we have drug policy, we have resistance, we have user groups. And what I've noticed particularly at this conference, there's a possible danger of fragmentation. We talk about the harm reduction movement, it's similar to what the gay community is, if there's some homogeneous group. Now, and then we've seen various aspects of the conference where there's going to be some conflict. And that's fine, what my question would be to the panel is, how do we ensure that we don't fragment our harm reduction movement, that in fact we make it healthier by unification. So what is the relationship between public health, policy, drug use movement and the potential politicization? Because there was an interesting side meeting yesterday evening about the talk about let's have a left wing of harm reduction movement. And I'm just a bit concerned about that because if I just make a point, I've been working 32 years in this field and spent a lot of time in Southeast Asia and I'm currently working in Tibet. And if we begin to be seen too much as a quasi-political movement, we may actually be doing a lot of harm in some of the areas, and me and Mars are a great example actually, our institute's been there for 20 years and we've been relentlessly apolitical. So it's a huge question I know but I think it's something that we've really got to grapple with otherwise we will end up with schisms and fragmentation. So it's a big question, I hope you can just begin to address that. Thank you. Anyone? Yeah, I'll make a comment and then pass it down. I think for me looking at the lesbian gay movement, for example, I think diversity has the potential to be a great asset and I think we have to learn how to manage that diversity and recognising that act up, for example, plays a different function than global advocates going into a UN meeting. If you did what the act up do in the UN, you'd blow the whole thing to pieces and it wouldn't actually be very effective. However, if you go and use diplomacy skills outside a demonstration, it's not going to work either. So I think it's about having that complementary skills and then learning how we communicate and think strategically. And you've also got to then apply it in local context so we don't talk about rights in Afghanistan in quite the same time. We talk about well-being. You have to think about being careful, because drug user rights will just put the drug users at risk. So we have to be very careful and it's always about local application of process and principles that may be more common. That's true. I think we can have our sort of differing kind of perceptions on the whole movement. I think there's room for, like you were saying, a diversity of strategies, a diversity of opinions, a diversity of even how we view how policy should change at all. I mean, there's some people, I'm sure, strong about drug legalization. There are other people who are concerned that it might get, it might worsen some problems under legalization and we should focus on decriminalization. But I mean, we're all here together and it gives us the ability to reflect on maybe where we can meet on certain issues, where we can collaborate on certain issues. I think it's harm reduction as a whole is still supportive of each other. I don't think... I have trouble seeing a split or a polarization coming. I think it's just a very politicized context right now. I mean, we have a federal government who is going to legalize cannabis in certain situations. But everybody is here to support each other, ultimately, I think. Other panelists, do you want to add something? Do you want to add something? So this... You know, also within our region, we discussed what does it mean harm reduction and do we understand equally what harm reduction is? Although there are philosophy and there are interventions listed in WHO or guidance, but still the understanding what harm reduction is and what influence it has to the communities is different. And I don't know if we need to reshape the whole understanding of harm reduction taking into account new challenges and new issues like new kinds of drugs and different populations, because also after this conference, we will discuss how can we address needs of, for instance, MSM in our region with the harm reduction interventions even in this conference, it's really very less addressed issues of other communities who need harm reduction interventions and what these interventions could be for them and properly works for them. Thank you. Anyone? Yes, sir. So, in Myanmar context too, let me talk about the harm reduction. So there's a very strong community movements out there. So as we were talking before, the harm reduction concept or harm reduction in the communities are different. So they have different kinds of perceptions, but to be kind of holistic to be a holistic harm reduction approach, we also need to think about the community, how should we make them in the harm reduction, and then how should we... This is also another important thing we have to think about, how should we, let's say, educate the community, because in Myanmar context, the power is in the community, so they can make everything. So the power is in the mass, not in the authority, not in the authority. So we have to think about this then, how should we do to be a better holistic approach for the harm reduction, something like that. So now we are in this conference too, we are looking and, you know, if something needs to be moved forward to be a holistic approach. So to be like that, we should think about the community. So that is the main thing now. I also think that the drug user movement particularly does have a role to stretch the harm reduction movement. So for example, in the Geneva harm reduction conference, I can't remember how many years ago, that was back in the early, mid-1990s, a group of drug users came together to write a paper called, to challenge the idea of why we were discussing drugs prevention at the international harm reduction conference, and it was called to prevent a human right. And we put forward for the first time the idea that drug use was a human right. Now there were leading harm reduction and drug policy figures in the room who sat with their arms closed going, they'll be dancing. The quote was, they'll be dancing in the streets of Vienna tonight, IEU and ODC, at the ridiculousness of that position. Now look at how prominent human rights is in our work. So I think it's sometimes recognising that that's our function to push you on as a wider harm reduction movement fraternally, but also strategically. Please go ahead. My name is Pierre, I'm from Canada. Again, for people who don't know, I'm the PWUD voice for the SIS project in Quebec City. It's a comment, a reflection, maybe I'm not in the right room, but we're talking about harm reduction and how to teach our peers and how to teach people, and I think one thing that, well, I don't know if we forgot, but wouldn't it be nice if in some curses, in university, college, wherever, people with whom we have to collaborate to get, well, to have our rights respected, to have our health insured shouldn't be made aware and have mandatory harm reduction classes or courses like for health, people who study health, law, politics, and teachers, yeah, and also the well, policemen and omever because most of the time we have to go and, sorry, train these people and train and train and train, but I think it's a bit of a waste of money. If the money was put, you know, prior to them actually coming into doing their work instead of us trying to go and lobotomize them to put new ideas in their head, it would probably be there, like it would be a lot easier for all of us to stand together and protect ourselves knowing that we won't be repressed. That's my view. I think you're right, Pierre. I have the chance every year, there's a doctor. I know Marie Evgoye, she was here and she invite me for a class called Population Vulnerable Population. And I have to do a conference every year for the students in medicine of first year and not only not everybody go to that classes, but I'm sitting in the back all the time and I see more than half of the students on Facebook and, say, buying clothes online and, you know, I mean, it's kind of discouraging a bit, but yes, we have to make our voices stronger and stronger. I try to go every year when I go there, I tell the future doctor, take your methadone license, please take your methadone license, because that, too, is not mandatory. You can be a doctor and not prescribe methadone and it's okay. So yes, we have to learn a lot of things to everybody in all fields. Thank you. I just want to caution everybody in this room to not rely on fixed site needle exchanges, methadone clinics, whatever you might have to reduce an overdose rate, because they're clearly not reaching the people you need to. There are six methadone clinics in Minnesota, three practicing needle exchange. Most of our needle exchange comes to an AIDS service organization where drug users are automatically subsumed by the overall bureaucracy of it and the fact that this AIDS service organization primarily exists to serve gay white men, which many of them around the country do. In 2014, my team dropped the OD rate by over 23%. There's no other explanation because our good Sam Lodge did not pass until August of that year. We got no fucking credit. So then in 2016, I was seriously close to burning out. I took a year off. The OD rate went up by 40%. I don't blame myself, but it's clear. There's a cause and effect and they're not reaching the people they need to do. Our ASO hands out two CCs of Naloxone per person, per fucking week. And it's reprehensible because we now. And the other thing is, and this is a downer, I don't know, but I had lunch with Maya Dosimkin from the Chicago Recovery Alliance a while ago, a couple weeks ago, and she pointed out that we haven't even turned the damn corner yet. In 1996, with the AIDS epidemic and proteas inhibitors, we knew the world was turning a corner. We have no idea. We're not over there yet. And another bad news. Sorry. There's some good news at the end of this. A study was done in Minnesota of unexplained or not suspicious deaths but totally unexplained deaths. We went back to the data. They found that the opioid death rate had been underreported by nearly 4%. That was just one year in one state with only like four or 500 ODs in one year. So if other states start doing this, it's going to become even more for us to bear. And the last thing is, as of July 1st, when Wyoming gets its Good Sam Law, the U.S. will have naloxone access in Good Sam Laws in all 50 states. We are doing it. I think it's just to say we know why you won the Travis Jenkins Awards. Okay. Any more questions? If not, maybe I have a question to you. In the last presentation, we saw a very powerful example how to use videos for advocacy. And I would like to ask the rest of the group, rest of the panelists, do you use videos for advocacy? What are your experiences? Especially in those countries, where the publicity is quite different. Just a second. I remember one time there was a French delegation coming to Montreal and at Acupe Sud we made a video on supervised injection site. It was all the way around supervised injection. And the video was so shitty. We all looked green. It was filmed with a little camera. And we were reading, you know, and you could see our eyes going like that. And it was really, really bad. And me and the director by interim at this time, we were looking on the floor, you know, I know my God. And when the video finished, it was such a success. The French delegation loved it. You know, they wanted it. And that's what we learned about it. We did film that video again with more effect, but sadly we lost the cassette. But anyway, yes, visual is important and especially users' voice and real experience, lived experience. And yeah, I think visual is strong. Yeah, I mean, we cheat because the team that made that the video is the, we've now started to join COAC as well. So Lexie and Igor are the video team. In fact, our next mission is to go to Kachin to help support community organizing among drug users in Kachin over the next year. And we have three missions and the second mission we are bringing Igor and Lexie out to teach the My My Drug Users how to do video advocacy. And you'll see that we've also got a great team called Select 18, who are actually a recovery-based drug user group who I used to work with one of their people and they produced this fantastic video on which I hope you'll all help us share, called in Hage's name. And then Nigel Brunzen has done an also great video for us about the myth, the story of that guy making methamphetamine pipe, which again you'll find on the COAC website. Okay, so we take a last question and then we finish. Hi, I'm Alex from Karmica in Vancouver. This one's a little bit of a controversial question, but so we focus a lot on protecting drug users and advocacy for drug users and harm reduction for drug users. But there's never, we never end up focusing on advocacy for people who sell drugs. And I think like sorry, I think like recently in Edmonton, they just charged someone for manslaughter who was selling a fentanyl in order to feed his own use. And so I think if you have any like examples of kind of how that can be done or kind of how to approach it, that would be awesome. Thank you. I'm from working with drug suppliers and we tend to call them drug suppliers to try to keep it more less stigmatising that it's absolutely critical to our work. So for example, it was in our article, I run a drugs outreach team in East London and our primary referer was a one woman drug dealer drug supplier in the local area and in fact it was covered in an article in the independent newspaper. It was a really positive story, but the headline was even drug dealers can show some compassion was this, was the story. But I've actually written for co-actors technical briefing on how these three models of working with drug suppliers. So if you want me to share that, I'm happy to do so. So please join me in thanking the presentation.