 Thank you, Karen. So our last speaker is Liz Evans. Liz trained as a nurse in one of Canada's poorest postal codes, and she's worked for over 20 years to create services that change the way drug users are seen and treated. People who were previously at risk or dying from overdose, being infected with HIV, can find dignity in housing, care, and supports, including in North America's only supervised injection facility. I guess everyone in this room has heard of or visited inside. Liz is currently a fellow with the Open Society Foundations in New York. Foundation or Foundations Cacha, I never know. Here there's no S. Okay, and works as a consultant with Insight for Community Safety. Liz has received a number of awards and recognitions, most recently in 2013 being awarded the Red Ribbon Award. In 2012, the Queens Diamond Jubilee Award for Community Service. Liz? So I just wanted to start by saying that I'm incredibly honored to be here with so many courageous people who take incredible risks every day to defend the rights of people who use drugs. And I want to thank you for that. Yesterday, yesterday I was excited, but also a little bit terrified to hear how the future for harm reduction is going to mean, mean that civil society actors have to step up and advocate to governments for continued funding. I'm excited about it because I'm going to share with you this morning how our work in Vancouver as civil society radically altered the landscape for people who use drugs in our city. So my point about civil society taking responsibility for transforming sustainable funding for governments. While I think from the story in Vancouver, you will learn that civil society was responsible for making some pretty significant changes for people who use drugs in our city. By starting innovative and lifesaving programs, we changed policing attitudes and policing practices. We changed the standards of health care for drug users and housing policies, and we almost eradicated the transmission at HIV among drug users in our community. Also, we increased the life expectancy of people by almost 10 years in our low-income community. But my trepidation around this future comes from knowing that many of you also know very well that taking on this role civil society faces risks and huge challenges. 25 years ago, I was working in the emergency department of a hospital where I saw people coming in in acute psychiatric crisis. They were admitted, medicated, and then usually ushered back to the street. For the people who were in crisis the most, we did the least. They were living in desperate poverty and many were using drugs. Labeled by the health care system as incorrigible, I watched the hospital kick people out almost gleefully as professionals stated these people were wasting their time. It wasn't seen as the responsibility of the health care system to reach out to them or to find the right way to engage people. They were seen as not being treatment ready. This experience caused me to leave the hospital and go and run a 70-room hotel in our low-income community where we had 16,000 people of whom 6,000 were injection drug users. I connected people from the street into housing and I filled up a building where there was only two of us on staff with the same cohort of people the hospital system and wider society refused to help because they were considered to be too difficult. The simple act of providing housing generated controversy and moral panic because we tolerated drug use. The media branded our neighborhood as four blocks of hell. We were told that drug users had chosen to live a life of depravity, that suffering was self-inflicted and junkies were pounded relentlessly. Messages were pounded relentlessly about crazy junkies. Obscuring the deeper social issues, we swallowed the simple narrative that drugs themselves were the cause of these problems and not our inhumane policies. I realized that this way of thinking was very convenient because it justified gentrification in our neighborhood to push out the poor and it was similarly used around the world to decimate low-income communities. This same reasoning is used to justify forced treatment, torture and mass incarceration. We saw a hatred for the poor really just because they're poor. Shockingly, I saw people that I cared about for absolutely no reason at all become randomly attacked, spat at, beaten. They were seen as easy prey. Housing across our community was grossly substandard, but our not-so-great little hotel was providing desperately needed stability and we committed to house people regardless of the challenges they faced and we created the first non-eviction policy in Canada. Our tiny hotel in the early 90s was a microcosm of what was going on across the community. For instance, initially people would hide their drug use in the building or they'd lie. Once a resident dragged a body of a friend who had overdosed into a communal shower, turned on the water and left them there scared that he'd go to jail. Highlighting the cost of our policies that had created fear, exclusion and intolerance because the sentence for addiction was death. So 25 years ago, we lobbied the police to stop attending drug overdoses. We gave staff access to naloxone. We trained everyone in CPR. We handed out clean needles and we equipped ourselves with ambi bags and airways. I started finding people turn blue and terrified and sad. I spent countless hours standing over people pounding on their chests and giving them breath. To me, these overdose incidents were horrific because it was Elliot or Dave or Linda, people that I knew and I cared about. This was not to me a story about harm reduction, a term that was completely unknown back then. Rather, it was a story about people who were broken, ignored and abandoned and we engaged in what we called benign neglect. We neglected to engage the systems of oppression to intervene in the lives of our residents and we were benign because we valued kindness over control and coercion. I met Joyce, who explained to me that when she was high, she didn't have to think about her daughter, her seven-year-old daughter who had been murdered by her ex-husband. And I met Fred, who had been left for dead many times by the side of the road in his own shit called a pathetic drunk by passersby. And I met Russ, who heard voices in his head that told him to cut his arms with glass. Described by people in the healthcare profession as being beyond help, I was once told the best way to fix the problems in our community would be to drop a bomb on our building. 25 years ago for me, it was incredibly intense and painful to hear these stories and for the first two years I cried a lot. I also realized that my own human frailty was what had led me here. As I listened, I heard stories of people who had hated themselves. It was easy to understand wanting to pick up a needle. But my own humanity was no different. And I had to make sure that my untended wounds didn't leave me to draw conclusions about what other people felt or what they needed. My own pain and my own lens only told me about myself. This was a lesson that was vital for all of us in our work. The occupation of this crappy old hotel made a human space where it had not previously been available. It was a simple but a radical act. Whether it was in our non-eviction policy, turning a bathroom trailer into an injection site, opening an emergency shelter with a crack inhalation room, our view was that space existed and we needed to occupy them. And the results were transformative. Because 20 years later this approach of designing support and care into a low barrier setting to people directly in their homes presented a model that would be replicated in many other buildings across our city. And it formed the basis for a provincially designed government funded housing initiative. It also formed the impetus for a complete redesign in healthcare delivery to reach marginalized populations. But for things to change beyond this more broadly, we had to first understand that support for the status quo came from many well-meaning people who just didn't understand what was going on. We had to get out of our own feedback loop where we met and talked only to people who agreed with us and we had to go out and explain what we had learned. And we had to tell a story differently and find a better solution. By 1998 the HIV infection rate in Vancouver was on par with Botswana and we had almost one drug-related death each day across our province. A friend of mine, a poet and a drug user came to my office and he said, we have to do something. And he was right. We blocked traffic with a giant banner and in the middle of the intersection we set fire to reports that had been produced over the previous decade. Reports that had been ignored and had made no effect in the media or in the public realm. In my backyard we built a thousand crosses. We erected these in a local park. Drug users came and wrote the names of lost loved ones. And we got the attention of the media. Our aim was to take a complicated message and make it simple. As long as people were dying there was no hope. We needed a much bigger tent to shift public attitude across our city so we had to agree to work with people who worked with drug users even people who thought very differently than we did. We were able to embrace a much larger audience that means people who had traditional views on prevention and on treatment and on enforcement. But in return they had to tolerate us. What we found was usually when people got the information in a way that worked for them they would come alongside. So we had to make a priority of extending the messages in a way that people could hear. We held this community event to speak to people on the ground and at a free gathering and a 10, 800 people came as international visitors presented alternative solutions and this was the first time the concept of supervised injection became sensible in people's minds. We brought police officers from Germany to speak about their support for heroin maintenance and we worked closely with the city as the chair of our board at the time was appointed to become the Drug Policy Coordinator and the creation of a four pillar strategic framework was adapted. Some of us very deliberately stayed out of the spotlight. My role was to focus mostly on negotiations within government and within other community organizations, making phone calls, building relationships, making presentations and telling stories in circles where empathy had to be nurtured. While others of us conducted more act up style campaigns, some of which were theatrics and only intended for a small audience, others for the media. None of them were random or reactionary. But taking on this role being at the pointy end of a stick at the same time that we were a government-funded agency was complicated. So initially we did all of our advocacy through the use of surrogates. Some of the events we created were even hosted by other groups. Drug users led and spearheaded, some were led and spearheaded by the Drug Users Union and by supporting their infrastructure and capacity, the Drug User Union van du was mobilized and earned a global reputation for their successful voice in advocating for change in Vancouver. We pushed the stories from families into the spotlight and people like this woman was flown to Vancouver for a special screening of her film. Good morning. A young woman dies. Strangled in a ransacked apartment. She was a happy man addict. She was a service to men. She was beautiful. She was my daughter. We created some organizations that existed only in name for key events and we involved churches, business people and we used every opportunity possible even if the audience was only one person, like here where it was the Minister of Health who was in Toronto for an AIDS conference. We asked researchers to help us distill information, key findings into sound bites that were easily digested by the media. From BGTV. We're talking about neighborhoods. Community activists are calling the city's downtown east side Vancouver's Killing Fields. They say their area has the highest percentage of people infected with HIV in the western world. After years of relentless work for many quarters the politicians in Vancouver were given a clear mandate from the people in our city and we had a landslide municipal election victory on the platform of Insight. And with funding guaranteed by our premier, Insight opened in 2003. The message people in our city had received was that drug users deserved a chance to live. By 2007, 76% of people in our city said they supported supervised injection. Over 40 peer reviewed papers were written, each one illustrating the positive impact of Insight and supervised injection. But in spite of this, the federal government was not interested in supporting it for their ideological reasons. After Insight opened, we had to fight with the federal conservatives to keep it open. A federal conservative government, though I'd like to proudly announce today that has been defeated in our federal election. I hear they've called it for the liberals. This conservative government crusaded against us for many years and in the end 2007, we had to launch a legal case against them to prevent them from closing the site. It was a last resort. And in 2011, we were handed a unanimous Supreme Court ruling on the basis that the Minister of Health had behaved unconstitutionally by withholding the exemption for the site. While we won our battle, we lost the war. We hadn't won the larger political battle. Not only did we fail to change the mind of our federal government about implementing more inclusive policies for drug users, the victory couldn't move forward. It was a very hard place to stand, securing space that could only be legitimated once institutions that funded them came along in support. And it was a hard place to stand in the context of people we loved being blamed for so many things that were wrong, even by those people who were being paid to care. And it was a hard place to remain, having built up an organization that had established over 1200 units of low barrier housing, including an emergency shelter with crack inhalation rooms, an alternative model of drug treatment, a drug users resource center, alcohol maintenance programs, a community bank, a free dental clinic, crack dispensing machines, numerous social enterprises where drug users could find employment and a network of supports across the community that defined socially inclusive spaces. But ultimately, it was impossible to stand in this space because after a politically motivated, damning report fueled by funders that were sick of our fighting fed into a public story that solicited our takedown. A year and a half ago, we were told that we had a choice, leave or they'd burn the village. So we chose to leave. And in a decision that hurt very deeply and one of the hardest days of my life, I said goodbye to the people that I had walked beside for 23 years and who taught me that really the only expertise in spite of all of my experience that I have is in being fully human. I think this video tells a more accurate story about why the government needed to sever our ties and hopefully illustrates one of the giant challenges presented to civil society in pushing government to do the right thing. Song for Mark and Liz and the PHS team are sending this out to you in Song Solidarity. This is a song written by Melvina Reynolds in 1964, a very fine year. And it's called It Isn't Nice. And in some tradition, we have adapted it to a small struggle across this evening. And we're just running it. So we hope that you can try it best. I want to thank you, Mark and Liz, for saving my brother's life. In a recession, opening Liz's presentations for discussion comments, questions. Yes, please. Thank you. I'm Louis Loutelier from Montreal, Canada. Cactus, board president for the last 12 years. Cactus was the first needle exchange program in North America. And we learned so much from the insight experience. Insight was an inspiration, Liz. And I wanted to thank you today because with this new government that we will have in Canada, because of you, because of all of us who are working so hard to make truth, to make people live together, we might have in Canada now in less than one year another safe injection sites. It's because of you, because of your courage. And also, I want to point out one more thing. Going to court is important for us. To make our rights recognized. And the insight case proved it. The Canadian Legal Network, HIV AIDS Network, with international harm reduction and cactus Montreal team up together and they were supporting you as a coalition at the Supreme Court of Canada. I was one of the legal councillor and I was proud to be there for you. Thank you. Hi, my name is Danisha. I'm from Malaysia. I'm a CCM representing transgender. My question is for Jules. I would like to know where the transgender sex worker are included in your movement. And if yes, tell me more about it. And if no, why? Thank you. We have a lot of trans... Apologies for leaving that out, actually. We do have a lot of transgender sex workers involved in our movement. Actually, we never ask what gender... I mean, I guess it's a bit... Some people that are involved with our project identify as women or men and not as transgender. And then there are others that do identify as transgender. But we accept everyone, you know? So we do have... It's important, like, everyone involved as a transgender sex worker. And it's important that people from those communities are speaking for themselves. So because I'm not transgender, I'm not speaking for transgender sex workers. But we do have a spokesperson who's the gender diverse spokesperson that if stuff comes up about those issues, that they can represent their own issues for their community. And I think often people think, you know, that even if you can't come out, you know, and there is somebody who is in a position to come out, you know, to represent their own community. Just because they are dealing with whatever issues or whatever reason, doesn't mean they don't have a voice. Yes? Can we have a microphone here in the front? Liz, thank you very much for that amazing presentation. And as you full well know, for many years, the INSIGHT case has been used for advocacy for supervised injecting facilities around the world. So the legacy is extraordinary. And my question is actually when will the elapsed Catholic, elapsed Irish Catholic, to the Pope, when will Liz Evans be made a saint? Yes, please. Liz, I'd just like to say that. I think you did an awesome job there. Absolutely fantastic. And it's such an excellent example of how people who use drugs can actually live and contribute towards society in healthy, constructive way that doesn't affect or demonise or instill fear in other people. And the reason why they took it away from you, Liz, is because they just weren't ready for us. Simple as that. It's a question about morality and until society can finally accept the fact that people who use drugs do not threaten the moral structure, we're always going to be faced with issues like you were. And I'm just really sorry for you, but at the same time I'm dead proud of you. And at the end of this I'm coming up there to give you a hug. Thank you. Everyone who spoke from the audience and of course our speakers, Rajiv, Naro, Jules, Liz, Karin, for taking this on in the last minute, I really thought it was an extraordinary session. It was about courage, rights, dignity, justice, humanity, fighting neglect, promoting tolerance, empowerment. I felt it to be not a conference session, but like a general assembly of a movement. So with that, enjoy the coffee.