 Good evening, I'm Peter Sharoschi and I welcome you all at today's discussion in our stories from the frontlines lives live video series on drug reporter. Today we will speak about how this crisis affects people use drugs in South Africa. Video is now live streamed on my personal Facebook page but we link it to the drug reporter page because of some technical difficulties but we hope that it will not affect the technically the video itself. I have two guests with me here today from South Africa, Sean Shelly, the policy advocacy and human rights manager of TV HIV care in Cape Town, and Julie McDonald who is the project and harm reduction and operations manager at the same organization. Thank you so much for accepting our invitation and being with us today. How are you guys, how is how is how is going with your work and with your personal lifestyle. Well, Julie, to start with that because she's been more in the front line than me I'm sort of a little bit behind the front line. So maybe just give some details. Yeah, so in South Africa at the moment we're under quite a stringent lockdown. We aren't, we aren't allowed out much at all unless we're going to shops or to receive medical care. So the only people that are allowed out beyond that are people that have specific permits to be out and about so it's been quite a challenge for a lot of people in our harm reduction field to obtain permits in the correct permits to be out there to help in the first place. I've been fortunate enough to to obtain one and I've been able to work at the, what's called the strength and team site which is where they're housing street based people at the moment. There are some other smaller shelters that are also providing services to them and providing shelter for them but the majority is almost 2000 people now that have been moved to this one site and where that's where we're trying to access to provide harm reduction services there. Yeah, Sean, go ahead. No, I think we're all pretty tired at the moment you know I'm thinking about other people who've been doing work on the front line, like MJ who's with us at Sanford and he gets a look for youth rise as well. He's been out every single day. I'm thinking about the trainer who's been doing some training and we've got Professor mocks up in Durban who's doing a lot of work there, and Michael also and the team from TVH healthcare. And then in the city of Swansea, I've also got appointments at the Department of Family Medicine. The community oriented substance use program up there is basically the only program providing medical assistance to drug users in South Africa and so we've got these three cities with very different responses and very different situations going on in the ground, which is, which is interesting. And we found some new allies in these circumstances, strangely enough in people like the Metro police who really tried to show compassion and have been overruled by politicians at times. And in other areas where Metro police have really assisted as well. And often there's been a blind eye turned by some of the medical fraternity, or some of the other NGOs and in fact the provincial health department, or the city health department hasn't been facing at all in any of these spaces. How is the general COVID situation in South Africa, like how much the infections are spreading and what is the reaction from the authorities. We don't really know. I mean, we know that they're about 1900 infections that was the last thing I've got it's actually on the same web page with cancer. I think 18 deaths, correct me if I'm wrong. We've gone up to 24 deaths today. Okay, so it doesn't appear to be a huge amount of people at this stage. I think that the president made the right decision in locking down very early. I don't think it was executed brilliantly but I think the decision in essence was right. I also think that we don't really know because we haven't started our big roll out of testing it. And, and what we do know is a lot of our population live in very cramped conditions physical distancing is almost impossible for them. And so, you know, that's going to be a problem and I find it quite ironic that some of the people are breaking the law which says only 50 people in the space and get there putting 2000 homeless people, a lot of them with TV, you know, and other infectious diseases as well into the same space. So I think the problem is we've got a lot of compromised people with HIV and TB and if this takes off, you're going to see a lot of deaths. How is the police in this behaves in this situation. Do they steal arrest people for drug use do do they use any repressive methods. Judy, I think you can speak to a bit of that. Yeah, I think there's a bit of a double edge side that we're seeing so the police, or I would say certainly Metro police and the saps have been quite supportive I think they're trying to turn a bit of a blind eye to the substance use itself. Certainly outside of the site we're not hearing about as as much police brutality, etc. But within the site they have been ready instances where flare ups from law enforcement they were firing rubber bullets people that were trying to leave on Tuesday afternoon so we've already seen that. And the site only been up and running since Sunday. So within the site, I believe there are, you know, there is going to be quite a lot of flare ups. And you just tell us the story like how the situation escalated to to this crisis that the police have to use the rubber bullets or how did it happen. If I can just add one thing before Judy answers that because she was there, but seeing other situations evolve like this. I think part of the problem is, is, is, and certainly there is pretend police brutality going on. The people that we've interacted with are really trying their best. But that's not everybody. But I think also when you take a group of people who are largely from formerly marginalized populations have been brutalized that will grown up with a lot of trauma. And you ask them to enforce what is essentially an unenforceable thing. Because because you just can't contain people where there's no health services, no food, no water, no help whatsoever. And especially when you've got a group of people often that are in withdrawal, whether that's from heroin or alcohol or just withdrawal from from life, you know, they're going to try and make a break for it. And if you try and stop that, there's going to be violence because the police are expecting to do expected to do something which really nobody should be expected to do. It's not their job. We're expecting them to do social services job. But Julie was actually there and sort of escalated I think. Yeah, so, so one of the issues that was coming up that we were hearing from the people on site was that there were some similarities. To two incidences in South Africa's history in terms of apartheid where police were just arriving on the streets, supposedly picking up street based people for testing. I think that a lot of people were told that they were just going to go for COVID screening and testing and then they would be allowed to leave. When they arrived at the site, it became apparent that they weren't going to leave and that they were going to be confined to the space for as long as the lockdown period, you know, as long as we're going to be in lockdown, which at the moment is until the end of April. And that caused a bit of uncertainty immediately there was the sense that they'd be lying to, and that now they were detained. And obviously there's the human rights element that none of these people are criminals and yet they're being forced to remain in a place against or some of them against their will. And then, as Sean says, there is the, the fact that some of the people that were going into withdrawals are very fearful of the withdrawals and wanted to be able to leave to access to access their drugs. And they were literally fenced in they've got these enormous big silver fences around the tents which which contain people. So yeah, there were people there were three people specifically that had left, and they they broke down the back fence and moved into the sand dunes which which are behind the premises, and the police then gave chase and to their managed to capture two of them. And the other one literally disappeared into the bush and they were firing, you know, rubber bullets. How was the media coverage of that event? Was it highly covered by the media. No, because the media have been have been restricted in their access to the premises. Certainly yesterday they had a good media presence that on the site but on Tuesday, when this was happening there was there was no media on site at the time. So I just wanted to mention there was another incident in Johannesburg on the first day of the lockdown, where people had they are we stolen from them they were rubber bullets fired. I think it's area J Johannesburg. There was. We've documented that. And another health, we were present there have taken good records and will be feeding that into the global funding and rights issues. And that was a particularly violent event and also we've got videos which would go up on one of the posts of people of police smashing bottles of alcohol, dragging people out of cars. So that kind of thing definitely does happen. As I said, but overall, our engagements are being more positive. But we've got to find a different solution to this. This is not going to work. Okay, what is the situation now. I'm not really sure what's going on that has been written to the president detailing a lot of the issues, because you've essentially got. And I'm speaking on USA Julie was there Mike was there. Other people from streetscapes were there. They basically got a place where they put people with no services. And you know, people need that kind of sense of belonging in a place and certainly no sense of belonging I've been to the site before. A lot of sand with scrub on it, the wind house through there, the poor ablusion facilities. And it makes me mad because because we've got all these empty hotels standing there. Surely that's a better solution but Julie's aware of what happened yesterday for instance when she was trying to bring some medications to people working with the doctor, and they were stopped. Yeah, that was that was a huge issue we when we've been there on Tuesday we had been able to provide medical care to two people that were in one. So on the site there are three different market areas, each supposedly housing up to 1000 people between 500 and 1000. So one, we were is managed by a particular organization and we were providing services to that particular teams. And on Tuesday we'd been there and we've been able to access quite a lot of the people that were within withdrawals we were able to administer some symptomatic medication to them. And it had gone fairly well we said we'd be back on Thursday which we went back yesterday. We were just we were about an hour into doing some medical screening and administration and then the CEO of the sites told us that we needed to leave because we weren't operating through the kind of political effect of what the city of Cape Towns authority, we were coming in as private NGOs. So we had to leave really difficult. However, we were being requested to be there by the Metro police requested assistance and by the organization that through Julian the doctor. So it's a mess but also what's interesting for me is the different approach in the three cities. So in Cape Town people, they were only 20 odd people on methadone in the whole of Cape Town on a very small global phone program. And then those people were given take home doses for the full period. In Durban, we had to stop the mission program and the needle into the program. There was no thing for the mission program. The needle into the program was really halted two years ago. And although it's been approved again, they still haven't given the authority to to start it again. So that was a problem. So, and Wilson and TVHRD kept working really hard there to try and get some relief to people, but then the state fortunate psychiatrist who was wanting to give people methadone for 10 days which is not a solution because we need to keep people's tolerance up and, and that but in the city where they had the community oriented substance use program, they initiated a thousand people will nearly a thousand people just need to check that figure because it's changing all the time in a week. And the problem is that we're going to run out of methadone in the country. And people aren't really excited about the fact that we're going to run out we had a stock outage last year which was devastating. And again, we're going to get it and the fact that methadone costs between 10 and 30 times the price of the cost anywhere in the world. So we're trying to use this as an opportunity to, to try and bring in a different source of methadone and my hats off to your names and you know to see who really supportive in this process. But there's a general apathy around breaking this absolute monopoly unnecessary monopoly on the price of methadone. It's very interesting what you say because you echo what other harm reduction professional saying that actually this crisis can be also used as an opportunity to change those, you know, outdated rules we had before and monopolies and break down the barriers. So do you think that these changes you can achieve now can be long lasting even after the crisis. I'm worried that the biggest death in this whole COVID thing is going to be human rights. I see it as an opportunity to come out of it, more socially connected. I don't like the term social distancing I like the term physical distancing and social connection, simply because for people to be socially distant creates, even in the language a sense of us and them. And I think this is the time we really need to be pulling together and I think we saw that we saw a bit of that with the police really being sympathetic towards the guys in withdrawal. I don't want to, I don't know what exactly happens but all I know is some of the guys got authority to go out and they weren't so much in withdrawal afterwards, but you know, it's really an opportunity to try and show things up to what I was saying to somebody yesterday was that in fact, this is what we deal with every single day of our lives. It's just been concentrated and pushed into the public face so they can't ignore it anymore. And that's what it is. It's what happens every single day with us. It just exposes the inequalities of in our society right and discrimination. So what do you see in the drug market do you see any changes like prices going up or drugs are changing Julie do you have any information about that. So I've been in touch with some of the people who mentioned earlier, and what what we have definitely seen with regards to I can only really comment on the heroine. And what we've seen is where where it was maybe costing 30 to 40 40 year and we're now looking at 50 to 60 year and so there has been an increase in some of the cities not in all of them. And obviously there is concern about, you know, as the ability to obtain drugs becomes less or as it's less on the market we have the risk of drugs being with adulterants added with the adulterants and the concern that that will will bring you know to the drug using community. We also hear reports about you know increasing domestic violence due to the the quarantine measures. Does it also happen in South Africa or you don't see that. I haven't, I personally haven't heard of that happening yet. I think the tension certainly will rise. But I haven't heard specifically of it causing you know being a direct correlation to an increase in domestic violence. One of the interesting things about South Africa is they also made a ban on the sale of alcohol and cigarettes during this period, which is, which is purely moralistic in my opinion. I've never smoked a cigarette in my life. So I've got no, no sort of staking this at all. But I think it's cool and I'm kind to do that to people who are dependent on cigarettes, even though cigarettes are not the healthiest thing in the world, there are lots of things that people do that aren't healthy. And the alternative to regulated cigarettes is cigarettes that come in on an illicit and unregulated market and that's dangerous. And already there are people talking about things like how to make alcohol on Facebook and the internet. And I remember at medical school there was many years ago there was a group of students who made methanol instead of ethanol and, and I think four or five of them died and you know these are the kinds, kinds of risks that take place. Whether or not that, that, that medical student stories and urban regions, I'm sure many people have heard it before, it does happen. Those kinds of things do happen. And, and we know that any unregulated drug is much more dangerous than a regulated drug. And to, for some people, the alcohol dependent people, it's, it's life threatening. Are there, do you experience any shortages in medications, OST or any other equipment such as masks or gloves? Everything. Everything at the moment here. We've got no, we don't dare initiate more people at the moment because the problem is, is we're going to struggle to keep the people currently on it, on it. So, you know, we've been trying the tramadol. We've been trying with sympathetic packs. And everybody says, oh, don't worry, you know, the withdrawals are going to be over soon. But the problems aren't going to be over soon. And people are going to need their painkillers or their medications or just some life relief and they're going to go out and they're going to use again, which is their prerogative and their choice. So for me, the number one priority is to maintain tolerance, you know, so people aren't going to overdose when they go out there. And my big worry is, we've got a large important trade relationship, especially in animal products with China. And we know that fentanyl, car fentanyl, those kind of analogs are coming from there into other countries. And I'm just hoping that we don't get a large amount of that because in South Africa, we don't have a lot of direct drug poisoning deaths. It's usually because of people that died from complications due to HIV AIDS, to the effect of endocarditis, septicemia, TB, those kinds of things, and hepatitis, those are the five big ones, which is terrible. But you know, we're not seeing adding to that fentanyl and no deloxone really available. You've got a recipe for disaster. So listening to you, I have the impression that at the moment you are more concerned about the impact of the lockdown than about COVID infections themselves. Is that correct? Or you are concerned about both? We're concerned about both. I think Judy can add to this more than I can. So from my side, I'm very concerned about both. And I think it's the way that they act with one another is very evident. We also have another concern, which a lot of other kind of countries in Europe and that don't have as badly as we do. Our townships have huge amount or we have huge number of people that still live in townships where they don't have proper housing and they don't have sanitation within their shacks. So you may have three or four people that are living within one shack without a toilet, which means that these people are having to walk to, you know, having to walk and move around anyway within the townships where there are thousands of people. And once the COVID virus reaches those townships, we've got very small numbers in the townships at the moment, but obviously that will grow. And without adequate sanitation and more toilets available, there's certainly no hand washing facilities in the shacks and things like that. So we're going to see a massive escalation with the COVID virus once it's in our townships. And that's a huge concern to me. And we also have a lot of alcohol dependence in the townships more. Yeah, so that very much I think in the South African context, the marginalized people and the people that live in the townships are going to be incredibly hard hit by COVID. They've suggested to us that towards the end of April, we're going to see the real figures starting to rise. And I think that's going to be an operas areas unfortunately. And an add to that 166 deaths a day due to TB tuberculosis, MDR TB, multi drug resistant TB and XDR TB as well. Some of the highest rates in the world, if not the highest and certainly the highest rate of HIV in the world. So you really look at a problem and already supplies of HIV meds have been disrupted. For example, in the so-called safe space in Strunford, I don't think anybody's getting the ALBs there. And TBH of EK are trying to make an arrangement to trace people because people have just been lifted up and we don't know where they are. The one thing that the City of Twiney team has been unbelievable in doing is keeping track of where everybody's going to with all these people on those T with people who are chronic care medications, psychiatric medications. And then I don't know how they do. But we also going to start seeing our health care workers get sick. In one German hospital there were 11 nurses who are sick already. A few days ago I read an article that in the sub-Saharan Africa, the Ebola crisis also had a devastating consequence on the HIV epidemic that people didn't have access to condoms and ARB. Are you concerned that the same can happen during the COVID epidemic that the HIV prevention efforts can be diminished or disappear? Yep, there were no condoms on site, were there? No, there was a call for that and then there was, I don't know how to say it diplomatically, there was a concern raised that they shouldn't be having sex on site anyway. So we don't need to have condoms. Which was just the harm reduction people just shake their heads and kind of think, you know. I think any people should shake their heads because they're just crazy. Do you still do HIV tests or do you have HIV tests? Yeah, I think we've got a very big program in the country of HIV testing. It's targeted testing and index testing. Yeah, I think the HIV testing, obviously because of our lockdown, we've got less healthcare workers that are allowed to be out in South Africa doing the testing. We're not supposed to have people on the streets. So the usual cohort of people which we would access to do testing is reduced at the moment. But I think the HAST workers and our general healthcare workers at work with HIV, AIDS and TB are still doing their very best to access people during this time. Unfortunately, again, at Stranfentane there were no, well, there were no ARVs available until yesterday and then I believe they brought in ARVs but only one particular type which is the ARVs that are only taken once a day. People that needed other variations of ARVs or needed ARVs that they were taking twice a day, that medication wasn't on site yet. So we had, I know of one particular patient that we saw who'd been there some Sunday and she'd had no access to any ARV medication at all since then, which is absolutely human rights violation. What do you think when people like middle class people hear about what terrible things happening with marginalized people because of this crisis, does it make them feel more solidarity or does it make them less? I can say something very specific around that. I don't belong to our local neighborhood group just because I get too angry with it. But my partner does and there was a set of messages complaining about the homeless people in the area and they live in a small cohort. What's really sad is the fact that the majority of them actually come from families that used to own property in the area and were forced out of the area during the apartheid era. So really they're not the intruders, you know, and we're not talking centuries ago, we're talking, you know, 60 years ago, 50 years ago. And anyway, they got rounded up and they got dragged off to Strunt Frontier. And when the reports came out, the Robert Bullets and that Sonia put on her message on the page, you know, the WhatsApp group, she reported this. And somebody said, this is not for general national matters, it's only for local matters. And she said, well, all our local people went there and they said, no, we're talking about community members. And that just shocks me because to me, we need to redefine community. Community is a geographical area and anybody who's within that space should be made to feel part of the community. And it really just upsets me because honestly, I see this as a kind of Darwinian process. The very wealthy are already socially distanced because just by the houses, the size of their houses, the middle class are being forced to be socially distanced now and are moaning about it. And the really poorest of poor are actually exactly the opposite happening. They're being forced into a closed space with other sick people altogether. They're being forced to see who survives, who comes after them. And I think that deep down, there's some people there that say, well, you know, let's solve some of this homeless problem this way. And it shocks me. Julie, do you share this pessimism? Yeah, I think to a large extent. Well, when you initially asked the question that I must, I must also just say that a lot of the more privileged communities are not aware of what's going on. The press has been there was a bit of a press blackout in terms of access to strength and ten certainly on Tuesday and Wednesday. Then they did allow the press there yesterday, but but they weren't allowed into within those kind of caged environment, you know, in the caged areas so they could see, you know, I was saying to Sean it felt like we were we were zoo animals being looked at by the media on the outside. You can see what was actually going on inside inside of the tent. So I think that the, maybe the middle class and the upper class privilege are saying oh well this is wonderful the city's providing services at least in the homeless people have a shelter during this difficult time. They're not willing to scratch the surface that much and have a look at what's really going on, you know, what's happening there. There's no cooperation with with with with like city city authorities and politicians in these times like do they listen to you, do they give you any support. I think I'll get sure. Yeah, it depends who it is. There's some people that really want to do a lot. There's some really good people, but the red tape ties their hands. I think that in some areas, there's a lot of commitment to doing things, but very few resources. And there's a lot of just not thinking about it. There's a lot of. We see that also in funded programs in particular, where, you know, people say, oh, my cohort of people are all right. You know, they're only interested in their set of figures. And, and I really don't have much tolerance for that and we see the same in the political structures where people aren't prepared to take ownership and to work collaboratively together. I know that, you know, often at the top, the good intentions, but it often doesn't filter down. And then in some pockets on the ground, there's some really, really good work being done by a few people, but then the sort of middle management doesn't listen to them at all. And then there's this massive group of people are just totally ignorant to what's going on. They don't understand. They don't speak to the right people to understand where to place resources and how to place resources. And also there's a, there's a reluctance to act very often. People don't want to make the wrong decision. And it was interesting actually listening to Bill Gates say today that they're building seven factories for COVID treatment, but they know that possibly only two of those will work. But if they wait until they know which to, you know, then they never going to get anyway because then they still years behind the curve. And so they, they prepared to spend billions on potentially four or five factories that will will never be operative just to get ahead of the curve. And, and we're not seeing that at all with politicians they just too scared to act. And once again, you know hop on the hotel thing because it's such an easy simple solution that will cost less than anything but whenever I ask politicians about that why aren't we doing this. No, because the hotel said no well tough luck they're paying them out they're paying for them already. Why not just put the people there. You know this is a time when which needs some good strong leadership and if we prepare to incarcerate people and imprison them, we should at least try and prison them in some level of luxury because they're not criminals they just very unfortunate people. Yeah, you mentioned imprisonment so we know that prisoners are one of the most vulnerable groups during the epidemic. Do you have any information about what's happening in in South African prisons. The prisons here are hugely overcrowded. They are incredibly overcrowded and I hate to think what happens when this happening when this breaks out. They did release some prisoners in some areas. But they're filling those prisons up very quickly with people who are caught outside, you know, walking their dog or something like that, you know, which, which is crazy. The thing that strikes me which I must just add before Julie can wait is is when I met Julian we started working together a number of years ago. I was only recently off the street at that stage. So about 12 years ago, I would be sitting in strength. You know, and let me tell you I wouldn't be sitting there calmly. I don't think anybody who's got any fight left in them would be sitting there calmly. And so this weighs particularly heavily on my heart, because I still would have got very, very likely being a very well educated white person. The less educated, the mentally ill people, the people who haven't had the privileges. I hate to think how they must be feeling. Just in terms of statistics, the only thing they've released in the press so far is that there's been one prisoners passed away in a prison in the Eastern Cape. But that's all the information they've released. So I would guess that is one that has already passed away. There's probably several very ill people there as well. But again, to get this actual information in South Africa is very difficult. You know, although we have the freedom of speech as as part of our constitution, it's not always when it comes to these particular issues around, you know, kind of prisoners and substance use and street based people. Definitely, you know, it's difficult to get the actual facts and figures but it has been widely kind of in the press that there was one prisoner who has passed away in the Eastern Cape. So that's the factor that you have. And do you, how do you see the response from donors internationally national national level, like, do you think they respond to this epidemic? Are there new funding resources available? I think we've been quite lucky in that our own some of our own funders have been wonderful and they've been really trying to assist us. I know the IDPC have been incredible. I'm not going to mention some of the others but yeah, we some of them have been wonderful in terms of saying right let me see what we can do how can we help you. One of the things that we work with directly want to help us. But unfortunately, some of them fall into bigger consortiums and there's often a gridlock or some bureaucracy at that level in terms of releasing funds. But once again it's quite interesting because because some of the large funds like global fund for example have got a very pure Japan and they authorize distribution of funds. But when you come down to some levels within the country, I'm not necessarily talking even pure level I'm talking sort of at government level sometimes just poses a PR. There's a lack of willingness to commit. But I think this is also about to do with the whole way that the funding system works where there's so little freedom of movement and everything has to be so controlled. That people are scared of messing up. And so they become paralyzed and they only so in South Africa, for example, we should never have started with harm reduction services for people to inject drugs. We should have started. They should have got needles and syringes from day one. It shouldn't have been a question, but we should have also offered things like OST and services to people who smoke because we never had an injecting culture in the country. But funders only want people who inject drugs. And so you kind of missing the curve there again. And I think with COVID it's the kind of same thing, you know, you arrive at a site and you're only allowed to record the people who are injecting drug users or just drug users or sex workers on your records. And to me, that should all just go away at the stage. It should go away most of the time. But at this point, it is just irrelevant. And it's the same with a lot of the OST. I've just finished writing new OST guidelines for the COVID situation, where we've taken away a lot of the barriers. You know, really, you can't give every single person an ECG, but you can take it with history of them. You can develop a rapport with them. You don't need to be drug testing people to check whether they're using or not using. You just need to treat them like people and you need to initiate them quickly. You need to have low thresholds, but with clinical care. And that's what it should be like all the time. Okay, so maybe just a last round of question to you. So what can we learn from this epidemic? What should we change in the future? What do you recommend to other professionals, decision makers? For me, it's really just to keep, and it's something that needs to be implemented around all healthcare facilities in South Africa, is to keep the emphasis on the patient as a person, regardless of their background, where they come from, what substances they choose to put or not put in their bodies, where they live, what color their skin is, but that every single person receives exactly the same medical care. And that's something that's seriously lacking in our country, not just in the substance use field, I think across generally people are stigmatized way too much. And I think it's come to a head now at the site, we're seeing a lot of advocacy and human rights issues being addressed or coming out now, that I think it's going to cause a shift in the way that people are being treated. We'll hopefully be able anyway. Thank you. From my point of view, just to answer your previous question better. I think that one of the big things is the restrictions on the way that funding is handled. And, and the lack of speed at which funds can be released in this kind of circumstance. So, I think a big lessons in this are that really what what people think we need to do during this epidemic in terms of levels of care is what we should be doing anyway. You know, we should get rid of these barriers, these unnecessary bureaucratic systems, we should have more unrestricted funding where there's a general goal in place. We should have, you know, more community based programs that don't just look at a person when there are patients, but look at them before that, you know, and offer continuous of care and just, just helping people live better lives and feel like they belong, you know, if they choose to and some people that don't want to, but I, and I think that that we need to put money into the communities, keep them in the community, keep the money in the communities and resource the communities. Because I don't understand why we still need community capacitation 20 years down the track. If people have been doing community capacitation for 20 years, you know, that money should be owned run by the community. And I think these are lessons to learn. I think that if we are empathetic, kind, and thoughtful about everybody, if we stay physically distant and socially connected and integrated, we could come out of this into a better world. And I, I've got a very pessimistic feeling that the first step will be human rights, and we are never going to regain the constitution that we've got in South Africa or the constitution, unless we work really hard. Very nice concluding words, I think we can all agree with them. And let's hope together that we will really learn the lesson from this crisis and we will do better after this. Julie, thank you so much for being here today. And thank you for those who are watching us online on Facebook. Please follow us on social media and we will keep you informed about harm reduction during this crisis. And don't forget to stay informed and stay safe. Thank you very much. Goodbye. Thanks Peter.