 Thank you, Deborah. That was an amazing, amazing speech. I just might open the floor to questions now. There'll be people running around with microphones. So if you just put up your hand, someone should get to you. Hi, Ernie Drucker from New York City. I work at New York University in Public Health now. I want to thank this panel for talking about this picture of the world that so many of us in America are clueless about and really need to understand. I think Deborah's summary of the human rights side of this is tremendous. So thank you very much. I haven't been able to get to one of these conferences for quite a few years, but I think the organization has made tremendous progress in this time and are needed at this moment, and it is a critical moment, and we have no map for a lot of that in our experience in the United States. I'll tell you that. And I think the drug issue is one with the overdose aspect of it is something that we can build on fantastically. And we're doing a project in the American South, a number of people are here from that project. And if it takes off the way it might, we're going to have something to do. So my question to the board is what about countries within a country that are ignored by that country, how to call attention to that and change the response from public health people with where it's a body count at this point. It's vast in America. So Ernie, thank you for that. So I want to, this is going to sound weird, but I want to make an analogy between the U.S. and Brazil, which is actually one of the places I wanted to talk about, but I didn't have a lot of time. There is a conversation that prevails in the world about Brazil that most of the problems exist in the favelas, and that favelas are like these discrete ghetto communities and sort of spaces of poverty, et cetera. But the thing that I found in traveling to Brazil, and I've been there five times now, is that the whole country is a favela. The majority of where people live are what is called favelas. The exception are the beach communities where the rich people are. And so if you have a policy where the majority of the people in your country live in areas that you've declared to be war zones, then that means everybody there is a potential enemy and a potential casualty of war. And I make that analogy because the U.S. is very similar. You know, we have this conversation that we have all these wonderful affluent communities, but the majority of America is what I call Walmart world, where that represents your best option for retail buying for everything, and it also is a mentality of a race to the bottom. And so, yes, most Americans live in Walmart world, which means that they're subject to Walmart world law enforcement, whether they're white, black, or whatever. And given this particular administration that's come in, we're going to see more of that. And there's not going to be a lot of public health response because they've taken the money away from the public health institutions because we don't have a commitment to health, at least not in the U.S. And so I actually think that our work will become more challenging and that it will be even more important for us to find ways to collaborate with other groups and other organizations and other people who are really committed to preserving human rights and human life. Hi, I don't actually have a question, but I just want to say how amazing it is to have an opening plenary of all women. Thank you. Hi, good morning to everyone, and thanks very much for the opportunity. My question is related to Olga. So I want to find out in the work that you do in North Africa, what are you doing to try and improve that in terms of trying to widen your reach in other parts of Africa elsewhere? And if you've done some work in Africa, not just in North Africa, what is the response? What is the attitude of governments in other parts of Africa if there is something that you've done already? Thank you. Yeah, sorry. The work that we're currently doing in the Middle East and North Africa, which is the region that we're covering, North Africa including Morocco, Tunisia, Algeria, Egypt, and other countries of the Middle East, basically is advocacy, capacity building, strengthening communities through a regional drug user organization, the Middle East and North Africa organization of people who use drugs with members from those countries and basically trying to contribute to any advancements and developments in this area through coordinating with countries and civil society, local civil society present in these countries. Other parts of Africa, our work has been limited to some participation in training because in our trainings, like some participants, because we don't cover those countries. I do know though that a couple of countries such as Sudan and Somalia have recently gotten large funding grants for HIV and harm reduction will be incorporated into these programs. But that's about it. I had a question. Hi, my name's Sarah. I'm a graduating medical student from Johns Hopkins School of Medicine and I had a question about the role of the mainstream medical community in the war on drugs from sort of a public health standpoint. I feel like the medical community certainly has not helped combat the war on drugs and has probably made it worse. And I was kind of wondering what roles do you think from sort of a research and a practice standpoint that sort of medical folk can do to kind of help reverse the place that we've come to today? Did you say you were from Johns Hopkins? Yes, ma'am. Yes. I thought so. I just wanted to... So, no, we're not in a bad way. I mean, to me, one of the things they could start is by telling the truth because, you know, the first teaching surgeon at Johns Hopkins was a drug addict who was addicted to cocaine for years, the entire time that he was teaching at the school. But that never gets talked about. The fact that people can be functioning drug users. When they talk about his career, when they talk about Freud, they never talk about their drug use. Those are like footnotes as opposed to important integral parts of who they were professionally. So, just to start with that, number one, two, to acknowledge that the first victims of the drug war were doctors. You know, when you go back and look at the history, the first prosecutions that happened under the Narcotics Act were of doctors. But not just any doctors, they were mostly Asian doctors. And so there is a history of racism and of attacking the profession, that it was a deliberate effort to separate doctors from drug addicts. So it's not to me surprising that it is the way it is. And the only way that the medical community seems to be able to deal with drug users is in a space of fixing them. But that's how they deal with everybody. So that's not particularly odd either. So my thing, and I'm just going to put it this way to you and everyone in the room, is I believe that part of our work is about transformation. It's about transforming people. It's about transforming consciousness. But you can't change anything that you have not changed in yourself. So every day I ask myself, how is Trump a mirror of me? Because he is not the problem. We are the problem. He is a manifestation of the problem. If we don't like what's showing up in our world, then we have to change the aspects of us that have that show up. So I'm clear, you know, that part of my work has to be about making sure that that transformation is front and center of everything I do, personally, professionally, and organizationally. So I'm going to challenge all of us to look at what are the aspects of our everyday activities that contribute to the problems that we're seeking to solve. Thank you. Yes, well I think with, you know, obviously the health approach to drug use and drug dependency, it does provide support in some ways, but I think we lack, you know, the criticism of it too, because there are certain effects of it that aren't always positive. So we as an organization have argued that, you know, it tends to pathologize people who use drugs and, you know, put them constantly in this victim mode or there's always an assumption that people who use drugs need to have a health intervention or some type of intervention in their lives, which is not, you know, always true. So I think, you know, we have to both recognize that it can be beneficial in some ways, especially if we're, you know, we're talking about moving from a criminalization model, but we also have to recognize that it can, you know, have these other effects that aren't always positive and can be quite disempowering and tends to also ignore, you know, social structural issues and, you know, stigma and discrimination. There's a lot of stigma and discrimination within the health care model, so I think we just have to keep that in mind. Hi, good morning. My name is Elmer, I'm with WARS, it's Western Aboriginal Harm Reduction, and I would just like to thank everybody here on a panel and also people that have sponsored me and my colleague to come here from Vancouver. The PORES, they call it the PORES Postal Code in Canada or in Vancouver, BC, and it is, trust me, but it's the richest, and people don't see that. I just see judgment, prejudice, racism and discrimination against whether it doesn't matter what color, because they're all there. We're all together in a community that cares, which is sad to see that all of that poison that they talk about is right in that small little area, and yet it's taking hold, it's taking grasp of harm reduction in a way that the whole area downtown east side has taken in, everybody's been trained in Narcan, everyone, like telling you people that you don't expect are training, elders are getting trained, people in the workplace down, right down there are getting trained. Even though we're getting gentrified out of that area, we're getting pushed out of that area right from, you know, from First Nations, not just First Nations, but all different organizations that can afford to live in that area, because it's poor, it's a poor area, and it's rich. That area used to be called, basically, Hastings, right on Hastings, that used to be our rich area way back in the day, a lot of people that are seniors that used to be rich, but I'm letting you know that it's going to be the Robson Street again, because that's what they're doing, they're pushing us out, and the rich are coming in, and that's pretty sad to see that they have to push people out that are living like they are, but they got to remember that their kids as well, their kids are going to come into town, which is showing itself quite prevalent. They've taken hold, and the death rate has lowered so much, now it's coming in from the surrounding communities that they're not looking at that. Their people are dying out there that haven't taken hold of Minoxon, that don't even believe in this. Do you understand what I'm saying? Communities around are not taking control, and that being responsible, because their kids are coming down to the east side, and they are dying there, they don't want to be recognized, and the reason why I'm saying this is because I'm letting you guys know that how can we as First Nations, and I am First Nations, my mother and father are First Nations, and did you guys know that because I'm a product of residential school, that all the things that they are finally recognizing us as damaged goods, that we are damaged from residential school, and there was no counseling, there was nothing there for us. We didn't have 911, or we call help for kids for five, six years old that were damaged, and I'm telling you, there's nothing still in place for us. They're taking everything away from us downtown and east side. Funding is going to people that will look after us. Under the Indian Act, we're still under control, and that's sad to see that as a Canadian country that we are still held down. We're a third world basically, living in a rich, rich, rich country that's supposed to be giving back to our people which is not happening, because the reserve system is not even included in this. First of all, last year when I attended a conference, I asked how many people that are working in the communities, First Nations, at a level higher than province where three people of First Nations held up their hand. That's sad to see in a country that's supposed to be 30% employment for First Nations. That's all I wanted to say. Thank you very much. Have a good day. Thank you very much. My name is Robert Powell from Australia. First up, I'd like to concur with the previous comment about the panel. I was at the first conference in Liverpool, and I've never been at a conference where the opening or very few plenaries are made up of all women. In Australia, we're part of a gender equity drive where we're actually told we can't go to conferences unless we can identify 50% of plenary participants being women, and I've taken a photo which I'll have to send back to our institute that they can post on our website. It's an international first. I've never, ever been at an international conference, an AIDS conference, or a harm reduction conference. I was blown away when I saw this. So that's the comment I'd like to make if I could. Thank you very much. I'd like to say hello to Ernie. Hi, Ernie, who's also at the first conference. I also have a question. If you look at the basic aid around the world, international aid, there's now very few countries that are contributing anything like 0.05% of their gross domestic product to international aid. I've been working in international health for 30 years. Where I now live, I haven't got an Australian accent, so I was born in Ireland through London now in Australia, last week there was another huge reduction in our international aid program. I work across the Asia-Pacific region, and that has a major impact on all those countries. And at the bottom of the pile, not surprisingly, is work around harm reduction and HIV prevention and the prevention of diseases that are predominantly impacted upon the poorest, the most marginalised, the least and the last and the lost of our world. So I do have a question to Katie, actually. I'd be very interested if you could tell us is there any progress at all around the 10 by 20, or is it going to be another target that we're going to hear about for many years, like the 1990, the 10 by 20, all the different ones we've had. I'd just be really like to know if there's any tangible impact so far in terms of other advocacy or anyone taking this up. Thank you. I think there is some progress. It's marginal. We have a Champions Network that HRI is setting up for champion countries. And you see, essentially it's for governments to step up and actually start doing something. There is limited international funding. We know that it's reducing. And if you look at countries like Republic, you've seen a huge decrease in HIV among people who inject drugs and hepatitis programs are now being rolled out. I mean there is some, there's definitely some hope. But yeah, it's venues like this where people can get together and we can actually hopefully make a real difference and kind of shout our message loudly. Judy? Yeah, I have a question. I listened to Kate's talk. I listened to all of the talks. And they're all of them saying something that Deborah said so well which is we're part of the movement for social justice and rights and things. My question is if we're part of that movement we obviously need to ally with all the other people who are trying to replace this system with something we can live in. The hard question it seems to me is how can we act to make them want to ally or even tolerate us. And that's a very serious question. Well I think it takes a lot of work particularly as networks of people who use drugs obviously due to stigma and discrimination and I think as I said in the opening I think change is a slow process but I think there are kind of moments of opportunities such as leading up to the ungas. There was a lot of civil society momentum and it drew a lot of attention to the need for drug policy reform, people arguing around that. Organizations working towards social justice, women's organizations and so I think those key moments look to align with other organizations and trying to align your arguments because drug policy reform is about social justice to elements of their work. With the women's movement sexual reproductive health rights is obviously an issue that faces women who use drugs bodily integrity violence so I think themes like that you try and work out the common platforms and then approach them and link up narratives and strategies. I think we also have to expand how we define our work. Some of the most so I've done a lot of traveling as part of my work in drug policy reform and the most educational part of it has been when I went to places like Brazil and Columbia and visited the farmers whose crops had been exfoliated as part of the COCA eradication program. And I think for me interacting with people who've been displaced from their land is also harm reduction. When I went to Brazil last year I had all these meetings with black women who express themselves as experiencing genocide right now because of both the killing of black men and the level of incarceration in their country which is so terrible that when I came back Brazilians would be grateful for the kind of policing that black Americans are protesting. That's how fucked up it is in Brazil. It is the second leading cause of death of black people. After black people killing each other because the drug war has become this great umbrella to facilitate the genocide of black people, brown people and indigenous people. And it's not just in the denial of services it's in all the different things I've been talking about that are designed to facilitate early death. Genocide isn't just lining people up and shooting them. It's creating policies and practices that are designed to lead to early death. And in the Americas from Canada to Chile those countries are still engaging in policies of genocide against the same people that they've been engaged in for years. And the drug war is a very convenient umbrella for that. So if we begin to see ourselves as part of the people who are fighting those struggles not just delivering needles and syringes to people and I'm not saying that's not a good thing I'm not in any way disparaging our work I'm arguing for us to expand the bandwidth around how we think about what we do for a couple of more questions I think there was one up at the back. Yeah, I'm here. My name is Bernice. I come from Kenya, Nairobi and I work for Canco. Currently we implement a project in Eastern Africa in eight African countries and it's HIV and ham reduction. I wanted to reach out to the panelists who talked about the Middle East and North Africa. Yes, we are in East Africa we have formed the East Africa ham reduction network we are doing advocacy and policy makers and we have formed new networks and the gap that we have right now is about capacity building. A lot of policy makers really do not know what ham reduction is and when you go to a forum they ask you what's the difference between you and the person who is promoting drug use so I want to reach out we are in East Africa, we need capacity a peer to peer approach would really help us a lot. Thank you. Before we... Hi, Scott Burris from Philadelphia Deborah you kind of alluded to this several times but something you also mentioned when we were talking last night I wonder if you could riff a little bit on your views about the importance of talking about healthy normal adaptive drug use. Okay She's like what did you say and what do you mean she's asking me older. So we're talking about the fact that not all drug use is bad. Yes Okay and that seems like a simple thing to say but I guess so this is the thing when we talk about Duterte which is important to talk about he represents the logical extension of drug prohibition which is why we have to have this fight be about prohibition of legal extension and as long as we have a frame that says that these drugs are bad and therefore the people who do them are bad we're always going to have people like that who can exploit that fear to justify the punishment and so the thing that Scott and I were talking about is that part of harm reduction is also fighting against the idea that drug use itself is problematic and even when I was listening to the minister of health yesterday talking and she was talking about the people whose lives are chaotic their lives would be like that whether they were on drugs or not because they're poor because they're marginalized because they have mental health issues and so we have to stop having it be that this is about the drugs I hope that's what you were talking about but yeah Yes, thank you everybody for a very lively discussion and debate in closing I'd like to thank our panel first only panel of major first plenary of women speakers and from very diverse range of backgrounds researchers, harm reductionist communities, people who use drugs you know I think what's really come out here and what we hear all the time is that we really need to bring you know politics back into harm reduction you know politicize it again and I think you know this debate really reflected that you know we talked a lot about well you know put the lens on inequality which I think you know obviously the war on drugs drives inequality but it's always been about inequality too and othering and excluding one category of people so yes I think moving forward you know we want nothing less than decriminalization if we are to do harm reduction properly and the legal regulation of drugs that's not you know focused on profit but really about people's lives so you know the thoughts that we have that I have moving forward and the theme of this conference looking back to the theme of the conference is you know placing people who use drugs at the heart of the response which feeds into inputs principle of nothing about us without us so we should keep this in mind in every forum where people use drugs that are on the agenda for national networks, regional networks global networks you know this is something we'll always be pushing for allies, harm reductionists and drug policy reformers you know we also hope that you'll advocate for our inclusion it's no longer acceptable or ethical or good practice you know to speak on what's best for drug users without consultation without giving people who use drugs a seat at the table and without a real belief that people who use drugs have agency and that our lives and knowledge have real and tangible value and that you know our decision making capacity may exceed sometimes those of socially acceptable experts so thank you