 We say ... ... and I'm Malah Gil Bill Nicholson. It's not just a broad welcome. It's welcoming you for a purpose and the purpose I'm explaining now as a gathering here to talk about the very important, you know, social situation healing of people. I would like to acknowledge the traditional owners of the land on which we meet, the Boon Rong and Wurundjeri Woirurung people of the Coolyen Nation. We pay our respects to elders past and present and note that sovereignty has never been ceded. We recognise that this land sings with 60,000 years of living culture and acknowledge that modern history is scarred by massacres, a violent dispossession of land and the trauma of the stolen generation. When we stop to acknowledge the violence of colonialism in Australia and name systemic racism as a source of the violence experienced by Aboriginal and Torres Strait Islander people, we take a small step towards creating a more equitable world. This always was and always will be Aboriginal land. What is the situation in the country in general in Australia? Well there's a lot of progress. Our capital has been the most progressive over the last two or three years. That involves legislation to decriminalise drug use and that is going ahead this year. They've legalised cannabis, possession of cannabis. They've had pill testing programmes at festivals. We've had medical cannabis in Australia for quite some time which has worked quite well. We've had a supervise and digging room set up in 2018 in a suburb not far from here where there was I guess high prevalence overdoses and a lot of public and digging and that room has been outstanding in terms of its achievements. We've had a 50% reduction in overdose deaths in that area. We've had significant change in public injecting. In the acting room if they want access they'll go through there but they can just come in and access regular needle and syringe services or access the consulting site. We've had over 6,000 separate individuals registered to use the service and there's almost 400,000 visits to the service in that time so we've had more than 6,000 overdoses. This is the injecting zone so it's got the capacity for 20 people to inject simultaneously. You get your syringe, a spoon, water and a torn decay. 95% of the visits to the room are to inject heroin sometimes in combination with other things and only about 3% methamphetamine. I really like this room because I know I'll come here and I can safely use whatever my substance of choice is up on the day and this is like one of the few places where I feel welcomed and not judged and not ostracised for what I do. I just feel safe here. I know that I'm not going to die in an alleyway. How would you feel about the service? The drug's actually being prescribed and supplied here rather than having to buy on the street corner. That would make it that perfect service. That'd be a dream. It's called a vein finder. It kind of can show up the veins more easily. I think this is probably our most informal area and it's also the place we really get to build our relationship and rapport with people. We can actually do a lot of our referral work, our psychosocial work and also engaging with people to check in on how they are. You can get a very quick rapid result within 60 minutes per hepatitis C RNA so indicating current hepatitis C infection. You can obviously get treatment prescribed very quickly and then client started on treatment very quickly as well. Do you have a range of services from primary care, the hepatitis testing you've seen, opiate dependence treatment, oral health care in conjunction with our oral health service, legal support, drug treatment, wound care, sexually transmitted infections, mental health support. There's a range of services that we provide in this space here. To see the holistic range of services you have here supporting the most vulnerable in the community is really heartwarming and to think that it's all paid for by the public purse is particularly encouraging and clearly there's a need for much more of it. Not only in this city and state but across Australia, my own country has nothing like this. We have a thousand people from 70 to 80 countries around the world. There's a huge amount of energy and the research being presented is incredible. The activism we're hearing about the personal stories, the peer leadership. It's really good to run into people that I haven't seen for a number of years and it's good to connect especially after Melbourne's lockdowns gives us opportunity to rebuild and regain momentum that felt sorely lost. In Japan, stigma against people full use drugs is deep rooted. Almost all people report to police once they know a person use drugs even in hospitals, social welfare offices, schools or shelters. So no one talked about their drug use when they need support or they just give it up. So that's why I started Harm Reduction Tokyo. So we provide psychosocial support to survive through chat services so you can talk freely and safely. And in the previous year we chat more than 2000 times and met over 200 people full use drugs. We will not stop doing this until the society changes. What is the general harm reduction situation in China? Well, 10 years ago it was still pretty good but more recently especially after the start of COVID, the Chinese services have deteriorated. The method program is still ongoing but other services, harm reduction services such as needle exchange only provided as a lip service. In Thailand you know about drugs. It's illegal. Provide the needles. It's illegal to government not provide the needles for our drug users. Right now just civil society provide. We need more funding and we need more organization to do harm reduction too. Often governments talk about oh we take a health approach to drug use. We have drug rehab programs for people but you need to look behind those kind of nice sounding words to see what the reality is and often it's still, it is almost always very punitive still. The biggest thing that the government could do probably is just to leave people alone and I think this is essentially the kind of the biggest challenge at the moment. In the words of a great Australian Michael Kirby the state should say out of the bedroom. What are the special needs of women who use drugs in Kenya? Many women who use drugs are homeless and they're homeless together with their children. We have established blood threshold shelters that are managed by women who use drugs at the community level. These shelters are near the drug using sites which can easily be accessible to the women. Can you talk about the advocacy toolkit you developed with the network? We can train using this toolkit harm reduction service providers so that when women who use drugs and gender diverse people who use drugs when they come for harm reduction services can they also access sexual and productive health services and if they cannot access contraceptives let's say they cannot even access safe abortion they cannot access information on perinatal and newborn care in harm reduction services where else would they access it? A lot of us just are starting to realize how important mental health is and actually addressing it not just for the people that we service or the people that we work with but also for the actual workers themselves. The overarching theme of the conference of course is strength and solidarity and for me as a trans person I find this to be a really important message. The fact that I have multiple intersecting identities both of which I'm marginalized as a person who uses drugs and as a trans woman really highlights how we need to have solidarity across different social justice movements. If you would like to send a message to these professionals in their suits what would that be? You just sort of like stopped and cleared your mind of oh these myths misconceptions that you've that we all learned throughout our whole lives because that's what's like bombarded to us about like who drug users are and what they're like if you just try and put that aside look at me as a person listen to me and my experiences maybe you learn something and you learn that we're not scary we're just fucking people like here in me and like drug use is probably the least interesting thing about me What I really like at the conference this year is the attention for diversion of funds away from drug control towards health programs that's something that I take home as a message like yeah we really need to bring our game better to push for that agenda in the Netherlands. Our final award for the evening is the International Rolliston Award now we had an incredible array of nominations for this but the absolutely outstanding one was the nomination for the Ukrainian activists organizations and service providers maintaining and continuing services throughout the Russian invasion of Ukraine so please come up We are back to understanding of harm reduction as a comprehensive approach which include the vocation of people from bombing shelters providing shelters providing food and sleeping bags for kids and families and that's all done by nurses doctors harm reduction activists in the under the bombing under missile attacks What we're doing now from the Latin American network of people who use drugs is we're trying to push further to talk about the stimulants harm reduction but mainly talk about human rights to see if the international funders start working on reducing stigma and discrimination instead of only focusing on injecting drug use that definitely it's important but it's an issue that you mostly see in Colombia or Mexico. What's really innovative in from the international perspective is the safer supply program in Canada can you explain to people who don't know about what is it? For the most part it's very medicalized safe supply so it is run through health clinics to engage people to get a prescribed supply of their substances there is a program running in BC that is being run through a drug user group where they are purchasing substances testing them repackaging them and giving them out to people that use substances in the community but that's a very unique experience there. You were speaking I think yesterday about decriminalization and how to do it in an adequate way can you explain that? Yeah you know decriminalization is a major intervention that we're pushing now and part of it is recognizing that criminalization is an inappropriate response to drugs. One of the things that we fear in doing decriminalization is moving it from the criminal punishment system and then letting another system take over that space and continue to criminalize people continue to stigmatize people to continue to take up all the resources that are necessary to give to communities. The things that I think will help turn the tide are solutions that have to happen way upstream. How do you prevent someone from being traumatized in the first place? How do we eliminate poverty right? How do we repair the harms caused by other structural violence like racism and white supremacy? Harm reduction it helps a small portion of the folks who need these kinds of services who manage to find us right? Harm reduction isn't in every corner of at least the U.S. the way it should be and even if it were it still wouldn't be enough. There are too many people hurting and in pain and I'm not suggesting that the only folks who use drugs are ones who are hurting in pain. I'm not suggesting that at all but for those who are help often doesn't come soon enough. Do you think these conferences can make a change? We are making changes now and the ideas that we're bringing forward what we're sharing but the actions right change is not just a word it's an action it's a place to be it is how you eat how you sleep how you walk how you wake up and being here and taking time from being on the field and sharing and going back with truths and ideas and collaborations and talking about real things how do you protest how do you impact how do you write laws how do you cheat how do you how do you make things happen this is important that is change so yes.