Vietnam’s Exploding Advocacy Movement

In October, Asia Catalyst supported the #StrongerTogether Summit, a groundbreaking meeting of LGBTIQ leaders from across Vietnam, organized by Lighthouse Social Enterprise. We went to Hanoi to join the activists, and interviewed three dynamic people at the forefront of this movement to share their thoughts on the challenges and opportunities ahead. 

Doan Thanh Tùng is an LGBTIQ and HIV activist, and the Executive Director of Lighthouse Social Enterprise, one of the first and largest LGBTIQ community-led organizations in Vietnam.

Q: Tùng, now that the first community-led national summit on LGBTIQ has wrapped, what’s next? What did it mean to you, putting on this ground-breaking summit? 

A: This was the first national LGBTIQ summit in Vietnam, and also the first time we had the opportunity to bring diverse communities together – with over 70 LGBTIQ activists and representatives from all over the country. The Summit covered milestones in Vietnam’s LGBTIQ movements, sustainability models, community challenges, and opportunities for collaboration.

We are particularly delighted with the Summit Statement, a powerful call to recognize the rights of all LGBTQ people and work together to build an equitable, sustainable and healthy future for everyone. An inclusive and diverse technical working group formed to disseminate the statement and address the issues faced by LGBTIQ community.

Our belief: together, we glow brighter, we grow stronger. Hand in hand, side by side, we can embrace an inclusive society with equity and health for all.

Tùng is a recipient of a 2019 APCOM HERO Young Achiever award. To learn more, contact Tùng at thanhtung.lighthouse@gmail.com


Mia Nguyen is a counselor, professor, activist, speaker, and writer in Ho Chi Minh City. Mia works on transgender and LGBTIQ advocacy with the United Nations, governments, and community organizations.

Q: Mia, what is your role in supporting LGBTIQ mental health, and what are some of the most pressing issues facing the community?

A: My role is providing training to clinicians, professors, healthcare providers and teachers on LGBTIQ issues, gender equality and equity, human sexuality and sexual health across Vietnam. I build pressure against “conversion therapy,” which some social workers or therapists are still practicing. I also help my students and colleagues to incorporate “inclusive practices and gay affirmative approaches” in therapy and social work. This is an important starting point to understand what LGBTIQ clients need.

In Vietnam, the law is based on binary genders so LGBTIQ students so have no protection at school, work, and in the community in general. LGBTIQ youth are generally not accepted, so they often rely solely dating apps to explore their sexual orientation and gender identity in hope of finding a partner. They easily become victims of sexual abuse. Sex education and health is not taught at school.

Today, the young generation wants to come out and express their sexual orientation and gender identity as soon as possible. Still, some issues have not progressed much. Transgender people are still not protected by laws or supported by healthcare providers. Same-sex marriage is not permitted. Last but not least, suicide and mental health issues are common in the community and there is not enough attention to help people in the healthcare system.

Mia is part of Vietnam’s Network of People Living with HIV and was nominated twice for “Most Inspiring Person of the Year” by Vietnam’s ICS Center. To learn more, contact Mia atmia@ladiesofvietnam.net

Ha Thanh is a transgender activist and researcher who is passionate about raising the voices and visibility of Vietnam’s transgender community.

Q: Ha, Last year, you founded “It’s T Time VN.” Tell us about how you became a leading trans advocate. What are your dreams for this year?

“It’s T Time” was founded late last year, and with other trans-led organizations in Vietnam, we have been strong advocates for passing a Gender Affirming Law. You can read about the legal struggle here. We have worked closely with the community so they could participate effectively in discussions with the Ministry of Health. 

This year, we conducted research on the experience of trans people living with gender dysphoria, with funding from USAID and presented our findings in Seoul at ILGA Asia. For the Transgender Day of Remembrance, we organized the largest Pride event ever for the trans community in Vietnam. The event sent a powerful message on tolerance, equality and diversity. We also alleviate some of the hardships trans people face during transitions so they can live the life they deserve. 

My hope for next year is that “It’s T Time” keeps moving forward, stronger, to assist fellow trans men and women claiming their safe spaces and raising their voices.

For more info, contact Ha at itsttime.vn@gmail.com

Thanks for reading and supporting inspiring activists like Tùng, Mia, and Ha. 

With gratitude,


An Up Close Look at Our Work in Myanmar

Greetings – It’s already been a busy fall at Asia Catalyst.

We were thrilled to bring Khine Su Win, our Myanmar Program Officer, to the United States in September. She traveled to New York and Washington, D.C., gave presentations to supporters and allies, and enjoyed some of the sites from Broadway to Chinatown! Khine started her career as a medical doctor in Yangon providing HIV-related care for sex workers and men who have sex with men. Motivated by her desire to understand the barriers to care clients faced, Khine went back to get a Master’s degree in public health. At Asia Catalyst she gets to address structural injustices that exclude people from healthcare by working with communities who are systematically discriminated against and denied access to public services.

It’s been two years since we launched our Myanmar Country Program. The hunger for our year-long intensive training program has been positively overwhelming. Over the past year, Khine has led our human rights documentation and advocacy program with rural women, LGBT communities, people who use drugs, women living with HIV, and opium farmers in Shan and Kachin states – and the demand is only increasing.

Khine’s work with the Mandalay-based LGBT rights group, TRY, is one example of how our partnerships foster positive change. Trans people and gay men were regularly being harassed and extorted for bribes or arrested by the police. In our program, TRY learned how to document cases of unfair arrests and present their evidence to local officials. When arrests escalated during a community festival, TRY honed in on the precinct where most of the arrests were taking place. They had a productive meeting with the police chief and set up an emergency legal response team. A year later, the arrests have gone down. And now, when people are detained, instead of being held for days or weeks, they are usually released by the next morning. Advocacy by TRY to address police behavior and spread awareness of LGBT people’s legal rights continues.

When asked how things have changed in the last year, the manager of TRY said:
Police are afraid to do violations to LGBT people such as physical abuse, verbal abuse or asking for bribes. They feel like they have been watched and know we will not be silenced.

Kyle Knight, who works in Human Rights Watch’s LGBT right program said:
To be able to get that kind of engagement from the police is amazing. It speaks volumes to how effective this advocacy has been.

All the best,


Expanding Access to Rights Documentation: Tools for Marginalized Groups in Myanmar

This article explores how nonprofit Asia Catalyst implemented a rights-training program for community-based organizations (CBOs) in Myanmar and the positive outcomes of these collaborations. The three CBO partners discussed represent heavily marginalized groups in Myanmar: people who use drugs, people living with HIV, and sex workers.  Through this program, Asia Catalyst taught rights-driven approaches to gathering data in interviews, which has helped the groups sharpen and enhance their advocacy skills, which in turn has enabled them to effectuate positive change.

Original source

Asia Catalyst is a nonprofit organization empowering community-based organizations (CBOs) with tools and resources to help them become more effective in human rights documentation and advocacy, which strengthens organizations’ ability to function democratically, sustainably, and more effectively cater to the needs of their communities. We have worked domestically, nationally, and internationally to empower hundreds of civil society groups across Asia, primarily in China and Southeast Asia, since 2006.  We began working concertedly in Myanmar in 2015 with our Regional Rights Training (RRT) program, which also included Viet Nam, Cambodia, and China.  The RRT program focused on strengthening CBOs through workshops on topics such as a rights-driven approach to data collection and documentation, regional coalition-building of like-minded organizations, publications of comprehensive reports highlighting findings and policy recommendations, and customized advocacy support to assist in implementation of rights-based advocacy projects for each of the participating groups.   In 2017, Asia Catalyst established a country program in Myanmar to focus on continued rights training demand from local CBOs following our successful RRT engagement. Through this new Human Rights Documentation and Advocacy Project in Myanmar, CBOs are guided through the rights framework and identify priority issues to document and create an evidence base for policy advocacy and coalition building.

Myanmar has undergone widespread changes in government and expansion of civil liberties since November 2010, when the long-ruling military junta was replaced by a military-backed civilian government.[1]  Accompanying changes such as the revival of democracy, the installation of a human rights commission, and the advent of legalized demonstrations in Myanmar are the collective efforts of government, nongovernmental organizations (NGOs), intergovernmental organizations (IGOs), and international nongovernmental organizations (INGOs) to improve access to healthcare for marginalized groups, such as people who use drugs and people living with HIV.  Focus in Myanmar on these areas is crucial.  Myanmar has the second highest HIV prevalence in Southeast Asia after Thailand,[2] with an estimated prevalence of 0.7% of adults living with HIV.[3] Myanmar is one of 35 countries accounting for 90% of new cases of HIV.  Illicit drug use is pervasive, with an estimated 83,000 people using opium or heroin in Myanmar.  HIV prevalence among people who inject drugs is 34.9%.  Among sex workers, another stigmatized group, 5.4% have acquired HIV.[4]  Given these alarming statistics, and in line with global health and development goals, in 2017, Myanmar pledged to end HIV as a public health threat by 2030 through a robust educational program and universal access to prevention, treatment, and care.[5]  The Myanmar government also plans to achieve ambitious 90-90-90 targets.[6] The 90-90-90 target means 90% of people living with HIV know their status, 90% of people who know they are living with HIV have access to treatment, and 90% of people in treatment have successfully suppressed viral loads.[7] Myanmar aims to complete the 90-90-90 plan by 2020.[8]

Accurate data on people living with or at high risk of HIV is essential for governments in order to address epidemics, yet criminalized groups are frequently denied, ignored, or invisible in national statistics and data collection efforts. Understanding HIV among key populations,[9] such as people who use drugs and sex workers, is essential for the appropriate design of and access to effective prevention and treatment programs.

To promote vital data collection by and for communities and to promote effective government advocacy from findings, we implemented workshops designed to expand the ability of CBOs to document rights abuses, contribute to the local evidence base, and advocate for their rights more effectively. This article highlights two recent examples from our program. The first describes documentation and advocacy by women living with HIV and sex workers, on access to healthcare including sexual and reproductive services. The second describes community-led data collection by people who use drugs on the impact of recent closures of harm reduction[10] drop-in centers (DICs) in Yangon, Myanmar’s largest city.

Rights-Based Data Collection on Accessing Reproductive Healthcare for Women Living with HIV and Sex Workers and Subsequent Advocacy

A core component of our rights training program includes building documentation skills to generate local evidence for advocacy. We worked with Myanmar Positive Women’s Network (MPWN) and Right to Health Action Myanmar (RHAM) to design and implement research on their communities’ priority concerns. For RHAM, this was access to sexual and reproductive health services for sex workers. For MPWN, this was collecting rights-focused data about sex workers’ experiences accessing health services at government healthcare facilities in Yangon. MPWN is a country-wide organization dedicated to empowering women living with HIV through training them to advocate for themselves to meet health, economic, and social needs.  RHAM is a Yangon-based CBO focused on improving access to sexual and reproductive health services for sex workers as well as fighting for improvement of policies that lead to discrimination and violence against sex workers.  It is imperative to address the issues facing these groups because 5.4% of sex workers[11] and 0.7% of women aged 15 and over are currently living with HIV.[12]

Overall, women living with HIV reported negative experiences in accessing treatment because of harassment from medical professionals and staff, public exposure of their HIV status, and addition of unnecessary treatment costs. In general, the interviewees reported feeling comfortable accessing healthcare at National Aids Program treatment centers. Interviewees reported easy access to condoms, but some sex workers stated access was harder due to discrimination from doctors and fear that their occupation would be disclosed to their families and neighbors. However, interviewees reported having very little information about preventing HIV transmission during pregnancy and childbirth.  Some women reported being shamed by healthcare workers for getting pregnant, and they were not provided meaningful education on how to have a healthy pregnancy with HIV. One interviewee reported forced sterilization.  Some reported further stigmatization because they were also sex workers. Stigmatization sometimes took the form of having to pay additional fees, such as cleaning costs and additional bedsheets, when non-sex workers did not have to.  Many respondents reported emotional distress when medical providers or staff disclosed their HIV status publicly. One interviewee stated that she “was traumatized mentally. Because of them, my family knows that I am HIV-positive and I faced a lot of family problems. The lab technician told my result to my mother-in-law.  My mother-in-law shouted at me in front of others, ‘you are a prostitute. That’s why you got HIV. You deserve this.’”

The data gleaned from these interviews helped the CBOs construct recommendations to township-level National AIDS Program team leaders about the needs and requests of sex workers in Myanmar. It also enabled the development of recommendations, such as nondiscrimination training of medical staff and doctors, by women living with HIV to the National Aids Program, INGOs, IGOs, NGOs, and the Ministry of Health and Sports.

Community-Oriented Data Collection on the Impact of Drop-in Centers for and Their Closures for People Who Use Drugs

We worked with five CBOs of people who use drugs in Myanmar to understand their human rights and document barriers to evidence-based harm reduction services.  It is crucial to work with this population because the Myanmar government chooses to address the epidemic, an estimated 83,000 people who inject drugs, through prison sentences and other punitive approaches by which numerous rights are violated.[13]

The example below provides results from documentation by Youth Empowerment Team (YET),  a Yangon-based organization run by young people who have drug use experience.  YET focuses on harm reduction programs and is dispelling the notion that harm reduction is equivalent to encouraging drug use.  Below, we report on community research methodology and findings as reported by YET.

YET trained four peer educators who interviewed 27 people who use drugs about access to harm reduction drop-in centers, where participants receive services such as methadone therapy, condoms, harm reduction techniques, clean injecting equipment, and referrals to methadone treatment centers and places where they could receive naloxone, which is administered to reverse opioid overdose. Interviewees reported feeling comfortable and welcomed at DICs, perhaps because they are partially run by peer drug users and did not experience as much shaming. They emphasized how crucial methadone is to their recovery and well-being.  One interviewee stated “because of methadone therapy I can concentrate more on my work.”

By October 2017, many of these DICs were forced to close due to a lack of funding. This was devasting for people who use drugs in the Yangon area. They reported difficulties in accessing methadone therapy and overdose treatments.  DICs were also important social settings for drug users.  One interviewee described how the DICs provided him with psychological benefits he can no longer access, stating “it was difficult to get counseling, which I really needed.” They felt comfortable meeting friends and counselors with similar struggles.  One interviewee shared that he “lost a place to rest.” Based on these findings, closure of DICs has been devastating for people who use drugs in Myanmar.  One interviewee stated I don’t get needles anymore, so I share with others. I don’t know where to [get] blood testing. I am worried that I could be infected by blood-borne diseases. I can’t control my desire to use drugs.”

However, inspired by needs articulated in interviews, YET has developed a plan to create its own harm reduction program with wide-ranging services such as clean needle distribution, risk-reduction education, and testing for sexually transmitted infections (STIs) including HIV.  YET encourages donors and the government to make efforts to reopen centers like DICs for the crucial medical, psychological, educational and social benefits they provided to vulnerable people who use drugs in need.  Notably however, CBOs such as YET engaging in outreach programs face the possibility of arrest and harassment by police.  For the most meaningful change to occur in reduction of drug-use-related harms including HIV and overdose, draconian laws against drug use must be reformed and people who use drugs should be decriminalized.

Looking Ahead

Myanmar has made significant strides in the post-military junta era in addressing healthcare, such as establishing Universal Health Care, which includes a Basic Essential Access to Health Services Package.[14]  It has also committed to addressing the HIV crisis through programs such as comprehensive sex education for Myanmar’s youth population[15] and a five-year strategic plan aimed to end HIV as a public health threat by 2030.[16]  However, data from interviewees confirm that key populations still face significant barriers to universal access to HIV services and other rights.  On April 29th, 2019, President Win Myint’s spokesperson, U Zaw Htay, stated that Myanmar’s drug policy would be to rehabilitate and reintegrate people who use drugs into society.  Reflecting a rehabilitative approach, Htay noted that people who use drugs need assistance instead of punishment.[17]  Gains are being made regarding HIV law and policy as well.  A bill designed to help people living with HIV, prevent new cases of HIV, eliminate discrimination on the basis of HIV status, and increase access to healthcare for people living with HIV, which has been in the drafting process since 2014, is about to be finalized.[18]  The political transition, the passage of progressive and transformative bills, and the introduction of new bills can help create more robust civil society, improved public health, and expand access to rights for all in Myanmar.

The grassroots groups we supported through our Human Rights Documentation and Advocacy Project continue to reap benefits from the training provided.  Based on recent feedback from interviewees, RHAM is distributing condoms to sex workers in Yangon. It is also engaging in an outreach program to interview more sex workers about their experiences accessing healthcare for the prevention and treatment of HIV and STIs.  MPWN has worked closely with local service providers from the Myanmar Ministry of Health and Sports.  MPWN representatives presented their interview findings, developed a regional strategy plan for improved access to healthcare, and discussed how the Ministry and CBOs can coordinate further in the future to meet the needs of women living with HIV. MPWN also advocated to medical service providers to end mistreatment of people living with HIV by medical personnel and establish mechanisms to ensure appropriate interactions. YET has been providing clean needles to people who use drugs and advocating to local team leaders in the Ministry of Health and Sports for the need to reopen spaces where people who use drugs are treated with dignity and can avail themselves of evidence-based harm reduction interventions without discrimination. In addition to advocacy at the local level, YET also presented its interview findings at a National Harm Reduction forum in December 2018.

Despite these critical lifesaving advancements, without investment in groups like MPWN, RHAM, and YET, Myanmar’s traction and gains for its civil society will wither, goals will not be met, and its people will unnecessarily and unjustly suffer. Given the success of our rights training programs, more groups than ever are requesting to take part. We plan to expand our capacity to respond to increasing demands for our training programs through staffing up and investing more in local leadership and coalition-building to improve sustainable civil society advocacy.   For more information on how to help these groups continue to perform their crucial work, please visit www.asiacatalyst.org or contact info@asiacatalyst.org.

References and Quotations

[1] “Timeline: Reforms in Myanmar.” BBC News. July 08, 2015. Accessed June 19, 2019. https://www.bbc.com/news/world-asia-16546688

[2] “HIV and AIDS in Myanmar.” AVERT. January 18, 2019. Accessed June 19, 2019. https://www.avert.org/professionals/hiv-around-world/asia-pacific/myanmar.

[3] Ibid.

[4] “Myanmar.” UNAIDS. June 14, 2019. Accessed June 19, 2019. https://www.unaids.org/en/regionscountries/countries/myanmar.

[5] Unaids.org. “Myanmar Launches New HIV Strategic Plan.” UNAIDS. May 19, 2017. Accessed June 19, 2019. https://www.unaids.org/en/resources/presscentre/featurestories/2017/may/20170519_myanmar.

[6] Ibid.

[7] Ibid.

[8] Ibid.

[9] UNAIDS defines key populations as “gay men and other men who have sex with men, sex workers and their clients, transgender people, people who inject drugs and prisoners and other incarcerated people as the main key population groups. These populations often suffer from punitive laws or stigmatizing policies, and they are among the most likely to be exposed to HIV. Their engagement is critical to a successful HIV response everywhere—they are key to the epidemic and key to the response. Countries should define the specific populations that are key to their epidemic and response based on the epidemiological and social context. The term key populations at higher risk also may be used more broadly, referring to additional populations that are most at risk of acquiring or transmitting HIV, regardless of the legal and policy environment.”  UNAIDS Terminology Guidelines.” UNAIDS. 2015. Accessed June 19, 2019. https://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf.

[10] UNAIDS describes harm reduction as “a comprehensive package of policies, programmes and approaches that seeks to reduce the harmful health, social and economic consequences associated with the use of psychoactive substances. The elements in the package are as follows: needle and syringe programmes; opioid substitution therapy; HIV testing and counselling; HIV care and antiretroviral therapy for people who inject drugs; prevention of sexual transmission; outreach (information, education and communication for people who inject drugs and their sexual partners); viral hepatitis diagnosis, treatment and vaccination (where applicable); and tuberculosis prevention, diagnosis and treatment. For example, people who inject drugs are vulnerable to bloodborne infections (such as HIV) if they use non-sterile injecting equipment. Therefore, ensuring adequate supplies of sterile needles and syringes is a harm reduction measure that helps to reduce the risk of blood-borne infections.”  Ibid.

[11] “Myanmar.” UNAIDS. June 14, 2019. Accessed June 19, 2019. https://www.unaids.org/en/regionscountries/countries/myanmar.

[12] Ibid.

[13] More information about drug laws in Myanmar can be found at: Frontier. “Myanmar’s Zero-tolerance Drug Policy Is Doomed to Fail.” Frontier Myanmar. January 28, 2019. Accessed June 19, 2019. https://frontiermyanmar.net/en/myanmars-zero-tolerance-drug-policy-is-doomed-to-fail.

[14] Tea Circle Oxford, Elliot Brennan. “Myanmar’s Public Health System and Policy: Improving but Inequality Still Looms Large.” Tea Circle. August 30, 2017. Accessed June 19, 2019. https://teacircleoxford.com/2017/08/30/myanmars-public-health-system-and-policy-improving-but-inequality-still-looms-large-2/.

[15] Unaids.org. “Positive Health, Education and Gender Equality Outcomes for Myanmar Youth.” UNAIDS. June 14, 2019. Accessed June 19, 2019. https://www.unaids.org/en/resources/presscentre/featurestories/2019/june/20190614_myanmar-youth.

[16] Unaids.org. “Myanmar Launches New HIV Strategic Plan.” UNAIDS. May 19, 2017. Accessed June 19, 2019. https://www.unaids.org/en/resources/presscentre/featurestories/2017/may/20170519_myanmar.

[17] Htut, Pars Yi. The Myanmar Times. April 26, 2019. Accessed June 19, 2019. https://myanmar.mmtimes.com/news/122549.html.

[18] This update has not been publicized yet.  It was provided to us by our partner, Community Network Consortium (CNC).  CNC is a Myanmar national consortium of nine community-based networks representing people living with HIV and key populations. Its members have been involved in consultations with government officials for current law reform processes.  CNC members have been co-authors of the new HIV bill titled Law related to People living with HIV and Affected Populations.


About the author

Julia K. Klein, J.D. is a research fellow at Asia Catalyst.  Klein is interested in international human rights law and public interest law.  Klein has worked on matters such as health justice for low-income populations in the United States, legal strategies for implementation of sex workers’ rights in Cambodia, and legal strategies for fighting human trafficking in the Mediterranean.  Klein received her Juris Doctor from Duke University School of Law in 2018 and is currently awaiting admission to the New York Bar.


Report back from the World’s Largest Conference on Women & Health

Last month, Asia Catalyst joined 8,000 people from 165 countries at WomenDeliver2019, the world’s largest conference on gender equality and the health, rights, and wellbeing of girls and women. It was an exciting opportunity to reconnect with colleagues, hear from practitioners about work across the globe to empower girls and women, and learn about new funding opportunities for grassroots advocacy.

Here are a few highlights from my experience at the Vancouver conference:

  • Every morning, I attended plenary sessions with extraordinary leaders who have taken their personal experiences and turned them into movements to address inequality. One of my favorites was “The Power of Movements,” featuring Tarana Burke, founder of #MeToo, and Ailbhe Smyth, who led the successful vote to ensure women in Ireland can make their own decisions in pregnancy and access abortion.
  • Another exciting moment was Prime Minister Justin Trudeau’s announcement that Canada will increase its funding for women’s health globally, reaching $1.4 billion annually by 2023 – including $700 million earmarked for sexual and reproductive health initiatives, making Canada a leader when it comes to this kind of international aid.
  • I participated in sessions like Feminist Frontline: Strategies for Resistance and Change, whose activist speakers described their groundbreaking work disrupting and dismantling the patriarchy and feminist philanthropy; and Women’s Rights and LGBTIQ+ Rights: Stronger Together, masterfully moderated by Jessica Stern, Executive Director of OutRight Action International. 

What was missing? Unfortunately, the voices of extremely marginalized women – sex workers, women who use drugs, trans and intersex women – were hardly present. I found only one session, hosted by Frontline AIDS, where women who use drugs talked about their work.

We know that work to promote gender equality and “leave no one behind,” as part of the Sustainable Development Goals, requires everyone, not just the privileged, well-resourced, and well-connected, to unite and strategize. Clearly, new opportunities must be created for these groups, while encouraging Women Deliver to widen its lens of who to feature in 2020. We will advocate for more diverse representation, and support more of our grassroots partners to participate next year.

The biggest benefit of Women Deliver, in my opinion, is the opportunity for quality, in-person interaction – an increasing rarity in this digital age – with friends, allies, and donors. Often, discussions and debates there spark new ideas and relationships that help us unite around work and strategies to advance women’s health. I was thrilled to connect with people from Asia Pacific Alliance for Sexual and Reproductive Health and Rights, above, which we are a proud member of and puts sexual health rights on the agenda of policymakers.       

Asia Catalyst advances women’s rights every day through our intensive human rights and advocacy programs that build leadership and give birth to grassroots organizations. To learn more about our work with marginalized women, visit www.asiacatalyst.org.

Best,


Postcard from Porto

Last month, Asia Catalyst attended the 26th International Harm Reduction Conference in Porto, Portugal. Harm reduction, or mitigating the negative consequences of drug use and making sure responses are rooted in human rights and social justice, is at the heart of what we support.

Portugal was an apt destination for the meeting, as it has been a leader in drug policy reform. For the last 18 years, Portugal has not treated personal drug use as a criminal offense. Their approach favors a “Dissuasion Commission” made of social workers, psychologists, and legal experts who work together to assess patients and connect them with the right services. As a result, more people are voluntarily entering treatment and the “overdose deaths, HIV infections, problematic drug use, and incarceration for drug-related offenses have plummeted,” Drug Policy Alliance reports.

Conversely, in Asia where we work, most governments rely on punitive, repressive tactics that undermine public health in spite of massive HIV, HCV, and shamefully under-documented overdose epidemics. The majority of people in prison are there for nonviolent drug-related offenses, and 11 countries still use forced detention in spite of a pan-UN agency opposition to the approach.

In Porto, our staff – Khine Su Win, Myanmar Program Officer, Guo Miao, Senior Program Officer, and Shen Tingting, Director of Research, Advocacy, and Policy – joined sessions, learning about strategies and solutions conceived by organizations and allies around the world. In Kenya, for example, the Muslin Education and Welfare Association has an outreach team working with the courts and police to identify people who use drugs before court dates and refer them to treatment programs rather than incarceration. In South Africa, a new community program is screening people for substance use, and running the country’s first publicly funded harm reduction, opioid substitution therapy, and needle exchange program. And AIDS Care China is piloting take-home methadone for drug users and working with police to allay concerns that the drug will end up on the black market.

Not every country, of course, is taking such an expansive people-first approach.

On the last day of the conference there was a protest to draw attention to the thousands of people killed in the war on drugs in the Philippines, where 33 people are murdered each day and thousands more held in over-crowded prisons. Other Asian countries like Indonesia have followed suit with their own drug wars. But according to a recent International Drug Policy Consortium report, use of illegal drugs has gone up by nearly a third in the last decade – proof that the punitive approach is not working.

Khine presented on Asia Catalyst’s work in Myanmar with a youth-based organization, Youth Empowerment Team (YET), to document how closing harm reduction drop-in centers is affecting people who use drugs in Yangon. Khine has trained YET and other grassroots groups to interview people who inject drugs about the problems they now face as a result of dramatically limited access to health services, including clean injecting equipment and HIV and hepatitis testing and counseling. YET’s research showed that the drop-in centers were “a lifeline” for hundreds of people now grappling with growing isolation, and without a safe space to foster healthy ways of coping.

The takeaway: in Myanmar and across the globe, there is an urgent need to invest in and expand community-run spaces where people who use drugs can feel safe and receive essential harm reduction services, including naloxone treatment for overdose prevention and support. And support directly-affected groups with the tools and resources to advocate for an enabling legal environment where they can thrive.

With great thanks,