Sober N Clean

Ottawa is determined to shut down Vancouver's safe-injection site because it's necessary to "draw a line" about which public health measures are acceptable, Canada's Health Minister says.

Tony Clement said that while the government supports needle exchanges as a legitimate intervention, providing a site to facilitate the injection of illegal drugs is going too far. He also invoked the slippery-slope argument.

"There are already people saying injection sites aren't enough, that true harm reduction is giving out heroin for free," the minister said.

"You have to draw the line somewhere and we feel we're drawing the line in a place Canadians are comfortable," Mr. Clement said in an interview in Mexico City, where he is attending the 17th International AIDS Conference.

Mark Townsend, a spokesman for the PHS Community Services Society, which helps run Insite, Vancouver's safe-injection site, called the notion "depressing silliness."

He said supervised injection sites provide better care for addicts and increase their likeliness to attend detox, so it makes little sense to throw support behind needle exchanges as a legitimate intervention.

"There's really little difference between needle exchanges and supervised injection sites, except for in a supervised injection site, there's a nurse there," Mr. Townsend said. "If you overdose, you don't die."

Earlier in the week, the World Health Organization issued a new guide for countries on how to best tackle the epidemic of HIV-AIDS that strongly endorsed a broad array of harm-reduction measures, including safe-injection sites.

Mr. Clement said that it is up to each country to decide what measures are appropriate, and "it's not my job to kowtow to orthodoxy."

The minister said intravenous drug use and its role in fuelling the epidemic of HIV-AIDS requires a mix of prevention, treatment and enforcement and he's convinced Canada has the balance right.

"I believe I'm on the side of compassion and on the side of the angels."

But Carolyn Bennett, the Liberal public health critic, balked at that suggestion, saying Mr. Clement "opposes supervised injection sites yet says he supports needle exchange, which makes no medical sense."

She said the Conservative government's stand is driven by ideology, not compassion, and accused Mr. Clement of "embarrassing Canada" on the world stage.

At the Mexico City conference, Canada has also been under fire for what some call its paltry contribution to the fight against AIDS, both domestically and internationally.

Julio Montaner, a Vancouver physician who heads the International AIDS Society, told Mr. Clement that Canada should be ashamed that it is not contributing as much, per capita, as its neighbour to the south.

Last week, U.S. President George W. Bush approved a plan to spend $48-billion (U.S.) over the next five years on AIDS programs.

Currently, Canada invests a fraction of what the United States does: $550-million over the past three years on HIV-AIDS programs abroad. In Mexico, Mr. Clement announced an additional $45-million in funding.

"I acknowledge that it's not $45-billion but it's commensurate with Canada's abilities," the minister said.

Mr. Clement said Ottawa is spending $84.4-million on AIDS programs this year, the highest amount in its history.
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source: The Globe and Mail, http://www.theglobeandmail.com