Why Africa Must Embrace Harm Reduction in Public Healthcare Policy

Alex Enumah in Abuja

The need for African leaders to embrace Harm Reduction in the initiation and implementation of public healthcare policies was a consensus of a gathering of healthcare practitioners and journalists from across Africa.

Besides, owing to the critical role communication play in behavioral change, journalists have been tasked to spread and deepen the gospel of harm reduction both as a concept and practice.

Harm reduction is a new phenomenon which refers to interventions aimed at reducing the negative effects of health behaviours without necessarily extinguishing the problematic health behaviours entirely or permanently. 

While the initiative is fully operational in some other continents of the world, in Africa, it still remains a challenge due to misconception, religion and morality as well as absence of relevant and adequate research in Africa’s public healthcare sector.

Speaking at a two-day conference on Harm Reduction Exchange in Nairobi, Kenya, participants came to the conclusion that African governments must begin to look at and embrace other alternatives, besides stringent laws in tackling challenges of drugs and substance usage, especially by adults.

Speaking during the third annual Harm Reduction Exchange themed: ‘Amplifying the voice of Harm Reduction advocacy across Africa’, the president of the African Medical Association and the Association of Medical Councils of Africa Dr. Kgosi Letlape challenged African governments to adopt harm reduction approaches when regulating public health challenges. 

On efforts by various governments across Africa at reducing tobacco-related death and disease, Dr Letlape, argued that harm reduction initiative would achieve greater results than the current prohibition-based policies of governments because of its transformative strategy.

He said, “Harm reduction is a practical and transformative approach that incorporates community-driven public health strategies including prevention, risk reduction, and health promotion to empower people who use drugs and their families with the choice to live healthy and self-directed”. 

He expressed hope that lobbying efforts will spark renewed conversations on tobacco harm reduction among all stakeholders, including regulators and policymakers, which according to him could lead to effective regulation and access to noncombustible product alternatives for adult smokers who are unable or uninterested in quitting.

Meanwhile, across the world, harm reduction strategies have been deployed in public health as a pragmatic and compassionate approach to address various issues, particularly in the context of substance use and other risky behaviors. Some of these strategies include Needle Exchange Programs, supervised injection sites, condom distribution, PrEP (Pre-Exposure Prophylaxis), Nicotine Replacement Therapy (NRT), Vaping and E-Cigarettes, and supervised consumption of medications, as some of these strategies.

According to one of the speakers, Dr Vivianne Manyeki, “Organizations that practice harm reduction incorporate a spectrum of strategies that meet people where they are on their own terms and may serve as a pathway to additional health and social services, including additional prevention, treatment, and recovery services”. 

Another speaker, Integra Africa Principal, Dr. Tendai Mhizha, identified how misinformation and disinformation adversely affect tobacco harm reduction initiatives and tasked journalists and media houses to through their reportage and analysis, ensure people as well as governments are adequately informed and educated.

While stressing that the media is crucial in accelerating progress towards full uptake of harm reduction strategies in all spheres of health across Africa, Mhizha observed that owing to latest technologies, misinformation and disinformation are becoming increasingly prevalent with the democratization of the information space. 

“Moving forward, there is a need to ensure that stakeholders are well informed with current and relevant information about the science, the changes that occur and how we can advance towards a smoke-free world,” Dr. Mhizha said. 

She explained that raising awareness for Tobacco Harm Reduction (THR) as a public health strategy encourages adult smokers who are unable or uninterested in quitting tobacco altogether to migrate to noncombustible product alternatives. 

“THR has the potential to bring about one of the greatest public health achievements of our time”, she added.

Similarly, a Public Health Specialist and Secretary General of Harm Reduction Society in Kenya, Dr. Michael Kariuki, observed that harm reduction is the better path forward, adding that, “With harm reduction, regulators provide adult smokers with information, choice and support to expand the off-ramp from smoking – while also continuing to drive down underage use”.