The transition to harm reduction: Understanding the role of non-governmental organisations in Malaysia
The transition to harm reduction: Understanding the role of non-governmental organisations in Malaysia
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DOI：
10.1016/j.drugpo.2011.01.002
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发表时间：
2011-07-01
影响因子：
4.4
通讯作者：
Robson, Noorzurani Md. Haris
中科院分区：
文献类型：
--
作者：
Narayanan, Suresh;Vicknasingam, Balasingam;Robson, Noorzurani Md. Haris
背景：毒品政策从禁止到减少危害的转变从来都不是一件容易的事。政策制定者和宗教领袖对禁令的根深蒂固的信念几乎没有提供其他选择的空间，而且变革也进展缓慢。马来西亚的非政府组织（NGO）在实现这一变革中发挥了关键作用。了解他们是如何做到这一点可能对其他类似国家具有启发意义。方法：通过审查已发表的二手资料、媒体报道以及对来自非政府组织、医疗从业者和警察的减少危害先驱者的深入采访而收集的数据进行分析以构建本文。结果：政策变化是毒品政策子系统中三个群体（国家、穆斯林宗教游说团体和非政府组织）之间竞争的结果。禁令计划的不良结果和艾滋病毒/艾滋病的爆发等事态发展并没有改变政策，但确实导致了对国家联盟核心信念的重新思考，并催生了国家与非政府组织的伙伴关系。随后，2005 年未能实现有关艾滋病毒/艾滋病的千年发展目标，这被视为卫生部的失败，随后卫生部以健康危机迫在眉睫为由，最终提出了政策改变。非政府组织在这一过程中发挥了关键作用，他们教育其在国家联盟中的合作伙伴，吸引学者和医疗从业者参与宣传，并与宗教游说团体接触（尽管取得了不同程度的成功）。他们也是实施减少伤害计划的前线参与者，并成功地将不相信的伊斯兰团体的批评转移到国家之外。 结论：鉴于非政府组织在针头注射器交换计划中的核心作用，它们完全有能力说服注射吸毒者选择自愿医疗。这有可能减少吸毒造成的危害及其流行。 (C) 2011 Elsevier B.V. 保留所有权利。
Background: The transition of drug policy from prohibition to harm reduction has never been easy. The deeply entrenched belief in prohibition shared by policy makers and religious leaders provided little room for alternatives, and change came only slowly. The non-governmental organisations (NGOs) in Malaysia played a pivotal role in effecting such a change. Understanding how they did so may be instructive for other similarly placed countries.Methods: Data collected via reviews of published secondary sources, media reports and in-depth interviews with pioneers of harm reduction drawn from NGOs, medical practitioners and the police were analysed to construct the paper.Results: The policy change was the outcome of competition between three groups in the drug policy subsystem - the state, the Muslim religious lobby and the NGOs. Developments such as the poor outcomes from the prohibition programmes and the outbreak of HIV/AIDS did not change policy but did lead to a rethink of core beliefs in the state alliance and spawned a state-NGO partnership. The subsequent failure to meet the Millennium Development Goal with respect to HIV/AIDS in 2005 - was seen as a failure of the Health Ministry which then led the final charge for a policy change arguing that a health crisis was imminent. The NGOs played a pivotal role in this process by educating their partners in the state coalition, by drawing academics and medical practitioners into advocacy and by engaging the religious lobby (albeit with varying success). They were also frontline players in implementing harm reduction programmes and successfully deflected criticisms from unconvinced Islamic groups away from the state.Conclusion: Given their central role in the needle-syringe exchange programme, the NGOs are well positioned to convince injecting drug users to opt for voluntary medical treatment. This can potentially reduce both the harm from drug use and the prevalence of it. (C) 2011 Elsevier B.V. All rights reserved.