Harare Declaration For African Women Who Use Drugs Launched

By Michael Gwarisa

In a move that is to end discrimination, as well as promote harm reduction interventions for African women who use drugs, women who use drugs recently read out content to the Harare Declaration by and for African Women who Use Drugs at the 22nd edition of the ICASA conference.

Despite the growing adoption of policies and  mechanisms to protect women on the continent, Sub-Saharan African women who use drugs continue to experience inequality, violence, stigma, high exposure to HIV and discrimination from all sections of society. Even where laws that protect them exist, the level of implementation is yet to reach the desired level to protect women who use drugs

Speaking during a Press Confrence at ICASA to mark the Harare Declaration for African Women who Use Drugs, Rita Nyaguthii Gatonye from the Women in Response to Hiv/Aids and Drug Addiction (WRADA) said women who use drugs deserve to be heard.

Women who use drugs on the African continent lack representation. They can be empowered on how to lead in the process of policies, advocacy, CLM and so many issues. That’s why we are here to mobilise ourselves to see how we can support ourselves through country practices, through different experiences,” said Rita.

Data shows that women who use drugs in Africa have less social, psychological, and economic support and are more likely to have experienced traumatic events, such as sexual and physical assault and abuse as children and/or adults and to be currently exposed to intimate partner violence. The experience of trauma can lead to the development of post-traumatic stress disorder or other mental health problems and can also increase the risk of substance use.

They also lack basic education and formation and cannot easily find jobs which help them live a more stable life. They are likely to have families of origin that have substance use problems and to have a substance-using partner. Economic burdens are heavier for women who use drugs as they experience lower prospects of getting employed and have lower income levels.

Tania Marumbwa, a community activist for People who Use Drugs in Zimbabwe said healthcare workers had bad attitudes towards those who use drugs in Zimbabwe.  Moreover, Health care providers have been reported to deny access to treatment and services to women who use drugs.

“Our experiences may differ. In Zimbabwe we have difficulties, our rights are less important when compared to the men. A woman who uses drugs faces stigma and discrimination in the hospital. The healthcare workers can treat you badly and this forces women who use drugs to shun healthcare services,” said Tanya.

Women who use drugs also risk suffering breaches of confidentiality relating to exposure of their drug use and their serostatus, which can lead to violence, harassment, and family disconnection. Vulnerability experienced by Women who Use Drugs pushes them to susceptibility to HIV. Women who use drugs are likely to share their injecting paraphernalia with more people than their male counterparts, trade sex for drugs and have difficulties in negotiating condom use with sexual partners.

Generally, women who trade sex are more likely to experience violence and many have limited power to engage in safe sex or safe injecting practices, placing them at an increased risk of infections.

Women who use Drugs face significant barriers to accessing both HIV and harm reduction services. UNODC’s newly released study of women who use drugs in East Africa has shown that a lesser proportion of them are able to access MAT, HIV and other health services due to factors such as mode of service delivery, attitude of care workers and inability to afford transportation.

The Declaration:

To African Governments and all stakeholders

1. 1. For women who have experienced or continue to experience intimate/ gender-based violence, trauma informed treatment is recommended. There is also a need to ensure high level collaboration between the health system, community systems and justice sector to address all sorts of violence against women who use drugs.

1. 2. SRHR services for women who use drugs should address their wide spectrum of needs. They include cervical cancer and STI screening and treatment and contraception to avoid unwanted pregnancy. Services for pregnant women should include gynecological/obstetric care and medically assisted treatment (MAT) in case of opioid dependence. Support for parenting, including skills development/mentoring is needed and address childcare provision concerns.
2. 2. Support women who use drugs in accessing harm reduction services in a manner that is stigma free and a way in which services are available and accessible to them. Efforts are required to counter stigma and discrimination faced by these women. A range of interventions should be made available including MAT, NSP, counseling among others.

1. 4. The growing number of incarcerated women who use drugs face unique challenges that prisons and jails aren’t equipped to address. This means that “incarceration should not ever be an option for women who use drugs unless for other reasons”. Incarceration also has devastating effects on the families of incarcerated women who use drugs as it leaves lasting negative impacts on their children and causes financial instability for their families as in most cases they are the sole breadwinners.

1. 5. Deliver services to women who use drugs in environments that are gender responsive and that are welcoming, non-judgmental, supporting and physically and emotionally safe. Spaces that are inclusive and safe for trans women and sex workers are needed. Services should be holistic and comprehensive, promoting healthy connections to children, family members, significant others, and the community.

1. 6. Ensure the participation of women who use drugs in policy and programme development. This will promote gender-responsive policies and programmes by introducing and expanding services and policies that meet the needs of women who use drugs. The leadership of women who use drugs should be deliberately sought in PWUID led structures and in other structures created to meet the needs of PWUIDs.

1. 7. Deliberate attempts should be made to assist in empowering women who use drugs both socially and economically. Women who use drugs led CSOs should be funded to create interventions that will adequately address the needs of women who use drugs