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- W1685777746 abstract "The history of the acquired immunodeficiency syndrome (AIDS) epidemic, here in Canada and in most other countries, is replete with weak political leadership and resulting deadly public policy. For example, although it was known from the earliest days of the epidemic that human immunodeficiency virus (HIV) was spread among injection drug users by sharing needles, there was little political will to address this public health crisis. As early as 1986, national panels warned Canadian health ministers that urgent steps were required and recommended needle-exchange programs so that drug users would have the means to protect themselves and reduce the harm of their addiction. Yet, it took several years for such programs to be initiated; in the interim, many people were infected. Even now, such programs remain constrained, resulting in a supply of sterile syringes that continues to fall well below demand. In other countries, such as the United States, the situation is even worse. Some US federal leaders refuse to fund needle-exchange programs for fear of appearing to condone illicit drug use, cloaking political cowardice behind a thin veil of ostensible moral sanctity. But, there are exceptions. Just as we should condemn cowardice in politics, we should celebrate political courage when it occurs. A case in point is Philip Owen, who was the mayor of Vancouver, British Columbia, Canada, until the end of 2002. Mayor Owen completed three 3-year terms as mayor, and a glance at his recent inaugural speeches provides some insight into the transformation in thinking he has undergone throughout that time. In 1996, he was still oriented toward a criminal justice approach to drug addiction. In December of that year, while referring to drug problems in Vancouver’s Downtown Eastside, he stated, “We must continue to address the serious challenge to law and order that presently exists. . . . We have to distinguish between people who live in the Downtown Eastside, and those who are there because it facilitates their criminal activity.” By 1999, just 3 years later, he had come to a very different conclusion. He had this to say in his inaugural address that year: “All research has led me to conclude that we cannot arrest or incarcerate our way out of the illegal drug problem. We all realize that the ’war on drugs’ has failed.” On the way, he had established his “Four Pillar” approach to drug addiction, which integrates prevention, treatment, enforcement, and harm reduction. The mayor has long been a proponent of needleexchange programs as one component of harm reduction and recently supported clinical trials of heroin-assisted opiate addiction treatment. At a meeting of the Federation of Canadian Municipalities in February 2002, he also proposed the test-" @default.
- W1685777746 created "2016-06-24" @default.
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- W1685777746 date "2003-03-01" @default.
- W1685777746 modified "2023-10-16" @default.
- W1685777746 title "Courage in politics and urban health: a cautionary tale" @default.
- W1685777746 doi "https://doi.org/10.1007/pl00022308" @default.
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