Resist and reverse rollbacks: A feminist call to protect harm reduction and sexual and reproductive health

Recent retrograde shifts in foreign aid and diminishing civil society space threaten gains made through decades of evidence-based harm reduction programming that has saved countless lives globally. Civil society organisations providing crucial peer support systems are being defunded and their voices repressed. Concurrently, feminism and LGBTQI+ rights and sexual and reproductive health services, including contraception, gender-based violence services and safe abortion are being assaulted. Now, more than ever, harm reduction and underserved populations are at risk as essential life-saving services are being closed down.

With the expansion of the measurably harmful Global Gag Rule, sexual and gender diversity are being actively attacked, with trans rights violated to the point of erasure of identity, sexual and reproductive health rights invalidated and gender equality goals undermined. Funding strangleholds are constraining lifesaving healthcare for trans people, women living with HIV, people who use drugs and other key populations. This spurious attempt to institutionalise patriarchal heteronormative hierarchy serves to sanction and popularise racism, sexism, userphobia, transphobia and homophobia. Patterns are emerging where under the guise of ‘family values’, ideology trumps science, propelling a climate ripe for societal destabilisation, hate crime and public health dismemberment.

On this International Women’s Day, we [...] stand in solidarity with our gender expansive and cis-sisters who use drugs to denounce the current undermining of public health, science and bodily autonomy which represent a wider offensive against equality norms, rights protections and common sense.

We recognise that the hard-won progress on gender responsive harm reduction is under threat. As part of the feminist movement, we are cognisant of the necessary collective peril we pose to patriarchy and that this new attempt at reinstalling sexist oppression and derailing public health must be rapidly reversed.

This is a call to action for governments, courts and donors for:

• immediate reopening of OAT clinics, recognising their lifesaving impact, (including for pregnant women who are opioid dependent)
• laws and policies that safeguard the rights of women and gender expansive people who use drugs and key populations in access to harm reduction and other healthcare, including gender affirming care, without discrimination and criminalisation
• direct, flexible, sustained and safeguarded funding for women and gender expansive people-led harm reduction organisations and networks of people who use drugs
• gender equity indicators and gender mainstreaming in health investments, including funding conditionalities where gender responsive harm reduction, women’s rights and inadequately served populations are prioritised
• accessible accountability mechanisms to track health investments and ensure that these are cost-effective, low threshold and congruent with the needs of people who use drugs

We stand in solidarity with the harm reduction and feminist movements and communities worldwide as the aid freeze forces lifesaving programs to shut down. Harm reduction is essential and a basic human right. These decisions are negligent, unjust, will cost lives and must be immediately revoked. We stand ready to continue our work to address systemic barriers to health and rights for women and gender expansive people who use drugs.

Full list of signatories and translations available on WHRIN's website.