scholarly journals Could 30 years of political controversy on needle exchange programmes in Sweden contribute to scaling-up harm reduction services in the world?

2020 ◽  
pp. 145507252096501
Author(s):  
Niklas Karlsson ◽  
Torsten Berglund ◽  
Anna Mia Ekström ◽  
Anders Hammarberg ◽  
Tuukka Tammi
Keyword(s):  
Harm Reduction ◽  
Drug Policy ◽  
Grey Literature ◽  
Scale Up ◽  
Valuable Insight ◽  
Control Drug ◽  
Policy Domain ◽  
The World ◽  
Key Events ◽  
Exchange Programmes

Aims: To end the hepatitis and AIDS epidemics in the world by 2030, countries are encouraged to scale-up harm reduction services and target people who inject drugs (PWID). Blood-borne viruses (BBV) among PWID spread via unsterile injection equipment sharing and to combat this, many countries have introduced needle and syringe exchange programmes (NEP), though not without controversy. Sweden’s long, complicated harm reduction policy transition has been deviant compared to the Nordic countries. After launch in 1986, no NEP were started in Sweden for 23 years, the reasons for which are analysed in this study. Methods: Policy documents, grey literature and research mainly published in 2000–2017 were collected and analysed using a hierarchical framework, to understand how continuous build-up of evidence, decisions and key events, over time influenced NEP development. Results: Sweden’s first NEP opened in a repressive-control drug policy era with a drug-free society goal. Despite high prevalence of BBV among PWID with recurring outbreaks, growing research and key-actor support including a NEP law, no NEP were launched. Political disagreements, fluctuating actor-coalitions, questioning of research, and a municipality veto against NEP, played critical roles. With an individual-centred perspective being brought into the drug policy domain, the manifestation of a dual drug and health policy track, a revised NEP law in 2017 and removal of the veto, Sweden would see fast expansion of new NEP. Conclusions: Lessons from the Swedish case could provide valuable insight for countries about to scale-up harm reduction services including how to circumvent costly time- and resource-intensive obstacles and processes involving ideological and individual moral dimensions.

scholarly journals A Sin or a Health Issue? : Morality Policy Framing and the State of Harm Reduction in East-Central Europe

Intersections ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. 97-115
Author(s):  
Iga Jeziorska
Keyword(s):  
Harm Reduction ◽  
Drug Policy ◽  
Selection Procedure ◽  
Needle Exchange ◽  
The State ◽  
Policy Outcomes ◽  
Morality Policy ◽  
East Central Europe ◽  
Policy Framing ◽  
Exchange Programmes

Aims. There are significant differences in harm reduction services availability and performance in various countries. The paper examines the state of one of the harm reduction interventions – needle exchange services – through the lenses of morality policy, attempting to establish possible relationships between policy framing and policy outcomes. Method. The research uses an explorative design with cross-country comparison. The unit of analysis is drug policy in a country, and the geographical scope includes Czechia, Hungary, Poland and Slovakia, following the maximum variation case selection procedure. Countries’ drug strategies are analysed to identify the policy frames and data on needle exchange programmes are used to assess the state of harm reduction. Results. The analysis identified health and social drug policy framing in Czechia and Slovakia, morality frame in Hungary and no frame in Poland. The availability of availability and coverage of needle exchange programmes is the highest in Czechia, followed by Slovakia, Hungary and Poland. Conclusions. The Hungarian case confirms the relationship between morality framing and poor policy outcomes, while the Czech case between health framing and effective policy. Further research is needed to establish the function of morality framing as necessary and/or sufficient condition for unsatisfactory policy outcomes.

The spirit of Vienna: health strategies in managing the world drug problem

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Morais ◽  
M Silva
Keyword(s):  
Control System ◽  
Harm Reduction ◽  
Drug Policy ◽  
International System ◽  
Well Being ◽  
World Health ◽  
Drug Control ◽  
Drug Problem ◽  
The World ◽  
Women Who Use Drugs

Abstract Health sciences have always had a lot of influence in the formulation of drug policies. However, the international system for the control of illicit drugs is distant from the World Health Organization, for example. It was in the name of health and well-being protection that the Single Narcotics Convention (1961) established a ban on drugs as a rule, with the exception of medical and scientific uses. But it was also in the name of a health category, Harm Reduction, that the so-called Vienna consensus began to break in 2009: it is about the global bipolarization around drug policy, locating member states in two groups. Taking strategy as a means designed to achieve a purpose, which updates the position of agents in the International Drug Control System and which operates the renunciation of the other (FOUCAULT, 2001), we ask: what, in the last decade, was their strategy groups of countries in managing the global drug problem? To answer this question, an ethnography of events and documents was carried out, in addition to semi-structured interviews and participant observation. The field research was the 62nd Ministerial Segment of the UN Commission on Narcotic Drugs (Vienna, 2019), when the last 10 years of drug policy were evaluated and the next decade was planned. Following the Brazilian resolution, created in partnership with Norway, entitled “Promoting measures to prevent transmission of HIV for women who use drugs, including by improving access to post-exposure prophylaxis”, it was possible to observe the effort to maintain that space as a place where health has no voice. Categories such as 'women who use drugs' and 'emergency contraceptives' have been the subject of controversy among diplomats, who have backed down to maintain the already weakened consensus. It is concluded that health is historically used as a strategy for the prohibition of substances, but it can be a tool for changing the paradigm if observed as an instrument in dispute and based on Harm Reduction Key messages Health is the strategy to legitimize drug prohibition, but it can also be the protagonist of the paradigm shift in drug policy if it is anchored in harm reduction. There is an effort to keep the UN's international illicit drug control system out of the health field.

scholarly journals Experimental and Numerical Investigations on Conductive Drying of Phosphate Washing Waste Clay

Minerals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 482
Author(s):  
Fatiha Berroug ◽  
Yassir Bellaziz ◽  
Naaila Ouazzani ◽  
Fatima Ait Nouh ◽  
Abdessamad Hejjaj ◽  
...  
Keyword(s):  
Scale Up ◽  
Free Water ◽  
Moisture Diffusivity ◽  
Sample Thickness ◽  
Total Production ◽  
Drying Process ◽  
One Dimensional ◽  
Numerical Investigations ◽  
The World ◽  
Drying System

Morocco is the leading producer of phosphate and its derivatives in the world with a total production of 35 Mt. However, the extraction and the valorization of this mine generate huge quantities of phosphate washing waste clay (PHWWC) that constitute a main environmental and economic concern. To facilitate this waste clay storage and handling, it is necessary to decrease its moisture content that represents 80% of PHWWC. The present paper is devoted to studying the conductive drying of PHWWC. Drying experiments were conducted in a laboratory pilot. Afterwards, the experiment results were implemented in a one-dimensional numerical model of heat and mass transfer in a porous media to identify the drying parameters and performances. It was found that most of the water contained in PHWWC is free water that is removed with a constant drying rate. The volume reduction with a marked cracks phenomenon attained 65% without any significant effect of drying temperature and sample thickness. The effective moisture diffusivity of the PHWWC for a conductive drying process is ranged between 10−9 and 1.1 × 10−8 m2·s−1. The thermal efficiency of the drying system is up to 86%. The results could be used for the purpose of design and scale-up of the industrial dryer based on laboratory-scale experiments.

scholarly journals Civil society involvement in harm reduction drug policy: reflections on the past, expectations for the future

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aileen O’Gorman ◽  
Eberhard Schatz
Keyword(s):  
Civil Society ◽  
Harm Reduction ◽  
Lived Experience ◽  
Political Institutions ◽  
Drug Policy ◽  
Policy Development ◽  
Policy Decision ◽  
People Who Use Drugs ◽  
Annual Conference ◽  
Health Crisis

Abstract Background A range of civil society organisations (CSOs) such as drug user groups, non-governmental/third sector organisations and networks of existing organisations, seek to shape the development of drugs policy at national and international levels. However, their capacity to do so is shaped by the contexts in which they operate nationally and internationally. The aim of this paper is to explore the lived experience of civil society participation in these contexts, both from the perspective of CSOs engaged in harm reduction advocacy, and the institutions they engage with, in order to inform future policy development. Methods This paper is based on the presentations and discussions from a workshop on ‘Civil Society Involvement in Drug Policy hosted by the Correlation - European Harm Reduction Network at the International Society for the Study of Drugs Policy (ISSDP) annual conference in Paris, 2019. In the aftermath of the workshop, the authors analysed the papers and discussions and identified the key themes arising to inform CSI in developing future harm reduction policy and practice. Results Civil society involvement (CSI) in policy decision-making and implementation is acknowledged as an important benefit to representative democracy. Yet, the accounts of CSOs demonstrate the challenges they experience in seeking to shape the contested field of drug policy. Negotiating the complex workings of political institutions, often in adversarial and heavily bureaucratic environments, proved difficult. Nonetheless, an increase in structures which formalised and resourced CSI enabled more meaningful participation at different levels and at different stages of policy making. Conclusions Civil society spaces are colonised by a broad range of civil society actors lobbying from different ideological standpoints including those advocating for a ‘drug free world’ and those advocating for harm reduction. In these competitive arena, it may be difficult for harm reduction orientated CSOs to influence the policy process. However, the current COVID-19 public health crisis clearly demonstrates the benefits of partnership between CSOs and political institutions to address the harm reduction needs of people who use drugs. The lessons drawn from our workshop serve to inform all partners on this pathway.

scholarly journals Achieving Net Zero Carbon Dioxide by Sequestering Biomass Carbon

2020 ◽  
Author(s):  
Jeffrey Amelse
Keyword(s):  
Carbon Dioxide ◽  
Carbon Cycle ◽  
Co2 Emissions ◽  
Energy Demand ◽  
Co2 Sequestration ◽  
Fossil Fuels ◽  
Scale Up ◽  
Biomass Carbon ◽  
Net Zero ◽  
The World

Mitigation of global warming requires an understanding of where energy is produced and consumed, the magnitude of carbon dioxide generation, and proper understanding of the Carbon Cycle. The latter leads to the distinction between and need for both CO2 and biomass CARBON sequestration. Short reviews are provided for prior technologies proposed for reducing CO2 emissions from fossil fuels or substituting renewable energy, focusing on their limitations. None offer a complete solution. Of these, CO2 sequestration is poised to have the largest impact. We know how to do it. It will just cost money, and scale-up is a huge challenge. Few projects have been brought forward to semi-commercial scale. Transportation accounts for only about 30% of U.S. overall energy demand. Biofuels penetration remains small, and thus, they contribute a trivial amount of overall CO2 reduction, even though 40% of U.S. corn and 30% of soybeans are devoted to their production. Bioethanol is traced through its Carbon Cycle and shown to be both energy inefficient, and an inefficient use of biomass carbon. Both biofuels and CO2 sequestration reduce FUTURE CO2 emissions from continued use of fossil fuels. They will not remove CO2 ALREADY in the atmosphere. The only way to do that is to break the Carbon Cycle by growing biomass from atmospheric CO2 and sequestering biomass CARBON. Theoretically, sequestration of only a fraction of the world’s tree leaves, which are renewed every year, can get the world to Net Zero CO2 without disturbing the underlying forests.

America and Security Sponsorship

2014 ◽  
Author(s):  
Simon Reich ◽  
Richard Ned Lebow
Keyword(s):  
United States ◽  
Empirical Analysis ◽  
Drug Policy ◽  
North Korea ◽  
The United States ◽  
Military Assistance ◽  
Self Interest ◽  
The World ◽  
Global Norms ◽  
The U.S

This chapter draws on a conceptual and empirical analysis to rethink America's posthegemonic role in the world. While guided by self-interest, the chapter contends that the United States should pursue a strategy that helps to implement policies that are widely supported and are often mooted or initiated by others. It should generally refrain from attempting to set the agenda and lead in a traditional realist or liberal sense. Drawing on Simon Reich's work on global norms, the chapter looks at the success Washington has had in sponsoring—that is, in backing—initiatives originating elsewhere. It examines the successful provision of military assistance to NATO's campaign in Libya, which offers a stark contrast to the U.S. approach to Iraq. The chapter then offers counterfactual cases of U.S. drug policy in Mexico and efforts to keep North Korea from going nuclear.

An examination of six macroenvironment forces on globalization between 2006 and 2018

2021 ◽  
Vol 9 (3) ◽  
pp. 235-245
Author(s):  
AbdulHafiz Henry James AbdulHafiz ◽  
Talal Alsaif
Keyword(s):  
United States ◽  
Social Media ◽  
The United States ◽  
The State ◽  
Economic Class ◽  
Positive Effects ◽  
Nation States ◽  
The World ◽  
Key Events ◽  
Convergence Of Cultures

This study looks at the economic, political, environmental, cultural, technological, legal, and ethical macro-environmental forces which impact globalization Pre-2018.  Key events are examined as indicators of the state of globalization around the world.  The examination of globalization centers on these key events in the United States and Saudi Arabia.  The issues that rose out these events are used to interpret whether the state of globalization is influenced.  The issues of economic class, unemployment, CEO compensation, The Kyoto Protocol, the rise of social media, and Saudi Arabia’s joining the WTO are examined based on their influence on the state of globalization.  The study concludes that convergence of cultures, based on nation-states’ responses to the arbitrage of information in the areas of economies, politics, environment, law, culture, and ethics has is a real influence on the state of globalization.  The negative or positive effects of globalization are irrelevant in comparison to the actions taking by nation-states in response to key events.

Aiding the Fourth Industrial Revolution in the Developing World

2021 ◽  
pp. 299-336
Author(s):  
Sampath S. Windsor ◽  
Carol Royal ◽  
Chatura C. Windsor
Keyword(s):  
Sri Lanka ◽  
Industrial Revolution ◽  
Scale Up ◽  
Academic Research ◽  
Cultural Leadership ◽  
Fourth Industrial Revolution ◽  
The World Bank ◽  
The World ◽  
Research Findings ◽  
Inclusive Society

Academic research that examines different leadership models utilised in the digital age within ICT4D that facilitates the Fourth Industrial Revolution for the marginalised people are scarce. This study focused on the e-Sri Lanka program, initially funded by the World Bank as a unique South Asian project that established a network of 1,005 Nenasala telecentres. Sri Lanka is further focused on building an e-smart, e-inclusive society through ICT4D. In 2020, the Nenasala 2.0 initiative is to be expanded on the Nenasala network to scale up e-society innovations. This context provides an exciting research bedrock to explore. The research findings revealed that leadership at various organisational levels will be key to Nenasala 2.0 and ICT4D program sustainability. The Nenasala model that benefitted from unique community-based leadership was termed socio-cultural leadership. A replication of the study in other developing countries to identify the leadership needed in ICT4D could prove invaluable as it may identify viable complementary options to commercially orientated telecentres.

A systematic review of costing studies for implementing and scaling-up breastfeeding interventions: what do we know and what are the gaps?

2020 ◽  
Vol 35 (4) ◽  
pp. 461-501 ◽  
Author(s):  
Grace Carroll ◽  
Cara Safon ◽  
Gabriela Buccini ◽  
Mireya Vilar-Compte ◽  
Graciela Teruel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternity Leave ◽  
Grey Literature ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Future Research ◽  
Cost Estimates ◽  
Costing Study

Abstract Despite the well-established evidence that breastfeeding improves maternal and child health outcomes, global rates of exclusive breastfeeding remain low. Cost estimates can inform stakeholders about the financial resources needed to scale up interventions to ultimately improve breastfeeding outcomes in low-, middle- and high-income countries. To inform the development of comprehensive costing frameworks, this systematic review aimed to (1) identify costing studies for implementing or scaling-up breastfeeding interventions, (2) assess the quality of identified costing studies and (3) examine the availability of cost data to identify gaps that need to be addressed through future research. Peer-reviewed and grey literature were systematically searched using a combination of index terms and relevant text words related to cost and the following breastfeeding interventions: breastfeeding counselling, maternity leave, the World Health Organization International Code of Marketing of Breastmilk Substitutes, the Baby-Friendly Hospital Initiative, media promotion, workplace support and pro-breastfeeding social policies. Data were extracted after having established inter-rater reliability among the first two authors. The quality of studies was assessed using an eight-item checklist for key costing study attributes. Forty-five studies met the inclusion criteria, with the majority including costs for breastfeeding counselling and paid maternity leave. Most cost analyses included key costing study attributes; however, major weaknesses among the studies were the lack of clarity on costing perspectives and not accounting for the uncertainty of reported cost estimates. Costing methodologies varied substantially, standardized costing frameworks are needed for reliably estimating the costs of implementing and scaling-up breastfeeding interventions at local-, national- or global-levels.

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