People who inject drugs demand a say in needle exchange services
Photo:
AFP
A group of people who inject drugs are demanding a greater say in the future of the South Island's needle exchange services - warning health leaders are gambling with their lives.
In seven weeks, needle exchange programme
DISC Trust will hand over its long-standing contract
, which provided sterile drug injecting equipment at six sites around the South Island.
That provider, Te Waipounamu Collective, with He Waka Tapu as the lead agency, was yet to disclose how, where - or with what staff - it planned to operate the service.
On Monday, a newly formed group of more than 100 clients, called the Peer Injection Collective (PIC) set out four pages worth of concerns in an open letter to the DISC Trust's board and chairperson.
The open letter demanded to know why DISC Trust lost its contract after 35 years, and why many clients only learned about the change through the media.
It asked DISC to give clients a seat at the table with Health NZ and the new provider in ongoing negotiations - and requested for the handover to be slowed down for a "patient and open process of relationship building with the community".
PIC member Gilbert May said the group was increasingly apprehensive about the change of providers in seven weeks' time.
"We're incredibly concerned about what seems like a complete farce in the construction of a new programme, and what is looking like a disaster in its rollout."
"We're concerned about the welfare of peers, of people who inject drugs, and we are really worried about the way that the process has been undertaken without any input - as far as we have any knowledge - from peers."
May, a former harm reduction worker at DISC and among the thousands who have used its services, said rolling out a comprehensive service by October seemed like a "logistical nightmare and a practical impossibility."
He said finding suitable new, suitable sites could take months.
May said the group also wanted guarantees the service would remain peer-led, non-judgemental and confidential.
"The risks of a failed or botched rollout are not the risks of bureaucrats. They're not the risks of board members. The people who are taking the risks are the peers. And we're risking our lives and our health."
He said giving clients a say was part of the sector-wide engagement standards set by Te Tāhū Hauora, and PIC would be raising its concerns to the Health and Disability Commissioner.
DISC Trust's executive director Philippa Jones said those concerns were fair, and the board would be providing PIC with a formal response.
She said last year DISC urged Health NZ to engage with its clients - but that never happened.
Jones said DISC still did not know what the new provider's plan looked like, including where the sites would be, or whether its 19 staff would keep their jobs.
However, He Waka Tapu, as the lead agency within the Te Wai Pounamu Collective, said it was working to "maintain continuity of services with minimal disruption" as it took over the programme.
"We are engaging with existing providers, including to respect their experience and to ensure knowledge transfer.
"We know the importance of building relationships with local communities... our goal is to build on the work done in this space already, and to future-proof the service for all."
It said it took the Peer Injection Collective's concerns seriously, and appreciated the group's advocacy.
"We are committed to involving people with lived and living experience in the design, delivery, and leadership of services, in alignment with Te Tāhū Hauora's standards. Harm reduction remains central."
"Our services will be peer-informed, non-stigmatising, confidential, culturally safe, and accessible."
The agency said it understood trust took time to build.
"Our goal is not to replace what exists, but to evolve it with care, integrity, and community leadership."
RNZ approached Health NZ with PIC's concerns that needle exchange users were not consulted.
In a statement, Director Starting Well, Deborah Woodley, said PricewaterhouseCoopers did engage with clients - as part of an independent review of the Needle Exchange Programme in January 2023.
"The review recommended a reset and a collaborative change process to progress a range of enhancements to the Needle Exchange Programme."
She said people with 'lived experience' were also involved in the evaluation panel responsible for assessing proposals during the procurement process - which eventually awarded the South Island needle exchange contract to Te Waipounamu Collective.
Woodley said Health NZ was confident DISC was given "well-researched information and advice at all times during the procurement process."
Dr Rose Crossin from Otago University's Department of Population Health has collaborated with DISC on past research.
She said it was a hugely successful service which had "averted a lot of harm in the in the drug injecting community", largely because of its peer-led, "very, very anonymous" approach.
Crossin said removing a trusted service without the community's backing could have serious health consequences.
"If people were not seeking going to the needle exchange and not able to access sterile injecting equipment, there is the potential that bloodborne viruses would increase again in New Zealand and that would include both hepatitis and HIV."
She said DISC helped connect clients to other parts of the healthcare system.
"If the needle exchange suddenly lost the trust of their clients, there's a risk that they just wouldn't seek help at all for these other health issues."
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