The first LATS took place in Curitiba (Brazil) on March 20, 21 and 23, 2000. It was organized by Sandra Batista from the Aids coordination of Paraná State.

LATS in Curitiba was a three day invitational meeting, with –amongst others- representatives from the health system, the criminal justice system, the educational system and neighbourhood representatives. It concerned policy makers as well as practitioners. The seminar was opened by the secretaries of Health, Education and Youth/family of the State of Parana.

There were about 200 participants. There were plenary sessions and subgroup meetings.

Both the local drugs and Aids situation as well as the situation in other parts of the world were presented. In the subgroups, discussions took place about the development of local policy on drugs and Aids. For many this was a new experience. They concluded that harm reduction was an important element to include in local drugs and Aids policy and they formed a working group to further develop the proposals of the seminar.

Jersey Conference

At the International Conference on the Reduction of Drug Related Harm in Jersey, April 2000, the experience in Curitiba was presented by Sandra Batista. The audience mainly consisted of people from Latin America and some experts from other parts of the world. The audience was very interested in LATS and some of them informed whether it would be possible to have LATS in their cities as well.

Evaluation

On June 5, 2000, the seminar was evaluated. The evaluation was organised by Sandra Batista from Curitiba. LATS was represented by Monica Gorgulho (Brazil) and Ernst Buning (The Netherlands).

The evaluation meeting was split into two part: in the morning with a small group of technical persons (14 people) and in the afternoon with a larger group where policy makers were included as well (26 people).

In the following the findings are summarised.

After the seminar in March, a group of around 20 people was formed. This group consisted of representatives from different sectors: health, education, family, policy, justice, NGO’s and the community. An official founding document of this group was presented (Câmara Técnica de Questões Relacionadas ao Uso de Drogas).

The ‘Câmara Técnica’ met 5 times and installed 4 working groups:

• Prevention
• Treatment
• Supply reduction
• Demand reduction

The work of the working groups was based on the reports of the subgroups of the seminar.

During the evaluation meeting, the following issues were presented:

One working group started with ‘mapping’ the existing initiatives. So far, it mainly consists of a list of names and addresses, but they plan to do the mapping in a more precise way.

Many organisations are working in isolation.

The discussion about ‘treatment’ and ‘prevention’ is still open. It is apparent that in Curitiba, many people and organisations are still not clear about their definitions of what treatment and prevention actually are.

A reorganisation of the mental health system is foreseen and in this debate, the drug issue is not taken into account in the proper way. The LATS group will make sure that the drug issue will be on the agenda

General hospitals have the possibility to detoxify drug users, but this is not done

The treatment in therapeutic communities is done according to very old fashion models

Aid to drug users is mainly done by volunteers.

LATS has helped the nursing organisation to look at drugs in a different way (that drugs are not only bad)

A survey was done among school and it turned out that teachers are not well trained in drug prevention. It was felt that drug prevention should be integrated in general prevention (which should include sex, citizenship etc.). A proposal has been made to include drug prevention in the extra training which teachers regularly receive in a specialised centre.

The civil police is involved in prevention at schools and they would like to establish a link with the prevention/helping field

The civil police want to serve the community and do more than just repression. They are looking for partners in this area

Representatives of the city council are looking for technical information to enable them to make proposals to change the law for promoting harm-reduction activities

CONEN (the state drug bureau) is not functioning properly, but now that they realise that the LATS group is starting to work, they are trying to get their work back on the rails. The representative of CONEN is worried about the LATS group. CONEN is responsible for policy. All new laws first have to pass CONEN. The representative of the State Health Bureau made clear that CONEN’s role is to deliberate and that the LATS group is more practical. It is important to recognise each other’s role. The LATS group can strengthen the position of CONEN.

LATS has helped to develop a broader view of what can be done in Curitiba

LATS motivated people to work together and empower them

LATS has created doubts about what they are doing, this is necessary to create change

LATS enabled representatives from different sectors to sit together, realise that they share a common goal and to start a debate. The drugs/Aids issue is now an item in all different sectors

LATS further stimulated the discussion about harm-reduction and included politicians in this debate

Sandra Batista is considering the possibility of organising a Latin American Conference on linking the health and criminal justice system. The civil police and health system in Curitiba will develop a number of projects in this field and there might be interest in Curitiba to be the host of such a Latin American conference mid 2001.

Preliminary conclusion

So far, it can be concluded that the concept of LATS was welcomed in Curitiba, that the need to change local drug & Aids policy in a more pragmatic and public health oriented way and to strengthen the co-operation between the parties involved is apparent. Given the fact that drugs and Aids related problems are on the rise in this part of the world, we believe that LATS might contribute to containing the Aids and drugs epidemic in this part of Latin America.

The two moderators: Sandra Batista (left) and Monica Gorgulho (right)

Plenary discussion, questions and answers

Robert Haemmig from Bern (Switzerland) spoke about the experience of implementing harm reduction in his city

Yael van Hulst (USA) spoke about Aids in the USA and their experience with harm reduction

Graciela Touze (Argentina), president of the Latin American Harm Redction Network (Relard) spoke about Rapid Assessment

On the third day, subgroups worked on formulating objectives of a local drugs and Aids policy. They also discussed which instruments were available and how a policy can be implemented and evaluated

The subgroups presented the results of their discussion to the plenary group

The secretary of Health of the State of Parana, Dr. Armando, supported the seminar and was enthousiastic about the results