Stories from the field | The youth movement driving harm reduction in Nigeria

Much of the Nigerian drug response has been driven over the years by the idea that Nigeria is just a transit country for drugs being produced in Latin America and being moved to thriving market in Europe and North America and other parts of Asia. And because of that, we use what we call a repressive policy to show that we are tough on drugs. But looking at what has happened over the past two decades, we’ve come to realize that Nigeria is not just a transit country.

Drugs are widely being consumed in the country and also being locally produced And as someone also working within the HIV and AIDS response I could see a clear linkage between the HIV epidemic and drug use, especially injection drug practices in the country. And Nigeria at the time had the second highest burden of HIV epidemic globally. So in 2010, I was selected as the African representative on International Working Group of YouthRISE International. And at that point, I was compelled to be able to bring together stakeholders within the HIV response to Nigeria for us to discuss how to comprehensively respond to the HIV epidemic, especially among people, who inject drugs.

In my work experience within the community, HIV and AIDS response, I’ve come to see many young adults engage in high risk HIV behavior practices such as injection practices that put them at higher risk of HIV. And many of these young people live within deprived neighborhoods. So many of them are actually out of a job. Many of them are not in school. Some of them live on the streets. They don’t have any family to live with. Some of them have to struggle to make ends meet on a daily basis. So they are actually within the lower economic socio-economic ladder of the society and they get engaged in injection practices.

That puts them at a higher risk, such as the use of contaminated needles and syringes, sharing of needles and syringes without even cleaning them up, injecting in groups, especially the young woman injecting alongside with their male partners who inject them or when they are in a group, they are often the last on the needle which put them at higher risk. Another thing that I witnessed is the issue around what is called “flash blood”, a situation where you see a young person withdrawing the blood of another young person who is already high on drugs to inject him or herself, especially when this limited amount of substance available.

This was a very high risk behavior that can increase the chances of getting infected with HIV. This and other issues that I saw in the field was so compelling for us to bring all stakeholders together to discuss the issues around injection drug practices and the HIV response.

One of the challenges we faced at the beginning was around the Nigerian drug policy and the health messaging. For many of these young people would have been used to over the years is the issue around beeing arrested by the police or the drug law enforcement agent, being locked up in detention being dehumanised, tortured just because of their practices. So when we got involved, they were first scared and at the back of their mind, they thought we were just like spy agents who have come to surveil what they are doing and to report back and for them to get arrested and locked up.

So we had challenges around getting them to understand that we are actually health workers who are interested in the total well-being. So we have to counter these by developing a strategy of education, getting a few of them to be trained and to be able to reach out to their other peers and educate them around, you know, giving them harm reduction messages. So along the line, you know, in terms of messaging and also in the past, what they have been used to is all about, “say no to drugs “ and which has not really been helpful to them. So we had to ensure that harm reduction messages are actually being disseminated by the peers within the drug using community.

It was tough, but along the line they got to see that YouthRISE is actually out for their own benefit. We develop the community trust and we started working together and alongside we had a couple of the committee members also working with us to reach out to the others peers.

that YouthRISE is coming with a different strategy to help in their wellbeing.

Youth led advocacy in Nigeria has now become a potent force within the HIV response drug policy reform and the implementation of harm reduction programmes. Advocates from YouthRISE Nigeria has been actively involved, in advancing the drug policy reform landscape. YouthRISE in Nigeria was also the organization responsible for forming the first National Drug User Network wich is now engaging even in implementation of the Global Fund activities within the country. For YouthRISE Nigeria the value of young people getting involved in this reform process and advocacy activity goes beyond just a country in need for a response to the HIV and AIDS or a response to drug use challenge.

But rather a situation whereby young people are also actively involved in shaping their own future.

First generate evidence, evidence is usually compelling. We had to do a study that showed that young people who have been arrested and locked up, you know, in detention or incarcerated for a certain period of time after being released, became worse off. And we showed this evidence in a lot of stakeholders meeting, and it was obvious that there was a need for a new approach. So for harm reduction advocacy, this need to generate evidence for policy change. Secondly your allies are people who are ready to work with you and work all the way with you for policy change or for practices in terms of harm reduction to be implemented.

And we need to also remember not all public health workers are allies. They are people within the public health practices practices who stood against what we were talking about. Because they had a misconception. But we had to work with people who had an understanding for us to move forward. And thirdly, don’t be confrontational. Many times you might be misunderstood. You might see people who are supposed to know standing up against what you are presenting or the need for a redirection. Don’t be confrontational. Keep presenting your advocacy point. Keep engaging with the stakeholders. When you continue to have the opportunity to sit at a table. It’ll be difficult for you to be ignored.

But when you are confrontational door is shut against you, it would be difficult to engage.