One of the most striking and pleasant ways that this Barcelona conference differs from the conferences of the past is that that there has been broader coverage of issues related to providing a continuum of prevention and care to one of the most stigmatised and vulnerable and difficult to reach groups world wide – injecting drug users.

This reflects both a growth in the awareness of the needs of this group and a growth in the body of scientific evidence about effective means of promoting health and preventing HIV transmission in this group.

There were well-attended sessions on Harm Reduction every day. The sessions presented a range of experience and evidence including proof that this group can be accessed successfully, proof that their risk behaviors can be chanced, proof that changing their behavior lowers HIV transmission, proof that needle exchange does not increase drug use, and proof that drug users can be compliant to ARV therapy regimens.

The sessions also made it clear that these effective approaches are still under funded and under-practiced. Political will which is a key factor in scaling up effective programs is still lacking in most parts of the world.

A closer look needs to be taken at the processes of advocacy for political will in countries like Spain and Brazil which have successfully scaled up harm reduction activities. The evidence is clear and available. Now it is time to advocate for its application.

AIDS 2002 Conference News produced by Health & Development Networks/Key Correspondent Team