It seems so puzzling to me that other countries do not see the importance of prevention programs like these. They are hugely beneficial for the health of the community, and they are amazingly cost effective. In an era when both the state and federal governments are far in debt, new and creative health care options must be explored. We need to find ways to lower the cost of health care while providing all with access to adequate health. While these goals seem impossible, programs like these may go a long way.
I understand that the moral implications of this program are extremely controversial. Even in Canada, where the right to health is in the Bill of Rights, the program is undergoing hearings in the Canadian Supreme Court to stay operational. Insite has a special exemption from the narcotics laws in Canada. While nurses cannot inject the patients with drugs, the patients are not at any legal risk for drug use.
What are the barriers that prevent countries like the United States from seeing the benefits of prevention plans and Public Health?
While I think that this is a very unique approach to HIV prevention and should be considered as a means of stopping the spread of the disease, I don't think that the U.S. government will be considering it in the near future. One of the main barriers to public health has always been cultural and social stigmas attached to certain diseases, and the same idea goes for drug use. There is such strong opposition to drug use in any form that I doubt the government would do anything that could be seen as endorsing this, even at the benefit of saving lives from HIV. I think the most important thing demonstrated by the article is the vitality of continuing to search for new methods for the prevention of diseases beyond those that we already have in place. I don't find this particular example to be an ideal one, but its underlying concept is something that public health needs to embrace: flexibility and innovation.
ReplyDeleteI think this is a fascinating attempt at a solution to the drug use-related HIV problem. It also ties in very well with the excerpt of the book Nudge that we read for class. Touching on what has already been mentioned, the approach of the Insite facility to reduce HIV certainly has some qualities of the gray area between government mandates and doing nothing. This seems to be so controversial because there are so many complex sides of the issue. It might be considered a "nudge" toward safer drug use (if there is such as thing) but also a nudge toward drug use in general. If the government considers good health to be its goal, how does that play into this situation? Should each individual's health trump the overall health of the community or is it the other way around? If the individual's health is considered, is possibly increased drug use worse than continued illegal drug use and an increased risk for contraction of HIV outside of the Insite facility? What role, if any, do morals and personal freedoms play into the legality of Insite? Once again, there are far more questions than answers. As mentioned, however, this kind of thinking has to be credited for being willing to go against existing cultural and political ideas.
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