Failed Mandates: Ministry of Health, VIHA, City of Victoria

Victoria’s only fixed-site needle exchange was forced to close on May 31, 2008. Since this time, the Vancouver Island Health Authority (VIHA) has sanctioned mobile exchange services within a limited area. VIHA discontinued plans to open a centralized and accessible harm reduction services site on Pandora Street in June, 2008 and eliminated a potential fixed-site needle exchange in the Burnside-Gorge area in September, 2009.

This critical situation exists despite multiple recommendations at the provincial, regional and municipal levels to enhance existing harm reduction services. HRV maintains that VIHA, the provincial government and the City of Victoria must coordinate their efforts in Victoria to ensure that the right to health and well-being of people who use drugs is respected. The following section summarizes commitments and responsibilities concerning harm reduction services in Victoria with regards to the province of British Columbia, the regional health authority (VIHA), and the City of Victoria.

a. The Government of British Columbia

The BC Government is responsible for determining province-wide goals, standards, target outcomes and performance agreements for health services, including those needed by people who use drugs . The BC Government has published numerous reports that recognize the value of harm reduction services and promote their availability. The British Columbia Centre for Disease Control (BCCDC), housed within the BC government, has a Harm Reduction Supplies Program that distributes harm reduction supplies across the province at no cost. This program is informed by health representatives, issues evidence-based recommendations and best practices.
Since 2001, the BC Ministry of Health has been contracting regional health authorities to deliver and manage health services. The Ministry of Health holds health authorities accountable for service delivery and management through “Performance Agreements” and “Health Service Redesign Plans”.

b. The Vancouver Island Health Authority (VIHA)

The BC Ministry of Health has mandated the Vancouver Island Health Authority (VIHA) to provide public health services on Vancouver Island. This mandate includes providing care for people who use illicit drugs. Over the past 7 years, VIHA has commissioned 10 reports that call for an increase in harm reduction services in downtown Victoria.
Along with VIHA's funding agreement with the BC Ministry of Health (2003), its Closing the Gap Service Plan (2006) require that the agency provide health services aimed at reducing the spread of HIV and hepatitis C (HCV). The service plan prioritizes people who are most at risk for infection, including those who use drugs.

c. The City of Victoria

The City of Victoria (2010) “has embraced harm reduction as a pragmatic, cost effective and socially responsible approach to reducing the personal and social harms associated with substance use”. It approved a harm reduction policy framework in April 2004, which commits the City to providing necessary supports for drug users through an integrated approach that includes prevention, treatment, housing and other supports. The framework promotes public and professional dialogue and collaborative action on harm reduction. In the fall of 2007, the Mayor’s Task Force released a report entitled “Breaking the Cycle of Mental Illness, Addictions and Homelessness”. The report recommends “strengthen[ing] harm reduction services to help mitigate public health and public order issues; in particular, investigat[ing] the use of substitution therapies and indoor supervised consumption sites” (p. 15).