Good Practices in Asia.Indb
Total Page:16
File Type:pdf, Size:1020Kb
cVH0V]:`:R1$I.1 Q1:`R:J1I]`Q0VR J:QJ:C`V]QJV QR`%$:JRL SCALE-UP OF HARM REDUCTION IN MALAYSIA Ministry of Health Malaysia WORLD HEALTH ORGANIZATION, WESTERN PACIFIC REGIONAL OFFICE AND WORLD HEALTH ORGANIZATION OFFICE OF THE REPRESENTATIVE FOR BRUNEI DARUSSALAM, MALAYSIA AND SINGAPORE cVH0V]:`:R1$I.1 Q1:`R:J1I]`Q0VR J:QJ:C`V]QJV QR`%$:JRL SCALE-UP OF HARM REDUCTION IN MALAYSIA Kuala Lumpur March 2011 Ministry of Health Malaysia WORLD HEALTH ORGANIZATION, WESTERN PACIFIC REGIONAL OFFICE AND WORLD HEALTH ORGANIZATION OFFICE OF THE REPRESENTATIVE FOR BRUNEI DARUSSALAM, MALAYSIA AND SINGAPORE 1G`:`7: :CQ$%1J$1J%GC1H:QJ: : !:H7cVH0V]:`:R1$I.1 Q1:`R:J1I]`Q0VRJ:QJ:C`V]QJV QR`%$:JRL7R` .:`I`VR%H%78 8`VHTV0VJQJ:JRHQJ `88VR%H88_VR1II%JQRV77TV0VJQJ :JRHQJ `888 8%71: 34 ^4;%<H:7< 8 _ ©Q`CRV:C .`$:J1<:QJ CC`1$. `VV`08?G:`A$<:QJHGG`A?5A$<:5 05!0 5<^87U 6`:67U 6R7G@Q`RV`8_8 I_`Q`]V`I11QJ Q`V]`QR%HVQ` `:JC: AG:T``Q`JQJHQIIV`H1:CR1GT GVVR A?5GV:RR`^`:67U 6R78_8JA V ?I?G:5_`Q`]V`I11QJ Q`V]`GVVR ?G:A 5 A$<:5IA `V ?5?8A836 55%5?5^`:67U 5R7G:88_8 O7VR:JR .V]`VVJ :` G76`7 1.: QV0`A$<:QJHQJHV`J1J$ .VCV$:C :`7Q%J75V``1 757` 1 :% .Q`15QJHV`J1J$ .VRVC1I1 :``QJV`G8VRC1JVQJI:]`V]`VVJ :]]`Q6 GRV` `Q`1.1H. .V`VI:77VG`VVIVJ8 O`HH``:H %`V`;7 .V7VVJRQ`VRQ` `VHG7A$<:QJ1J]`V`V`VJHV QQ .V`` %`V .: :`VJQ IVJ8Q`:JR QI11QJV6HV] 5`Q]`1V :7QR%H :`VR1G7:CH:]1 V`8 CC`GVH:%QJ.:0G@G7A$<:QJ Q0`7`Q`I:QJHQJ :1JVR1J .1 G:8V0V`5G GGVR11 .Q% 1:``:J7`7@568 OG7`Q` .V1J V`]`V :` V`1:CC1V11 . .V`V:RV`8VJQ`CRV:C . A$<:GG`Q`R:I:$`8 ? % Cover photograph: V` @8Photographs courtesy7<:O5%7<64GC1:JR `.:`I:J:JR:VC0:`V8 OQ$`:].1J .1I: V`1:C:``Q`1CC% `:076777H%C:`.V:C . :55 G01Q%`5`7QJ1.Q:]]V:`1J .V].Q Q$`8 TABLE OF CONTENTS H`QJ7 0 @VIVJ 011 J`V1Q`R 6 6VH%0V%II:`7 8 J `QR%HQJ %7;`V]QJV QR`%$:JR 4:7QJ V6 20 8 I]CVIVJ :QJQ`.:`I`VR%HQJ1J:C:71: AG %QJ .V`7^AO_ 4VVRCV:JR7V]`Q$`^4?_ J`V `Q01`:C `V: IVJ^IO_`^?_ V6%:C `? J V`0VJQJ1JHCQVRVJ$ 8 J:C71Q`H`QRH%J$ .VIV <QII%J1H:QJ:JR:R0QH7 V:C .7 VI:JR.%I:J`VQ%`HV ?:` JV`.1] 8 QJHC%1QJ:JRVHQIIVJR:QJ 49 <7`QQR]`:HHV IVHQIIVJR:QJ Members of the Technical Working Group GJ,J`4B3J_`5%7`5%71: J6J3G,J`J+`5%7`5%71: 4JG,J`JYJ5%7`5%71: iGYJUG,J`JAA5%7`5%71: J,J%7J5AV ?IA <J``7<`5AIV]`VVJ :0A `35%71::JR1J$:]Q`V YJ`BG5AIV]`VVJ :0A `35%71::JR1J$:]Q`V %?-YO`B15<:J`A GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA Acronyms 00 _VR1II%JVRV77QIV %% %`%71: 4? 4 1@`? 4 QH1:`4QJ IO :J`V `Q01`:C .V`7 O :I].V R7I%C:J 33 GG < R`R `V AO R1`7G0VR `V: IVJ5RQ%`V J?%?% JVRV`:`?: %?:HQJV`;5%71: !? $VJV`:C]`:HQJV` 3 .V]:3 < .V]:< .%I:J1II%JQRV7 I .:`I`5 :JR.%I:J`VQ%`^=_ I! I@!Q%] % IQJ1 Q`1J$:JRV0:C%:QJ %< %7< %I? IQ R: R@QJ %! %VCQ]IVJ! %%O IV .:RQJVI:1J VJ:JHV .V`7 %A %7` %A %7`:1` 4 4:QJ:CJR7 4!A JQJ$Q0V`JIVJ :CQ`$<:QJ 4? JVVRCV:JR7V]`Q$`:IIV 4OJI 4:O@JQ`IVR%HQJ AO G %QJ .V`7 ?; ]VQ]CVC101J$11 . ?O ?OJQ%JR:^7@?@O_ ? = ? ]VQ]CV1.Q%VR`%$ I% %71:J`1J$$1 1VR1.J V`J:QJ:CV0VCQ]IVJ $7 A? :JR:`RQ]V`:J$]`QHVR%`V GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA O V67`VHQJ 0101 O3 GH%CQ1 %< V`7%7< ``Q`RR1HQJH1VJHV 4! 4!G7^L_ %%< V`7%7%< `V 4 4QJ 4 x4?Q$`:IIVQJL A A$<:QJ ?IA IA `V ? GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA Acknowledgements 011 OIQJQ$`:].1 .V`V%C `:V`1V`1 V011 HQ%]CVR11 .@V7 @V.QCRV` 1J V`01V18 J 5 V6 VJ10V `V01V1 1: RQJV ` .V :0G G C1 V`: %`V :JR RQH%IVJ H:] %`1J$ .V V6 ` .V HR ` .:`I `VR%HQJ1J%78A1Q%CR@V Q@:CC .QV1.Q.:`VR .V1`5 R: ::JRI: `Q` .V]`V]:`:`8 1JHV .V1J V$`:QJ`.:`I`VR%HQJ1J .V4QJ:C `: V$1H]C:JQJL T5 .V%7`V:C .:JRQ .V`J:QJ:C:$VJH1V.:0V]C:7VR:HVJ `:C `QCV1JG<CQH:C$Q0V`JIVJ 5CQH:C.V:C .V`5]VV`Q% `V:H. 1@V`5Q .V`H7RGHG: Q`:JR`VCV0:J VH Q`1JHC%R1J$G 7 QRVC10V`]`V0VJQJV`01HV Q]VQ]CV1.Q%V57 .QV1.Q=84G75 .VV6`JVVRCV:JR7V]`Q$`:IIV :JRIV .:RQJVI:1J VJ:JHV .V`7.:GR`:I:HQ0V` .V]: V7V:`8 ?V]:`:` 1Q%CRJQ .:0VGG11 .Q% .VRVR1H: VR 1@`8 O IQJQ$`:]. 1: RV0VCQ]VR %JRV` .V CV:RV`.1] ` ` JG %_5 OVH.J1H:CA 5:`II5L:JRO5AIV$1QJ:CA `Q` .V V V`J?^?IA_:JR`:`]:C5OVH.J1H:CA 5A ` .VA IV]`VVJ :0V`Q`35%71::JR1J$:]Q`V11 . .V%]]Q` ``<<5AIV]`VVJ :0V`Q`35%71::JR 1J$:]Q`8 J ]:`H%C:`5 ` %_: :JR ` 1J$. ]`Q01RVR H`1H:C HQJHV] %:C %]]Q` 1J .VRV1$J` .V]`=`V]Q` 1.1CV%?:H:CO:J$%:75AHQJ%C :J5 ]`Q01RVRVVJ8 VV6VQ%`@ Q]VV``Q` .V1`0QC%J :71@8O1JHC%RVG i<5< V``6HVCCVJHV`Q`IVV:`H.1J^<I_5%76CV6 @5 J V`J:QJ:C :`I IVR%HQJ QH1:QJ ^I_6 JJV 3$VJ `5 VR4QJIV$1QJ:CO@JQ`HV^4IOJ_6V:J;51:J4 1@`?VQ]CV 1.Q`%$^4?_6i:.1J<5x VR4QJ?Q$`:IIVQJL ^4_6%4<:`54QJ:CJR$7^4_5%76 i5 %71:J < ^%<_5 %76 :JR I7 O5 ?@ O`1:J$CV ^?O_JQ%JR:5%76?<:J5%<5%76x5%<5 %76<5%<5%78 % 5 HQJ1 VJ VcQ` ` :JR %]]Q` ]`Q01RVR G7 : ` ::J G GI51`VH Q`R!:C`V:C .^?G_6`;@@G 51`VH Q``1V:V< `6`;:`1G45V:R`LO GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA VH Q`51V:V< `QC5%7`5%75 Q .V7 0111 :JR1I]CVIVJ :QJ`.:`I`VR%HQJV`01HV.:0V]:0VR .V1:7`Q` .1`8 V:CQ@V .V%]]Q` ]`Q01RVRG7:JRVcQ` `: `:1R:.G = %5 1`VH Q`R!5 4QJ:C JR $75 %71: Q1:`R 7`8 ]VH1:C:JR1JHV`V:]]`VH1:QJ$QV Q .V1VR1.J V`J:QJ:CV0VCQ]IVJ $7 ^_ `Q` .V1` $VJV`Q% :1 :JHV 1J G .1 `V]Q` .`>55VQ%`?^I_?=8 GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA Foreword 6 =R`%$%V:JRV61@.:0VC:`$7R`10VJV]1RVI1H1JI:J71:J HQ%J5 .Q%$. `:JI11QJ .: `QCCQ1VR R1cV`VJ ]:V`J :HHQ`R1J$ Q .V CQH:CHQJ V68ORV0VCQ]IVJ ` .V%71:J`V]QJV Q:JRR`%$.: G7:JRHQQ`R1J: 5:JR1 Q0V`:CC1I]CVIVJ :QJ.:G$`Q%JRVR1J H1VJ5:JR`VHQ$J1QJ` .V0:C%V`I%CVH Q`:C]:` JV`.1]:JR ]QC1H:CCV:RV`8 J 5 .V % V` ` ; G :JJQ%JHVIVJ Q% C1J1J$ .V J:QJ:C HQII1 IVJ Q `7 :RR`V `:JI11QJ CVR Q .V C:%JH. ` .V ]1CQ IV .:RQJV I:1J VJ:JHV .V`7 ^%%O_ ]`= 1J AG 5 7 .V`V: V`5 .V1I]CVIVJ :QJ`1 JVVRCV:JR7V]`Q$`:IIV^4?_1J 7 8OV6_VR1JHV .VJ:JRCVQJCV:`JVR .`Q%$. .1 H`1H:C]`QHV.:0VGHG8OVJRQ`VIVJ `.:`I`VR%HQJG7 %]]Q`0V:JRHVRCV:RV`.1].:G`@G51J .: VcVH0V.:`I `VR%HQJ 1J V`0VJQJ .:0V G 7 VI:H7 V6 :JR 1J V$`: VR 1J Q G .V:C . V`8 !V`JIVJ CV:RV`.1] :JR % :1JVR ]:` JV`.1] 11 . Q .V`$Q0V`JIVJ :JRJQJ$Q0V`JIVJ :$VJH1V.:0V1JRVVR]`Q0VJ QG:@V7 VCVIVJ `%7;8H.:CCVJ$V`5 .VHQJ1 VJ V0QC%QJ `:JR]`Q$`V1J .VJ:QJ:C`V]QJV Q:JRR`%$.:0VGVJHQ%`:$1J$5 :JR%HHV`7G<VRC:`$VG`RVR1H: VR:JRHVR1JR101R%:C :JR$`8 OQ`CRV:C .A$<:QJ^A_:JR%7`V:C .^%A_1J%71::`V .V`V`Q`VHVR Q% :1J1J$%H.Vc51.1H..:0V:CQG:`H%C: VR 1J A; :C:71: Q%J `7 QQ]V`:QJ `: V$7 T8 O .1`R <7 <:QJ `: 7 `Q` %71: HQ0V` 1Q `: V$1H :]]`Q:H.V Q` >?8 O :`IVJHQI]:VA;%]]Q` Q%71:1JVCVH VRJ:QJ:C.V:C . 51J :JRVI11 .A;%]]Q` Q%7HQJG Q`V$1QJ:C :JR1J V`J:QJ:C.V:C .HG:QJ:]:` ` .VVHQJR8OVHQJR:`I %768 O ]`VVJ RQH%IVJ 1 :C1$JVR 11 . .V `: V$7 Q .:C :JR `V0V`V .V IH I ]VQ]CV 1 =H R`%$ 1J % :JR .V &HH ]`Q]QVRG7A:JR`VHVJ7RV0VCQ]VR=7G7 .V4IV$1QJ:CO@JQ`HV QJ = `%$ 5 A :JR Q .V` 4 :$VJH1V :JR ]:` JV`8 O `: 7 `V]`VVJ : >H:CC `Q` ? RV1$JVR Q ]`Q01RV ]`:HH:C QQC T %H. : .1 RQH%IVJ T `Q` %V G7 J:QJ:C $Q0V`JIVJ :JR Q .V` :$VJH1V Q $%1RV .V 66 `: V$1H]C:JJ1J$]`QHV:JRV`01HVRVC1078J .1`5%7;VcQ` Q H:CVRQ1JHQI]%CQ`7R`%$ `V: IVJ :JRRV0VCQ]HQI]`V.VJ10V.:`I`VR%HQJ V`01HV:`VVCVIVJ`QQR]`:HHV .: RVV`0V G 8 O`:H1J:J$V6:I]CVG1J .1IQJQ$`:].`VI1JR%` .VCV:RV`.1] 5 .V 0:C%V ` H7 ]:`H1]:QJ :JR .V JVVR `Q` I%CVH Q`:C HG:QJ:JRHQQ`R1J:5IV$1QJ:C `: 78 : Q;`::JG1JGR%C:.I:J `Q`1JJV:]%:JQ )HQ`R+`5 01V]`VVJ `2)I5 1J1`58 :C:71::JR1J$:]Q`V EXECUTIVE SUMMARY GOOD PRACTICES IN ASIA: SCALE-UP OF HARM REDUCTION IN MALAYSIA 1212 Executive summary O]`V:R`1J%75 .Q%$.JQ `7HQJ 5.:GQJ .VRVHC1JV Q0V` .V]: RVH5`QI JV1H:V`VHQ`RVR1J Q= Q0V` H:V 1J 8 V]1 V HQJ1RV`G VcQ` Q G L `:JI11QJ 1J %75`VI:1J:J:QJ:C78OQ`CRV:C .A$<:QJ^A_ _V %7; V]1RVI1H : >HQJHVJ `: ?7 CQ1 `: V ` `VHQJ 1J .V $VJV`:C]Q]%C:5:V01RVJHVRG7:JVI: VR:R%C ]`V0:CVJHV`8Q5:JR 71QC: VR.1$.]`V0:CVJHV`: V:IQJ$R@$`Q%]%H.:]VQ]CV =^?_5 `VI:CVV6@V`8 1JHV .V1JHV]QJ`]1CQ .:`I`VR%HQJ]`=:`Q%JR 5JVVRCV:JR7V ]`Q$`:IIV ^4?_ :JR ]:`7 IV .:RQJV I:1J VJ:JHV .V`7 ^%%O_ .:0V `VI:1JVR : .V .V:` ` .V J:QJ:C `V]QJV Q R`%$ :JR L8 J :RR15 .V%71:J.:`I`VR%HQJ]`Q$`:IIV`VI:1J .VHQ`JV` QJV` .V J:QJ:C]`V0VJQJ `: 751.1H.1:CIQ VJ`7`G7 .V%71:J $Q0V`JIVJ5 .Q%$.QIV VH.J1H:C:1 :JHV.:G7 VI:H7]`Q01RVR G7A8 VR1J]:` JV`.1]11 .JQJ$Q0V`JIVJ :CQ`$<:^4!A_ :JR ]`10: V .V:C .