Reenvisioning Harm Reduction As Reparations

Last year marked the 400th anniversary of the commencement of the Transatlantic Slave Trade in North America.  As politicians and others began announcing their plans to run for President, reparations once again became a prominent mainstream talking point. Subsequently, a historic hearing held by the House Judiciary Committee in Washington DC, on the question of reparations, coincided with Juneteenth

The intent of the hearing was not to determine reparations but, instead, determine if the H.R. 40 bill, a bill to convene a commission to study, document, quantify and make recommendations for reparations, should move forward. For over a century, despite what a fringe group may claim, Africans across the globe have been advocating for reparations beyond that hearing. However, since that hearing, reparations have, once again, left the mainstream conversation in favor of the misuse of “harm reduction”.

It is hard for many who reside in the U.S to imagine thinking in ways that do not center the U.S. This includes reparations. Unfortunately, even that only extends so far. The term “harm reduction” has become casually interjected in arguments in favor of not only participating in 2 party neoliberal elections but voting for Democrats who have placed reparations on the back burner. 

Many Black people see “harm reduction” as the implementation of social welfare programs that ease the stronghold of oppression just a bit. But here’s the problem, that’s not what “harm reduction” means. 

Harm reduction is a spectrum of practical strategies and ideas implemented by grassroots organizations aimed at reducing the negative consequences associated with drug use (specifically the carceral state). From safer use to managed use, to abstinence, to meeting drug users “where they’re at,” harm reduction addresses conditions of use along with the use itself while respecting the rights of people who use drugs. It also addresses broader social health issues, like HIV/AIDS, in the same manner. These are all things that disproportionately affect Black communities.

When we hear people talk about harm reduction, they are certainly not referring to drug users and people with HIV/ AIDS, who are socially marginalized and othered. They are referring to their individual selves and all that voting can and will help them obtain— whether healthcare or education. Most importantly, they are certainly not seeing that the actual definition of harm reduction IS an act of reparations. 

When we look at the “progressive” frontrunners, Senators Bernie Sanders and Elizabeth Warren, and dissect their platforms, both approach reparations in an insulting manner, insinuating that “equality for all” is somehow the same as the fight for reparations. After centuries of colonization and chattel slavery that built the U.S, progressive candidates approach reparations as  “a check” while giving lip-service to the plight of ‘Blacks In America’. What they believe Black communities truly need is “housing, healthcare, education” and other things offered to everyone without ever having to truly reckon with or even bother to dismantle the systemic and systematically racist policies that have created and sustained that inequality. 

What if we approached harm reduction as reparations, addressing it in the context of what it actually is? Will that finally change just how “progressive” we see these candidates who haven’t uttered the word in months? While both progressive candidates have vowed to implement a more progressive (read: controversial) approach to stopping drug overdoses (if they were to be elected), both campaigns ignore criminalization and policing. 

The countless enforcement of laws criminalizing personal drug use and possession in the U.S have and continue to cause devastating harm in Black communities despite the existence of “safe spaces”. The discriminatory enforcement of drug laws ruins individual and family lives while blatantly undermining public safety and health. 

The Human Rights Watch published a 196-page report, “Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States,” that details the enforcement of drug possession laws that cause extensive and unjustifiable harm to individuals and communities across the country. In the report, the consequences listed are separated families; exclusion from job opportunities, welfare assistance, public housing, and voting; and exposure to discrimination and stigma for a lifetime. 

graph provided by FBI, uniform crime reporting program and Human Rights Watch analysis of US Dept of Justice, FBI, UCR program, 2014.

There is not one state in this country that does not criminalize drug use and drug possession. More people are arrested for simple drug possession in the U.S than for any other crime. Despite officials’ claims that drug laws are primarily used to combat drug distribution, four times as many [predominantly Black] people are arrested for possessing drugs as they are for selling them. 

graph provided by FBI, uniform crime reporting program and Human Rights Watch analysis of US Dept of Justice, FBI, UCR program, 2014.

Harm reduction includes looking at broader social health issues like HIV/AIDS where we can also see not only the effects of long term disproportionate care but criminalization within the Black community. While from 2010 to 2017, HIV diagnosis decreased 15% among Black people in the U.S overall in 50 states and the District of Columbia, Black (and Latinx) men and women still have higher rates of not just contraction, but death. This can be attributed to not just the xenophobic stigma projected onto all people of African descent, but direct neglect. The socioeconomic issues associated with poverty that plagues many Black communities in the U.S—including limited access to high-quality health care, housing, and HIV prevention education, things we do not have control of in Black communities—coupled with Democratic Party-led bills promoting abstinence (see: The Global AIDS Bill) without actually offering care, has, directly and indirectly, increased the risk for HIV infection and affect the health of Black people living with and at risk for HIV.


Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 pdf icon[PDF – 10 MB]. HIV Surveillance Report 2019;30

When healthcare is discussed in ways that draw attention to unfair and racist practices, what is not acknowledged is why and how this became a reality for Black people in the U.S. The Black Panther Party for Self Defense, a radical organization inspired by Queen Mother Audley Moore’s push for reparations (See: Ten Point Program), understood the significance of healthcare in the Black community. In many ways, their call for self-determination was predicated on preventive health care, noting the importance of health literacy to the overall vitality of poor Black working-class people.

“We believe that the government must provide, free of charge, for the people, health facilities which will not only treat our illnesses, most of which have come about as a result of our oppression but which will also develop preventive medical programs to guarantee our future survival. We believe that mass health education and research programs must be developed to give Black and oppressed people access to advanced scientific and medical information, so we may provide ourselves with proper medical attention and care.”

True harm reduction policies, if approached as reparations, can have positive effects for Black communities. We cannot afford to conceptualize the harm reduction out of context during this continuous war on drugs, war on crime and, ultimately, the war on the Black poor that invites MORE (militarized) policing into communities directly harmed by police in cities hellbent on building more new jails.

The reparations movement exposes a history of white privilege. Wealth and poverty made under capitalism have been shaped immeasurably by slavery and racism. Safe spaces are good, safe sex is good, but which candidate is pushing decriminalization and the adequate healthcare Black communities need in order to really thrive independent of the system? Reparations are key in that it allows for the revitalization of social justice so when, where and how did we decide to limit how we push for it?