Date: 2025-10-20
Source: The Lancet, World Report — “Harm Reduction in Colombia” (Thornton, 2025)
The Essentials
Type: Qualitative/policy analysis of Colombia’s harm-reduction strategy, centered on Bogotá’s Project Cambie — South America’s first supervised drug-consumption site.
Key results: 1,564 visits by 67 users in year one; 14 overdoses reversed (10 onsite, 4 nearby); 88 registered users as of mid-2025.
Economics: Operates on ~US$6,500/month, currently funded by Open Society Foundations; national harm-reduction funding ~US$300,000/year (upper bound).
Policy impact: For the first time, Colombia’s 10-year National Drug Policy formally includes harm reduction; in March 2025, a UN CND resolution led by Colombia calls for reviewing the global drug regime.
Equity relevance: Reframes drug use from crime to a public-health issue, centering dignity, rights, and social inclusion.
Why It Matters
Cambie is not a miracle but a proof of concept: the politics of care can outlast the politics of punishment. In a country long defined by a “war on drugs,” this small room redefines success — not tons seized or hectares eradicated, but lives preserved.
By embedding care within rights, Colombia’s experiment shows harm reduction is not moral leniency but institutional intelligence: governance that accepts reality to save lives. The site’s existence exposes how systems that count repression as progress often forget people.
Moral arithmetic: dignity — not prohibition — is the variable that decides who survives.
What Changes in Practice
Health/Regulation: Opens space for community-based, rights-driven services within public-health frameworks; highlights regulatory gaps (e.g., oxygen restrictions) that require adaptation.
Industry/Innovation: Encourages cross-sector funding (e.g., earmarking “sin taxes” from combustible tobacco, alcohol, and ultra-processed foods) to sustain prevention and care.
Society/Environment: Reduces overdose deaths, humanizes users, and fosters civic empathy through peer-led, non-transactional care — turning stigmatized spaces into networks of recognition and trust.
Scenarios & Next Steps
Short term (1–2 years): Expand Bogotá’s pilot; strengthen overdose-response training; create legal exceptions for oxygen use; secure municipal co-funding.
Medium term (3–5 years): Institutionalize harm reduction in national health services; build real-time monitoring (better data, process metrics, outcome tracking); replicate the model in other Latin American cities.
Long term (5–10 years): Shift from punitive to preventive paradigms; embed harm-reduction diplomacy in regional frameworks (OAS, UN); measure success by dignity and survival, not repression metrics.
The Takeaway
Between the syringe and the law, there are people — and that is where history, truly, happens.
Further Reading:
The Room Where the War Pauses
The idea is simple. The politics aren’t. You walk in expecting policy; you meet people. Start with the mirrors: tilted to catch a breath before it fades. In central Bogotá, Cambie—South America’s first supervised consumption site—rehearses a slow, unfashionable politics: keeping people alive. Colombia is taking its case abroad and, as Jacqui Thornton re…
Original report: Thornton, J. “Harm Reduction in Colombia.” The Lancet — World Report, 17 May 2025.
