After 36 years of pioneering work in the field of harm reduction, Mainline, a leading Dutch harm reduction organisation, has to close due to budget constraints. We interviewed its executive director, Ancella Voets, on this occasion.
Drugreporter: Many in the harm reduction community were shocked to learn that Mainline, a pioneering harm reduction organization for more than three decades, has to close down due to a lack of funding. I believe I can speak on behalf of many others when I ask: is this really a final decision?
Ancella Voets: Yes, unfortunately this decision is final. Mainline has been struggling with funding gaps for several years. The decision by the Dutch Ministry of Health, Welfare and Sport to terminate our funding was the final blow. It would be irresponsible toward our staff and the partners we work with to continue any longer, because we would risk a sudden and forced disruption in the coming months. By announcing this now and phasing out our activities one by one, we hope to leave the experience and legacy of the past 36 years in the hands of partners who will take good care of it.
The decision by the Dutch Ministry of Health, Welfare and Sport to terminate its subsidy appears to have been the tipping point. What reasons were given for this decision, and what does it say about the current political climate around harm reduction in the Netherlands?
The decision to terminate our funding was taken under the former extreme right-wing government. The Ministry stated that responsibility for Mainline’s work would be moved from the central level to the municipal level. However, for the small grassroots organisation that we are, it is utterly impossible to build relationships in all 342 municipalities of the country, or even to obtain, manage, and report on funding from, let’s say, the ten largest municipalities. Still, the new cabinet, installed on the 23rd of February, sticks to the argument of its predecessor.
The political climate around harm reduction… well, what to say? The political climate in general has been one of “self-reliance” for many years in the Netherlands, basically meaning more privatisation and less care for marginalised or economically disadvantaged populations. This culminated in the creation of an extreme right-wing government that fortunately did not last long. But it did provide a free pass for increased hatred and violence toward various groups such as refugees and transgender people. In this light, the destruction of harm reduction is almost logical.
Looking back over the past 36 years, what do you see as Mainline’s most important contributions to harm reduction and to people who use drugs?
In the Netherlands, Mainline has been vital in reaching people who could not access services, without stigmatising them further, and in providing them with information. This also allowed us to collect crucial information on drug trends for the government, for example on the increase in crack cocaine use in recent years.
Over the past 15 years, Mainline has also played a leading role in addressing chemsex, both in the Netherlands and internationally. And I think I can say we have been a beacon of light for many grassroots organisations across the world — at least that’s what I’m hearing now from the heartwarming messages coming in from all corners of the globe.
With the closure of Mainline, what gaps do you fear will appear in harm reduction services in the Netherlands?
For people who live on the margins of society and who cannot, for whatever reason, access basic services such as shelter, information, and healthcare, life will become even harder. No other organisation works the way our outreach workers do: making contact without an agenda and meeting people where they are, without pushing them into a “trajectory” that does not fit their needs.
On the other hand, policymakers and healthcare providers will notice an increasing lack of information once we are no longer around to translate signals from street scenes into training and policy recommendations. In other words, the disconnection between people and services will increase at a time when we already see rising homelessness and more street-based drug use.
As for the (predominantly) gay men turning to us because of chemsex issues, they will lose their safe spaces to meet and discuss these issues, both online and offline.
Mainline worked not only in the Netherlands but also internationally. For many organizations in countries where harm reduction is less developed, Mainline has long served as an important point of reference. Are you concerned that Mainline’s closure sends the wrong message to those countries?
The messages and funding cuts coming from the United States have much more impact, of course, than whatever the Dutch government does. But I do hear from many grassroots partners around the world that they are extremely disappointed that something like this can happen in the Netherlands. Fortunately, the global harm reduction movement is much stronger than it was 26 years ago, when Mainline started working internationally. In many parts of the world we have seen knowledge, awareness, and skills around harm reduction grow significantly. This will survive without Mainline. But the symbolic loss is huge — almost as if a parent were passing away.
We are seeing both progress and backlash in drug policy around the world. Do you think harm reduction is entering a new phase globally?
Personally, I’m very happy to see that harm reduction has grown immensely over the past 20 years. Around the globe there are people who deeply understand harm reduction and who give everything they have to implement this approach to drug use. Of course, these are mostly people from — or closely connected to — communities of people who use drugs.
At the institutional level, however, we see that most governments still try to avoid implementing harm reduction and continue to criminalise and marginalise both people who use drugs and those who want to stand by them. The fact that repression and conservatism have become so strong in countries that used to fund and promote harm reduction makes it much easier for other governments to stall or simply ignore this life-saving approach.
After years of leading Mainline, what have your clients — people who use drugs — taught you?
Oh! So many things: humbleness, kindness, patience, resilience, humanity. All those things I had to learn. I’ve had the privilege to work not only in the Netherlands but also in many other countries, notably in Central and Eastern Europe, in Eastern, Western, and Southern Africa, and in Brazil and elsewhere in Latin America.
Even though the context is different each time, the issues people struggle with are generally the same: criminalisation, marginalisation, deeply entrenched stigma, often leading to depression, burnout, and sometimes destructive behaviour. I don’t want to romanticise it, because people are literally dying. But every time I took the time to see the person behind their problems, a connection would form. And then that person would reveal themselves to be a full-fledged human being — of course, like any of us.
So I think that’s the most important thing I learned: taking the time to truly see and acknowledge the other person.
