Policy translation in global health governance: Localising harm reduction in Tajikistan

Global Social Policy. 2021. Vol. 21. No. 1. P. 75–95.

Kluczewska K., Korneev O.

This article analyses how global governance frameworks and knowledge claims are
translated to fit local contexts. It specifically looks at harm reduction initiatives targeting
injection drug users utilising the case of Tajikistan. In the 1990s, this post–Soviet
Central Asian country became exposed to an inflow of cheap and easily available heroin
from Afghanistan. While Tajikistan mainly became a transit country, some parts of the
local population also became addicted. To tackle the negative consequences of heroin
addiction, starting from the 1990s international donors proposed the country adopt
a range of harm reduction measures, including providing access to opioid substitution
therapy and establishing drop-in centres where single-use needles and syringes would
be distributed. This article discusses how donor-promoted harm reduction initiatives
were localised in Tajikistan, why and with what outcomes. It argues that instead
of a full acceptance or rejection of knowledge promoted by international actors, a
complex translation process can be observed on the ground. International norms are
thus localised by taking into account societal attitudes towards injection drug users,
the changing nature of legitimate expertise, evolving national legislation and everyday
practices, against the background of other conflicting global governance regimes and
local geopolitical priorities.

Keywords: Центральная Азия, Таджикистан, локализация, Central Asia, Tajikistan, HIV/AIDS, global health governance, глобальное управление в сфере здравоохранения, ВИЧ/СПИД, harm reduction, Policy translation, localisation, снижение вреда, перевод политических курсов