Thank you, Mr. Chair.

Honourable members, thank you for inviting me to participate in your work.

As national operations director at Doctors of the World, I am honoured to bear witness to the realities on the ground experienced by our teams in Canada.

As a nurse by profession, I walked the streets of Montreal in 2006 to provide frontline care to marginalized people and people experiencing or at risk of homelessness. I now accompany a team of nearly 20 health professionals who provide care and community support.

Doctors of the World is an international health organization with a presence in more than 70 countries. It has been here in Canada since 1996. Our mission is to ensure and defend access to health care for people in exclusion, insecurity or crisis situations.

In Montreal, for nearly 30 years, the teams at our mobile clinic and in our mental health program have been working with people who are homeless or at risk of becoming homeless, including urban indigenous populations and people who use licit or illicit psychoactive substances.

Our teams witness growing precariousness on a daily basis, alarming deterioration in living conditions and the harmful consequences of prohibitionist policies on these individuals and communities.

As a health organization, we advocate for a risk and harm reduction approach based on public health considerations and respect for human rights. When it comes to this health and social crisis, our observation is clear: Whether in legislation, policies, care protocols or the practice of health care and social services professionals, we must seek to support these individuals, not punish them, coerce them or further exclude them.

Our teams are concerned that they are seeing more and more people using alone, putting them at increased risk in the event of an overdose or drug poisoning. It is essential to support and design measures that promote safe consumption and, in particular, to provide support where people are not afraid of being judged or repressed. This means maintaining and expanding supervised consumption sites, providing access to naloxone and ensuring safe supply. Every day, our teams witness the positive impact of these interventions on people's health and safety. Beyond these services, we need to provide comprehensive support for people at risk of overdose and drug poisoning, particularly those the traditional system cannot reach.

I want to highlight the role of peers and community-based intervention in preventing and adapting services and approaches to people who use drugs. People with experiential knowledge have a unique ability to build trust with people experiencing substance use problems. They have invaluable life experience to help them identify and prevent crisis situations, such as overdoses and relapses. By adapting to the realities of the people they meet, they share vital information on risk and harm reduction, help people better understand and access essential health services, and guide them through their journey.

Community organizations, on the other hand, play an invaluable role by providing a support and solidarity framework for people in precarious situations. These organizations are often the first points of contact for people in crisis. They provide basic services, such as meals, shelter and clothing, but above all they provide a safe and non-judgmental space where people can get support.

Finally, a diversity of tailored approaches and services is critical. Substance use involves individuals of all backgrounds and gender identities, as well as all ages and socio-economic status. Every life course and every consumption experience is unique, which requires a great deal of flexibility and tailoring of interventions to be effective. A rigid or one-sided approach will not meet the complex needs of these individuals.

For example, our work with urban indigenous communities has shown us that standard services do not always suit their reality. We are working closely with the Indigenous Community Network in Montreal, because the solutions to this crisis must be determined, designed and put in place by those who are living and experiencing the direct impact of repressive policies.

In summary, we need to prioritize risk and harm reduction measures, because they save lives. Collaboration among peers, community organizations and health systems must be funded and encouraged to reach those who traditional services cannot reach.

We advocate for a diverse strategy that promotes dignity, respect and support. It's important to support these individuals, not punish them.

Thank you.