On January 23, 2023, in the modest overdose prevention space at ENSEMBLE in Moncton, New Brunswick (NB), quiet history was made in Canada with the launch of the first Our Healthbox machine during a small ceremony. The atmosphere was filled with hope, anticipation, and a shared commitment to building an accessible, healthier and more inclusive future for New Brunswickers and people living across Canada.

The weather on January 23, 2023 was a true testament to the resilience and determination of the people of New Brunswick and Canada. Despite the freezing temperatures and heavy snowfall from an ongoing storm front, a patient crowd lined up outside the ENSEMBLE building (Moncton), showing their support and the need for Our Healthbox - to access the things they needed for their health and well-being in
their community.

Our Healthbox launched as new HIV cases continue to increase and Canada’s opioid crisis inflicts tragic impacts on people, families and communities across the country. New Brunswick, like many other regions in Canada, has been grappling with substance use and its associated public health challenges for several years. The rise of opioid use in Canada has led to a surge in overdose deaths and an alarming increase in the spread of infectious diseases including Hepatitis C, HIV and other sexually transmitted infections. Unfortunately, the stigma attached to substance use and HIV has hindered the delivery of critical harm reduction services including access to harm reduction supplies and things we often take for granted.

“We are currently in the midst of a substance use crisis that sees the death of one New Brunswicker every four days.” - Deborah R. Warren, Executive Director at ENSEMBLE.

Providing easy access to harm reduction and healthcare supplies for free to people in spaces they frequent is a strategy experts consider as key to reaching people who are underserved (typically with complex healthcare needs) and who have barriers to accessing testing, harm reduction materials, treatment, care and prevention due to racism, homophobia, stigma and discrimination. Our Healthbox is a comprehensive initiative and program that aims to provide low barrier access to things people need for their help and connect people to healthcare and harm reduction services in Canada. The program is built on the foundation of leveraging the latest new technology (interactive dispensing systems) to improve health outcomes and wellbeing for people, and foster community engagement support for underserved populations.

“Everyone in Canada deserves to have what they need, when they need it, to take care of their health. But we know that this is not the case, and so we are doing everything we can to bridge that gap in ways that work for each person in their community.” - Dr. Sean B. Rourke, Scientist at MAP Centre for Urban Health Solutions at St. Michael’s Hospital, and the Director of REACH Nexus, a national research group working on how to address access and treatment for HIV, Hepatitis C and other sexually transmitted and
blood-borne infections.

One of the critical aspects of Our Healthbox is its focus on harm reduction, especially in the context of substance use and HIV. Our Healthbox is a smart machine that dispenses free self-testing kits for HIV and COVID-19, naloxone kits, essential harm reduction, sexual health and wellness supplies. The machines will operate like a vending machine and will also provide health educational resources and a service directory for people to find much-needed healthcare and supports in their community without fear of judgment or discrimination. Through this initiative, we hope to reduce the transmission of blood-borne infections, prevent overdose fatalities, and ultimately offer pathways to care and recovery for those who seek it – in ways that can work better for them in their community. Our Healthbox directly addresses this need for harm reduction supplies by providing easily accessible Healthboxes in strategically placed locations in communities across New Brunswick and Canada like
health clinics, pharmacies, and public spaces to ensure that individuals can obtain the supplies they need without judgment or barriers. The community determines what items are needed and each Healthbox - which can contain a range of harm reduction items, including naloxone kits, new needles, condoms, hygiene products and HIV self-test kits along with educational materials about safe practices and other
health-related topics. By normalizing the availability of harm reduction resources, the initiative aims to create a safer environment for everyone in New Brunswick and across Canada, regardless of personal circumstances.

“Our Healthbox will ensure underserved individuals in the community have low barrier access to resources that not only reduce their risk of infections, but in fact save their lives… Providing access to free naloxone will save many lives.” - Deborah R. Warren, Executive Director at ENSEMBLE (Moncton, NB).

The success of the Our Healthbox relies on the collaboration and support of individuals and organizations committed to reducing inequities in communities. The East Coast launch of Our Healthbox is generously funded by Even the Odds, an initiative by Staples Canada and MAP Centre for Urban Health Solutions to raise awareness of inequity in Canada and to help build vibrant, healthy communities. This partnership demonstrates a shared commitment to addressing health inequities in communities across Canada.

"Staples and Even the Odds are focused on building and empowering communities. We believe that Our Healthbox is an important opportunity to do just that, by connecting people with the resources they need, and empowering people to take charge of their health and wellbeing. We are so pleased to be part of bringing Our Healthbox to the Maritime Provinces." – Wanda Walkden, Chief Human Resources and Communications Officer at Staples Canada.

Thanks to research funding from the Canadian Institutes of Health Research (CIHR), Public Health Agency of Canada (PHAC), Canadian Foundation for AIDS Research (CANFAR), TD Bank, St. Michael’s Foundation, and Even the Odds (Staples Canada and MAP Centre for Urban Health Solutions partnership) we will learn how well it reaches and supports those most in need and underserved across Canada. We believe that everyone should have access to what they need for their health and wellbeing, and the opportunity
to thrive.

By raising awareness about this initiative, we can help to break down stigma surrounding substance use, promote harm reduction as a vital public health strategy, and encourage open dialogue about healthcare needs. Our Healthbox can make a lasting difference in the lives of people across Canada and pave the way for stronger, healthier and more resilient communities.

Authors: Darshanand Maraj, Sean Rourke

ENSEMBLE is a community-based organization in Moncton (NB) that works to address complex social issues by providing support, education and prevention initiatives.

REACH Nexus is an ambitious national research group working on how to address HIV, Hepatitis C, and other STBBIs (sexually transmitted and blood-borne infections) in Canada. Our focus is on reaching the undiagnosed, implementing and scaling up new testing options, strengthening connections to care, improving access to options for prevention and ending HIV stigma. REACH Nexus is part of MAP Centre for Urban Health Solutions at St. Michael's Hospital, Unity Health Toronto, and is funded by the Canadian Institutes of Health Research.

Even the Odds is a partnership between MAP and Staples Canada to raise awareness of inequity in Canada, and to help build vibrant, healthy communities.