IHRA Counts the Costs of the War on Drugs

A key cost of the war on drugs is the the lack of access to to harm reduction (including needle exchange and opiate substitution treatment) and treatment, and the still high prevalence of HIV/AIDS amongst injecting drug users, that results where such access remains inadequate. Drug war politics continue to prioritise punitive enforcement over proven public health interventions, even when these have been clearly and unequivocally advocated in widely adopted declarations by UN health agencies. Worse still, it is invariably the the most vulnerable groups in society who carry the greatest burden of these costs - in terms of their health and wellbeing, freedoms and human rights.

Transform is pleased to support this year's IHRA conference declaration (sign here , download the pdf here) copied below, that highlights many of these issues and calls upon Governments to meet their commitments to address them. We encourage all interested parties to do the same.

IHRA is a partner organisation in the new Count the Costs project, launched this March at the UN Commission on Narcotic Drugs in Vienna. They are part of the grouping of organisations helping to gather and present more resources over the coming year, highlighting the health and human rights costs of the continued political commitment to a global war on users, suppliers and producers and the communities in which they live.

The Official Declaration of the 2011 International Harm Reduction Conference

Of the 33.3 million people living with HIV globally, an estimated three million are people who inject drugs.^{12 3} They account for 30% of HIV infections outside of sub-Saharan Africa, and up to 80% of infections in Eastern Europe and Central Asia.


The 2001 UNGASS Declaration of Commitment and the 2006 Political Declaration on HIV/AIDS established time-bound targets to be met and reported on by countries worldwide. The commitments aimed to address the needs of people who inject drugs, their families and the communities in which they live through an “urgent, coordinated and sustained response.” ^{4 5} These commitments remain unfulfilled. People who inject drugs are increasing as a percentage of global HIV infections with devastating consequences for individuals and communities.

The mobilisation of an “intensified, much more urgent and comprehensive response”⁵ to HIV for people who inject drugs requires strong global leadership, concrete national policies and adequate funds to implement and scale up evidence-based services. The targets and commitments set in the 2006 Political Declaration must be met to address the needs of, and to fulfill the human rights of people who inject drugs living with and at risk of HIV. World leaders gathering at the June 2011 UN General Assembly High Level Meeting on HIV/AIDS must ensure that these commitments are met as a matter of urgency.

At the 2011 United Nations High Level Meeting on HIV/AIDS, we, the undersigned, call for:

1. Acknowledgement that people who use drugs, as a key population group affected by HIV and AIDS, have not reached universal access to HIV prevention, treatment, care and support;
2. Renewed commitment and action toward the goal of universal access to comprehensive HIV prevention, treatment, care and support for people who inject drugs through the financing, implementation and scale-up of evidence-based harm reduction interventions; and
3. Commitment to removing legal and policy barriers to achieving the aims above, particularly a reorientation of punitive drug policies toward evidence- and human rights-based approaches.

It is time for action on HIV-related harm reduction. It is time for accountability for the rights of people who inject drugs.

A number of commitments made in the 2006 Political Declaration to address the international response to HIV remain unmet for people who inject drugs. Among them:

Commitment: “Ensure that a wide range of prevention programmes...including sterile injecting equipment and harm-reduction efforts related to drug use...is available in all countries, particularly the most affected countries” [paragraph 22]

Of the 158 countries and territories with reported injecting drug use globally, almost half lack essential harm reduction services.⁶ In most countries where needle and syringe programmes and opioid substitution therapy are available, coverage is still poor, reaching far below the numbers needed to have an impact on the epidemic.^{7 8} The situation for people held in places of detention is dire. Thirty-nine countries currently provide opioid substitution therapy in prisons, while only ten provide needle and syringe exchange, often reaching small numbers in few institutions.⁹

Action required: Evidence-based programmes targeting people who inject drugs need to be implemented and scaled up urgently across all settings in order to effectively prevent the further spread of HIV.

Commitment: “Reduce the global HIV/AIDS resource gap” [paragraph 39]

Less than 10% of the estimated need for harm reduction funding globally is presently being met. Current expenditure works out to less than three US cents per day per person injecting drugs.^{1011 12}

Approximately US$160 million was spent on HIV-related harm reduction in low and middle income countries in 2007, falling far short of the US$2.13 billion that UNAIDS estimates was needed in 2009, and the $3.2 billion in 2010.

Action required: National and international resources for HIV-related harm reduction must be scaled up as a matter of urgency.

Commitment: “Eliminate gender inequalities, gender-based abuse and violence; increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of health care and services” [paragraph 30]

Women and girls who inject drugs are more vulnerable to drug-related harms, including HIV infection, than are men who inject drugs.¹³ In a number of regions globally, injecting drug use is often perceived to conflict with the “socially derived roles of women as mothers, partners and caretakers”, exposing them to greater stigma and human rights violations than men who inject drugs.^{13 14 15} Most women do not have access to services that meet their sexual and reproductive health needs and increase their capacity to protect themselves from HIV infection.¹⁶ Incarcerated women who inject drugs face elevated health risks, including HIV infection, than do non-incarcerated women, yet have little or no access to legal frameworks and services that address their particular needs.^{17 18 19}

Action required: Gender-specific services and policies that facilitate their implementation are urgently required to ensure that women who inject drugs can effectively protect themselves from HIV infection.

Commitment: “Address the rising rates of HIV infection among young people to ensure an HIV-free future generation through the implementation of comprehensive, evidence-based prevention strategies” [paragraph 26]

Young people are increasingly affected by HIV and other harms associated with drug injecting.^{20 21} While we know that early intervention is necessary across age groups, legal barriers often prevent their implementation.^{22 23} In accordance with recent recommendations by the UN Committee on the Rights of the Child, there remains a need to provide “specialised and youth friendly...harm reduction services for young people” and to “amend laws that criminalise children for possession or use of drugs” in countries where such policies continue to be enforced.²²

Action required: In order to effectively address drug injecting among young people, legal age restrictions for accessing sterile equipment and opioid substitution therapy must be lifted. Services integrating harm reduction, HIV testing and prevention, and sexual and reproductive health for young people must be made widely accessible.

Commitment: “Overcome legal, regulatory or other barriers that block access to effective HIV prevention, treatment, care and support” [paragraph 15]

There is clear evidence that criminalisation of people who use drugs and law enforcement have not only failed to reduce the prevalence of drug use, but have created harms that fuel the HIV epidemic.^{23 24 25 26} Many countries continue to prohibit the provision of sterile injecting equipment and opioid substitution therapy and criminalise drug possession and paraphernalia.^{2728 29 30}

Such measures can drive people who inject drugs away from prevention and care services and increase the risk of HIV infection. People who inject drugs face further discrimination in terms of access to effective HIV treatment.

Action required: Ineffective and punitive drug policies, particularly criminalisation of drug possession, must be reformed to ensure the realisation of human rights, and to support the implementation of evidence-based interventions for people who inject drugs, as outlined in the Vienna Declaration.³¹

Commitment: “Eliminate all forms of discrimination against and ensure the full enjoyment of all human rights and fundamental freedoms by people living with HIV and members of vulnerable groups” [paragraph 29]

People who inject drugs, particularly women, continue to experience multiple layers of stigma and discrimination that effectively undermine HIV prevention, treatment and support efforts.^{3233 34 35 36} Record incarceration figures due to drug law enforcement have led to overcrowding and poor conditions in prisons.^{37 38}

Severe human rights violations against people who use drugs, such as cruel, inhuman and degrading treatment, arbitrary arrest and detention, and extortion and police violence have been documented widely in a number of countries.

Action required: Punitive and discriminatory measures must be discontinued, and adequate resources dedicated to promoting health and human rights-based responses to drug use and HIV.

References

¹ UNAIDS (2010) Global Report on the AIDS Epidemic. View report Geneva: The Joint United Nations Programme on HIV/AIDS.
² Mathers B et al (2008). The global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. Lancet, 372 (9651), 1733-1745.
³ Mathers B et al (2010). HIV prevention, treatment, and care services for people who inject drugs: A systematic review of global, regional, and national coverage. Lancet, 375, DOI:10.1016/S0140-6736(10)60232-2.
⁴ 2001 Declaration of Commitment on HIV/AIDS, UN GA Special Session on HIV/AIDS, 25-27 June 2001, paragraph 7.
⁵ Political Declaration on HIV/AIDS UN GA Res 60/262, 2 June 2006, paragraph 14.
⁶ Cook C. (2010) The Global State of Harm Reduction: Key Issues for Broadening the Response. London: International Harm Reduction Association.
⁷ Mathers, B. Degenhardt, L. Ali, H. Wiessing, L. Hickman, M. Mattick, R. P. Myers, B. Ambekar, A. Strathdee, S. A. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. The Lancet. 2010 Mar. 20: 375(9719):1014-28.
⁸ WHO, UNODC, UNAIDS (2009) Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users. Geneva: World Health Organisation.
⁹ Jurgens R. (2010) ‘Out of sight, out of mind: Harm reduction in prisons and other places of detention.’ In The Global State of Harm Reduction: Key Issues for Broadening the Response. London: International Harm Reduction Association.
¹⁰ Stimson G., Cook C., Bridge J., Rio-Navarro J., Lines R., Barrett D. (2010) Three Cents a Day Is Not Enough: Resourcing Harm Reduction on a Global Basis. London: International Harm Reduction Association.
¹¹ Stimson G., Cook C., Bridge J., Rio-Navarro J., Lines R., Barrett D. (2010) Three Centre a Day Is Not Enough: Resourcing Harm Reduction on a Global Basis. London: International Harm Reduction Association.
¹² UNAIDS (2007) Financial Resources Required to Achieve Universal Access to HIV Prevention, Treatment, Care and Support. UNAIDS Inter-agency Task Team on Young People. World Health Organisation: Geneva.
¹³ Roberts A., Mathers B. and Degenhardt L. (2010) Women who inject drugs: A review of their risks, experiences and needs. Secretariat of the Reference Group to the UN on HIV and Injecting Drug Use. National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.
¹⁴ Sherman, S.G., Women and drugs across the globe: A call to action. International Journal of Drug Policy, 2008. 19(2): p. 97‐98.
¹⁵ Olszewski, D., Giraudon, I., Hedrich, D., Montanari, L., Women's Voices: Experiences and perceptions of women who face drug‐related problems in Europe. 2009. European Monitoring Centre for Drugs and Drug Addiction.
¹⁶ Roberts A., Mathers B. and Degenhardt L. (2010) Women who inject drugs: A review of their risks, experiences and needs. Secretariat of the Reference Group to the UN on HIV and Injecting Drug Use. National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.
¹⁷ Ashdown J. and James M. (2010) Women in Detention. International Review of the Red Cross. Volume 92: 877.
¹⁸ Ashdown J. and James M. (2010) Women in Detention. International Review of the Red Cross. Volume 92: 877.
¹⁹ WHO, UNODC (2009) Women’s health in prison: correcting gender inequity in prison health. Download PDF. Copenhagen, Denmark.
²⁰ EHRN (2009) Young people and injecting drug use in selected countries of Central and Eastern Europe. Eds. Jean-Paul Grund and Simona Merkinaite. Eurasian Harm Reduction Network View PDF.
²¹ WHO (2006) Preventing HIV/AIDS in Young People: A systematic review of the evidence from developing countries. Eds. David A. Ross, Bruce Dick and Jane Ferguson. UNAIDS Inter-agency Task Team on Young People. World Health Organisation: Geneva.
²² Committee on the Rights of the Child (2011) Fifty-sixth session: Consideration of Reports Submitted by States Parties Under Article 44 of the Convention.
²³ Degenhardt L, Chiu W-T, Sampson N, et al. (2008) Toward a global view of alcohol, tobacco, cannabis, and cocaine use: Findings from the WHO World Mental Health Surveys. PLOS Medicine. 5:1053-67.
²⁴ Jurgens R, Ball A, Verster A. (2009) Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infectious Disease. 9:57-66.
²⁵ The National Centre on Addiction and Substance Abuse at Columbia University (2009). Shoveling up II: The impact of substance abuse on State budgets. New York: Columbia University.
²⁶ Reuter P. (2009) Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction 2009;104:510-7.
²⁷ Reuter P. (2009) Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction. 104:510-7.
²⁸ Lert F. and Kazatchkine M.D. (2007) Antiretroviral HIV treatment and care for injecting drug users: an evidence-based overview. International Journal of Drug Policy. 18:4.
²⁹ IHRD (2008). Harm Reduction Developments 2008: Countries with Injection Driven HIV Epidemics. New York: International Harm Reduction Development Program (IHRD) of the Open Society Institute.
³⁰ Wolfe D., Carrieri P. and Shepard D. (2010) Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward. Lancet. 376: 9738, 355-366.
³¹ The Vienna Declaration (2010) View declaration.
³² Ahern J, Stuber J, Galea S. (2007) Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence. 88:188.
³³ Gallahue P. and Lines R. (2010) The Death Penalty for Drug Offences: Global Overview 2010. The International Harm Reduction Association. London: International Harm Reduction Association (IHRA).
³⁴ Open Society Foundations (2010) Human Rights and Drug Policy Briefings for the UN Commission on Narcotic Drugs “Briefing 2: Human Rights and Drug Policy: Drugs, Criminal Laws and Policing Practices.” Download PDF. December 2010.
³⁵ Human Rights Watch (2010) Where Darkness Knows No Limits: Incarceration, Ill-treatment and Forced Labour as Drug Rehabilitation in China. Ed. Joseph Amon. New York: Human Rights Watch.
³⁶ IHRD (2009) Human Rights Abuses in the Name of Drug Treatment: Reports from the Field. New York: International Harm Reduction Development Program (IHRD) of the Open Society Institute.
³⁷ United Nations General Assembly. A/65/255 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Paragraph 68.
³⁸ C. Hughes and A. Stevens (2007) The Effects of Decriminalization of Drug Use in Portugal. The Beckley Foundation Drug Policy Programme. Briefing Paper 14.

IHRA launches 'The Death Penalty for Drug Offences: Global Overview 2010' report

 
The International Harm Reduction Association released a study on the death penalty for drug offences today on the opening day of the 19th session of the UN Commission on Crime Prevention and Criminal Justice, taking place in Vienna. The report, titled ‘The Death Penalty for Drug Offences: Global Overview 2010’ (2.4meg pdf), finds that hundreds of people are executed for drug offences each year around the world, a figure that very likely exceeds one thousand when taking into account those countries that keep their death penalty statistics secret.

The report is the first detailed country by country overview of the death penalty for drugs, monitoring both national legislation and state practice of enforcement. Of the states worldwide that retain the death penalty, 32 jurisdictions maintain laws that prescribe the death penalty for drug offences. The study also found that in some states, drug offenders make up a significant portion – if not the outright majority – of those sentenced to death and/or executed each year.

 

IHRA conference plenary : 'The Next Generation of Drug Policy: Decriminalisation and Beyond'

Transform, in collaboration with the International Drug Policy Consortium organised the Tuesday plenary session at this year's International Harm Reduction conference in Liverpool, titled 'The Next Generation of Drug Policy: Decriminalisation and Beyond'. The Session was chaired by John Ashton, and the presentation abstracts are copied below (full program available here in pdf). Transform's contribution made the front cover of today's conference report (see below), with Alex Steven's presentation on Portuguese decriminalisation also covered on page 6. When the video of the session is available online we will add a link here.

Session Chair John Ashton, Director of Public Health for Cumbria

Shift of paradigm in drug-related public policies in the Argentine Republic and Latin American countries

• Presnted by Martín Acuña: High Court judge and Ministerial advisory board on Narcotics member, Argentina

Argentina, like all the other Latin American countries, has adhered to the 1961, 1971 and 1988 United Nations Conventions on drugs and the subsequent laws that have been passed reflect this by penalising possession of drugs for personal use and imposing heavy penalties for drug trafficking and even micro-traffic. This enforcement- focused approach to drug control has placed a heavy burden on the judicial system and the high incarceration rates for drug-related offences have led to prison overcrowding.

To address the negative consequences of prohibition, many countries in Latin America have enacted a series of laws to discriminalise the possession of small quantities of drugs for personal use: Brazil (2006), Chile (2005), Paraguay (1988), Uruguay (1998), Mexico (2009). Argentina’s and Colombia’s Supreme Courts have recently followed suit in the cases of “Arriola” and “Bastidas” 2009, respectively.

The Argentinian goverment’s decision, translated at an international level into the United Nations (51st session, March 2008), advocating a paradigm shift in drug policy towards greater emphasis on access to the health care and respect for the drug user’s dignity and basic human rights. At a national level the shift led to the establishment of the Scientific Advisory Committee on Drugs, aimed at developing drug-related programmes from a public health perspective, and pursuing reform of domestic and international drug control systems in line with the international conventions on human rights.

The committee’s calls for reform highlighted the need to ensure access to health care as the central focus of any drug policy, as well as critiquing the failure of the current drug policy on supply control and demand reduction indicators. This critique demonstrated in particular the futility of enforcement efforts which disproportionately focused on low-level users and small-scale dealers.

Decriminalisation: pushing the limits of drug control

• Presented by Genevieve Harris from Release/IDPC,
• Originally to be presented by Ann Fordham from IDPC, who was unable to attend because of the volcano flight disruption.

Almost all nations are currently members of the global drug prohibition regime. This operates via a UN-based treaty system comprising a suite of three international drug control conventions: the 1961 Single Convention on Narcotic Drugs (as amended by the 1972 Protocol), the 1971 Convention on Psychotropic Substances and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. The bedrock of the regime is the Single Convention. This contains a general obligation for signatory nations, subject to the provisions of the convention, to limit exclusively to medical and scientific purposes the production, manufacture, export, import, distribution of, trade in, use and possession of drugs. Although the prohibitionist ethos of the regime is beyond doubt, the conventions nonetheless contain a certain degree of flexibility. This presentation explores the various legal mechanisms behind such “wiggle room” and outlines how a growing number of parties to the conventions have engaged in “soft defection” from the regime’s prohibitive expectancy; a process involving interpretative strategies that keep national policies within the confines of the letter, if not the spirit, of the international legal framework.

Despite such grey areas, latitude is by no means unlimited, however. Indeed, it will be shown how, in expanding domestic policy space, many states are now at the limits of what is legally permissible within the extant regime. The presentation will also show how, while the conventions permit a degree of policy flexibility in terms of possession for personal use, there is no such scope for production and supply. This is a particularly acute point of tension as more jurisdictions adopt tolerant approaches to dealing with the recreational use of cannabis.

National strategy on drugs in Portugal: innovation and evidence

• Presented by Alex Stevens, criminologist from Kent University
• Originally to be presented by Fatima Trigueiros from the Institute for Drugs and Drug Addiction, Portugal, who was unable to attend because of the volcano flight disruption.

In 1999, the Portuguese government approved the first national strategy on drugs, a historic turning point for drug policy. One of the measures proposed by the strategy was the decriminalisation of consumption and possession of all illicit drugs for personal use (defined as a quantity that must not exceed that needed for average individual consumption over ten days). In 2001, this was made law in Portugal. This new law meant that personal consumption and possession would no longer be considered a crime, but would constitute an administrative offence – therefore no longer carrying a penalty of imprisonment.

The main purpose of this law was to prevent and reduce drug use and to promote and protect the health and social well-being of people who use drugs and encourage them to enter treatment. Eight years later, all the available evidence and indicators suggest that the overall impact of this law has been positive – although a direct link between these results and decriminalisation cannot be assumed. Decriminalisation is one element of a comprehensive national strategy aimed at preventing drug use, facilitating access to counselling and treatment, and establishing effective measures to reduce the adverse health and social consequences of drug use.

There have been some problems and challenges in implementing the law and we intend to propose some adjustments to it in the near future, based on past experiences. The INCB orginally accused Portugal of disrespecting the UN conventions on drug control but – after two missions to Portugal – they now recognise some of the benefits of Portuguese law. The 2009 World Drug Report noted that “Portugal’s decriminalisation of drug usage in 2001 falls within the Convention parameter”.

The2009 Annual Report of the EMCDDA has also recognised that decriminalisation has not led to an increase in drug use or drug tourism in Portugal.

After the War on Drugs: Blueprint for Regulation

• Presented by Steve Rolles, Senior Policy Analyst for Transform

This presentation explores what an evidence-based drug policy, based on public health and harm reduction principles, might look like if freed from the constraints of existing absolutist prohibitions on drug production, availability and use specified by the UN drug conventions. In a post-drug-war world how might legal regulation and control of drug markets function? What would the appropriate models be for different drugs? How could they be developed and implemented?

It will be argued that legal regulation of drug markets – finding the optimum point between the extreme poles of absolute prohibition and unregulated legal commercial activity – is the rational continuation of a broader harm reduction approach; one that considers the origins of drug harms in macro policy environments, specifically the punitive enforcement approaches.

The menu of possible regulatory options for drug markets will be reviewed in summary, including potential legal controls over products, outlets, vendors, availability, premises and using environments, and purchasers, to consider how to control availability in ways that deliver the best outcomes both for users and wider society.

It will be proposed that different drugs, depending on product risk assessments and local environments, could be made available either through medical prescription models, a specialist pharmacist model, various forms of licensed sales or licensed premises, or unlicensed sales. More risky drugs would be less available, less risky drugs relatively more available, thus in the longer term progressively shepherding patterns of use towards safer drugs, preparations, behaviours and environments, in direct contrast to the harm maximising impacts of illicit drug markets. Implementation would be phased over a number of years and supported by rigorous monitoring and evaluation.

This presentation aims to broaden the harm reduction debate by providing a foundation for discussing legal drug regulation as a practical option for the next generation of drug policy development.

Security, development and human rights: Normative, legal and policy challenges for the international drug control system

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Copied below are the abstract and conclusion from paper published last week in the International Journal of Drug Policy,  by Damon Barrett (Senior Human Right Analyst at IHRA), titled 'Security, development and human rights: Normative, legal and policy challenges for the international drug control system'.  In this important and groundbreaking commentary Barrett outlines a series of theoretical and practical challenges for the international drug control system, reconceptualizing it within a broader human rights law analysis.

A clear call for an Impact Assessment on international drug control policy is also made (in the conclusion see below). The full paper is available at the International Center on Human Rights and Drug Policy website (pdf)

Transform's Danny Kushlick (credited) was involved in developing the thinking behind the paper, and Transform's 'Blueprint for Regulation' is also cited along with our recent Impact Assessment briefing paper.

Abstract

This commentary addresses some of the challenges posed by the broader normative, legal and policy framework of the United Nations for the international drug control system. The ‘purposes and principles’ of the United Nations are presented and set against the threat based rhetoric of the drug control system and the negative consequences of that system. Some of the challenges posed by human rights law and norms to the international drug control system are also described, and the need for an impact assessment of the current system alongside alternative policy options is highlighted as a necessary consequence of these analyses.

Conclusion
International drug control, as currently formulated, may be conceptualised as an ‘international risk environment’ for the related damage to security, development and human rights that has been documented worldwide. The human rights risk is particularly clear. The first step in addressing this is to begin to shift the debate at the international level away from threat based rhetoric and towards meeting the aims of the UN. Based on modern debates concerning human security and human development, this demands consideration of more locally and culturally appropriate responses that place individuals and communities at the centre of drug policies. An impact assessment of the current approach is necessary, set against alternative policy options that may achieve better results in terms of security, development and human rights. That call is supported by international human rights law.

This assessment should have happened at the ten year review of international drug policy at the UN Commission on Narcotic Drugs (March, 2009). Instead, the same policies, with some minor amendments to language, though hard fought by some of the more progressive governments, were prescribed for the next ten years. Indeed, it may be argued that advocating for a move towards policy based on the aims of the UN naively presumes genuine governmental support for those aims, when in fact other political agendas are more likely the drivers of current drug control efforts. This is likely the case for some governments. But this does not stall the discussion. Indeed, it is one more argument for reframing the debate so that the UN system, within which international drug control resides, is not one behind which these agendas may hide (Barrett & Nowak, 2009).

The Barrett and Nowak reference in the conclusion is for a book chapter titled 'The United Nations and Drug Policy: Towards a Human Rights Based Approach'  (Nov 2009) that explores some of the themes in the IJDP paper in more detail. Highly recommended, it is also available in full here on the International Center for Human Rights and Drug Policy website (pdf).  Barrett's co-author Manfred Nowak is the UNs Special Rapporteur on Torture.

End the Death Penalty for Drug-Related Offenses

Joint Statement by The Anti Death Penalty Asia Network (ADPAN), of which Amnesty International is a member, Human Rights Watch and the International Harm Reduction Association

As the International Day Against Drug Abuse and Illicit Trafficking approaches on 26 June, the Anti Death Penalty Asia Network (ADPAN), of which Amnesty International is a member, Human Rights Watch (HRW) and the International Harm Reduction Association (IHRA) call upon governments in Asia to cease applying the death penalty for drug-related offences.

There is a clear, longstanding and worldwide move toward restriction or abolition of the death penalty. Only a small minority of countries continue to implement the death penalty: in 2008, 25 countries carried out executions. ADPAN, Human Rights Watch and the International Harm Reduction Association oppose the death penalty in all cases as a violation of fundamental rights- the right to life and the right not to be subjected to cruel, inhuman and degrading punishment.

Sixteen countries in Asia apply the death penalty for drug-related offences. As many countries in the region do not make information on the death penalty available, it is impossible to calculate exactly how many drug-related death sentences are imposed. However, in Indonesia, Malaysia, Singapore and Thailand, reports indicate that a high proportion of death sentences are imposed upon those convicted of drug offences. ADPAN, HRW, and IHRA express particular concern that China, Indonesia, and Vietnam continue to execute individuals for drug offences – and that some countries, such as China since the early 1990s, and Indonesia in 2008, have marked the occasion of June 26 with such executions.

Despite the executions in Asia there is no clear evidence of a decline in drug-trafficking that could be attributed to the threat or use of the death penalty. There is no credible evidence that the death penalty deters serious crime in general more effectively than other punishments. The most recent survey of research findings on the relation between the death penalty and homicide rates, conducted for the United Nations (UN) in 1988 and updated in 1996 and 2002, concluded: "...research has failed to provide scientific proof that executions have a greater deterrent effect than life imprisonment. Such proof is unlikely to be forthcoming. The evidence as a whole gives no positive support to the deterrent hypothesis."

UN human rights mechanisms – including the UN Special Rapporteur on extrajudicial, summary, or arbitrary executions, and the UN Human Rights Committee -- have concluded that the death penalty for drug offences fails to meet the condition of “most serious crime”, under which the death penalty is allowed only as an “exceptional measure” where “there was an intention to kill which resulted in the loss of life” (UN Doc, A/HRC/4/20, 29 January 2007, para 53). The UN High Commissioner for Human Rights and the director of the UN Office on Drugs and Crime have likewise expressed grave concerns about the application of the death penalty for drug offences.

Death sentences are often handed down after unfair legal processes, a problem made worse by laws, policies or practices regulating drug offences in some Asian countries. Mandatory death sentences are applied for certain drug offences in Brunei, India, Laos, Singapore and Malaysia, leaving a judge with no discretion over the sentence for defendants found guilty. Mandatory death sentences violate international standards on fair trials. Individualised sentencing is required to prevent cruel, inhuman or degrading punishment and the arbitrary deprivation of life. Singapore, which has one of the highest per capita execution rates in the world, as well as Malaysia, continue to hand down death sentences to individuals alleged to be drug traffickers after trials that presume guilt, and in which death sentences are mandatory.

Confessions that have been coerced sometimes form the basis of guilty verdicts, death sentences and executions. Competent legal assistance is unavailable to many defendants, including defendants facing drugs-related charges, leaving many with little capacity to mount a defence at any stage of the proceedings.

Draconian penalties for drug offences, including the death penalty, hinder public health programmes that reduce the harm drugs may cause to individual drug users, their loved ones, communities and states. China, Malaysia and Viet Nam have recently stepped up their harm reduction programmes to reduce HIV, hepatitis C and other drug-related health and social harms. However, excessive punishments and overly repressive drug law enforcement have been shown time and again to drive target groups away from such services. The death penalty therefore not only violates the right to life of those condemned, but is actually counterproductive to efforts to reduce the harm caused by drugs.

On the occasion of UN Anti-Drugs Day 2009 ADPAN, Amnesty International, Human Rights Watch and the International Harm Reduction Association appeal to Asian governments to:

• Introduce an immediate moratorium on executions with a view to the abolition of the death penalty in line with UN General Assembly resolution 62/149 and 63/168 on “moratorium on the use of the death penalty”;
• Commute all death sentences including for drug offences;
• Remove provisions within their domestic legislation that allow for the death penalty for drugs offences;
• Abolish the use of mandatory sentencing in capital cases;
• Publicize statistics on the death penalty and facts around the administration of justice in death penalty cases;
• Use the occasion of Anti-Drugs Day 2009 to highlight public health policies that have proven effective in reducing drug-related harms.

see also:

The death penalty for drug offences (IHRA 2008)

Transform organise major session at IHRA Bangkok conference: 'Can Harm Reduction End the Drug War'

Transform has organised a major session at the upcoming International Harm Reduction Conference in Bangkok next week, titled Can Harm Reduction End the Drug War, the session abstracts for which are copied below.

The broad principles of harm reduction have been widely adopted in much of the world but remain controversial for some political groupings in the prohibitionist camp. Some view harm reduction’s non-judgemental position and tolerance of continued use as tacitly condoning drug use, even encouraging or facilitating it, whilst for others the movement is portrayed as little more than a sinister ‘trojan horse for drug legalisation’. Yet for most working in the harm reduction field it is more simply a pragmatic set of principles and strategies aimed at, first and foremost, saving lives, and such debates are an irrelevance and distraction from the harsh day to day realities they have to deal with.

Whilst there is substantial support for moves towards legally regulated supply for some or all drugs within the movement – most obviously regards a medical model for prescribing of opiates - an anti-prohibtion / pro law-reform position does not yet feature specifically in the definitions or lists of harm reduction principles. Part of the reason for this is that it is far from the consensus view (particularly regards the wider debate around non-medical use), but there are also frequently aired practical concerns that vital harm reduction work might be jeopardised in some areas where it is most needed if more contentious elements of the drug law reform debate become too prominent. There is also an element of institutionalisation with the harm reduction movement – a reluctance to ‘bite the hand that feeds’ as it were and jeopardise funding (often from the state) through vocal dissent, a phenomenon that has similarly ensured a troubling degree of silence on drug law reform from the treatment sector (for more discussion see 'In pusuit of truth', by Danny Kushlick here - p.12).

Thus in contrast the claims of ‘Trojan-horse’ conspiracists, the drug law reform movement has in fact struggled to activate the wider harm reduction field, whose concerns are often far more immediate than the longer term goals of system wide legal reform. That said, a significant difference between the harm reduction movement and many of its most vocal opponents remains; it is at least genuinely open to honest intellectual engagement with the prohibition / regulation debate, which is now a regular fixture in harm reduction journals and conferences.

“Harm reduction approaches also seek to identify and advocate for changes in laws, regulations and policies that increase harms, or which hinder the introduction of harm reduction interventions.”

The International Harm Reduction Association

Acknowledging the spectrum of views around what ‘harm reduction’ means, the important thing in the context of this discussion is to highlight the underlying principles of the paradigm, without necessarily endorsing everything done under its banner. From Transform's perspective Harm Reduction as currently described is somewhat limited in scope – a defensive position against the harms largely created by prohibition. It needs to evolve not only to more fully engage with the harms created by prohibition, as opposed to drug use harms, but also to evolve into a more creative and positive position that looks at wellbeing maximisation, not just mitigating harm.

Session abstract:

Can Harm Reduction End the Drug War?

For many in the drugs field, the harms caused by drugs are conflated by harms caused by the war on drugs – which makes harm reduction vastly more complex than it needs to be. This Major Session will explore the relationship between advocacy for harm reduction and advocacy to end the global war on drugs and replace it with an effective system of regulation and control.

The presentations will analyse which harms are created by the war on drugs and which are created by the use of drugs. The session will explore the extent to which harm reduction can reduce harms caused by the war on drugs and how the two movements can best work together. This session sets out to offer delegates the opportunity to explore issues that are rarely discussed in the harm reduction field – partly because of political pressures and partly due to the pressing need to save lives. It will be relevant to anyone in the harm reduction field whose work is influenced both by the behaviour of drug users and by the negative consequences of the war on drugs.

Session Chair:

Ethan Nadlemann; Drug Policy Alliance

Time and location:

Thursday 23rd April, 11.30am , Queens Park Room2, Queens Park Hotel, Bangkok

Session presentation abstracts:

Differentiating between drug-related harms and policy-related harms

Steve Rolles Transform Drug Policy Foundation

There is a growing understanding and acceptance within the drugs field that a significant proportion of what are broadly termed 'drug related harms' stem directly from the policy of prohibition and the illicit markets it has inadvertently fostered. Attempts to disentangle the harms caused by drug use per se, and those created or exacerbated by policy, specifically the enforcement of punitive prohibitions, have been comparatively under-explored and specifically have not been a prominent feature in the harm reduction discourse. This short presentation, as part of the proposed major session, will develop this theme by considering analysis from Transform Drug Policy Foundation and the 'Taxonomy of Drug Harms' by Reteur and McCoun (in 'Drug War Heresies' 2001). The broad analysis will then be illustrated by comparing harms associated with illicit use of 'street' heroin with supervised legal use of prescribed heroin. 'Prohibition harms' will be demonstrated to include:

• Dirty/shared needles (Hep C / HIV risk)
• unknown strength/purity (poisonings, infection, overdose risks)
• Drug litter
• Fueling large volumes of low level acquisitive property crime and street prostitution (low income dependent users fund raising to support a habit)
• Organised crime from local street dealing (including drug-gang violence and turf wars) to international criminal networks (links to conflict and terrorism)
• Destabiliation of producer countries (corruption and violence in Afghanistan)

A case will be made for the definition of harm reduction to be broadened to include the harms (or as the UNODC describes them 'unintended consequences') related to enforcement, for the harm reduction movement to more pro actively engage in the debate around the policy implications of this analysis; including changes to enforcement practice and alternatives to prohibition, and in the longer term, decriminalisation of use and legally regulated drug production and supply.

The Limits of Harm Reduction within the context of Prohibition

Donald MacPherson, Drug Policy Co-ordinator City of Vancouver

This presentation will consider the limits of harm reduction initiatives as a response to problematic substance use within the context of the criminalization of drugs and drug use. Harm reduction efforts take place in the margins between illegal underground drug economies, cultures of drug use and officially sanctioned efforts to deliver health care interventions and/or punishment to drug users and sellers. Current approaches to the use and sale of illegal drugs do not acknowledge how the criminalization of drug use limits the impact of health and/or criminal justice responses. International agreements that criminalize drug use have prevented communities from developing a full range of harm reduction interventions. These agreements have also prevented countries from developing alternative responses to illegal drug use and sales. The City of Vancouver has developed a strategy to prevent and reduce harm from substances that includes a call for dialogue on alternative regulatory mechanisms for currently illegal substances with a goal of maximizing prevention and reduction of harm. Regulation and control of currently illegal substances combined with social and economic development efforts can provide an alternative response to problematic drug use. This presentation will consider the significant limitations of harm reduction initiatives within a context of the continued criminalization of psychoactive substances in society.

Can Harm Reduction Win the War on Drugs? A Thai User’s Perspective

Paisan Suwannawong, Thai AIDS Treatment Action Group (TTAG)

Thailand drug policy consists of drug eradication, suppression and prevention approaches, with the heaviest financial and human resource investment on law enforcement and military techniques to achieve a “drug-free” country. Harm reduction is not included in its approach. In 2003, Thai drug policy reached its nadir when 2,500 people were extra-judicially executed and tens of thousands of other people allegedly associated with drugs experienced numerous other human rights violations in the name of drug control.

My community of both HIV-positive and HIV-negative people with a history of drug use is virtually the only group in Thailand to have publicly advocated against abuses committed by government sectors toward drug users. Thai drug users have introduced community-driven harm reduction interventions since the 1990s in spite of the ongoing repressive legal and policy environment: prior, during and following the infamous 2003 crackdown.

My presentation will depict the peer-led harm reduction interventions that we implement regardless of what stage of suppression the government wages, and how the drug war specifically effect the efficacy of our work. Our interventions are severely compromised by the lack of government support for this important rights-based public health approach. Until harm reduction policy becomes a reality in Thailand, drug users are placed at higher risk of HIV, viral hepatitis, TB and other severe diseases due to overemphasis on criminalization and resultant high rates of detention and incarceration.

The lack of support for evidence-based harm reduction approaches, plus the failure of relevant government ministries to recognize the various harms experienced by people who use drugs, combined with a criminalizing and stigmatizing environment condemns drug users and harm reduction workers to ultimately fail to make a significant impact due to the increased risk, extreme duress under which we work, lack of funding and political support, etc. Drug wars must be stopped.

The Bigger Political Picture: International Discourse on Harm Reduction and the Drug War

Sanho Tree. Institute for Policy Studies

Politicians and drug warriors often say that we know where the drugs are coming from, so why don't we stop them at the source before they can reach our kids? This is easier said than done. After decades of trying this simplistic strategy, more drugs than ever are reaching consumers. Despite spraying more than 3 million acres under Plan Colombia, coca cultivation has actually increased in that country and has been pushed into other countries in the region as well. In Afghanistan, attempts to curb opium poppy cultivation have been spectacularly unsuccessful. In both countries, hard line eradication policies have left peasant farmers with few economic alternatives and have helped drive some of them into the arms of insurgents.

There is simply too much ungoverned territory in the world and a relatively inexhaustible supply of impoverished farmers willing to take the risk of cultivating illicit crops. Attempts to eradicate these crops have been short-sighted -- trying to produce quick results (no matter how unsustainable) to meet the targets established by political officials -- while the economic development projects to compliment the eradication programs have been woefully under funded. In short, these supply side control measures have been about as effective as shovelling water.

The collateral damage associated with the drug war impacts the poor and people of color in ways unheard of to most harm reductionists. These lives are not squandered by necessity, but by political choice and accompanying neglect. Just as we advocate harm reduction policies for drug users on the demand side, there is a need for harm reduction in source country crop control on the supply side. This presentation will examine why these supply side policies have failed as well as the political dynamics driving this failed paradigm.

UN CND: final human rights resolution emerges in diluted form

At March's UN Commission on Narcotic Drugs in Vienna I had witnessed at first hand the painful process of some of the more progressive countries trying to have a resolution on human rights compliance in international drug policy adopted, against the express wishes of small group of opposing countries, perhaps unsurprisingly made up largely of some of the world's most notorious human rights abusers.





It was a welcome experience to be genuinely supportive of the UK's official high level efforts in the international arena, and impressed by their principled commitment to human rights despite potential political or diplomatic costs. The UK delegation was notably supported by various NGO partners, most prominently the IHRA HR2 team who deserve particular praise for their expert input on points of human rights law.

The Committee of the Whole at the UN CND (March 2008)

The human rights resolution has now been published in its final form - which is notably different from that in which it was originally submitted to the CND's Committee of the Whole for discussion (the COW is the sub-committee that discusses resolutions that are then agreed in the main plenary session). The COW's deliberations were often tortuous with hours spent wrangling over seemingly irrelevant tweaks in precise wording of specific sentences or the positioning of a punctuation points. Petty disagreements between countries, often evidently reflecting wider geo-political tensions that had little to do with the matters being discussed, were frequently played out in tense and protracted head to heads over minute often pointless details. Some countries (most prominently and perhaps least surprisingly; China), tried to have the resolution scrapped altogether, whilst others insisted that key sections be dramatically revised or removed completely. Notable casualties of this lengthy editing purge were any references to the rights of indigenous peoples (from countries with particular indigenous peoples issues), and any references to the death penalty (from retentionist states) although the issue of the use of the death penalty in drug enforcement practice loomed large elsewhere in the CND.

The other most notable change from the original text is the drastic excision of any real operational elements within the resolution relating to effective monitoring and reporting on human rights compliance in drug enforcement or any deadlines or commitments for the UNODC itself. Instead what remains is a worthy but essentially toothless re-commitment to the broad human rights principles of the UN.

None the less this still represents a substantial achievement for the nominating countries, as the first time that a human rights resolution has been passed by the CND in 51 sessions, as a useful starting point in developing future resolutions and policy discussions on human rights at UN level (it prompted several hours of unprecedented debate on the issue in the plenary), and as a real achievement for NGOs and civil society engagement with the CND. Despite other frustrations with the leaden bureaucracy's of the CND more generally, the NGO involvement in the process can be seen as positive step forward at this important juncture in UN drug policy with the 10 year strategy review approaching.

For more discussion see various accounts on the March CND on the IHRA HR2 blog:

A detailed account of the final resolution text, and how it was adapted from the original:

• The Life of a Human Rights Resolution at the UN Commission on Narcotic Drugs

How China and others attempted to derail and water down the resolution

• Discussion of political issues such as human rights are inappropriate at CND” – China leads charge against human rights resolution

An account of the process made at the event

• CND passes a ground-breaking - yet watered down - human rights resolution

For related discussion of current UN drug policy issues see also the new Transnational Institute UNGASS 10 year review page.

Transform will be attending the UN's NGO forum 'Beyond 2008' in Vienna in June (where the reports from the 8 regional consultations will be discussed and synthesised into one final report to be submitted to the 2009 CND as it deliberates over the next ten year strategy), as invited delegates and in our capacity holding special consultative UN ECOSOC status.

UNAIDS and NGO statements shake CND out of its stupor

Amidst the mind numbing tedium of hours of pre-prepared self-congratulatory country presentations at this year's United Nations Commission on Narcotic Drugs (which I am currently attending in Vienna) there were a few rays of light that challenged the consensus that 'everything is fine - let's continue as before'. A few of the non state participants briefly threatened to turn the thematic session in to the 'debate' it was billed as. (a more detailed commentary on the CND to follow)

There were a series of useful contributions from various NGO's (given unprecedented access to the plenary session this year) including this powerful statement from Rick Lines at IHRA, that challenged the CND to fully incorporate human rights into drug control mechanisms, with specific reference to this being the 60th anniversary of the UN universal declaration of human rights.

Below is the complete text of the contribution from the Joint United Nations Program on HIV/AIDS (with references) delivered to yesterday's plenary session by Susan Timberlake. Its pragmatic tone was particularly striking in that it followed series of desperately dry political statements, including notably from the US, that entirely failed to touch on the public health vs criminalisation debate, HIV, or the rights of users, and in the case of the US, actively spoke out against harm reduction. That UNAIDS the statement additionally came with the UN imprimatur - so was impossible for the state representatives to ignore.

Chair, distinguished representatives, ladies and gentlemen, The Joint United Nations Programme on HIV/AIDS (UNAIDS) is pleased to have this opportunity to address the Commission on Narcotic Drugs to seek your support in breaking the dangerous link between injecting drug use and the HIV epidemic. As measures to control drugs and measures to control HIV are critically intertwined, the steps governments take in drug control are likely to have significant impact on progress against HIV.

In most regions of the world, unsafe injecting drug use is a major vector of HIV transmission. It has been estimated that up to 10% of all HIV infections worldwide result from injecting drug use, up to 30% if infections in Sub-Saharan Africa are excluded. Once HIV enters a community of people who inject drugs, it can move to the rest of the population if appropriate steps are not taken.

UNODC, WHO and UNAIDS recommend a comprehensive set of measures for people who use drugs that includes the following: (1) needle and syringe programmes; (2) opioid substitution therapy; (3) voluntary HIV counselling and testing; (4) anti-retroviral therapy; (5) prevention and treatment of sexually transmitted infections; (6) condom programming; (7) targeted information, education and communication; (8) hepatitis diagnosis, treatment and vaccination; and (9) tuberculosis prevention, diagnosis and treatment. The efficacy of these interventions is supported by overwhelming evidence.

Yet in spite of the fact that we know how to address the close links between HIV infection and unsafe injecting drug use, many countries fail to provide this comprehensive set of measures to drug users, who instead continue to face discrimination and other human rights violations. In 2006, fewer than 20% of people who inject drugs received some type of HIV prevention service, with coverage of less than 10% reported in Eastern Europe and Central Asia. Even fewer have access to opioid substitution therapy, needle and syringe programmes, or anti-retroviral therapy, despite the fact that people who use drugs can achieve the same levels of adherence to treatment as other patients with HIV.

In the 3:1 ratio mentioned by Mr. Costa – where enforcement receives three times the resources that prevention and treatment receive – it is clear that many countries take an approach to drug use that focuses on criminalization while neglecting a public health response. A public health response would provide treatment to people who evidence drug dependency and illness and would employ health and social interventions, which have been shown to reduce the harms associated with drug use. Instead, legal and social barriers severely impede access to such health and social interventions. For instance, many countries criminalize possession of syringes without prescriptions and continue to classify methadone and other opioid substitutes as illegal. In many countries, imprisonment and forced treatment with ineffective methods are the primary responses to drug use, with little to nothing being done about HIV. And in some countries, imprisonment is compounded by killings, rape, unwarranted use of force, arbitrary arrests, harassment, extortion, and violation of medical privacy and confidentiality.

Chair, distinguished delegates, UNAIDS supports countries to implement a rights-based response to the HIV epidemic for two reasons: first, because it fulfills obligations under human rights law, and secondly, because it is the most effective way to address HIV. In our efforts against the epidemic, we recognize that all people, even those engaged in activities that are deemed criminal, have human rights, including people who use drugs. Even where drug use is criminalized, people who use drugs have the rights to be free from violence and murder, to benefit from full due process before the law, to be free from discrimination and any forced treatment that violates medical ethics, and to receive comprehensive and voluntary health and social services of good quality, including for drug-related illness and for infections, such as HIV, hepatitis and tuberculosis.

In the Declaration of Commitment on HIV/AIDS (2001) and in the Political Declaration on HIV/AIDS (2006), governments have also committed themselves to an approach to HIV that is based on human rights and the full participation of those affected. In particular, they committed themselves “to intensify efforts to ensure a wide range of prevention programmes, including harm-reduction”, “to overcoming legal...or other barriers that block access to effective HIV prevention, treatment, care and support, medicines, commodities and services”, and “to intensify efforts to enact, strengthen or enforce legislation….to eliminate all forms of discrimination against and to ensure the full enjoyment of all human rights of… members of vulnerable groups”. All this in the context of committing “to scale up efforts…with full and active participation of people living with HIV, vulnerable groups.. towards the goal of universal access to…prevention, treatment, care and support by 2010”.

UNAIDS is working hard to support governments to fulfill these commitments, and much progress is being made. In this context, we ask that those engaged in drug control efforts: (1) respect and protect human rights, including the rights of people who use drugs, (2) ensure access to HIV and health and social services to people who use drugs and remove impediments to such access, and (3) allow people who use drugs or their representatives to participate in the design and delivery of HIV and harm-reduction services so that programmes will be as effective as possible.

Progress towards universal access will be reviewed at the High Level Meeting on HIV/AIDS in June where UNAIDS is also supporting the involvement of civil society as critical partners for accountability. In this regard, a representative of people who use drugs is included in the President of the General Assembly's Civil Society Task Force for the High Level Meeting. In order to provide leadership and guidance to governments in the area of HIV and drug use, UNAIDS urges the consideration by the Commission of measures to:

• Help establish a process by which States’ obligations relating to drug control are clarified to ensure that they conform to human rights obligations, and indeed support the achievement of public health and human rights, including universal access to HIV prevention, treatment, care and support.
  
  
• Support States to enact and implement domestic legislation and policy in the area of drug control that will protect human rights and the public health, including of that of people who use drugs, either vulnerable to HIV or already infected.
  
  
• Finally, encourage States to use the High Level Meeting on HIV/AIDS in June and the current review based on the UNGASS on Drugs (1998) to consider and intensify their efforts to address HIV in the context of drug use, including greatly increasing voluntary and effective HIV prevention, treatment, care and support programmes for people who use drugs.

UNAIDS thanks the Commission and its valuable Cosponsor, the UN Office on Drugs and Crime, and offers its full support in any manner possible.

References

Aceijas, Friedman, Cooper, Wiessing, Stimson, Hickman, Estimates of injecting drug users at the national and local level in developing and transitional countries, and gender and age distribution, Sexually Transmitted Infections, Volume 82, Suppl III, June, 2006.

IPU/UNDP/UNAIDS (2007). Taking action against HIV. A handbook for parliamentarians. Geneva.

Lert F, Kazatchkine M (2007). Antiretroviral HIV treatment and care for injecting drug users: An evidence-based overview. International Journal of Drug Policy 18: 255-261.

Materials produced for UNAIDS Reference Group on HIV and Human Rights, Eighth Meeting, December, 2007.

Office of the United Nations High Commissioner for Human Rights and UNAIDS (2006). International guidelines on HIV/AIDS and human rights (2006 consolidated version). Geneva.

UNAIDS (2005). Intensifying HIV prevention: a UNAIDS policy position paper. Geneva.

UNAIDS (2006). Report on the global HIV/AIDS epidemic. Geneva.

UNAIDS (2007). Practical guidelines for intensifying HIV prevention: Towards universal

access. Geneva.

UNAIDS/WHO AIDS epidemic update, December, 2007

WHO/UNODC Evidence for action series and policy briefs available at http://www.who.int/hiv/pub/idu/en/: Ball et al. (2005)

WHO/UNAIDS/UNICEF (2007). Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report, April 2007. Geneva.

WHO/UNODC/UNAIDS. Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users (IDUs) (in draft)

IHRA slams International Narcotics Control Board secrecy

In a new report released this week by the International Harm Reduction Association (IHRA), the International Narcotics Control Board (INCB - a quasi judicial body set up within the UN drug control agencies to 'police' the UN drug conventions) comes in for some heavy criticism for being overly secretive, closed to external dialogue with civil society, and out of kilter with similar agencies in other UN programes. IHRA also debunks the INCB’s defence that it is ‘unique in international relations’

.

click to view pdf

"The International Narcotics Control Board (INCB or the Board) plays an important role in the international drug control system, serving as an independent body monitoring states’ implementation of their obligations under the international drug conventions. It has, however, been criticised for being one of the most secretive bodies in the UN system. It holds its meetings behind closed doors. No minutes are published. There is no opportunity for nongovernmental organisations (NGOs) or civil society organisations to observe or make submissions.

The INCB has claimed that it is ‘unique in international relations’, and has used this allegedly unique status to justify its exclusion of civil society

from its deliberations and its closed meetings. However, far from being unique, the INCB is instead an early example of the ‘independent committee of experts’ model that has been adopted and developed within the UN human rights system, and regional human rights systems, over the past four decades. It is a common model that continues to be used today. Yet in contrast to these similar bodies, the INCB has failed to modernise its processes, and retains working practices inherited from defunct monitoring bodies."

This is the third publication from the HR2 (Harm Reduction and Human Rights) programme. The report points out that whilst the INCB was established along the same lines as the UN human rights treaties, it does not engage with civil society in the way parallel organisations do.

Various recommendations are made in order to reform the INCB.

• Clarify the scope of the mandate

• Include civil society and NGO input

• Promote transparency

• Make all documents and minutes public

• Get guidance from the Office for the High Commissioner for Human Rights (OHCHR)

• Work with NGOs, people with HIV/AIDS and drug users during country visits

• Seek assistance from WHO and UNAIDS for drawing up guidelines for dealing with drug users and people living with HIV/AIDS

This is not the first time the INCB has been comprehensively critiqued by the NGO sector. As reported before on this blog, the Canadian HIV/AIDS Legal Network , accused it of being 'an obstacle to effective programs to prevent and treat HIV and chemical dependence'.

see: UN INCB is 'obstacle' to HIV prevention and drug treatment programs’.