UNGASS 2016: ‘Harm reduction saved my life’

UNGASS 2016: ‘Harm reduction saved my life’

The following remarks were presented on April 21st in plenary at the United Nations General Assembly Special Session on Drugs in New York.

Namaste! My name is Charanjit Sharma and I am from Manipur a state in the North Eastern part of India. I work for India HIV/AIDS Alliance, and I am also the Secretary of the Indian Drug Users Forum. I am here today because harm reduction saved my life. But I have many friends who were not as fortunate. Their lives were lost simply because they could not access harm reduction services.

We, the International HIV/AIDS Alliance family, are reaching close to 300,000 people who use drugs with community-based HIV and harm reduction services each year in nine countries in Asia, Africa and Eastern Europe. This gives us a unique perspective on what it takes to prevent HIV and hepatitis C transmission and what it takes to get treatment to people who inject drugs.

I have witnessed firsthand the negative impact of prohibition and the fallout of law enforcement as a mechanism of drug control. I have seen police action on drug users and have myself been subjected to exploitation, violence and detention for simply being suspected of using an illicit drug. As drug users, we are soft and easy targets for law enforcement while big players remain elusive. The drug trade continues despite harmful efforts to control it, and we pay the price.

It’s hard to get HIV treatment to people when they are incarcerated, detained or hiding from services for fear of arrest. How can we end AIDS when we can’t get HIV treatment to the people who need it most?

I know from my personal experience the devastating consequences of forced drug treatment and entirely ineffective rehabilitation programs. I have friends who have been tortured and publicly humiliated for days and weeks in the name of treatment. I know too many people incarcerated for years for possession of a small amount of drugs for personal use. Is this justice? Is this fair? Is this humane? Will this end AIDS?

Widespread criminalization and punishment of people who use drugs confirms that the war on drugs is, in fact, a war on drug users – a war on people – a war on us.

On behalf of people who use drugs in India, in Asia and in every country around the world, I appeal to you to put the health, rights and security of people who use drugs at the centre of international and national drug policy. I appeal to you to ensure that policy is informed by evidence of what works: accessible, holistic, people-centred services, tailored to the needs of people who use drugs. I appeal to you to stop arresting and incarcerating people for consumption and possession of drugs for personal use. The death penalty for drug-related offences must be abolished. I appeal to you to support drug users and organisations working with us to improve access to HIV and hepatitis C treatment and overdose services. Support drug users to participate meaningfully in the design and delivery of harm reduction services.

The former UN Secretary-General Kofi Annan has recognized the failure of the war on drugs, recently saying, ‘We need to accept that a drug-free world is an illusion. We must focus instead on ensuring that drugs cause the least possible harm.’

 Harm reduction saved my life. Harm reduction saves lives. When lives are saved, communities thrive.  When communities thrive, nations prosper. We can’t end AIDS until we scale up harm reduction and end the criminalisation of drug users. Support. Don’t punish.

Thank you.

 The author of this post, G. Charanjit Sharma, is Technical Advisor: Drug Use & Harm Reduction at India HIV/AIDS Alliance in New Delhi.

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United Nations, Divided on Drugs

United Nations, Divided on Drugs

Vienna hosted the 59th session of the UN Commission on Narcotic Drugs (CND), a high-level commission convened by the UN Office of Drug Control (UNODC) to discuss drug policy reform. Over ten intense days, country delegations, experts and community advocates like me met to negotiate wording of a document that will guide drug policies around the world for the next decade or so. The Outcome Document from these negotiations will then be agreed at the UN General Assembly Special Session (UNGASS) on Drugs from 19-21 April at the United Nations in New York. Not all countries had representation at the CND in Vienna, raising legitimate questions about the inclusiveness and transparency of this process and whether all nations truly understand the urgency of this issue. Early on, it also became clear as country delegations spoke that we have some substantial work to do as civil society and community advocates. The Asia-Pacific Group Statement presented by H.E. Ayesha Riyaz, Ambassador and Permanent Representative of the Islamic Republic of Pakistan and the Incumbent Chair of the Asia Group in Vienna, reflected unrealistic aspirations and political popular if poorly targeted priorities as it resolved to strengthen efforts to achieve a society free of drug abuse and address the specific needs of women children and youth within balanced and integrated policies. Evidence-based harm reduction responses for people who use drugs were not mentioned. India’s position as in previous years focused on international cooperation to stem the flow of funds from drug trafficking and other transnational organised crime. Most discouraging was India’s rejection of UNODC’s recommendation to offer evidence-based and voluntary treatment, rehabilitation and care as an alternative to punishment or incarceration to individuals charged with drug offenses. On a more positive note, India described a commitment to ensure the availability of controlled substances for medical and scientific purposes through the removal of the regulatory barriers for drugs such as morphine and methadone for palliative care, pain relief and opioid substitution therapy. I was able to meet the Indian delegation and raise some concerns about our country’s position and share documents including the report from the Regional Civil Society Consultation we was held to ensure community priorities would inform the CND and UNGASS processes, along with the International HIV/AIDS Alliance‘s position paper for the Special Session. I unfortunately doubt that they actually read either through to its end. Vietnam’s statement mentioned that the country carried out harm reduction interventions for drug users. It was encouraging to see this, even while the statement used stigmatizing language such as “drug addicts” and “drug abusers” and repeated ASEAN’s misguided Zero Tolerance approach against drugs. As the Outcome Document comes into focus, it troubles me that there are still many key areas that are ‘under consideration’ – most notably paragraphs that contain terms like ’human rights’ and ‘evidence-based.’ Equally distressing is the prevalence of the escape clause – ‘in accordance with national legislation’ – which allows governments to pick and choose how the actually proceed regardless of sign-on to the Outcome Document. The news is not all bad. I take heart that in the Operational Recommendations section there is agreement on prevention, treatment and care for HIV/AIDS, Hepatitis C and drug overdose through ‘medication-assisted therapy programmes’ and ‘injecting equipment programmes’ – compromise language for ‘opioid substitution therapy’ and ‘needle and syringe exchange programmes.’ While member states once again couldn’t come to consensus around the term ‘harm reduction,’ it was also heartening to see a commitment to involve civil society and affected communities in program development. In the meantime, our team at India HIV/AIDS Alliance has been actively engaged in the run-up to UNGASS. After much behind-the-scenes effort, Alliance India’s Community Action on Harm Reduction (CAHR) project manager Charan Sharma has been selected as a civil society speaker for UNGASS where he will share his grassroots experience during a plenary session in the General Assembly Hall along with four other civil society speakers. In addition, our Indonesian colleague Ricky Gunawan from the Community Legal Aid Institute (LBH Masyarakat) has also been selected to speak at the Civil Society Forum. Coming up soon, I will report from New York with updates and insights on UNGASS 2016.

 The author of this post, Simon W. Beddoe, is Senior Advocacy Officer: Drug Use & Harm Reduction at India HIV/AIDS Alliance in New Delhi.

Health and rights crisis of people who use drugs and their families in the Philippines

I must continue to raise the issue of criminalisation of people who use drugs and its impact on the AIDS response in the Asia region. I take this opportunity to highlight the recent happenings in the Philippines. As I recall, the Mayor and other government officials made somewhat progressive remarks at the Cities event, while now the words ‘Philippines President Calls on Civilians to Kill Drug Addicts’ and “If you know of any addicts, go ahead and kill them yourself as getting their parents to do it would be too painful”,  simply shock. The Philippines’ president is asking civilians to murder drug addicts in the island nation — adding to a growing list of outrageous actions from the newly elected official.

However, the Philippines at the UN is remarkably different. On 9th March 2015, at the UNGASS Special Segment meeting, the Philippines in its official statement recognised the vital role of cooperation in implementing drug strategies, “On demand reduction, we promote prevention, education, treatment and rehab, by involving communities and conducting capacity building programmes on substance use, in collaboration with UNODC.” On 19th April 2016, at the UNGASS Roundtable 1 on Demand reduction and related measures, the Philippines in its official statement spoke of the dilemma in terms of balancing the fight against illegal drugs operations and focusing on health as well as the need to establish more alliances by sharing best practices. On 20th April 2016, at the UN General Assembly: Thirtieth Special Session of the General Assembly on the World Drug Problem (3rd plenary meeting), the Philippines in its official statement did not support capital punishment for drug offences and that it was happy to report on progress of treatment and rehabilitation of drug users and anti-drug plan of action until 2020.

As recently as at the Sixty-Ninth World Health Assembly 23-28 May 2016, the Executive Board recommended the adoption of the draft global health sector strategies for HIV, 2016–2021. Enshrined in this document lie probable solutions to the crisis affecting the lives of people who use drugs and their families: Para 26 seeks to overturn laws and change policies that marginalize and stigmatize populations; Para 67 is explicit on Harm reduction for people who inject drugs; Para 86 is grounded in an enabling environment that promotes health equity and human rights; Para 105 recommends enforcing laws and policies that eliminate gender inequality, protect and promote human rights and reduce vulnerability to and risk of HIV infection; Para 106 reminds us that HIV programmes have an important role in monitoring policies, laws and regulations in other sectors to determine their possible implications for the HIV and broader health response, and where barriers exist to advocate for appropriate reviews and reforms to ensure pro-health outcomes. The Government of the Philippines participated in the adoption of this document.