English/Russian: Statement Eurasian Harm Reduction Network for the CND in Vienna (by HCLU)

ЗАЯВЛЕНИЕ НПО от имени Евразийской сети снижения вреда (ЕССВ) по поводу тематической секции дебатов (i) (Общая ответственность как основа интегрированного, сбалансированного и устойчивого подхода к борьбе против наркотиков в национальной и международной политике).

Докладчик:

Г-н Балаш Денеш

Член Руководящего комитета ЕССВ

Исполнительный директор Венгерского союза гражданских свобод (Hungarian Civil Liberties Union - HCLU)

Благодарю г-на председателя! Для меня большое удовольствие выступать на Комиссии по наркотическим средствам от имени Евразийской сети снижения вреда. Спасибо за предоставленную возможность обратиться к делегатам.

Как представитель гражданского общества, мне очень приятно видеть позитивные изменения в языке и подходе данной встречи.

В ходе этой сессии много раз прозвучали заявления о необходимости сбалансированного подхода в наркополитике, что подразумевает достижение баланса между снижением поставок и спроса на наркотики; между уголовным правосудием и общественным здравоохранением. Но в реальности, дамы и господа, соответствующий баланс редко виден в докладах институций ООН или Международного совета по контролю над наркотиками. Также не сбалансированы бюджеты и действия на местном, национальном и международном уровнях. В то время как УНП ООН и Международный совет по контролю над наркотиками превозносят сбалансированный подход, создается впечатление, что они более обеспокоены знаменитостями, которые нюхают кокаин, чем здоровьем и правами человека миллионов потребителей инъекционных наркотиков, живущих с ВИЧ, которые не имеют доступа к спасительным услугам и медикаментам. Исполнительный директор УНП ООН критикует дома мод, так как модели употребляют наркотики, как и миллионы других молодых людей. В то же время, не поступает критики в адрес России, где запрещено заместительное лечение ПИН метадоном – медикаментом, который включен в Список необходимых медикаментов ВОЗ еще два года назад. Многие страны, которые восхваляются Международным советом по контролю над наркотиками за их достижения в сфере снижения поставок, не соответствуют международным стандартам по правам человека и внедрению экономически эффективных услуг по снижению вреда, которые могут уменьшить степень преступности, смертности и заболеваемости. Я не могу найти баланс даже в своей стране, в Болгарии, где правительство тратит 50 миллионов долларов на снижение поставок и только 12 миллионов долларов на снижение спроса и вреда от наркотиков; где тысячи непостоянных потребителей марихуаны принуждаются к лечению, которое им не нужно, в то время как зависимые от героина должны стоять в очередях для получения особо необходимого лечения.

Нынешняя система по контролю над наркотиками не кажется мне ни сбалансированной, ни основанной на доказательствах. Также не похоже, что она способна „сдерживать“ проблему наркотиков, как заявил г-н Коста в своем выступлении. Эта система придает особое значение уголовному правосудию, пренебрегая правами человека и общественным здоровьем; правительства непропорционально распределяют ресурсы в пользу снижения поставок, за счет снижения спроса и вреда от наркотиков. Я хочу воспользоваться этой возможностью и призвать делегатов настаивать ни просто на том, чтобы их правительства использовали „сбалансированный подход“ как пустой лозунг, но чтобы общественному здоровью уделялось такое же внимание, как и уголовному правосудию, что касается права, бюджета и координации.

Request for NGO STATEMENT on behalf of the Eurasian Harm Reduction Network (EHRN) regarding the thematic debate Section (i) (Shared responsibility as a basis for an integrated, balanced and sustainable approach in the fight against drugs through domestic and international policies)

Presenter:

Mr. Balázs Dénes

member of the Steering Committee of EHRN

Executive Director of the Hungarian Civil Liberties Union (HCLU)

Thank you Mr. Chair! It is a big pleasure to speak on behalf of the Eurasian Harm Reduction Network at the Commission on Narcotic Drugs, and I appreciate the opportunity to adress the delegates.

As a representative of civil society, I am very pleased to see the positive changes in the language and approach of this meeting.

At this session there is a lot of talk about the need of the balanced approach in drug policies, which means a balance between supply and demand reduction, criminal justice and public health. But in reality, ladies and gentlemen, we rarely find the appropriate balance in the reports of UN institutions or in the reports of INCB, neither in drug policy budgets and activities in local, national and international level. While UNODC and INCB praises balanced approach, it seems to be more concerned about celebrities snorting cocaine than about the health and human rights of millions of injecting drug users living with HIV – without access to live saving services and medications. The Executive Director of UNODC criticises fashion houses because their models use drugs just as a millions of other young people do, but it fails to criticise Russia for prohibiting methadone substitution treatment for IDUs, a medication included to the List of Essential Medicines by WHO two years ago. Most countries praised by INCB for their achievments in the field of suppy reduction do not comply with international standards with regard to human rights and cost-effective harm reduction services, which can reduce the risks of crime, death and disease. I cannot find the balance in my own country, Hungary, where government spends 50 million dollars on supply reduction and only 12 million dollars on demand and harm reduction, and thousands of occasional marijuana users are coerced into treatment which they don’t need, while heroin addicts are put on waiting lists to get into much needed treatment.

The current drug control system does not seem to have a balanced and evidence based approach, or that it can „contain“ the drug problem, as Mr. Costa put it in his speech. The drug control system overemphasizes criminal justice at the expense of human rights and public health, governments allocate resources in a disproportianate way on supply reduction at the expense of demand and harm reduction. I would like to use this opportunity to ask delegates to urge their governments not to simply use „balanced approach“ as an empty slogan, but to put as much emphasis on publich health as on criminal justice in terms of legislation, budget and coordination.

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Statement by UNAIDS for the 51st session of the CND in Vienna

Commission on Narcotic Drugs
Fifty-first Session
Vienna, 10-14 March 2008

Speaker Susan Timberlake, UNAIDS

Statement by the

Joint United Nations Programme on HIV/AIDS

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)

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