By Ricardo Baruch (The PACT) and Murtaza Majeed (Youth RISE)
Two very important meetings are scheduled in 2016: the United Nations General Assembly Special Session (UNGASS) on Drugs and the High Level Meeting on HIV/AIDS. Both will take place in April and June consequently in New York. All Member States will discuss what should be done at the global level in order to deal with issues around drug use, drug markets, drug control among others.
The drug control models and conventions came into play in an era where homosexuality was considered a “sickness”, abortion was a “crime”, and from history we know how stigmatizing and marginalizing communities have affected homosexual populations; but, thanks to persistent advocacy and activism, most governments accepted the fact and the health risks decreased among them. Alas, drug use is still stigmatized, people who use drugs are still marginalized groups, and data clearly indicates that the morbidity rate of drug users due to current repressive policies and health care is very high.
But why is it important for stakeholders working on HIV issues? HIV epidemics in most regions have started from people who inject drugs. Eastern Europe, Central Asia and Southeast Asia are regions with high rates of HIV among drug users. For example in Asian countries, it is estimated that 16% of people who inject drugs are living with HIV. In Irkutsk, Russia 64,5% of injecting street drug users were living HIV. Other regions like North America, South America and Western Europe also have a strong problem with injected drugs and its relation with HIV and hepatitis transmission. Drug use is an issue faced by other key populations such as sex workers, transgender women and men who have sex with men. Therefore reluctance towards drug use can affect all mentioned populations, and has already led to social and health harms due to lack of services including HIV testing, counselling, treatment, care and support.
UN agencies such as World Health Organization and UNAIDS have recommended harm reduction as an evidence-based approach for HIV prevention for many years; nevertheless, lack of coordination among the UN itself has made it challenging for agreed common language on harm reduction support. Many Member States are reluctant to implement life-saving public health interventions. Communities of people who use drugs have low or no access to essential HIV prevention tools such as needle and syringe exchange. As a consequence, children, youth, women and other drug users could not have the essential human rights which are access to health. Young people also face barriers to access youth friendly harm reduction services, including age of consent laws.
Lack of harm reduction services at the grass roots level has deeply damaged our society. It has created stigma and discrimination. Lack of support and stigmatization has led drug users to stop believing in services and have made them reluctant to talk about their drug issues. United Nations Office for Drugs and Crime (UNODC) acknowledges very little changes in the overall global situation of production, use and health consequences of illicit drugs. For this reason, the General Assembly’s Special Session should bring a new step towards the drug problems of people who use drugs. We cannot afford to lose time and lives because another important meeting of the member states fails to act.
It is important for the HIV community, advocates and stakeholder to push their governments to take on more progressive positions regarding drugs and especially harm reduction, in order to improve public health and respect the human rights of people who use drugs. From the vantage of human rights, access to the highest quality of health care – as well as from the point of view of politicians making decisions on behalf of the best interest of the society – harm reduction is a key element to be discussed and accepted for HIV preventions among people who use drugs. In order to protect our societies, Member States, UN agencies and other stakeholders should support harm reduction and decriminalization of drug use.
In order to protect our societies, Member States, UN agencies and other stakeholders should support harm reduction and young people’s access to youth friendly services leading up to UNGASS in the next few months – this will feed into processes to ensure we secure similar language in the High Level Meeting Declaration in June.