The UN Human Rights Council, the highest political body in the UN dealing specifically with human rights, has adopted two resolutions of considerable importance to harm reduction – HIV/AIDS and human rights, and access to essential medicines. Within the resolution on HIV/AIDS and human rights the Council supports in both the preambular and operational paragraphs the need for a“comprehensive package of services for injecting drug users, including harm-reduction programmes in relation to HIV” and reaffirms the commitment to expand "access to essential commodities, including…sterile injecting equipment” and “harm-reduction efforts related to drug use”. The wording reflects both a recent ECOSOC resolution relating to UNAIDS and the 2001 and 2006 declarations of commitment on HIV/AIDS adopted unanimously at the General Assembly.
This is the first resolution on HIV/AIDS adopted by the Council, which was established in 2006 to replace the much maligned Commission on Human Rights. It is the first human rights resolution at the UN to specifically recognise harm reduction as a part of a rights based response to HIV/AIDS. It stands in stark contrast to the UN Commission on Narcotic Drugs which has still, shamefully, never recognised harm reduction in any resolutions. During the recent ten year drug policy review at the Commission, harm reduction was an extremely controversial issue, and was eventually omitted from the subsequent political declaration that is intended to set the tone for the next decade of drug policy. Harm reduction has now been supported and recognised at the General Assembly, the Economic and Social Council and the Human Rights Council – all senior to the CND. The Commission on Narcotic Drugs is clearly out of step, and badly misfiring. This is particularly troubling given that the CND is the governing body for the UN drug control programme within UNODC – the lead in the UN system for IDU and HIV/AIDS.
The second resolution adopted by the Council recognised that access to essential medicines is a component of the right to the highest attainable standard of health. Again, this is controversial at the Commission on Narcotic Drugs, despite the fact that access to controlled substances for medical and scientific purposes is ostensibly half of the aim of the entire drug control regime. While the resolution does not specifically mention opioid substitution therapy, or any form of medicine for that matter, it is clearly of central relevance to the issue – methadone and buprenorphine are both on the WHO essential medicines list. The Human Rights Council has confirmed that denial of essential medicines to those who need them is a violation of the right to the highest attainable standard of health. This must include those in need of OST. The resolution asks the UN Special Rapporteur on the Right to health, Anand Grover, to look into this issue, and for the Office of the High Commissioner for Human Rights to convene an expert consultation on the matter.
Crucially, the resolution also asks for this issue to form part of state reports under the Universal Periodic Review mechanism, whereby member states of the UN report to the Council on their human rights record. This is an important milestone for access to medicines. An important question will be whether the International Narcotics Control Board is willing to co-operate with the human rights system or if it will continue with its isolationist approach.