INPUD is a global network of people who use and have used drugs. INPUD has an evolving regional network structure and also strong ties with a number of national and local drug user organisations. A key role of the organisation is to support people who use drugs to access and take part in international policy processes.

El INPUD es una red mundial constituida de personas que usan o han usado drogas. Su estructura en red es cambiante. La organización ha desarrollado estrechos vínculos con una serie de organizaciones nacionales y locales cuyos miembros son usuarios de drogas. Uno de los papeles claves de la organización es ayudar a los usuarios de drogas a tener acceso y participar a los procesos de decisión política al nivel internacional..

INPUD est un réseau mondial constitué de personnes qui consomment ou on consommé de la drogue. Sa structure en réseau est en constante évolution. L’organisation a, par ailleurs, développé des liens étroits avec un certain nombre d’organisations nationales et locales constituées d’usagers de drogues. L’un des rôles clés de l’organisation consiste à aider les usagers de drogue à avoir accès et à participer aux processus internationaux de décision.

International Network of People Who Use Drugs (INPUD)

The impact of US foreign aid cuts on the health and well-being of people who use drugs has been massive and monumental. The International Network of People who Use Drugs (INPUD) is conducting a rapid assessment to understand the depth and breadth of this impact. Over the course of 5 days, INPUD received 76 responses to its online survey evaluating the real-time consequences of these new US policy directives on the lives of people who use drugs and their service providers. Preliminary findings highlight:

The severity of funding cuts have “cut harm reduction services at the knees”

, gutting the organisational capacity of community-led service provision, forcing service disruptions, closures and mass lay-offs of harm reduction’s essential workforce (i.e., peer educators, outreach personnel, clinic staff).

Evidence-based harm reduction models are at-risk

: Harm reduction is founded on strong peer-led front-line service delivery, such as outreach, peer education, and community leadership and engagement. Without peer-driven harm reduction services, the entire harm reduction model and its systemic infrastructure is placed at significant risk.

Sustainability is bleak for rights-based harm reduction models that have proven effective in the fight against HIV and hepatitis C

: The collapse of harm reduction services will have direct human impact, meaning a return to raging HIV, hepatitis C and overdose epidemics among people who use drugs globally.

The following recommendations are based on INPUD’s preliminary findings presented below:

Alternative pooled funding mechanisms must

 be urgently established by global partners to prevent service collapse and resultant spiking rates of new HIV/HCV infections, and preventable overdose deaths.

 to support harm reduction services previously reliant on U.S. funding, including equitable access to opioid agonist treatment (OAT) and social contracting arrangements that prioritise community-led responses.

International and multilateral organizations

 must prioritize emergency resource allocation to affected programs and key populations, including for people who use drugs.

 to restore funding and highlight the long-term public health consequences of these directives.

The human cost of policy shifts: The fallout of US foreign aid cuts on harm reduction programming and people who use drugs

On January 24, 2025, U.S. Secretary of State, Marco Rubio, issued an immediate halt to most foreign aid programmes for 90 days, pending a comprehensive review to ensure alignment with the current administration’s values and policies. Since then, it has been made public that approximately 10,000 US foreign aid grants, awards and contracts have been, or will be terminated over the coming days causing heightened confusion and disbelief within the HIV, TB and malaria sector and well beyond. This U.S. policy directive affects a wide range of global health and development initiatives with wide ranging implications for people who use drugs and their access to services.

We’ve developed this survey to get a better sense from harm reduction organisations and networks of people who use drugs of how these recent US funding directives are affecting harm reduction services, HIV and hepatitis care, and human rights programming for people who use drugs at the regional and country level. 

We will present the findings from this survey during the UN Commission on Narcotic Drugs (CND, March 10-14, 2025) and widely with our partners and funding agencies.

Time is of the essence. Please take a few minutes today and complete this survey to share how these devastating U.S. policy changes are affecting your organisation and the services you provide to our community.

This survey should take 10-12 minutes of your time and your responses will be fully anonymised.

 Your candid responses are crucial to monitoring and documenting how this US-policy affects the lives of our community and will help to inform our collective advocacy efforts. While this survey will remain anonymous, we have also provided the option for you to share your contact details should you wish to provide additional quotes or testimonials in this report.

Documenting the early impact of the US foreign aid directives on harm reduction programming

During the Interactive Dialogue with the Working Group on Arbitrary Detention at the 57th session of the Human Rights Council, Harm Reduction International, jointly with Centro de Estudios Legales y Sociales (CELS), Dianova International, Hayat, International Drug Policy Consortium (IDPC) and International Network of People who Use Drugs (INPUD) delivered a statement highlighting the arbitrariness of the death penalty for drug offences and mandatory sentencing.

Judicial discretion during sentencing is a key tenet of fair trial. Yet mandatory sentencing remains a common feature of punitive drug laws in many countries, preventing judges from considering the circumstances of the crime and of the defendant – including situations of coercion or vulnerability.

This is often one of many features which result in a particularly harsh treatment of people charged with drug offences – such as mandatory pretrial detention and exclusion from alternatives to incarceration; which result in a heightened risk of disproportionate punishments and exacerbate overincarceration and prison overcrowding, insomuch that 1 in 5 people today are incarcerated for often minor drug offences.

This practice can lead to extreme consequences: the death penalty remains a mandatory punishment for drug offences in 11 countries, including some that regularly carry out executions.

Echoing the Working group recommendations, we urge countries to reform their drug laws to fully align with human rights standards and promote proportionate and effective approaches to drugs, including by abolishing the death penalty and removing mandatory sentences.

On Mexico, we share the Working Group’s concerns on the country’s punitive approach to drugs, leading to increased incarceration of drug users and rights violations. We reiterate recommendations to Mexico to reject attempts to extend the applicability of mandatory pretrial detention, and to continue in its path towards rights- and evidence-based drug policies.

Abolish mandatory sentencing and all extreme punitive responses - Joint statement to the UN Working Group on Arbitrary Detention

Harm reduction services for people who inject drugs are essential interventions. There are many tools for HIV and HCV prevention amongst people who use drugs. Low dead space syringes and needles (LDSS) is one such tool.

This discussion will explore the uses and benefits of LDSS syringes for people who inject drugs.


Low dead space syringes: Analysis and benefits for people who inject drugs

We, the undersigned organisations, are deeply concerned about the drastic intensification of anti- drug operations in Sri Lanka leading to significant human rights violations.

On 17 December 2023 the Acting Inspector General of Police Deshabandu Tennekoon, with the endorsement of Minister of Public Security Tiran Alles, spearheaded an operation titled “Yukthiya”, with the stated aim of controlling “the drug menace”. The operation is ongoing as of 10 January 2024, with at least one thousand persons arrested daily.

This operation is unfolding in a context of already severe repression against persons who use or are suspected of using drugs, who suffer discrimination and stigma within the Sri Lankan criminal justice system and society.

Alongside the Sri Lankan police, members of the armed forces have been supporting this operation, during which several human rights violations have been reported. These violations include alleged arbitrary arrests, primarily against individuals from marginalised socio-economic communities; searches conducted without warrants or reasonable suspicion; and degrading treatment including strip searches in public as well as cavity searches. The searches and arrests have been televised, in violation not only of the right to privacy (and of basic human dignity) but also of a person’s right to be presumed innocent. According to lawyers, persons are being arrested even when no drugs are found in their possession, simply for having been arrested for drug offences or having been sent to compulsory rehabilitation in the past. The arrests of main livelihood earners and mothers have adversely impacted the ability of families to meet their basic needs during a time of economic crisis in Sri Lanka, and the wellbeing of children.

Persons are being arrested primarily under Section 54A of the Poisons, Opium and Dangerous Drugs Ordinance, an offence which is non-bailable. As a result, those arrested are bound to spend time (sometimes months) in pretrial detention, thereby exacerbating already poor conditions of imprisonment in an overburdened prison system. The Human Rights Commission of Sri Lanka has previously stated that the existing prison conditions and treatment of incarcerated persons are “inhumane and degrading.”At present, as per statistics issued by the Department of Prisons, the level of overcrowding of the prison system is at nearly 200% - with punitive drug policies playing a significant role: as of 2022, 63% of convicted persons were sentenced for drug-related offences.

The total reported number of arrests pursuant to operation Yukthiya has exceeded 29,000 as of 9 January 2024, while nearly 1,500 people are in administrative detention in police custody for further investigation.  At least 1,600 more persons have been sent for compulsory drug rehabilitation, in violation of several fundamental rights; including the right to the highest attainable standard of health, which includes the right to consent to and withdraw from medical treatment. “Drug treatment” in these centres is abstinence-based, essential harm reduction services are not available, and persons undergo severe withdrawal symptoms without any medical assistance while in detention. The use of violence to discipline and punish has been reported in at least two compulsory drug rehabilitation centres which are within the purview of the Bureau of the Commissioner General for Rehabilitation and are operated by the military, which is in itself a violation of international standards.

The UN Working Group on Arbitrary Detention in its statement at the conclusion of its visit to Sri Lanka in 2017 expressed concern regarding the involvement of military personnel in drug treatment and rehabilitation, the fact that strenuous physical exercise was the core component of compulsory drug treatment, and at the lack of trained professionals to monitor the health of people in detention. Furthermore, the statement highlighted the irregularities in the judicial process by which persons were sent to drug rehabilitation centres without a medical assessment.

More broadly, the UN Special Rapporteur on Torture has highlighted that by denying persons access to substitution therapies, states are subjecting “a large group of people to severe physical pain, suffering and humiliation, effectively punishing them for using drugs and trying to coerce them into abstinence.” The Special Rapporteur has further stated “forcible testing of people who use drugs without respecting their autonomy and their right to informed consent may constitute degrading treatment, especially in detention settings. States are obliged to respect the enjoyment of the right to health, including by refraining from using coercive medical treatment. The requirement of informed consent, including the right to refuse treatment, should be observed in administering any treatment for drug dependence.”

Since the 2016 UN General Assembly Special Session on drugs, there is international consensus on pursuing a holistic and health and human rights-based approach to drugs, which encompasses supply and demand reduction as well as harm reduction. The 2019 Ministerial Declaration on drugs – the current global drug policy document - as well as multiple resolutions of the UN General Assembly, the UN Commission on Narcotic Drugs, and the UN Human Rights Council reiterate and recommend a similar approach.

A punitive and militarised approach to drug control contravenes recognised international human rights standards and guidelines, is ineffective to protect individual and public health, and ultimately fails to make communities safer.

Africa Network of People Who Use Drugs (AfricaNPUD) (Africa)

Anti-Death Penalty Asia Network (ADPAN) (Asia)

Association for Humane Drug Policy (Norway)

Centre on Drug Policy Evaluation (CDPE) (Canada)

Centro de Estudios Legales y Sociales (CELS) (Argentina)

Corporación Acción Técnica Social (Colombia)

Correlation - European Harm Reduction Network (Europe)

Drug Harm Reduction Advocacy Network Nigeria (Nigeria)

Foreningen Tryggere Ruspolitikk /Safer Drug Policies (Norway)

GREA - Groupement Romand d'Etudes des Addictions (Switzerland)

Helsinki Foundation for Human Rights (Poland)

International Commission of Jurists (ICJ)

International Drug Policy Consortium (IDPC) (Global)

International Network of People who Use Drugs (INPUD) (Global)

Skoun, Lebanese Addictions Centre (Lebanon)

Zimbabwe Civil Liberties and Drug Network (Zimbabwe)

Sri Lanka: Stop abusive anti-drug operation and release those arbitrarily detained

, European Network of People who Use Drugs (EuroNPUD)

, Women Harm Reduction International Network

International Network of People who Use Drugs

,European network of People who Use Drugs

This webinar was built on the recognition that narcofeminism calls for the participation of all women who use drugs. Women who use drugs have been addressing and presenting their concerns and recommendations to the Committee on the Elimination of All Forms of Discrimination against Women (CEDAW), which monitors this United Nations Convention on Human Rights. There are some examples around the world and this webinar describes a substantial part of them. Designed to explore a narcofeminist perspective on human rights, with the valuable collaboration of the Women Harm Reduction International Network (WHRIN) and the International Network of People who Use Drugs (INPUD).

Narcofeminist Advocacy at CEDAW

Wednesday, 20th September 2023, 13:30 - 15:00 (Geneva - CET)


Organised by the Office of the High Commissioner for Human Rights, in collaboration with Albania, Brazil, Colombia, Greece, Guatemala, Mexico, Paraguay, Portugal, Switzerland, Uruguay, UNAIDS, Amnesty International, Centro de Estudios Legales y Sociales, Dejusticia, the Global Commission on Drug Policy, Harm Reduction International, the Helsinki Foundation for Human Rights, the International Drug Policy Consortium, the International Network of People Who Use Drugs and the Open Society Foundation.

The Panel will provide a platform for international human rights experts, representatives of State and civil society organisations to discuss findings and recommendations of the report of the Office of the United Nations High Commissioner for Human Rights on ‘

Human rights challenges in addressing and countering all aspects of the world drug problem

Abdoul Thioye, Chief, Rule of Law, Equality and Non-discrimination Branch, OHCHR

Nekane Lavin, Human Rights Officer, OHCHR

Ann Fordham, Executive Director, International Drug Policy Consortium

Haryati Binti Jonet, Member, Asian Network of People Who Use Drugs

José Ignacio Juarèz Garcia, Director, Human Rights, Ministry of Foreign Affairs, Mexico

Hélène Tigroudja, Member, Human Rights Committee

Suki Beavers, Director, Gender Equality, Human Rights and Community Engagement, UNAIDS

Diego García-Sayán, Commissioner, Global Commission on Drug Policy

Special event: Human rights challenges in addressing and countering all aspects of the world drug problem

In 2016, INPUD commissioned a project that used in-depth, qualitative interviews with twenty peer drug user activists and harm reduction specialists from a range of different countries to develop a comprehensive set of seventeen key harm reduction interventions based on ‘best and worst practices’ in these areas. The result was a “Harm Reduction Best Practices Tool Kit”, intended for harm reduction service providers around the world.

The document focuses on three key harm reduction interventions:

Opioid and Stimulant Agonist Therapies (OATs/SATs)

The intention of this brief is to provide globally relevant recommendations for best practices in harm reduction policy and programming while drawing attention to some of the main obstacles that currently hamper these efforts. Peer-based expertise is utilised to provide an insider inventory of best and worst practices in the three harm reduction interventions identified above. These peer-informed recommendations are relevant to and centred around the needs and priorities of fellow drug users working in and making use of these programmes and services across the globe.

Although these interviews took place several years ago, it is fair to say that peer-driven advancements within OATs/SATs, NSPs, and ODP interventions around the globe have been slow in coming. This is true both in the general adoption of harm reduction interventions in countries that formerly or currently lack them, as well as within the services of those countries that do provide them. And maddeningly, the majority of harm reduction services continue to be staffed by non-drug users and other professionals and tend to prioritise their needs over those of drug using clients and, where they exist at all, drug using staff members. This continued lack of peer-led interventions means that the feedback of the interviewees continues to hold relevance today and there is much we can take away from it, as the following pages illustrate.

Harm reduction best and worst practice: Peer-informed policy and program recommendations in the time of Covid-19

As organisations that work in drug policy and harm reduction, we welcome the evidence-based proposals in the new report published by the Scottish Government proposing a road map for the future of drug policy and law in Scotland. We share the view of the report that drug policy based on health and human rights achieves better outcomes for individuals, their families, communities and wider society.

In recognition of the damaging global impact of criminalisation, the United Nations 

 a legal and policy position that promotes the reduction of harm and the decriminalisation of people who use drugs. We welcome this report as a step towards the UN’s position, and the development of effective policy and services in Scotland.

Ending criminal sanctions for people in possession of drugs for personal use; the provision of a full range of harm reduction services and support; and improvement in the accessibility and acceptability of treatment services for people who experience drug dependency are all required to address the public health emergency that Scotland has been in for some years.

Scotland has made progress on all these fronts, and yet the prevalence of people experiencing drug dependence, and the number of drug related deaths remain very high by international standards, underpinned by persistent broader health inequalities. Further innovation and investment is clearly required.

We further support the proposed evidence-led review into how the use of drugs, their production and supply could be regulated. This review would inform a debate around wider reforms to drugs legislation.

We welcome the recognition of the harmful role that criminalisation, poverty and stigma, play in the lives of so many. People who use drugs, especially those who experience dependence, face discrimination every day, and the Scottish Government’s desire to end the exclusion of this group from equality legislation is to be commended.

We also welcome the Scottish Government’s acknowledgment and commitment to centring those with living and lived experience in policy making and implementation.

UK legislation and regulations, especially the Misuse of Drugs Act 1971, serve as an impediment to many of the urgently needed evidence-based reforms highlighted in the report, including the decriminalisation of drug possession; the provision of supervised drug consumption facilities and drug safety checking services; and even heroin assisted treatment.

Scotland has developed innovative responses using its own legal system, police force, healthcare system and civic society. Progress has already been made in terms of the extension of recorded warnings for drug possession, policing arrangements and the legal basis for injecting equipment provision services and its world-leading take home naloxone programme. Scotland must also use these same assets to deliver supervised drug consumption rooms and drug checking services as a matter of urgency.

Drug-related deaths are at an all-time high, in Scotland and across the UK. The UK Government must either work to reform legislation to enable the vital reforms proposed in this report across all four nations, or sufficiently devolve powers to allow each country to enact these policies themselves in order to save lives, and support communities.

INPUD – International Network of People who Use Drugs

EuroNPUD – European Network of People who Use Drugs

Jason Kew, Senior Innovative Practice Officer,

International Network of People Who Use Drugs (INPUD)

Region

Translations

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