On 19-21October 2014, a regional dialogue was organized in Tbilisi, Georgia. It focused on the regional proposal regarding access to treatment for vulnerable groups in Eastern Europe and Central Asia, which is being prepared by ECUO and EHRN for submission to the Global Fund (GF). Information is already available on our website regarding an initial proposal that was submitted to the GF and supported by it at the stage of an expression of interest.

The meeting of key populations, vulnerable groups, people living with HIV, governmental specialists and international agencies was very fruitful. Not only was the common goal of the future regional project agreed upon, but there was also a detailed discussion of its objectives as well as a common way of interaction between the partners.

The main issues discussed, both at the plenary session and within the working groups, were the fundamental challenges that are relevant not only to the project, but also to ensuring the viability and effectiveness of the response to the epidemic in our region.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

What is the HIV care continuum and how can we ensure access to it by vulnerable groups?

November 1st has been observed as International Drug Users Day since 1995. Globally, there is a growing movement by activists and policy experts calling for de-criminalisation of drug users.

India has a long history of cannabis and opium use for social, cultural, religious and medical purposes. There are several examples of the use of these substances being sanctioned by particular communities. In sharp contrast today, India’s explicit constitutional aspiration to eliminate all forms of drug use from society is possibly the single most dangerous ideal that has fueled utter disregard for the health and rights of people who use drugs in India.

Political apathy is evident from the 2014 amendment to the principal Indian drug law, NDPS Act 1985, which leaves very little space for the promotion of evidence-informed and rights-based programming for drug users. The amendment does have a few positive features in its handling of harm reduction, treatment and recasting the death penalty. However, it enhances punishment for consumption and possession of small quantities for personal use from 6 months to 1 year, which is in direct contrast to developments in countries like Portugal, Spain, Italy and even America where the War on Drugs originated. The response in India to drug use has primarily been a health services-based approach. Though it mitigates some aspects of vulnerability, this approach fails to address the central role that rights protections play in ensuring the overall wellbeing of drug users.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

India: End the war on drug users

Lib Dem Home Office Minister Norman Baker said politicians were out of step with public opinion and called for an end to "robotic mindless rhetoric".

Backbench Conservatives also expressed doubts about current policy but Downing Street said there would be no change.

A report found no obvious link between tough laws and levels of drug use.

The findings of the Home Office report, commissioned by the Liberal Democrats to compare drugs policies in different countries, prompted a row at the top of the coalition.

Lib Dem deputy prime minister Nick Clegg accused his Conservative colleagues of trying to block the report, and of a "totally misplaced, outdated, backward-looking view".

Downing Street in turn accused Mr Clegg of sending "an incredibly dangerous message" and said that drug use in the UK was "plummeting" because of existing policy.

But during the Commons debate brought by Green MP Caroline Lucas, Conservative MPs Robert Syms, Bob Stewart and Zac Goldsmith expressed unease with the current approach.

Mr Syms said: "Contrary to press reports, there are many of us on these benches, the Conservative benches, that believe in evidence-based reform to have a more effective policy in dealing with the scourge of drugs."

End 'robotic rhetoric' on drug policy, says UK Minister

There are an estimated one million crack users in Brazil, many of whom reside in Cracolândias (Cracklands)—open-air drug markets where users freely smoke in a de facto legal environment. The largest of these markets is located in São Paulo, where a new approach has recently been implemented. The Open Arms program, launched in January 2014, is a city-sponsored harm reduction initiative that provides housing, food and job training to users without asking participants to quit using.

Harm reduction in Brazil’s Cracolândias

What happened to North America's boldest drug policy experiment?

In 2001, after much campaigning by activists, academics and public health officials, Vancouver's municipal council approved the boldest, most progressive drug policy in North America: 

A Framework For Action: A Four-Pillar Approach to Vancouver's Drug Problems.

The philosophy was simple but revolutionary: government should lessen the harms associated with drug use, even if those drugs are illegal. Heroin prescription, methadone maintenance and supervised injection are some of the ideas you will find in the document's 36 recommendations.

was passed over 13 years ago. Where do they stand today? This is our season-opening 5-part series, 

podcasted on iTunes and syndicated at the University of British Columbia, the University of Victoria and Simon Fraser University.

To read the articles and listen to the files, click on the links below or go to the series page.

 Prevention, treatment, harm reduction, and enforcement—Vancouver’s four pillars. It’s the most progressive drug plan of any city in North America. But its authors fear that the pillars are crumbling. More >>

 Do you remember DARE? It’s a drug education program, but researchers say that it doesn’t work because it exaggerates the harms of drug use. We profile people who say we need to try something new: tell kids the truth. More >>

When somebody decides that it’s time to kick drugs, who is there to help them? In this explosive expose, we reveal a chronically underfunded drug treatment system that is dominated by unregulated flop houses, questionable pharmacists and dogmatic providers. More >>

 This summer, an activist named Ann Livingston signed a lease for a bubble tea cafe in the heart of the busiest drug market in suburban Vancouver. Ann has one goal: invite the drug users in and start a political movement. The Bubble Helping Centre in Surrey is to be that movement’s headquarters. But how will the neighbourhood react? More >>

: The authors of Vancouver drug policy always wanted to end the ‘War on Drugs’ but they made a compromise. While their fight against prohibition has stalled, Seattle is forging ahead. Will Seattle's compromise get any closer? More >>

The Four Pillars revisited: A 5-part series about Vancouver drug policy

Public discussion of cannabis legalisation has leaped to a new high in Austria after the neoliberal newcomer in parliament, the Neos party, has voted to push the issue at its annual general meeting last weekend.

Party chairman Mat(thias) Strolz, who was first surprised that his economy oriented party showed a majority interest in cannabis, came out after a two day hiatus, fully supporting the decison.

"We support self responsibility and liberty. Legalisation makes sense", said Strolz in a first statement on Tuesday. Recommending a step-by-step plicy towards legalisation, the Neos fully support "grow your own" as a first move that would especially benefit Austria’s legion of cannabis patients who nurture their medicine in grow closets at home. A next step towards regulation may be the distribution via pharmacies, Strolz said further, lifting the spirits of tens of thousands currently criminalised cannabis patients who still face jail if they get caught with their medicine of choice.

"Decriminalisation would immediately benefit one in 8 Austrians. It is estimated 500,000 Austrians light up regularly and another 500,000 occasionally", said Toni Straka, chairman of the Hanf-Institut (Austria).

The Neos are the first party to officially jump the legalization bandwagon after a first parliamentary citizens initiative to unhinge cannabis from current drug laws. With so far almost 27,000 signatories the initiative jumped into third place of the most successful citizens activism in Austria’s history.

A huge leap forward in Austria: ‘Neos’ party votes for legalisation of cannabis

Naloxone kits, which help reverse the effects of an overdose, were introduced in Scotland in 2010. New figures reveal the distribution of the kits by health services and prisons has increased from 3,878 in 2012-2013 to 6,472 in the past year. Health statistician Prof Sheila Bird believes the programme has helped to save more than 40 lives.

Naloxone works like an epi-pen, which are used to treat allergic reactions. Drug users suffering an overdose can be given the treatment easily by family members or a friend, giving extra time for emergency services to arrive.

A national naloxone programme was introduced three years ago with Scotland the first country in the world to make such a move.

More naloxone drug overdose reversal kits distributed in Scotland

Arriving in Baltimore the night before the 10th National Harm Reduction Conference last week, I walked out of the hotel to get my bearings and buy a sandwich. Downtown was a desert, with banks and other businesses closed for the night. Turning a corner, I suddenly came upon a brightly lit cluster of exotic dance clubs and sex shops, guarded by intimidating bouncers, with people milling around with their hoods up, some intoxicated, the young women tottering on heels. There was a Subway open.

I learned at a panel the next morning that this incongruous patch is known in Baltimore as “The Block.” And since 2008 it’s benefited from an outreach program, thanks to activists, volunteers and the city health department. A van parks up regularly to hand out syringes and other supplies to cut the risk of HIV and hepatitis C infections for people who use drugs. “On The Block are some of the riskiest dance clubs,” said Susan G. Sherman of Johns Hopkins Bloomberg School of Public Health. “Some are like unsanctioned brothels.” A study she’s engaged in found that 42% of the women working in these clubs exchange sex, and that 55% currently use heroin, or crack or powder cocaine. The concentrated nature of The Block and its high turnover of dancers and clients means that intervening here has great potential to impact HIV and at-risk populations across Baltimore.

A woman who has worked on The Block stood up to share her knowledge: “Girls are absolutely doing things without condoms. The higher the drug use in the club, the more that is happening. The bartenders prefer it when the girls are on drugs because the girls are motivated [to make more money].”

Recently, a second van joined the needle exchange vehicle. Staffed by a doctor and an assistant, this one offers on-board pregnancy testing, STI testing and contraception. “We learned that combining needle exchange and reproductive health is feasible and affordable,” said Mishka Terplan, an OB/GYN who volunteers on the van. The team had to learn to work fast: “Most of the women have a very brief period of time, basically a cigarette break, to do the paperwork, receive the services and get back to work before they get in trouble.” But they now have over 500 clients. “This marriage of needle exchange and reproductive health is exciting,” said Terplan. “Preventing unplanned pregnancies is harm reduction.”

Harm reduction 2014: bigger, bolder and hungry for more

Bulgarian society seems to be in a state of apathy when it comes to decriminalisation of drug use. Neither a so-called “reform” of the drugs law (making it harsher than ever), nor an outrageous fine for the pro-legalisation Green party, was a loud enough wake-up call for Bulgaria to distance itself from the current punishment-based approach. Read the guest article from human rights expert journalist Krassen Nikolov.

Recent parliamentary elections in Bulgaria have deepened the country's political crisis. Eight parties received enough votes to take seats in Parliament, and analysts anticipate a weak coalition government, which will not be able to conduct serious reforms in the most important public sectors – education, healthcare, and the judicial system.

The previous government put out a draft new Penal Code for public consultation. The draft was harshly criticised by NGOs and the Supreme Court of Cassation. According to the Supreme Court judges, the new code would do more harm than good. One of the reasons for their criticism was that the draft is very restrictive on the question of the supply and use of drugs.

If the parliament passes the new code, anyone caught smoking, or even possessing, a single marijuana cigarette is liable to a term of 1 to 6 years' imprisonment. The current punishment for somebody caught with a small amount of drugs for personal use, is a fine. This issue was widely discussed earlier this year; even so, government authorities refused to withdraw and rewrite the draft. The opinion of senior magistrates, such as Evgeni Dikov, director of the National Investigation Service, was unable to sway them. Dikov said that it was "ridiculous for a marijuana cigarette to spin the entire judicial machinery."

Legalisation of marijuana is a political taboo in Bulgaria

A delegation of the UNAIDS Programme Coordinating Board (PCB) conducted a field visit to Indonesia from 22 to 24 October to see how the country has implemented an integrated and decentralized response to AIDS that has accelerated the strategic use of HIV treatment, increased testing and counselling and strengthened HIV prevention services for key populations.

Indonesia demonstrates how a multisectoral approach to HIV, combined with consistent leadership at all levels, is helping the country to stabilize the epidemic, accelerate treatment and provide innovative and comprehensive HIV services. The country’s AIDS response is guided by an investment strategy, developed with support from UNAIDS, which focuses resources and efforts where they are most needed.

According to national estimates, 638 000 people are living with HIV across Indonesia, and latest national data show that new infections are stabilizing, although there are increases among men who have sex with men. Indonesia’s epidemic is largely concentrated among key populations, including sex workers and their clients, men who have sex with men, people who inject drugs and transgender people. While national HIV prevalence is low, a higher burden of HIV is found among key populations and in certain geographic areas, such as urban settings and in the Papua provinces.

Leadership and focus on key affected populations frame Indonesia’s response to HIV

In most countries in the world, if you asked the local authorities for permission to grow 750 cannabis plants in a residential area of the capital city, you would probably end up in trouble.

But in Chile, the state has just agreed to such a project. The cannabis will be planted on 29 October in La Florida, a district of Santiago. It will be harvested next April and turned into an oil which will be used as a painkiller for 200 cancer patients.

It is the first project of its kind with state backing anywhere in Latin America. Much of the recent debate in the region over cannabis use has centred on Uruguay, which this year became the first country in the world to legalize the cultivation, sale and consumption of the drug.

But in Chile, the authorities have taken a different approach, permitting the use of cannabis for medicinal purposes only.

Chile plants cannabis for medicinal use

This plenary session from the 10th National Harm Reduction Conference, Baltimore, features Kasia Malinowska-Sempruch, Director of the Global Drug Policy Program, Open Society Foundations. In this presentation, Kasia poses the question "Is the 2016 United Nations General Assembly Special Session (UNGASS) on Drugs an Opportunity to Change the World?".

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