Why do we need advocacy for decriminalisation and harm reduction in Eurasia for effective HIV response?

Why are we speaking about harm reduction advocacy in HIV response? Why bother yourself with the issue of drug policy and decriminalisation of drug use and possession?

A simple response is – even the best medicine cannot cure while it is placed in the box in hospital storage. Harm reduction – is the best vehicle connecting people using drugs to testing, treatment and health care. It is the best comprehensive way to provide access to medical help and social support for people using drugs.

I was growing up in University campus area in Kyiv, Ukraine. In 1991, when I reached 15, soviet social systems crashed and violent primitive accumulation of capital (sorry for Marxism) started. University campus became the best scene for open drug trade, accompanied by gangsters’ shootings, corrupted police from the highest level to local cops, easy access to thrown away drugs around. The most surprising story for our peers was not about starting using homemade opiates (sadly, it was quite common), but to quit “the system”. Now I don’t know how many from my class survived alcohol poisoning, drug overdoses or violence.

Since 1996, HIV infection has been spreading lightning-fast among people using drugs in post-soviet countries. At the beginning of 2000s, up to 90% of all HIV-positive cases were among injecting drug users. Available ART treatment appeared in Ukraine only in 2004. My neighbours and friends had all chances to be infected through needles but had no chances for prevention, testing or treatment.

Why are we speaking about harm reduction advocacy in HIV response?

BOGOTA — Colombia is advancing towards meeting a court's requirements that will allow it to renew aerial herbicide spraying of coca crops, the chief ingredient of cocaine, the minister of defense said Monday.

The Andean country, considered one of the world's foremost cocaine producers, finished 2019 with 154,000 hectares (380,542 acres) of coca crops and a potential cocaine output of 1,137 tonnes a year, according to the United Nations Office on Drugs and Crime.

Though coca crop size fell 9% in 2019 to the lowest level in six years, the capacity to produce cocaine rose 1.5% due to increased productivity. Colombia faces permanent pressure from the United States, the main destination for cocaine, to reduce crops.

The government of President Ivan Duque is looking to meet various health and environmental requirements demanded by Colombia's Constitutional Court to re-start aerial spraying with the herbicide glyphosate.

Colombia suspended spraying campaigns in 2015 following a recommendation by the World Health Organization, which warned glyphosate could potentially be cancerous and harmful for health and the environment.

Colombia to restart aerial fumigation of coca crops, Defense Minister says

Annual panel on technical cooperation and capacity-building - Upholding the human rights of prisoners, including women prisoners and offenders: enhancing technical cooperation and capacity-building in the implementation of the Nelson Mandela Rules and the Bangkok Rules

This statement is given on behalf of the International Drug Policy Consortium, Penal Reform International, the Washington Office on Latin America, and the Association for the Prevention of Torture.

As we approach 10 years since the Bangkok Rules were adopted, we bring your attention to the increase of the female prison population over the past two decades.

It is clear from country-based research that the number of women in prison has not grown dramatically because of an increase in criminal activity, but because of political choices – notably drug policies. The proportion of women imprisoned for drug offences is significantly higher than that of men.

Some of the highest rates are to be found in Latin America and South East Asia, with as many as 82 per cent of women in prison in Thailand imprisoned for a drug offence, 53 per cent in the Philippines and over 60 per cent in Peru and Costa Rica. In Brazil, 63 per cent of women in prison in 2014 were there because of minor drug related offences – compared to a quarter of men.

The harms of imprisonment on women, and their children, are well documented, as are the contexts in which women become involved in drug crime, with violence, coercion and vulnerability thread through the lives of many.

Against this backdrop, we are alarmed that many of the Bangkok Rules remain on paper, especially the provisions that call for non-custodial alternatives and for sentencing practices to take into account mitigating factors.

Swift and bold reform is needed to turn the tide on women’s imprisonment. We call on the Human Rights Council and its mechanisms to pay greater attention to the harm and violations suffered by women who come into contact with criminal justice systems – including by building on the work to-date to address human rights violations associated with drug policies.

Association for the Prevention of Torture

Oral statement at the 44th session of the Human Rights Council - Thematic panel discussion on technical cooperation and capacity-building

By Catalina Gil Pinzón & Isabel Pereira Arana

What does the coronavirus crisis show us about drug policy in Colombia? In this article, we reflect on how Colombia's highly punitive drug policies have fueled the prison crisis, which has escalated with the spread of COVID-19.

The coronavirus pandemic has brought attention to the shortcomings our society has been facing, including weaknesses in our healthcare system, gender-based violence that increased during quarantine, high levels of informal labor, and the challenges of online education in rural settings. There is a demonstrable need for better policies to shore up these issues. However, little has been said about the drug policies that govern us—policies that have high cost and a limited effect—and the current need for a transition to evidence-based policies with a focus on human rights and public health.

This pandemic is also shining a light on a subject usually resigned to the outer limits of public debate: how our punitive drug policy fuels the country's prison crisis—a crisis that has escalated with the spread of COVID-19. Addressing this issue is also particularly relevant in the wake of Decree 546 of 2020, which provides measures to alleviate overcrowding in prisons during the pandemic, with the exclusion of drug offenders.

As of April 14th, according to figures from the National Penitentiary and Prison Institute (Inpec), in Colombia there are 120,885 persons deprived of liberty in 132 prison facilities. Collectively, these facilities have a theoretical capacity of 80,928. Comparing these two figures shows an overcrowding of 49.37%. Yet, this is not a new crisis, quite the contrary. Since 1998, the Constitutional Court has declared the country's prisons to be in an Unconstitutional State of Affairs due to their overcrowding and the deplorable conditions inside the penitentiaries.

Punitive drug policy is fuelling the prison crisis in Colombia

Evidence-based drug policy simply refers to the use of evidence (data, proofs) to guide our response to drug control. It is simply ensuring that current best evidence is being used in making decisions. This means the quality of our outcome will improve or become better if our response is influenced by science, data or evidence. This also means that for us to use current best evidence, we have to be ready to systematically evaluate our laws, policies and practices to determine whether they are actually fit for purpose.

If we take a look at drug laws and policies that exist today, we will realize that most of them were developed based on opinions, sentiments and not really by critically examining what the situation was, what they intend to achieve and how best to achieve them. For example, in West Africa, Nigeria inclusive, most of the drug laws are reactive. They were developed just to respond to the outcry against drug trafficking and illicit drugs transiting through the region to the thriving markets in North America and Europe. So, the laws were developed based on the idea that we need to just stop the flow of drugs through the region. This further influenced the metrics or indicators that were being used to measure the success in the drug control effort. That’s why you hear about the number of arrests, seizures, people jailed or criminalized and so forth.

Unfortunately, the drug laws do not reflect the realities of what the drug situation is in the countries across the region. This was part of what prompted the efforts of the West Africa Commission on Drugs (WACD) to embark on a fact finding mission, which released an outstanding report in 2014 titled “Not Just in Transit: Drugs, The State and Society in West Africa” . This report brought to the fore front that illicit drugs are not just transiting through the region but are also being consumed and produced in West Africa. Therefore, a drug control effort that has majorly focused on cutting drug supply is not only inadequate but cannot solve the health, security and development challenges posed by drugs.

When advocates talk about evidence-based drug policy reform in Africa, what do they really mean?

For five years, a secret supervised drug injection site has operated in the US, allowing drug users to inject more than 10,000 times in a sterile, protected environment.

The illegal operation is modeled after similar, legal sites in Canada and Europe, which seek to provide drug users with a place to get clean supplies, connect with social services and avoid overdosing in a dangerous place.

A study of the underground site published in the New England Journal of Medicine online on Wednesday revealed how lives could be saved if the US were to sanction such facilities.

At the clandestine site, there were 33 opioid-involved overdoses, which were reversed with the medication naloxone, according to researchers at the not-for-profit RTI International and the University of California, San Diego.

“Not only were the 33 overdoses all saved, none of them required anyone calling 911 or being sent to a hospital,” said Alex Kral, an RTI International epidemiologist. “This is a big piece of this – we don’t need to overburden the emergency system with all these overdoses if people are inside, if they have trained people monitoring them.”

Secret US drug injection site shows how supervision could save lives

Drugreporter and INPUD presents the first episode of a 10 chapter long series documenting how people who use drugs around the world have organised and formed collectives and unions to protect and defend the health and human rights of their community. The first episode uncovers the history of the movement in the Netherlands, and how it inspired activists in Belgium and France.

Since January 1981, when the first drug user group ‘Junkie-bond’ was established in Rotterdam in the Netherlands, the drug user movement has grown exponentially: people who use drugs have continued to organise and form collectives and unions to protect and defend the health and human rights of their community. This struggle for autonomy, self-determination and empowerment of people who use drugs has been, and is, a global phenomenon.

The Rights Reporter Foundation (Drugreporter) and the International Network of People who use Drugs (INPUD) produced this documentary film series that aims to document how the movement of people who use drugs have formed around the world, how they maintain momentum and mobilise, and how they undertake their work and show resilience in a context of criminalisation, marginalisation and oppression.

Taking back what's ours! – Episode 1: The Netherlands, Belgium and France

By Hakimie Amrie Hisamudin for Free Malaysia Today

PETALING JAYA: An expert in epidemiology has called for a halt to the jailing of minor drug offenders, saying this would reduce overcrowding in prisons and be in the interest of containing the spread of Covid-19.

Dr Ehab Salah, who works for the United Nations Office on Drugs and Crime, said the existing prison environment was not conducive to measures to contain virus transmission.

Key preventive measures such as social distancing and the use of face masks were not applicable in the prison setting, he added.

Ehab alleged that prisoners were not receiving healthcare services of the same standard available to the public at large.

Prior to the Covid-18 pandemic, he said, the spread of tuberculosis, HIV and Hepatitis C in Malaysian prisons were always a health concern.

Malaysia: End jailing of minor drug offenders, says medical expert

Pride has become a time defined by love and acceptance for the LGBTQ+ community (LGBTQ+ stands for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning and the + is for everyone else who identifies in the community). For better or for worse, it has become a month long event with sporting and cultural bodies as well as small businesses and large, international corporations showing the rainbow flag and expressing their support for the LGBTQ+ community. The community has reached new heights of acceptance where being seen to be supportive of LGBTQ+ people is deemed to be profitable. This rainbow-tinted image of the community’s position in society is one that hides many of the problems our community still faces.

Aside from our community facing regular homophobia, transphobia, and other forms of discrimination, we experience a range of other issues in a manner different to our cisgender and heterosexual peers. The link between the LGBTQ+ community and drug use is incredibly evident when spending any amount of time in LGBTQ+ spaces. This link is also there in non-LGBTQ+ spaces, just go to any pub on a Saturday night or even your local Garda station. Drug use is present in all sections of society and prohibition has failed to have any tangible impact on drug use and addiction.

LGBTQ+ spaces are overwhelmingly places that are traditionally associated with alcohol consumption and illicit drug use. Gay bars and clubs were the original safe havens for our community and remain a place where LGBTQ+ people can come together and embrace their identity without having to fear the judgmental gaze of wider society. These spaces have changed and developed over time to what we see today in many city centres around the world. As time has gone on new spaces have been forged, notably with the more recent rise of Chemsex within the MSM (Gay, Bisexual and Other Men Who Have Sex With Men) community specifically.

Drug use and the LGBTQ+ community - Taking pride in harm reduction

Two years ago, the International AIDS Society (IAS) chose the United States of America (U.S.) as the site for the 2020 International AIDS Conference (AIDS2020). Community advocates argued that the U.S. was an inappropriate choice given legal travel restrictions on sex workers, people who use drugs, and Muslims, which would have made it very difficult for members of these communities to enter the country. The Trump regime’s racist immigration, detention and family separation policies, state-sanctioned violence against Black and Brown people, and the country’s worsening human rights conditions for LGBT people, added to advocates’ grave concerns.

The IAS’ decision created a dilemma for many in the global HIV movement and revealed a willingness by mainstream HIV actors to tolerate the discrimination of immigrants, people of color, Muslims, people who use drugs, sex workers, and transgender people in the conference’s host country. The IAS’ decision also resurfaced questions about the community-relevance of large, multi-million-dollar conferences in the face of shrinking global HIV investments. Moreover, persistent barriers to HIV prevention, care, and treatment services like the costs of medicines and diagnostics as well as criminalization, stigma, discrimination, and violence, compel community advocates to ask:

How can IAS better and more meaningfully 

directly benefit people living with and most affected by HIV 

(gay and bisexual men, people who use drugs, sex workers, and transgender women)?

improve its community-relevance and usefulness to the global HIV movement

How can future conferences model and evaluate participatory and dynamic approaches to sharing knowledge and deliberating new research findings with 

community advocates valued as equal partners and acknowledged as experts?

How can the conference be better leveraged to develop and advance 

interlocking HIV research, program, and policy agendas?

Advocates demand structural changes to all future International AIDS Conferences

At least 122 children, including a one-year-old, have been killed during President Rodrigo Duterte’s “war on drugs” in the Philippines, according to a report that concluded some children have been deliberately shot at and targeted as proxies.

The study, by the World Organisation Against Torture, adds to growing calls for the UN human rights council to establish an independent investigation into abuses committed under Duterte. Rights groups estimate that tens of thousands of people may have died as a result of unlawful killings during anti-drug operations launched after his election in 2016.

The report, which examines child deaths between July 2016 and December 2019, reports that police were responsible for just over half of the killings documented. Others involved unknown individuals, often wearing masks or hoods, some of whom allegedly had links to the police.

‘War on drugs’ blamed for deaths of at least 122 children in Philippines

The number of people using illegal drugs globally has risen by 30% over the past decade to 269 million while 35.6 million people have drug use disorders, according to the latest World Drug Report from the United Nations Office on Drugs and Crime (UNODC).

The report, published on 25 June, also warns that the covid-19 pandemic could worsen the situation because the resulting restrictions on borders and other areas are causing shortages of drugs locally, leading to increased prices and reduced purity.

UNODC’s report gives a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine type stimulants, and new psychoactive substances, and their impact on health.

Cannabis was the most used substance worldwide in 2018, with an estimated 192 million people using it, the report said. It noted that while frequent use of cannabis had increased in all countries that had legalised it, it remained the main drug that brought people into contact with the criminal justice system.

Opioids, however, remained the most harmful drug. Over the past decade, the total number of deaths from opioid use disorders rose by 71% to more than 110 000 in 2017.

News