UN CESCR reports reveal drug policy and harm reduction shortcomings in seven countries

On 27 September, the UN Committee on Economic, Social and Cultural Rights (CESCR) finished its seventy-sixth session, adopting concluding observations on the reports of Albania, Cyprus, Honduras, Iceland, Kyrgyzstan, Malawi and Poland.

Approximately every five years, the CESCR reviews reports submitted by the 172 countries that have accepted the International Covenant on Economic, Social and Cultural Rights (ICESCR). The Covenant ensures that certain economic, social and cultural rights—such as education, fair and just labour conditions, an adequate standard of living, health and social security—are protected as fundamental human rights. The reports provide an overview of the implementation of the ICESCR, and the Committee highlights positive aspects and areas for improvement. This process allows for international accountability and the advancement of national policies that promote equality and well-being.

The CESCR's review of state reports from each of the seven countries contained, in part, recommendations and remarks related to drug policy. Notably, the Committee's comments underscore the need for human-rights- and public-health-based approaches to drug use as well as the importance of harm reduction and decriminalisation.

Relevant excerpts from the CESCR's concluding observations are listed in the following section.

Concluding observations related to drug policy

Albania

The Committee is concerned about the enforcement of punitive measures for drug-related behaviour, including drug possession for personal use, and the lack of adequate harm reduction programs available for persons who use drugs (art. 12).

The Committee recommends that the State party review its legal framework to ensure a human rights-based approach to drug use, ensuring that harm reduction programmes, health care and services, psychological support and rehabilitation for persons who use drugs are available and accessible, and eliminate obstacles that might limit access to them.

On health, the Committee has also recommended that "the State party strengthen the public healthcare system to provide comprehensive HIV-related services, including prevention, treatment, and care, while addressing the shortage of antiretroviral medications."

Cyprus

The Committee is concerned about the sizeable health disparities across income groups, the high level of fatalities as a result of tobacco consumption, as well as recent years’ rise in cases of HIV/AIDS. The Committee is also concerned about reports of inadequate access to mental health care, including for refugees, asylum seekers, and migrants. The Committee is also concerned that certain forms of drug use for personal consumption continue to be criminalized (arts. 2 (2) and 12).

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(c) Increase access to antiretroviral treatment and improve specialized health-care facilities and training of health workers with a view to reduce the prevalence of HIV/AIDS;

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(e) Ensure a human rights-based approach to addressing drug use and decriminalize drug use for personal consumption.

Honduras (translated)

The Committee is concerned by the punitive approach to drug use and the limited availability and accessibility of harm reduction and treatment programs.

The committee recommends the state revise its legal framework to ensure an approach to drug use centred around human rights, ensuring that harm reduction programmes, health services, psychological support and the treatment of people who use drugs are available and accessible and that obstacles are removed, particularly for persons who use drugs which belong to marginalised or disadvantaged groups.

Iceland

The Committee welcomes the information provided by the State party during the dialogue that a working group appointed by the Ministry of Health has been tasked with drafting the first harm reduction policy in the State party and proposing an accompanying action plan. However, the Committee is concerned that the State party continues to criminalize the possession of drugs for personal use, which may prevent persons who use drugs from accessing harm reduction programmes and healthcare services (Art. 12).

The Committee recommends that the State party develop effective drug policies, including by considering the decriminalization of drug possession for personal use. The Committee also recommends that the State party expedite the development and implementation of its harm reduction policy and accompanying action plan, under the leadership of the Ministry of Health's Working Group.

Kyrgyzstan

While acknowledging that the State party takes measures to provide drug replacement therapies, the Committee notes with concern the limited availability, accessibility and quality of harm reduction programmes and specialized health-care services available to persons who use drugs. The Committee also expresses concern about the excessive fines imposed on persons who use drugs, leading to cases of effective criminalization of drug use for those who cannot afford to pay the fine and are incarcerated (art. 12).

The Committee recommends that the State party review its legal and policy framework to ensure a human rights-based approach to drug use, including by prioritizing harm reduction strategies over punitive measures, focusing on health care and services, psychological support and rehabilitation for persons who use drugs or other substances are available and accessible, enhancing the quality and accessibility of harm reduction services and eliminating obstacles that might limit access to them. The Committee further recommends that the State party implement training programmes, with international assistance if needed, in the area of drug policies, targeting social workers, medical professionals, child protection officers, law enforcement and other public officials, with a view to enhancing protection of human rights of persons who use drugs.

Malawi

The Committee is concerned about the punitive approach to drug use and the limited availability and accessibility of harm reduction and rehabilitation programs (art. 12).

The Committee recommends that the State party review its legal framework to adopt a human rights-based approach to drug use, ensuring the availability and accessibility of harm reduction programs, healthcare, psychological support, and rehabilitation services.

Poland

While noting the information provided during the dialogue, the Committee is concerned about reports of inadequate services for mental health care, including for refugees who are victims of war, and for women and children who are victims of domestic violence. The Committee is also concerned about the punitive approach to drug use and the insufficient availability of harm reduction programmes (art. 12).

The Committee recalls its general comment No. 14 on the right to the highest attainable standard of health[1] and recommends that the State party:

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(b) Review its drug policies and legislation to bring them into line with international human rights norms and best practice, and improve the availability, accessibility and quality of harm reduction programmes.

In the subsequent seventy-seventh session (10–28 February 2025), the Committee will review reports from Croatia, Kenya, Peru, the Philippines, Rwanda and the United Kingdom.