Punishment over care: The failing drug policy of Moldova - Submission to the UN CESCR

Section I. Executive summary & Recommended question

1. The Eurasian Harm Reduction Association (EHRA), Union for Equity and Health, and Community Puls welcome the opportunity to present this shadow report ahead of the preparation of the list of issues for the review of the Republic of Moldova under the International Convention on Economic, Social, and Cultural Rights.
2. The report is based on a focus group consultation with people who use drugs in Moldova, supplemented by desk research and the extensive experience of the contributing organizations. We have included the direct recommendations of people who use drugs throughout the report.
3. Our report documents the pervasive discrimination faced by people who use drugs in the enjoyment of their economic, social, and cultural rights. This discrimination is the result of a highly punitive legal framework that effectively criminalises drug use, widespread stigmatisation by public officials, healthcare and social workers, and a system of compulsory registration that is used to label, surveil, and limit the right to work of people who use drugs.
4. While this report focuses on a broad range of topics, the main section concerns the lack of available, accessible, adequate, and quality harm reduction services for people who use drugs. Although 2.14% of the population aged 15 to 49 is estimated to inject drugs, and over 40% of respondents in a recent survey reported having experienced an overdose in the prior 12 months, the coverage of life-saving opioid agonist treatment such as methadone is at just 5%. On top of that, services are trying to adapt to the use patterns and harms associated with synthetic drugs (normally called ´New Psychoactive Substance´or ´NPS), which now represent a majority of drug use in Moldova.
5. A separate section of this report addresses the particularly serious situation in the Transnistrian Region, where an extremely punitive framework and the lack of any form of harm reduction has brought a human rights and public health emergency for people who use drugs.
6. Considering the content of this shadow report, we recommend that the Committee incorporates to the List of Issues the following question, modelled after prior questions related to drug policy:

‘Please provide information on the steps taken to adopt a human rights- and evidence‑based approach to drug policy, for instance by effectively decriminalising drug use and possession for personal use, removing the compulsory registration of people who use drugs and its related limitations on the right to work, expanding coverage of harm reduction services for injecting drug use and for New Psychoactive Substances, and addressing stigma and discrimination against people who use drugs, particularly amongst law enforcement and providers of health care and social services’