围绕着2015年后的发展议程和2016年联合国大会关于药物的特别会议的讨论将会影响到携带艾滋病毒的毒品注射使用者的未来。 英文版本拥有更多信息，请阅读下文。

随时掌握与药物政策发展相关的最新信息。

By Ann Fordham (IDPC) and Khalid Tinasti (Global Commission on Drug Policy)

Two important global policy processes are underway that will shape the future of the HIV response for people who inject drugs (PWID).

The first is the debate around the post-2015 development agenda that is currently in play at United Nations in New York, where member states, HIV advocates, communities, scientists, policymakers, healthcare providers and donors are discussing a specific target towards ending the AIDS epidemic. The current MDG target, to reduce new HIV infections among PWID by 50% by 2015, has sadly not been achieved. A new target should be included that focuses on the decline of HIV incidence, the reduction of stigma against key-affected populations, improved access to antiretroviral treatment and the end of AIDS-related deaths.

The second process, for which momentum is building among drug policy advocates, networks of people who use drugs (PWUD), policymakers, scientists, academics and UN agencies, is the preparation for the UN General Assembly Special Session (UNGASS) on the “World Drug Problem” to be held in 2016. These two processes, almost happening in parallel, are complementary. The post-2015 development goal on health will determine the global HIV response architecture for the coming decades, while the UNGASS on drugs will define the global policy environment in which the HIV response for PWID will operate.

Both processes require vigilant and sustained advocacy from civil society and community organizations working in the field of HIV and drug use.

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

2016年联合国大会关于药物的特别会议，在2015年之后时期，第一个对艾滋病倡导者的挑战

该报告呼吁国际捐助者，各国政府和联合国机构采取具体行动来解决资金危机。 英文版本拥有更多信息，请阅读下文。

Funding for HIV-related harm reduction programmes globally is in crisis. There can be no ‘AIDS free generation’ without targeted efforts with and for people who inject drugs. Yet funding for harm reduction falls dangerously short of estimated need. While this has been the case for some time, the situation looks set to deteriorate with changing donor policies and national government neglect.

This failure to invest will bring an exponential rise in HIV transmission which in turn will cause additional costs to government health sectors.

This report investigates international donor commitments, both multilateral and bilateral, as well as national investments in harm reduction. It calls on international donors, national governments and UN agencies to take concrete actions to address the funding crisis.

Watch this video presenting the main findings of the report at the International AIDS Conference, July 2014:

Read this infographic for key data on harm reduction across the world:

用来减少伤害的资金出现危机

The illicit manufacture of methamphetamine has traditionally been concentrated in North America (primarily in Mexico and the United States) and East and South-East Asia (China, Indonesia, Malaysia and Thailand), close to the major consumer markets. The latest UNODC's Global SMART Update study, however, shows that it has recently spread to other countries such as Guatemala, the Islamic Republic of Iran, Kenya, Nigeria and South Africa.

The Update also reveals that some countries in Africa and the Middle East have recently emerged as important regions for methamphetamine supply, and that methamphetamine manufacture is also spreading across Europe, though at low levels.

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

New trends and regional differences in the manufacturing of methamphetamine 

科罗拉多州的让大麻合法化的举动是历史性的，做了一些其他国家没有做过的事：合法化大麻的零售。 英文版本拥有更多信息，请阅读下文。

In November 2012, Colorado voters decided to experiment with marijuana. Formally, they approved Amendment 64, modifying the state constitution. This move was historic and did something which, to that point, no other state or modern foreign government had ever done: legalize retail (recreational) marijuana.

As part of the amendment, the state was required to construct legal, regulatory, and tax frameworks that would allow businesses to cultivate, process, and sell marijuana not simply to medical patients—as had been happening in Colorado for over a decade—but to anyone 21 and older. This change came despite existing federal prohibition of marijuana and opposition from the governor, state attorney general, many mayors, and the law enforcement community.

At its heart, this report is about good government and takes no position on whether the legalization of retail marijuana was the correct decision. Instead, it takes for granted that Amendment 64 and its progeny are the law and should be implemented successfully, per voters’ wishes. The report examines what the state has done well and what it has not. It delves into why, and how, regulatory and administrative changes were made. Finally, it offers an evaluation of how effective the implementation has been.

科罗拉多州首次展示大麻的合法化成功：国家实施大麻合法化的报告

由于2014年2月提交的公民请愿书的敦促，巴西参议院和众议院最近展开了关于大麻管理问题的讨论。 英文版本拥有更多信息，请阅读下文。

The prohibitionist model for combatting drugs has run its course in Brazil, as shown by the violence associated with the drug traffic, illegal trade of adulterated substances, lost fiscal revenues, waste of public resources, diversion of attention from society’s real problems (in favor of a false solution), and lack of clinical studies on the efficacy and effectiveness of currently banned medicinal plants. However, the Brazilian Legislative Branch appears to be aware of the population’s evolving opinions on the issue. The National Senate and Chamber of Deputies recently launched a discussion on the regulation of marijuana in Brazil, urged by a citizens’ petition submitted in February 2014.

The website of the National Senate provides a mechanism for citizens’ participation called the e-Citizenship Portal, established by Ruling no. 3/2011 of the Senate Steering Board. Legislative Ideas is the link in this portal that offers citizens the possibility of petitioning for bills to create new laws, amend existing ones, or improve the National Constitution. The ideas are analyzed according to the portal’s terms of usage, verifying the wording’s consistency and coherence, absence of inappropriate, disparaging, or offensive terms, and non-violation of inalterable Constitutional provisions.

巴西参议院关于大麻的规定：一个公共卫生问题

这个研究暗示单一管理型的氯胺酮不论是对单极性还是双极性的抑郁症都能进行快速而有效的治疗。 英文版本拥有更多信息，请阅读下文。

Interest has been growing in ketamine as a treatment of depression (Aan Het Rot, et al 2012; Diamond et al., 2014) and there is some genuine excitement among some of the elvish bloggers.

Mainly used in veterinary surgery, ketamine has been discovered to rapidly improve even the most severe cases of unipolar and bipolar depression. However, as yet there are still many questions left unanswered before ketamine can become a licensed treatment alternative.

For one, there needs to be more clarity about the safety and effectiveness of the drug before an informed weighing of pros and cons is feasible. In addition, in order to stay on top of the immense interest ketamine has spurred, it is essential to have an updated overview of all studies out there. To this end McGirr et al have provided the most recent systematic review of methodologically sound studies (McGirr et al, 2014).

氯胺酮抑郁症：新的回顾凸显了对RCT的需要

审前羁押在全球的过度使用是一种普遍的，深深的伤害，但是它却经常被忽视。 英文版本拥有更多信息，请阅读下文。

The arbitrary and excessive use of pretrial detention around the world is a massive form of human rights abuse that affects in excess of 14 million people a year. The right to be presumed innocent until proven guilty is well established. Yet this right is violated widely and often—in the developed and developing world alike—and the violation goes largely unnoticed. Few rights are so broadly accepted in theory, but so commonly abused in practice. It is fair to say that the global overuse of pretrial detention is one of the most overlooked human rights crises of our time.

Given that the presumption of innocence is universal, detaining arrestees pending trial should be rare. However, many jurisdictions around the world violate the principle that pretrial detention should be used sparingly, as a last resort. Instead, it has become the default setting of criminal justice systems.

One out of three people behind bars has not been found guilty of a crime. In some parts of the globe, pretrial detainees outnumber convicted prisoners. At this moment, 3.3 million people are in pretrial detention worldwide. And that is a conservative estimate, because official data ignore the tens of thousands of people detained in police stations. Cutting the number of pretrial detainees could resolve prison overcrowding, limit the spread of disease, reduce poverty, and spur development.

有罪推定：审前羁押的全球过度使用

Protection of the human rights of People who Use Drugs (PUD) is important, not only because the rights of these people must be respected, protected and fulfilled, but also because it is an essential precondition to improve their health (Jürgens et al., 2010). Therefore it is important that harm reduction organisations advocate for the human rights of PUD (Beyrer et al., 2010). Organisations working on harm reduction, however, struggle in advocating for human rights, which is a major problem, according to experts such as Friedman et al. (2012). Studies and guidelines are written about how to advocate for the human rights of people who use drugs (Kaplan et al., 2009). However, it is unclear to what extent small organisations succeed to implement these guidelines in advocating practices and make use of a human rights framework. Therefore this study examines how and to what extent advocacy for human rights of People who Use Drugs is currently used and how human rights advocacy can further improve the effectiveness of harm reduction strategies and services.

Qualitative explorative methods were used, in addition a survey. Fourteen semi‐structured interviews were done Interviews where done with respondents from harm reduction organisations and national advocacy organisations based in eight countries: Ukraine, Tajikistan, Kyrgyzstan, Pakistan, Georgie, Nepal, Indonesia and Kenya. These interviews where complemented with three interviews with experts from international advocacy organisations in the field of drug use. The survey was handed out during a meeting including representatives of organisations based in the eight countries: sixteen surveys where obtained. The interviews where recorded and transcribed afterwards. The transcripts were analysed by using coding techniques in three different steps; open coding, axial coding and selective coding. The results of the analysis where when possible compared with the results of the survey.

The results of this research show that all organisations included in the research do advocate for the human rights of PUD. However, some organisations are not aware of practising advocacy and most organisations do not plan advocacy activities as being advocacy activities. Organisations reckon face to face communication and organising workshops as the most effective ways of bringing the advocacy message. Most organisations see (social) media as important tools as well, but do not know how to make use of these tools properly. In addition, important differences were found between organisations. For example, the expertise level of advocacy differs between organisations. The main difference in expertise was found in the application of human rights theory, which is seen as an important tool for advocacy according to international advocacy experts. Most organisations have little knowledge of human rights. Next to this, most organisations have difficulties in documenting human rights violations.

Advocacy for the human rights of people who use drugs

LA BioMed researchers surveyed emergency patients tested for THC levels

LOS ANGELES – (Oct. 2, 2014) – Surveying patients with traumatic brain injuries, a group of Los Angeles Biomedical Research Institute (LA BioMed) researchers reported today that they found those who tested positive for THC, the active ingredient in marijuana, were more likely to survive than those who tested negative for the illicit substance.

The findings, published in the October edition of 

, suggest THC, or tetrahydrocannabinol, may help protect the brain in cases of traumatic brain injury, the researchers said. The study included 446 patients who suffered traumatic brain injuries and underwent a urine test for the presence of THC in their system. The researchers found 82 of the patients had THC in their system. Of those, only 2.4% died. Of the remaining patients who didn't have THC in their system, 11.5% died.

"Previous studies conducted by other researchers had found certain compounds in marijuana helped protect the brain in animals after a trauma," said David Plurad, MD, an LA BioMed researcher and the study's lead author. "This study was one of the first in a clinical setting to specifically associate THC use as an independent predictor of survival after traumatic brain injury."

The researchers noted that the timing of their study was "pertinent" because of current efforts to decriminalize marijuana and other research that has shown THC can increase appetite, reduce ocular pressure, decrease muscle spasms, relieve pain and alleviate symptoms associated with irritable bowel disease. But they noted that their study has some significant limitations.

"While most – but not all – the deaths in the study can be attributed to the traumatic brain injury itself, it appears that both groups were similarly injured," Dr. Plurad said. "The similarities in the injuries between the two groups led to the conclusion that testing positive for THC in the system is associated with a decreased mortality in adult patients who have sustained traumatic brain injuries."

Marijuana use associated with lower death rates in patients with traumatic brain injuries

A regulated cannabis market could be a good thing. Potential benefits range from breaking the dominance of drug cartels and redistributing law enforcement budgets to taxation, consumer choice, quality control, and reducing criminalisation of mostly young and otherwise law abiding citizens. But we mustn’t end up with a net public health loss.

Any attempt at regulation must protect young people from early initiation into use and minimise the risk of a collateral increase in tobacco consumption. Cannabis is a gateway to tobacco use. In most countries, more than 80% of cannabis smokers mix cannabis with tobacco; this has synergistic health harms and makes it harder to quit. A regulated market should encourage the production of cannabis with lower levels of tetrahydrocannabinol balanced by cannabidiol to reduce the frequency of unwanted effects, such as memory impairment and paranoia.

Click here to read the full article [restricted access].

Cannabis regulation: the need to develop guidelines on use

This report presents the key findings and recommendation of the review of Myanmar's legal framework and its impact on acess to health and HIV prevention and treatment services for people living with HIV and key populations.

This review was conducted through a partnership of UNAIDS, UNDP and Pyoe pin in the period August - December 2013, in consultation with the National AIDS programme.

This review involved the following steps:

Consultation meetings with NGOs, people living with HIV and key populations;

A National Legal Review Meeting, converned in Naypyitaw on 25-26 November 2013;

Analysis of all inputs to define key recommendations;

The literature review, consultations and National Legal Review Meeting identified key areas requiring action, including in relation to :

Access to legal aid services, legal literacy and legal empowerment programmes;

It is recognised that law reform is a long-term strategy and that much can be achieved in advance of law reform, for example through policy innovation, capacity building and partnerships between organizations representing key populaitons and law enforcement bodies to promote a shared understanding of HIV prevention objectives and approaches.

National HIV league report in Myanmar

This publication has been produced with the financial support of the Drug Prevention and Information Programme (DPIP) of the European Union. The contents of this publication are the sole responsibility of the authors and can in no way be taken to reflect the view of the European Commission. The publication charges for this supplement were funded by AbbVie as an unresitricted grant to Rigshospitalet, the University of Copenhagen, Denmark.

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