As the world continues to grapple with an unprecedented pandemic that has crippled countries, one of the many issues that has emerged is the gap that is our prison response—and how our shortcomings in this area may very well render the rest of our COVID-19 response useless. The International Drug Policy Consortium recently held a webinar covering countries in Southeast Asia to examine just that.

Southeast Asia suffers from some of the most overcrowded jails in the world. The Philippines stands at over 500% capacity, with 75% of people in detention still awaiting their sentence. Indonesia and Thailand are not far behind housing around 150% of their capacities.

Dr. Raymund Narag, one of the panelists in IDPC’s webinar on “Reducing Incarceration in the Time of COVID-19,” notes how one of the primary contributors to the continuously increasing prison population remains the harsh drug laws in the region. This is compounded by case delay due to the sheer number of people our justice systems have to process and the long prison sentences that are the norm for nonviolent drug offenses—among many other institutional issues exacerbated by disproportionate drug policing. Yohan Misero of Indonesian Act for Justice (AKSI) and Dr. Nang Pann Ei Kham of Drug Policy Advocacy Group Myanmar echo these frustrations, noting how easy it is to arrest people who use drugs in Indonesia and how 50% of people in Myanmar’s prisons are detained for drug offenses.

The poor state of jails and prisons in Southeast Asia make people in detention some of the most vulnerable for COVID-19. Overcrowding, malnutrition, and poor sanitation in the facilities have already left them with poor health and immunity. The difficulty in accessing health services and limited resources to prevent the spread of infections among the prison population only make it worse. In Cebu where Atty. Cathy Alvarez of StreetLaw in the Philippines resides, even prior to the pandemic, the eleven detention centers that spanned three of their islands were only covered by one lone doctor. As of the webinar, more than 300 people in detention in Cebu have tested positive for COVID-19.

In Myanmar, almost 25,000 people were pardoned and released from prison following the largest ever presidential amnesty granted, during local new year celebrations. In Indonesia, about 50,000 people will be freed through an early release process. The Philippines has begun this process as well with 10,000 people released from detention so far and hearings of further cases ongoing. The Philippines has also taken steps to lower the threshold for release through reducing bail amounts, with advocates aiming to have it reduced even more, and to conduct hearings through video conferencing. These initiatives are brave and important steps for countries in protecting the health of their people, but more needs to be done.

In the Philippines, although the Board of Pardons and Parole have recommended vulnerable populations in detention (such as the elderly) to be granted executive clemency, this also excludes those charged with drug offenses as they’re classified as “high-risk.” And despite having one of the highest number of releases, Indonesia’s director-general has emphasized that most people imprisoned for drug crimes are excluded (only people imprisoned for less than a 5-year term and who have completed at least ⅔ of that term are eligible for release, and due to the high level of penalties for possession any quantity of drugs, most people in prison for drug offences have greater than a 5 year sentence. Typically only people charged or convicted of consumption alone will be sentenced with less than 5 years in prison). Those who have been released have been met with hostility and discrimination in their communities, with community members still wary of those who have come out of prison and jails.

As countries navigate the COVID-19 crisis, we’re faced with the impact of our overreliance in the criminal justice system in dealing with drug-related issues. Systems that had been left behind prior to the pandemic might just be the gap that exacerbates the outbreak. We need to strengthen our health and justice institutions now to ensure that we’re not faced with the same crisis in the future.

At the same time, the stigma against people who use drugs continues to blind the justice sector from seeing just how important it is to include people involved with drugs in our emergency release responses. We cannot leave them behind. The need to advocate for better drug laws has always been urgent, but now it’s even more apparent as a matter of life and death for our communities.

Leave no one behind bars in the time of Covid-19

IDPC in collaboration with AKSI Keadilan Indonesia, the Drug Policy Advocacy Group Myanmar, LBH Masyarakat, the NoBox Transistions Foundation, Inc. and UNAIDS created this webinar about reducing incarceration in prisons and Covid-19 in Southeast Asia.

The online discussion will be held on Zoom on Thursday 14 May at 9:30am Yangon / 10am Bangkok & Jakarta / 11am Mania & Kuala Lumpur.

A blog summarising the event is available here.

Webinar - Southeast Asia: Reducing incarceration in the time of COVID-19- Recording and summary available

Myo Min knows all too well about the negative effects of excessive drug use. He started using methamphetamines more than a decade ago after being pressured to try it by some friends, and quickly graduated to heroin.

Since then, he has seen it all: sleepless nights, failing health, fights with his family, paranoia, and tragedy. Several years ago, a close friend became so paranoid from using drugs that he jumped from the fourth floor of a building to his death.

Despite all of this, Myo Min hasn’t managed to get himself completely clean.

“It is much easier now to buy yaba compared to before,” he said, referring to Thai word for the cheap methamphetamine pill. “I sometimes use yaba now, although not as much as before. Now I think I have things more under control.”

Myo Min’s experience is not unique in Myanmar, where health workers say that drug use is becoming increasingly common in many communities across the country.

Why Myanmar can’t shake its drug problem

In September 2014, Myanmar’s health ministry announced plans to establish pilot treatment facilities in so-called “one stop service centers” across seven townships in the country. These centers will provide comprehensive services for people who use drugs, including methadone maintenance therapy, anti-retroviral treatment, tuberculosis referral and treatment, treatment for sexually transmitted infections, counseling, vaccination for hepatitis B, hepatitis C testing, condoms and educational materials.

However, a significant barrier to effective outreach to people who use drugs is the limitation of efficient and effective community-based harm reduction programs. Improving the capacity of civil society organizations including peer-led groups to deliver such programs is important in achieving the harm reduction goals of the country.

Myanmar (formerly known as Burma) is notorious in South East Asia for its illicit opium cultivation (second only to Afghanistan in terms of global production) and the production of heroin and synthetic drugs, especially amphetamine-type stimulants. Within the past twenty years, drug use trends among young people in Myanmar changed from traditional opium smoking to more risky forms of use, such as smoking and injecting heroin. Due to the sharing of unclean needles and other injecting equipment, the rate of infectious diseases, especially HIV, became alarmingly high among people who inject drugs.

In the beginning of the HIV epidemic in the 1980s, the Myanmar government authorities were hesitant to address the issue. In addition, the drug law imposed punishment for drug use: a person suspected of being dependent on drugs could be sentenced to three to five years’ imprisonment for failing to register for drug treatment at a designated government center. Possession of needles and syringes is also a criminal offence, which can be met with either a fine or six months imprisonment.

Nonetheless in the early 2000s, the government tackled HIV as a national concern. Since then, harm reduction approaches have been implemented in high-risk areas in the country under the guidance of the National Strategic Plan on HIV/AIDS.

Currently in Myanmar, available harm reduction measures include drop-in-centers and outreach strategies focusing on needle and syringe exchange, peer education, overdose prevention, primary care services, and HIV testing and treatment facilities for people who use drugs. The needle-syringe exchange programs are delivered by NGOs with funding from international donor agencies. The government provides methadone substitution therapy at 35 centers across the country. Although the government has committed limited budget to harm reduction measures and the availability of methadone treatment is still limited, the expansion of service delivery points are an improvement.

Regarding drug policies, it is now a good time to revise Myanmar’s harsh drug laws. This will enable the scaling up of harm reduction services and voluntary treatment options rather than arresting and imprisoning people who use drugs. A legal review was recently conducted by UNAIDS in collaboration with other actors such as UN agencies, donors and key populations affected by HIV, resulting in recommendations focused on increasing access to health care services, especially in closed settings; adopting harm reduction in the national drug policy; ending the compulsory registration of people who use drugs; and decriminalizing drug use. There needs to be ongoing and effective advocacy efforts, and strong collaboration between civil society actors and government to change the drug laws so that they are in accordance with international health and human rights practices.

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

New drug treatment services announced for Myanmar

Nang Pann Ei Kham is a medical doctor from Myanmar. She has experience and expertise in public health, harm reduction and drug policy reform work across South East Asia. After graduating from the University of Medicine in Yangon, she also received a Master of Public Health from the Mahidol University in Bangkok. As a Hubert Humphrey Fellow, she studied drugs and alcohol prevention and treatment at the Virginia Commonwealth University in the USA. She is now working as a coordinator of a national network called the Drug Policy Advocacy Group (DPAG), composed of like-minded activists advocating for health, development and rights focused drug policies and practices. In addition to the coordination and advocacy work, her strengths include working and empowering affected communities such as people who use drugs, people living with HIV, youths and opium farmers etc.

Nang Pann Ei Kham es médico de Myanmar. Tiene experiencia y conocimientos en salud pública, reducción de daños y reforma de la política de drogas en todo el Sudeste Asiático. Tras licenciarse en la Universidad de Medicina de Yangon, también obtuvo un máster en salud pública en la Universidad Mahidol de Bangkok. Como becaria Hubert Humphrey, estudió la prevención y el tratamiento de las drogas y el alcohol en la Virginia Commonwealth University de Estados Unidos. Ahora trabaja como coordinadora de una red nacional llamada Grupo de Defensa de las Políticas de Drogas (DPAG), compuesta por activistas de ideas afines que defienden políticas y prácticas de drogas centradas en la salud, el desarrollo y los derechos. Además de la labor de coordinación y defensa, sus puntos fuertes son el trabajo y el empoderamiento de las comunidades afectadas, como las personas usuarias de drogas, las que viven con el VIH, juventudes y personas cultivadoras de opio, etc.

Nang Pann Ei Kham est une docteure originaire du Myanmar. Elle possède une expérience et une expertise en matière de santé publique, de réduction des risques et de réforme de la politique en matière de drogues dans toute l'Asie du Sud-Est. Après avoir été diplômée de l'université de médecine de Yangon, elle a également obtenu un master en santé publique à l'université Mahidol de Bangkok. En tant que boursière Hubert Humphrey, elle a étudié la prévention et le traitement des drogues et de l'alcool à l'université Virginia Commonwealth aux États-Unis. Elle travaille actuellement en tant que coordinatrice d'un réseau national appelé "Drug Policy Advocacy Group" (DPAG), composé d'activistes partageant les mêmes idées et défendant des politiques et pratiques en matière de drogues axées sur la santé, le développement et les droits. En plus de son travail de coordination et de plaidoyer, ses points forts sont le travail et l'autonomisation des communautés touchées, telles que les personnes qui utilisent des drogues, les personnes vivant avec le VIH, les jeunes et les cultivateurs d'opium, etc.

Nang Pann Ei Kham

South East Asia (Drug Policy Advocacy Group)

Translations

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