Plenary – Agenda item 6: Follow-up to the special session of the General Assembly on the world drug problem held in 2016, including the seven thematic areas of the outcome document of the special session (Friday, March 17, 2017 – Morning)

Chair: It is my great pleasure to start this morning. Everyone who has worked so hard in the COW, congratulations – especially congratulations to the chair. We will continue our consideration of item 6.

Uruguay: Thank you. We believe it is of utmost importance that we carry out the right follow up to these suggestions, to meet our objectives of social inclusion and the SDGs. We believe that the approach to drug policies should be based on democratic institutions. Drug disorders are a health issue. We call for an approach which puts individuals at the centre. We believe it necessary to enhance common and shared responsibility and strengthen the rule of law. We promote responsible implementation of policies, ensuring we have evidence based results to resolve the world drug problem. Moving forward, we ask that we continue working towards consensus on those issues we do not agree with now such as the death penalty.

Korea: I would like to start by expressing my appreciation of the show. In association with the current drug control commitment, our government has been working to combat crimes. We have been developing a special programme to seek out drug transactions. I believe that many member states have made significant progress in fight against drugs in past decade, however because of our efforts, criminal groups have become more sophisticated.

Oman: We welcome the efforts of the UNODC and the ambassador of Portugal as chair. My country attaches importance to the three drug control conventions. We need to respect the cultural and religious specificity of states. We believe the CND is the prime place for tackling the world drug problem – for strengthening international cooperation and reducing supply and demand. We welcome cooperation programmes. My country welcomes activities of UNODC, programmes for practitioners in those areas. We believe that new realities must be predicated on new conventions. We affirm that any legalisation runs counter to these principles.

Palestine: Welcome plan for sustainable development. Drug problem is a common and shared responsibility that requires multilateral cooperation that is multidisciplinary, balanced, comprehensive, and evidence-based. We are a transit country. Successful in implementing a number of programs. Since we are an occupied country, our law enforcement authorities cannot work like their counterparts. Imposes restrictions on our work. We have a national anti-drug plan that includes demand reduction and measures to implement our national strategy based on three conventions. Committed to become an active partner in international community to deal with drug scourge in the world. In alignment with human rights and inherent dignity of people. Established a centre to deal with addiction and rehabilitation. Thank Europol for technical kits in detecting drug abuse and help with seizures. Reaffirm strategic partnership with Europol. Launched centre for opioid substitution therapy. First of its kind in Arab world to meet the needs of this category of addicts. Second phase is to cover different parts of country. Appreciate support from WHO. Established crime and forensics laboratory. Implementing project in cooperation with UNODC, as well as Canadian cooperation agency. Government and national committee for prevention has mainstreamed prevention efforts. Enhancing cooperation with civil society. Using the concept of community policing under the motto of partnerships to solve problems. Support regional and international efforts to treat drug dependence within human rights. In need of technical assistance to implement recommendations. Stress the need to provide transit countries with adequate and sustained support for capacity building, especially in developing countries. Occupation of our territory is a major challenge. Hope to realize recommendations of UNGASS Outcome Document. Call on member states and UNODC to continue supporting us to enhance law enforcement, criminal justice, and national programs to prevent, treat, rehabilitate and counter the world drug problem in general.

WHO: Welcome UNGASS Outcome Document. Working in collaboration with UNODC, INCB, and other partners, including civil society and academia. Will intensify normative function in public health with focus on addiction and related conditions, including HIV, hepatitis c, and mental health conditions. Will develop norms, guidelines, and standards. Upon request, provide technical support for prevention, treatment, care, and harm reduction, within overall objective of universal coverage for drug use disorders. UNODC and WHO standards for treatment of drug dependence being tested currently. Will provide special support to health ministries at country level to strengthen public health capacities. Cooperate with justice, education, and law enforcement sectors. Drug dependence is a disease and this is a public health matter. Within the framework of global health sector, we must strengthen, promote, and support harm reduction package of interventions with aim of reaching 2020 and 2030 fast track targets in line with SDGs. Further collaborate with UNODC on monitoring of evidence-based preventions for HIV, hepatitis c, and tuberculosis in communities and prisons. Diversify and expand activities on normative guidance and continue technical support for access to essential medicines, in collaboration with INCB, UNODC, and other partners. ECDD will provide timely evidence-based advice to inform decision making of CND on scheduling, and will continue to meet annually. Creating a mechanism for surveillance of substances, including NPS. Monitoring drug use, mortality, and morbidity. Include technical support and guidance to improve national monitoring, with special attention on treatment coverage. NPS needs special attention. Support capacity building of health systems and professionals to address NPS use. WHO will do everything possible to implement operational recommendations from UNGASS Outcome Document. Require resources for its implementation. Look forward to strengthening partnerships with key collaborators to make this happen.

UNDP: I am pleased to make this intervention on behalf of UNDP. In September 2015, UN Member States adopted the 2030 Agenda for Sustainable Development, which encompasses 17 sustainable development goals or SDGs. In so doing, they committed to ‘leaving no one behind’. In the outcome document of the 2016 UN General Assembly Special Session on drugs, Member States acknowledged that efforts to achieve the SDGs were “complementary and mutually reinforcing” to efforts to address the so called “world drug problem.” Guided by its 2014-2017 strategic plan, whose goals include the eradication of poverty and the reduction of inequalities and exclusion, UNDP can play an important role in shaping drug policies that incorporate and support these goals. Illicit drug markets and efforts to address them implicate and cut across almost every one of the 17 goals, especially poverty eradication, health and well-being, gender equality, decent work and economic growth, reduced inequalities, making cities and settlements safe, biodiversity, peaceful and inclusive societies and inclusive and accountable institutions.

Efforts to tackle drug cultivation and production have had harsh effects on the health and human rights of people living in poverty, including poor farmers, indigenous persons and others living in areas where drugs are produced, trafficked or sold. The enforcement of opium, coca and cannabis bans and crop eradication efforts have eliminated the principle source of income for thousands of families and displaced populations dependent on drug crops as well as those who are not. Displacement exacerbates the poverty and insecurity of poor farmers, with disproportionate impacts on rural, indigenous and ethnic minority persons. Addressing the root causes that sustain the cultivation of illicit crops is critical to achieving SDG 1 on poverty eradication, SDG 2 on ending hunger and SDG 8 on sustained economic growth. This can be done through long-term investments in sustainable livelihood strategies and strengthening core human rights, including access to ownership and local control over land, developing sustainable markets and infrastructure for crops or products to replace drug crops and ensuring the meaningful involvement of farmers in development strategies. The nexus between drug control and development often has strong implications on gender equality. Poor and otherwise marginalized women often become involved in the drug trade because gender discrimination limits their opportunities for education and employment. While usually employed at the lowest levels, such as transporting or selling small quantities of drugs, they often suffer the same harsh consequences, including severe criminal penalties, as those with greater involvement in the drug trade. In many countries, women from racial minorities, including indigenous women, represent the fastest-growing segment of the prison population. Women’s health and economic circumstances are often under-represented in programs to provide alternative livelihoods in rural communities dependent on illicit crops.

Alternative livelihoods programs that foster the cultivation of alternative crops usually target landowning farmers, mainly men who are traditional titleholders and often the primary beneficiaries of agricultural extension services, training, credit and tools. These programs further inscribe gender inequality, as women are barred by law or practice from holding title to land in many crop-cultivating areas. Addressing the disproportionate impact of drug control efforts on women would constitute an important contribution to achieving SDG 5 on gender equality and SDG 10 on inequalities within and between countries. These are but two examples. In June 2015, UNDP released a discussion paper elaborating further on these and other development dimensions of drug policy. A second paper, released in April 2016, described innovative alternatives to current drug policies that can be used to meet the SDGs. 2 As we face these challenges, we see key opportunities to achieve more development sensitive and rights-based drug policy. For more than two decades, UN Member States have affirmed their commitment to ensure that drug control efforts be conducted in full conformity with the purposes and principles of the Charter of the United Nations and the Universal Declaration of Human Rights, with full respect for all human rights, fundamental freedoms and the inherent dignity of all individuals.

UN Member States and entities have also recognized the Sustainable Development Goals, grounded in human rights, as a framework for the implementation of drug control efforts. Despite these commitments, there is little clear, comprehensive assessment of what it means to apply human rights to drug control policy. As a result, UN Member States, UN entities and civil society often struggle to meaningfully incorporate human rights into national policymaking or to systematically engage human rights issues in international fora. The elaboration of international guidelines on human rights and drug control would help provide guidance on how to systematically integrate a human rights framework into international drug control. It would strengthen accountability, assist with implementation at the national level and further implementation of the global development agenda. Such guidelines would thus be an important tool to better understand and to advocate for human rights-based drug policy and to support human rights-based development efforts. With the generous support of the German, Swiss and Colombian governments, UNDP is partnering with the University of Essex, the Canadian HIV/AIDS Legal Network and Harm Reduction International to develop the guidelines. The process of developing the guidelines will also entail close consultation with several UN Member States, international organisations, civil society and communities of people affected by drugs. Their advent would be a fitting way to celebrating the 70th anniversary of the Universal Declaration in 2018 and provide an important tool for Member States to meet their commitments to leave no one behind. Full statement here.

UNAIDS: Madam Chair, Excellencies, members of civil society organisations and colleagues. Thank you for this opportunity to address the CND. UNAIDS is also thankful for the opportunity to support the UNGASS on Drugs and High Level Meeting (HLM) on AIDS in 2016. The Outcome Document and the Political Declaration on AIDS provide us with the path to meet the needs of key populations, including people who use drugs and prisoners. The Fast-Track Strategy to End the AIDS epidemic by 2030 is at a pivotal time. We have the opportunity to learn from our successes and failures, and apply what we learn to reach bold and inclusive targets that leave no one behind. Around the world, 14% of the 12 million people worldwide who inject drugs are living with HIV. An estimated 10 million people who inject drugs have hepatitis C infection. People who use drugs are 24 times more likely to be living with HIV than people in the general population, and among prisoners the prevalence may be up to 50 times higher. The world has missed the target set in the 2011 High Level Meeting Political Declaration on AIDS to reduce HIV transmission among people who inject drugs by 50% by 2015. Globally, there was no decline in new HIV infections among people who inject drugs between 2010 and 2014. In fact, new HIV infections among people who inject drugs globally climbed from an estimated 114 000 in 2011 to 152 000 in 2015 (per year). The coverage of harm reduction programmes is insufficient and policies that criminalize and marginalize people who inject drugs are failing to reduce new HIV infections. Of 158 countries where injecting drug use is reported, over half (78) do not offer OST and more than a third (68) still do not provide NSP.

Between 2010 and 2014 only 3.3% of HIV prevention funds went to programmes for people who inject drugs. This in spite of the fact that we know that harm reduction approaches that prioritize people’s health and human rights work and are cost-effective. Countries that have introduced harm reduction and do not criminalize or imprison people for drug use and minor possession or sale have greatly reduced HIV linked to drug injection. The UNGASS on the World Drug Problem Outcome Document and the High-Level Meeting on Ending AIDS Political Declaration outline important commitments from Member States and provide critical opportunities. One of the targets set is to ensure 90% of key populations have access to HIV combination prevention services. This includes, people who inject drugs and prisoners. UNAIDS supports people-centred, public health approaches to reduce HIV and other vulnerabilities among people who inject drugs. A comprehensive package of interventions, including needle and syringe programmes and opioid substitution therapy, provided in a legal and policy environment that enables access to services, prevents infection and reduces deaths from AIDS-related illnesses, TB, viral hepatitis and STIs. People centred programmes are also cost effective. They deliver wider social benefits, such as lower levels of drug-related crime and reduced pressure on health-care systems. The social benefits exceed treatment and prevention costs. To apply a people-centred, public health approach, change is needed. Scientific evidence about what works and our concern for health and human rights must shape drug policy. Ending punitive and repressive approaches and protecting health and human rights will guarantee greater access to services for those most in need. It will also greatly reduce the harms of drug use. In addition to supportive policies, we need investments in services.

Combination prevention services must be adequately resourced and available, tailored to populations, locations and interventions with maximum impact. If annual investment in harm reduction in low and middle income countries increases to US$1.5 billion by 2020, just a fraction of the estimated US$ 100 billion already spent each year to reduce the supply of and demand for narcotic drugs, we would be able to reach 90% of people who inject drugs with HIV prevention and harm reduction services. And while domestic investments in harm reduction in low and middle-income countries need to be increased, international solidarity will remain key to be able to end the AIDS epidemic by 2030. Madam Chair, we have a collective responsibility to fulfil our commitments to end the AIDS epidemic by 2030. If we do not fast-track our response we risk a rebound of the epidemic. To end the AIDS epidemic and achieve the SDGs, we need approaches that put people at the centre and restore dignity to people who use drugs. Ending the AIDS epidemic is only possible if no one is left behind. Full statement here.

Harm Reduction International (HRI):  Thank you to the Chair for the opportunity to make this intervention on behalf of Harm Reduction International. Paragraph 1 of the UNGASS outcomes document commits to minimising the adverse health and social consequences of drug use – in other words to harm reduction. It encourages states to introduce medication assisted therapy, injecting equipment programmes, antiretroviral treatment and Naloxone for the prevention of overdose related deaths. This is an historic first for a UN document on drugs, and an important step forward for harm reduction.  But the true value of the UNGASS commitments can only measured in the implementation of harm reduction services at country level. Harm Reduction International’s Global State of Harm Reduction report, released in November, reveals that since 2014, no new countries have begun providing needle and syringe programmes, and just three have introduced opioid substitution therapy.  Of 158 countries where injecting drug use is reported, over half still do not offer OST and more than a third do not provide needle and syringe programmes. UNAIDS figures published in November show that in the five years leading up to the UNGASS, HIV infections among people who inject drugs increased by a staggering one third.

Under the Sustainable Development Goals, UN member states pledged to end AIDS by 2030.  We will not achieve that target if people who use drugs are left behind.  There is but one message that we can take from the UNAIDS and Global State figures: that now it is time for harm reduction. In order to implement harm reduction services, countries must make funding available. Harm Reduction International’s 10 by 20 campaign calls on governments to redirect just ten per cent of the resources that they currently spend on drug enforcement to harm reduction. Data modelling from our Harm Reduction Decade report, which we released at last year’s CND, shows that with a redirection of just 7.5% we could virtually end AIDS among people who inject drugs by 2030. We urge countries to take this bold step and begin to reverse the alarming increase in HIV infections among people who inject drugs. We urge all UN agencies, and those countries which have already made the often difficult but always rewarding decision to invest in harm reduction, to act as champions for these life saving services and support countries to meet the challenge ahead.” Full statement here.

International Council of AIDS Service Organizations (ICASO), on behalf of ICASO and the International Network of People Who Use Drugs (INPUD): My name is Brun Gonzalez and I am making this intervention on behalf of ICASO. I would like to thank the Chair and the CND for the opportunity to raise up the voice of the community of people who use drugs in this space. ICASO is an NGO that acts as a global policy voice on HIV issues that impact diverse communities around the world. We have welcomed the operational recommendations on cross-cutting issues; drugs and human rights, youth, children, women and communities. We welcome member states commitment in paragraph 4 to work towards drug policies that respect human rights, fundamental freedoms, and the inherent dignity of all individuals, including people who use drugs. We are open and willing to cooperate with relevant UN agencies including those with mandates respectful of human rights and who are willing to collaborate with civil society to achieve these goals.

The operationalization of the recommendations of the UNGASS on drugs, human rights, women and communities is critical. A regression in human rights and drug policy is something that we should all avoid, we can work under the umbrella of the three drug control conventions but still move forward towards a more humane and empathic configuration for the international control system and regulations.Right now, in many different countries around the planet, our communities are subject to: the scaling up of compulsory drug detention centers; attempts to reinstate the death penalty for drug offences; an epidemic of preventable drug overdose deaths, where globally over 200,000 people die each year; over 8,000 state sanctioned killings of people who use drugs since July 2016 in the Philippines; and, more than 180,000 people killed and over 50,000 disappeared since 2006 under the war on drugs in Mexico. INPUD has advocated on the above issues, including using the human rights mechanisms, and building public awareness. To operationalize Paragraph 4 of the UNGASS Outcome Document effectively, we urge member states to:

  1. Invest in Community Systems Strengthening, so that communities can build resistance and resources in order to protect our human rights. This strategy was recognized as best practice by the UNAIDS PCB in December 2016.
  2. Invite community members – and regional or national networks of people who use drugs where they exist – to policy and programming decision making forums. People who use drugs bring many valuable resources to these processes. We can advise on what works; and what is acceptable, feasible and realistic for our communities.
  3. Allow human rights observers access to monitor national programmes to ensure that they are aligned with the UDR, the International Covenants (ICCPR, ICESCR) and the 2030 Agenda for Sustainable Development, and to report on human rights to the CND pursuant to operational recommendation 4(e).
  4. We urge progressive national, bilateral and multilateral states and agencies to continue to pressure, and use economic and political means at their disposal to halt the continued human rights violations on people who use drugs.
  5. We promote the incorporation of full spectrum harm reduction strategies and policies than acknowledge the realities surrounding psychoactive substances beyond HIV, opiates and injected drug use; a few examples could be substance analysis services, harm reduction for non-injected substances, stimulants or supply side harm reduction.

Attention to cross cutting issues of drugs, human rights, youth, women and communities is critical to our survival. Our rights as citizens are not revoked due to drug use. Psychoactive plants and substances have been part of our human history since the beginning, if we remember this and learn from the collective experience that has been gathered for thousands of years we might find collectively new ways to generate a peaceful and beneficial interaction with what we refer to as drugs and amongst ourselves. Finally, we must move towards the decriminalization of drug use, as the most effective and surest way of realizing the human rights of people who use drugs and stopping the many different harms and negative impacts that we are experiencing as a direct consequence of prohibition and the war on drugs. In closing I’d like to sincerely thank the Chair for giving ICASO and the International Network of People who Use Drugs the floor. Thank you very much. Full statement here.

IOGT International: IOGT International members – 133 Member Organizations from 56 countries – work with all aspects of drug-related harm: they conduct advocacy, provide prevention programs, and conduct treatment and rehabilitation interventions. They work on all levels from grass-roots to the global level. Please allow me to start by congratulating and thanking the chair and facilitator for a very successful CND. Our contributions are focused on sharing evidence-based, high-impact solutions, bearing in mind the UNGASS 2016 outcome document. In that spirit, please allow me to present 5 priorities for the coming years.

A Child-centered approach: A Human Rights-based approach to the world drug problem must comprise child rights. As governments work to deliver on the UNGASS outcome document a child-centered approach to drug policy-making should be the primary way forward, rooted in the Best Interest principle of the Convention on the Rights of the Child. A child-centered approach is characterized by three dimensions: 1) Development of supportive parenting and enabling social environments. 2) Promotion of skills and opportunities to choose healthy lifestyles. 3) Fostering of equal access to education and vocational training.

Putting development perspective at the core: In September 2015 the Sustainable Development Goals have been adopted and the global community is working to implement the Agenda2030. As UNODC’s World Drug Report shows, the development perspective matters because harm caused by illicit drugs has significant impact on peace, security and development. The response to the world drug problem needs to build on the Agenda2030, especially by taking into account the conditions and needs of the most vulnerable and marginalized populations. From experience within our worldwide network, we know that Alternative Development can work, particularly when initiatives are integrated into broader agendas and driven by a long-term vision, sustained with funding and political support. Best practices show that when Alternative Development is approached comprehensively, it has the potential to break the vicious cycle trapping poor farmers. Alternative Development should become a catalyst for viable livelihoods that do not depend on illicit cultivation. Putting a development perspective at the core means that discussions about the world drug problem should no longer be dominated by Western experts, focused on Western solutions to Western problems. We urge governments to put a high priority on assuring that substance use in developing countries does not increase to the levels that exist in Western countries. We know that many risk factors and circumstances that render people more vulnerable to illicit drugs can be prevented. Putting a development perspective at the core means to work with communities and identify solutions that integrate measures to prevent as well as to reduce harm.

A public health approach: According to data available, there has been little change in the overall global situation regarding the production, use and health consequences of illicit drugs. Data also shows that prevention and treatment of drug use work if they are based on scientific evidence and are gender-sensitive; and the excessive use of imprisonment for drug- related offences of a minor nature is ineffective in reducing recidivism and overburdens criminal justice systems. In the UNGASS outcome document, the global community emphazises the recognition of drug dependence as a complex, multifactorial health disorder characterized by a chronic and relapsing nature with social causes and consequences that can be prevented and treated. Working in communities for the prevention and reduction of drug-related harm, we are mindful of the fact that health consequences of illicit drug use continue to be a matter of concern, as the vast majority of problem drug users continue to have no access to treatment. Access to treatment and support on the road to recovery are essential public health cornerstones, which need to be part of any strategy to tackle the world drug problem. But clearly, drug use is not only a health issue that affects the individual user; it is also a public health issue. The overall positive health benefits of population-based approaches far exceed those that are available only from clinical interventions on the individual level. A public health approach to the world drug problem is characterized by the promotion of the well-being of society as a whole through the elaboration of effective scientific evidence-based prevention strategies centered on and tailored to the needs of individuals, families and communities as part of comprehensive and balanced national drug policies, on a non-discriminatory basis. We urge governments to address risk factors and structural causes of drug-related harm on a population level and in this way improve both the well being of individuals and populations.

Prevention first: In the UNGASS outcome document, the global community has committed itself to increasing the availability, coverage and quality of scientific evidence-based prevention measures and tools that target relevant age and risk groups in multiple settings, reaching youth in school as well as out of school, among others. In light of the Sustainable Development Goals, putting prevention first means prioritizing the most cost-effective, hence most sustainable, the most people-empowering, and the most humane policy option, especially for extremely vulnerable groups such as children, women, or people from socio-economically deprived settings. For every dollar spent on prevention, at least ten can be saved in future health, social and crime costs.

Prevention first, however, does not mean prevention only, and it does not mean demand reduction only. Prevention is more than that. Prevention at its best is an investment in protective factors for the well-being of children, adolescents and young people. Prevention goes beyond protecting vulnerable populations from harmful substances and helps to foster community resilience, builds stronger family ties and promotes young people’s self-esteem and self-efficacy. Needless to say, we do not think that strategies to prevent harm and strategies to reduce harm are mutually exclusive. Such a polarization is not helpful in tackling the world drug problem.

New momentum: Tackling the world’s drug problem requires strong international collaboration. The World Drug Report shows that illicit drug use has in fact remained stable. It is estimated that a total of about 250 million people, or 1 out of 20 people between the ages of 15 and 64 years, used an illicit drug in 2014. The magnitude of the world drug problem becomes more apparent when considering that more than 11% of drug users are suffering from drug use disorders or drug dependence. With an estimated 207,400 drug-related deaths in 2014, the number of drug-related deaths worldwide has also remained stable, although unacceptable and preventable. To understand the extent of the global drug problem, let’s consider the global problem caused by legalized drugs: every year more than 9 million people die because of alcohol and tobacco. Not one death from harmful substances is acceptable, especially because we have the tools to largely prevent them.

Therefore, IOGT International proposes a global commitment to reduce the use of illicit drugs by 30% until 2030, when the SDGs will be re-evaluated. We believe that with renewed commitment and new momentum from the UNGASS 2016, this is a bold but achievable goal. With the approaches and solutions we are suggesting, and building on existing work and evidence, we look forward to collaborate with governments, UNODC and other UN agencies and civil society partners in the coming months and years.

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