CHAIR: Good morning to all of you. Welcome back to our third day thematic segment. Today cross cutting issues human rights, youth, children and communities. We will continue with the considerations from yesterday along with a number of statements and presentations.
UNODC Justice Section Chief, Valerie Lebaux: Thank you for giving me the opportunity to discuss chapter 4 of the outcome document. The work of the justice section has its normative foundation in the UN standards and norms in crime prevention and criminal justice which are developed under the auspices of the other commissions. Both include the Tokyo Rules, the Bangkok Rules and the Nelson Mandela (NM) Rules as well as the UN principles and guidelines on access to legal aid in criminal justice systems. Interestingly those standards and norms have been referred to and are included in the text of recommendations of the UNGASS final outcome document. This is in fact only natural because of the high proportion among the people in contact with the criminal justice system, of people with drug use disorders and of people convicted in prisons for drug related offences. Therefore what can UNODC specifically do under the thematic programme in which the justice section is in charge – what we do to implement the standards and norms to deal with prisoners, with alternative to imprisonment, with access to legal aid – all of this has inevitably an impact of how people with drug use disorders, people in prison are treated for drug related offences by the criminal justice system. It also has an impact on how human rights are protected and promoted and this is why this presentation of our work is highly relevant.
So, allow me, Mme Chair to begin with recalling the recommendation included at the beginning of chapter 4. So, this is the commitment of MS during the UNGASS, reiterating their commitment to protect, respect and promote all human rights, fundamental freedoms and the inherent dignity of all individuals and the rule of law in the development and implementation of drug policies. Our presentation will focus on 5 areas; 1) on the treatment of women by addressing risk factors that make women and girls vulnerable to exploitation and participation to drug trafficking. On 2) youth by promoting the skills and opportunities of youth at risk but also in terms of primary prevention measures that youth should be protected from drug use, its recommended access for youth to regular sports to promote healthy life and lifestyles and also providing youth with opportunities of having healthy and self-sustained lives. On 3) alternatives to imprisonment and the recommendations of the document relating to proportionate sentencing policies for drug offenders. There was a specific encouragement to establish alternatives or additional measures to conviction or punishment and promote proportionate national sentencing policies and we will address also the work of UNODC related to those recommendations. There are also references to the NM Rules, and 4) prison reform with an encouragement for self-assessment of confinement facilities, taking into account the NM Rules; an encouragement or recommendation to implement measures to address prison overcrowding and violence in prisons, and to provide capacity building to relevant national authorities. Last area is 5) access to legal aid. In order to ensure legal guarantees in due processing penal proceedings, including timely access to legal aid.
Access to legal aid is a major guarantee of human rights and in particular the right to fair trial for suspects/accused persons and later on prisoners. It is also a way within the criminal justice system particularly to protect vulnerable groups, the poor, the marginalised, or other groups at the disadvantage – when they are young – when they are in contact with the criminal justice system, facing difficulties in navigating the system. Since 2012 UNODC has been devoting efforts to strengthen access to legal aid through technical assistance. We have developed a number of technical assistance tools. The first tool that we developed relates to early access to legal aid. Why is that important? It is because in the first stages of contact with the criminal justice systems, like in police detention, in police custody people are at most at risk of experiencing human rights violations. Also it is the point at which decisions that will impact the outcome of the criminal justice process are being taken. As in – how will prosecutions being tackled, whether diversion from the criminal justice system will be considered, protection against torture, various forms of ill treatment. All these happens through access to legal aid. This is why the UNODC devoted its first technical assistance tool to this one aspect. After that, we have been developing another important tool, which is the model legislation and the accompanying commentaries on the model rule, on access to legal aid, which intends to guide MS who want to adopt or update legislation on legal aid to do so. MS can take advantage of experiences from other countries or regions. We have also, in 2016, conducted a study together with UNDP and finally we are now, this week, having an expert group meeting and reviewing a handbook on quality of legal services, including criminal justice processes. In fact, this was one of the outcomes of the global study. We asked national authorities as well as legal aid practitioners – what was then the most pressing issue on which they thought support and technical assistance was most needed. This was the quality of legal aid services. How to ensure, how to monitor, how to evaluate the quality of legal aid services provided. Often the service provided to the poor is also of a poor quality. Now we are working on this handbook which will provide guidance. We are not establishing standards of any sort of normative value, but we are gathering advice and guidance for MS who want to improve/strengthen the quality of their legal aid services.
UNODC Justice Section, Sven Pfeifer: 1. On women, let me highlight the most recent trends. Firstly the 2018 WDR has some interesting findings with a specific focus on women, not only for women with drug use but also for women in supply, concerning women in conflict with law. Worldwide the proportion of women that are convicted of drug offences is higher than their male counterparts. For women its 35% and for men is 19%. This indicates that drug laws, policies and measures affect women disproportionately. The report also confirmed what we already knew based on other studies, that women who are incarcerated for drug related offences face worse consequences than men. They also have less access to health care services, not only of their drug related issues but also other gender-specific health issues, as well as upon release the face the double stigma that is related to gender but also of being ex-offenders. The usually are facing discrimination in accessing health care, social services. Women face social isolation. I would also like to touch upon some technical assistance. Our office has been providing tools to support the implementation of the Bangkok Rules for those women who are in prison and the ones who used to be in prison.
First of all, in 2017 we organised a sub-regional workshop in Panama, hosting prison officials from Costa Rica, El Salvador, Panama as well as Guatemala where we looked into different aspects and issues of drug offences that women unfortunately are affected by drug control. In March 2018 UNODC launched an important technical toolkit on women’s access to justice, specifically for women incarcerated. This was launched at the Commission on the status of agreement between the CND and the CCPCJ and also includes a focus on drug related aspects. Finally, in September 2018 UNODC participated in an international conference for women in prison which brought together over 40 researchers and experts from different parts of the world to discuss strategies and good practices in order to implement the Bangkok Rules and also considering amongst friends confirming that at some regions the situation of higher rate of women being in prison for drug offences is still worrying. Also, I would like to mention that there are global prison challenges. We are trying to focus on gender even more with the launch of fundraising efforts with the focus not only on prison but also on non-custodial measures which is the part of the Bangkok Rules that is sometimes less prominent therefore neglected – an important concern. I am happy to inform you that Thailand has already provided generous funding. From this and of course the additional support of other countries would enable progress in regions that require assistance on that aspect.
UNODC Crime Prevention and Criminal Justice, Johannes de Haan: 2. I would like to say a few words about what new initiatives were adopted regarding youth, crime prevention and the drug use prevention in line with the recommendations of the UNGASS outcome document. As you know, for early prevention the development of personal and social skills is important, as illustrated by the WDR which lists this amongst protective and risk factors. This programme that we have started to implement in 2016 in close cooperation with prevention, treatment and rehabilitation centres is called ‘prevention through sports’. Through that programme we look specifically at effective and local-based youth-crime and drug use prevention building, through the power of sports, enabling sustainable development and as a tool to strengthen resilience of youth. It is based on the fact that life skills have a positive impact on antisocial behaviour and promote health. Besides the component which you maybe have heart about – a sports-based life skills training called ‘line-up/live-up’ – we also support policy development, programme development in countries that we operate, as well as raising awareness on the use of sports for crime and drug use prevention. There, we work closely with partners from civil society to keep young people away from crime and drug use.
In line with the evidence we have on our life skills and training and works in respect to early prevention as well as the UNGASS outcome document, ‘line-up/live-up’ addresses [not only] stream mediating factors, life skills training but also norms on drugs, crime and the risks involved as well as attitudes of youth and how they are affected by normative beliefs. ‘Line-up/live-up’ combines all of these in a 10-session intervention from 13 until 18 year-old youth with mixed levels of risk-related behaviour. The initiative responses to a need for support people with substance use disorders as identified in the international standards on drug use prevention and in this respect the programme also includes a research component of impact assessment. What we have done so far is develop the training curriculum and related tools, we started to roll out first by testing our material in a couple of communities in Brazil – Brasilia and Rio de Janeiro – and based on the input we received there – both from sport coaches, school teachers as well as from youth we finalised the material and we started piloting the programme in Brazil and now also in 8 other countries around the globe. So far we have targeted more than 2000 at-risk youth that have gone through the 10 sessions and we have also certified around 270 coaches that are now able not only to run this programme but also coaches are trained to deliver interactive ways of teaching and engaging youth. The programme is built up in such a way that there is a component of sports, training and physical activity gains but also including debriefing sessions at the end which the physical activity gains are translated into learnings for everyday life scenarios ready to be implemented. What we will do next is an impact assessment where we will look at how the programme had an impact in terms of social activities, substance use, risks etc. We hope that by the end of the programme – in 2019 – we have data to present. In addition, we are working with NGOs that are reaching at-risk youth with vocational trainings and capability skills, the girl empowerment initiatives, youth ambassadors and community mobilisation more broadly, with an aim to target as many as possible risk factors that vary at the communities we pilot. This initiative forms part of our wider initiative as Justice Section on youth crime and prevention.
UNODC Crime Prevention and Criminal Justice, Gia Illy: 3. It is my pleasure to share some information with you on UNODC support plan on alternatives to imprisonment. As you know in the recent decade the global prison population has been increasing in an alarmingly way. It is very well documented that in most regions of the world people detained or convinced of drug related offences represent disproportionately high percentage of the global prison population and in the case of people with drug use disorders and in contact with the criminal justice system – what is needed are effective and evidence-based treatment and care interventions rather than imprisonment. As stated in chapter 4 of the UNGASS outcome document, using alternative measures to conviction or punishment in cases of an appropriate nature in accordance with the three international drug control treaties as well as international standards and norms of crime prevention and criminal justice, such as the Tokyo Rules. The treatment and care for people with drug use disorders who are in contact with criminal justice system as an alternative to conviction or punishment is a joint initiative between UNODC and WHO in order to provide support to MS in their efforts to implement treatment and care for this population. This initiative explores strategies and options to direct people with drug use disorders – in appropriate cases – to the healthcare system, including practical measures that can be implemented by national governments.
At this year CND and CCPCJ, UNODC together WHO launched a publication on this topic which had been prepared based on 50 MS’ replies as well as it was put together by 2 expert consultation groups with professionals from both health and justice sectors. The publication outlines the available options to use for the treatment of people with drug use disorders as an alternative to different stages of the criminal justice process and focuses on how to achieve those solutions. This publication which has been prepared based on a collaboration between justice and health practitioners is providing practical information for policymakers as well as health and justice practitioners to identify the scope of the problem in their community, resources that can be used to address them, gaps that need to be filled and practical approaches for addressing them and moving forward. Based on this publication and other activities in UNODC work to promoting the use of alternatives and supporting drug dependence treatment, UNODC Justice Section and the Prevention, Treatment and Rehabilitation Section of the Drug Prevention branch has been providing targeted technical assistance to requesting countries on this topic. In November 2017, UNODC help a national workshop in Cote d’Ivoire on this topic where good practices on treatment as an alternative to various stages of the criminal justice process will shared and in December 2018 we will holding a workshop in Mombasa, Kenya with the objective of enhancing the knowledge and understanding among relevant health and justice professionals. In addition to these activities, UNODC also plans on giving technical assistance in this area, including regional workshops on the use of alternatives for serious offences in Jakarta, Indonesia and Cairo in the upcoming months with the objective of identifying priorities in their national and regional contacts and ways to overcome those challenges.
UNODC Crime Prevention and Criminal Justice, Philipp Meissner: 4. Thank you for giving me this opportunity to provide with some updates on the thematic area of prison reform. The UNGASS outcome document highlights the relevance of the value of the required standard minimum Rules of treatment of prisoners – the Nelson Mandela Rules – in the form of capacity building and an absolute point of promoting self-assessments in prisons to measure compliance to the Rules. The background of this recommendation is obvious on the higher prevalence of drug use and drug dependence amongst prisoners. The Rules explicitly refer to prisoners with drug use disorders giving the context of screenings upon mission or reiterating the need for close relation between prison-based healthcare services and the public health administrations. I also want to stress that this recommendation is also due to the very close linkage between overall prison conditions on one hand and opportunities for treatment and rehabilitation on the other.
I wish to focus in my presentation on 3 very concrete initiatives that the Justice Section has been pursuing with specific moves to the development of visibility and checking compliance on the NM Rules. The first is to focus on getting the message of the NM Rules out – if I may say so – and more specifically to let this message enter the prison walls for the benefit of the prisoners and the prison staff. The question on what they should know on the Rules and routines led us to the development of a series of instructiona and core provisions on the thematic areas in the NM Rules which are designed to be posted in relevant parts of prison facilities. The thematic areas can cover range from basic principles of healthcare, legal aid but also not very prominent security related issues such as restrictions and sanctions as well as searches. The prisoners are entitled to receive necessary healthcare services free of charge, all consultations should be confidential, the healthcare records of prisoners should be accessible only to healthcare services and their patients, and finally arrangements should be in place to range for a continuity of care both in prison and upon release.
Another initiative – a more extensive one – related on to our recent publication of a comprehensive checklist to assess compliance to the NM Rules. This is a direct response to the UNGASS outcome document reference to supporting self-assessment of confinement facilities but it also relates to the NM Rules themselves – in particular rule 83 – which now not only calls for external inspections but also asks central prison administrations to calls upon internal administrative inspection. So in the first step we really went towards consolidating the 122 Rules in the NM Rules into the 7 thematic areas that ranging from safe cards, to safety, to the prison regime but obviously also including health care, including the role of core position of health professionals working in prisons. In the second step we broke these 7 thematic areas down to so called expected outcomes, to insure compliance with the NM Rules – as well as corresponding indicators which would large process the extent to which the outcome is actually achieved. Overall this checklist comprises a total of 36 outcomes and 248 indicators which gives us an idea of the complexity of the issues that need to be looked at. In prisons, the checklist has been met with great interest amongst MS. It has been used for the requirement of internal inspection mechanisms in many – we have widely disseminated.
Last but not least, I would like to draw your attention into capacity building – again something that has been mentioned in the UNGASS outcome document. Most specifically our ongoing work on developing an e-learning training course on the NM Rules. We decided to compliment this with a set of 35 practical scenarios in the form of short videos which have been filmed or are about to be filmed in prisons in Algeria, Argentina and Switzerland so the prison staff using the tool is practically exposed to situations that are likely to arise in prison given the context of the admission of prisoners, given the context of prison conditions, healthcare services, sanctions, etc. The user will be asked to make a choice on how to respond in certain situations and after it will continue to show them the consequences of their decision and whether or not this was in compliance with the NM Rules. This exercise also gave us a much more concrete and practical idea of the complex decisions prison staff need to take on a daily basis and very often in a short amount of time. We very much hope that with training course, with these scenarios we provide practitioners with a meaningful tool that they can identify which, a tool that can be disseminated in e-learning courses and can be easily built into national training curricula for prison staff. For your information we intend to have this course ready on time of the next CND.
USA: With respect to the prevention programmes among the youth, we are interested to hear if you have been able to gather evidence from longitudinal or follow-up assessments to determine any lasting impacts of these programmes on outcomes related to drug use.
Chair: Regarding the initiative ‘line-up/live-up’, I would like to know whether the UNODC is partnering with the UN office for sports, development and peace – for example – and if there are any special advisor of the UN secretary general under the national focus points at the SDG segments.
OHCHR, Mahmood Zaved: With regards to fair trial, from our research we found that pretrial detention is a factor leading to overcrowding in the prison. What are UNODC’s views on that?
Slovenia: Can you explain how it is going on with the implementation of harm reduction in prisons?
UNODC Justice Section Chief, Valerie Lebaux: To our colleague from OHCHR, I can only confirm that in many countries those in pre-trial detention represent up to 70% of people in prison. So, alternatives to imprisonment, diversion from the criminal justice system, access to legal aid – all of those measures are likely to have an impact in reducing the pre-trial detention population and this is indeed the focus of our activities.
UNODC Crime Prevention and Criminal Justice, Johannes de Haan: Regarding the impact assessment, we are at the moment – we are just starting with the impact assessment targeting around 1,000 youths in Brazil, but we are conducting in October a baseline study with short-time data collection – 3 months after the programme has ended – and then we will collect data a year later, so by 2020 we will have the data analysed. Needless to say, it will be a collection of qualitative and quantitative data collection with a focus on discussions with teachers and youth.
About the question posed by Mme Chair, inter-agency cooperation is key for us and this initiative. Within the UN-family sort to speak we have very recently the UNDESA, taking up the role of focal point and connecting various human entities around sports. We also work closely with – actually this week we have a training in Uganda – but we also collaborating with UNESCO and WHO in designing this programme. When possible, we make connections.
UNODC Drug Prevention and Health Branch Chief, Gilberto Gerra: We have contributed to promote harm reduction measures, we have contributed in 52 countries for the opportunity to promote methadone in prisons and needle exchange programmes only – unfortunately – in 11 countries. We face many times a sort of denial. We know that prisons are permeable to drugs and also to injectable drugs. In the future, the visits that we do with WHO systematically and in the countries we operate for both treatment and harm reduction we have the opportunity to meet together with the Ministry of Justice and the Ministry of Health. There is a need in exchanging perspectives.
Qatar: The state of Qatar has been funding UNODC programme. I wish to thank the UNODC that is helping the youth. What we note is that you haven’t referred to the contributions of the state of Qatar.
Chair: Regarding the NM Rules and in relation to technology. Have you incorporated new technologies like virtual reality in your training courses for example. Or if you have identified new technological tools or partners. If there are also any of the delegations that have and want to share information of best practices.
Morocco: In regard to alternatives to imprisonment. Among the measurements adopted by MS the electronic bracelet has been proven problematic, especially in rural areas.
Tanzania: As I could see many drug users are poly-substance users. They tend to use many/other types of drugs like cocaine, amphetamines, etc. Now one of the challenges I see ahead of us is our failure to our proper technical guidance/ materials in case of treating individuals who use stimulants. I would like to know the status of the UN-family on the matter.
UNODC Drug Prevention and Health Branch Chief, Gilberto Gerra: We are in preparation of 2 tools that would be ready before the end of the year; one about treatment for stimulants and one about the risk of HIV associated with the use of stimulants. We are really concerned that stimulant use is not receiving enough attention. Many of the users and not contacting the services because there isn’t something appealing for them to reach out to a service. We will provide these tools by Christmas and for sure by the next CND we will have the publication on this.
UNODC Justice Section Chief, Valerie Lebaux: One point of clarification concerning the Doha declaration and implementation programme we have mentioned the activities that we are conducting in the area of youth crime prevention. This Doha implementation programme has also a set of activities for the rehabilitation and social reintegration of prisoners but also conducting by the Justice Section. All those are generously funded by the government of Qatar.
Referring to social reintegration/rehabilitation of prisoners and the risk of electronic bracelets, I would like to promote alternatives to imprisonment but our programme – in line with the Tokyo Rules – also puts an emphasis on nations that have the potential to rehabilitate and socially reintegrate offenders and prisoners. In that respect the electronic bracelet has potential but also, as it has been mentioned, raises challenges; one is technical, having to rely on technology, and the second one is financial. Often the private sector is promoting the use and the sale of those bracelets which represent a high cost to prison administrations. It has also been challenged from the human rights perspective because its use may seem to be “soft” but at the same time this is a significant limitation of the freedom of movement. So, there are a number of challenges and therefore our office does not include that option in its suggestions to in particular to developing countries among the first line of alternatives to imprisonment.
UNODC Crime Prevention and Criminal Justice, Philipp Meissner: Regarding the innovative training modalities for prison staff and if you allow me Mme Chair I would like to first do a quick reality check – referencing facts – a lot of countries unfortunately do not yet have dedicated prison staff training academies, in some countries is still incubated into a type of police-training maybe with some add-on to the specificities of prison staff, so there is still of overall work that needs to be done to provide training to prison staff and I believe some research ahead of our decision to this e-learning course on the NM Rules we discovered that in many countries it is not yet as innovative as it could probably be. When it comes to virtual reality however I would like to refer to the fact that one of the organisations that we have partnered with – the international committee of the Red Cross – is working on such a tool that is displaying prison environments within different aspects.
Chair: If there are no further questions I would like to go further with our expert panellists and I have the pleasure to invite Mr. Mahmood of the OHCHR.
OHCHR, Mahmood Zaved: In my presentation, I will reflect on three key areas. Why are human rights relevant in the discussion of drug policy? What is the role of UN human rights mechanisms in the drug policy debate? What are findings and recommendations of the recent report of the High Commissioner on joint commitments and human rights? Despite some shortcomings, human rights are at the core of the outcome document of UNGASS 2016. If we read it very carefully, we would find that throughout the text of the document, human rights and related principles are included righteously.
In the introductory paragraph of Chapter 4 of the Outcome Document, all Member States of the United Nations reiterated their commitments “to respecting, protecting and promoting all human rights, fundamental freedoms and the inherent dignity of all individuals and the rule of law in the development and implementation of drug policies”. This is not the first time that human rights are mentioned in the context of the drug policy debates at the United Nations. (Human rights never been an issue of ‘far distance’ in the debate on the drug policy.)
In the 2009 Political Declaration, all members States reaffirmed their unwavering commitment to ensure that all aspects of drug control efforts (demand reduction, supply reduction and international cooperation) are addressed in full conformity with the purposes and the principles of the Charter of the United Nations, international law and the Universal Declaration of Human Rights. And indeed, human rights are one of key principles of the Charter of the United Nations. The United Nations, its agencies and Member States are bound by overarching obligations under articles 1, 55 and 56 of the United Nations Charter to promote “universal respect for, and observance of, human rights and fundamental freedoms.” We welcome the fact that these human rights commitments further reflected in various resolutions adopted by this Commission in recent years. For example, the Commission’s resolution 61/7 on addressing the specific needs of vulnerable members of society, or resolution 61/11 on promoting non-stigmatizing attitudes, or resolution 61/9 on Protecting children from the illicit drug challenge- all these and many other resolutions of the Commissions are not only based in the drug convention, but also, to some extents, founded on the relevant human rights treaties, principles and norms. Our Office welcomes this human right based approach, and urge the Commission to continue further rigorously pursue the promotion and protection of human rights in addressing and countering the world drug problem.
Mme Chair, this take me to the next part of my present. How are UN human rights mechanisms contributing the implementation of joint commitment of States? In March 2015, Human rights Council adopted resolution 28/28 entitled “Contribution of the Human Rights Council to the special session of the General Assembly on the world drug problem of 2016″. Pursuant to this resolution of the Council, our office prepared and published first-ever comprehensive report on the human rights impact of the world drug problem; Our 2015 report addressed the impact of the world drug problem in five main human rights areas: the right to health, rights relating to criminal justice, the prohibition of discrimination including, in particular against ethnic minorities and women, the rights of the child and the rights of indigenous peoples. The OHCHR also organised a panel discussion for the Human rights Council on this in topic at the Council in 2015.The summary of the panel and our office’s 2015 report shared with this Commission as a contribution for the preparation of UNGASS 2016. In March this year, the Human Rights Council adopted second resolution on issues related to drug policy and human rights. In its recent resolution 37/42, the Human rights Council requested our office to prepare and submit a report on the implementation of the joint commitment of States to effectively address and counter the world drug problem with regard to human rights. The Council also requested our Office to share the report with this Commission as a contribution to your work in this field and in preparation for the sixty-second session of the Commission. On 14 September, the report was presented to the Council; and we’ve also shared the report with the Secretariat of the Commission; and it is now available at the Commission’s website on “preparations for the 2019 ministerial segment”. The report discusses human rights aspects of joint commitments of States on a wide range of areas. These include prevention and treatment of drug abuse, law enforcement and criminal justice system, international cooperation, alternative development, measuring drug policy from human rights perspective- as well as joint commitments on women, youth, children, vulnerable members of society and communities- as agreed in the outcome document of UNGASS. Throughout the text, the report shows that how various UN human rights mechanisms, treaty bodies and special rapporteur, have addressed human rights issues in the context of drug policy in the last few decades; and provided recommendation to State in the development and implementation of national drug policies, laws and programmes in line with their human rights obligations under international law.
In recommendation 4(a) of the Outcome Document of UNGASS, States committed to enhance the knowledge of policymakers and the capacity of relevant national authorities on various aspects of the world drug problem in order to ensure that national drug policies fully respect all human rights and fundamental freedoms, among other issues. In this regard, States further encourage cooperation with and among relevant United Nations entities, within their respective mandates. We hope that the recent report of the High Commissioner will contribute to enhance knowledge and capacity of national authorities and other stakeholders to advance human rights in the formulation and implementation of drug policies.
In the following, let me provide few examples of findings and recommendations of the report A/HRC/39/39. In regard to access to treatment in prisons and other custodial settings, the UNGASS outcome document calls for the implementation of treatment-related initiatives in prisons and other custodial settings, and also for access to health care, social services and treatment for those in prison or pretrial detention. On several occasions, while examining State parties’ report, the Committee against Torture has recommended that the provision of medical services to prisoners, particularly those who are addicted to drugs, should be ensured, and that all measures necessary to implement the United Nations Standard Minimum Rules for the Treatment of Prisoners should be taken. The Committee on the Elimination of Discrimination against Women recommended “gender-sensitive and evidence-based drug treatment services to reduce harmful effects for women who use drugs, including harm reduction programmes for women in detention”. The Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment recommended the introduction of effective drug-replacement therapy in detention centres. Furthermore, noting that detention settings are high-risk environments for HIV, hepatitis C and tuberculosis transmission, various human rights treaty bodies have recommended that States ensure access to harm reduction services in prison. It’s also reported that in many countries, disproportionate numbers of racial, ethnic or minorities are detained or imprisoned for drug related offences. OHCHR and UNDP in Cambodia are jointly implementing Access to Justice without Barriers for Persons with Disabilities – a project aimed at enhancing the capacity of duty bearers to better understand the obstacles of persons with disabilities, including those who use drugs, in accessing justice.
In regard to eliminating prison overcrowding and violence, in the outcome document, all States committed to addressing and eliminating prison overcrowding and violence. UN human rights mechanisms have expressed concern about the unnecessary and disproportionate use of the criminal justice system for drug-related offences. The report found that some legal policies and practices lead to overcrowding of prisons and other places of deprivation of liberty: These includes: tougher law and order approaches mandatory use of pretrial detention, disproportionate lengths of sentence, frequent delays in the judicial system, poor monitoring of inmate status and release entitlement, and the failure to grant parole. The High Commissioner for Human Rights has recommended several measures for addressing over incarceration and overcrowding. These include; adopting a proactive and holistic approach; ensuring respect for detainees’ right to challenge detention,-ensuring provision of assistance by legal counsel and access to legal aid; using places of detention only for the purpose for which they are fit; using pretrial detention only as a last resort; developing and implementing alternatives to custodial measures during pretrial and post-conviction; reviewing penal policies and legislation to ensure proportionate sentencing; -providing effective rehabilitation services to contribute to reducing reoffending rates; and ensuring the existence and proper functioning of independent oversight and complaints mechanisms.
With regard to women, the report found that in many countries, there has been a disproportionate increase in the rates of imprisonment of women, including for low-level drug-dealing offences. For example, in several Latin American countries, women convicted of drug-related offences make up more than half of the female prison population. Very high levels of incarceration of women can also be found in East and South-East Asia. In its 2014 report on prison conditions in Tunisia, the Office recommended, inter alia, that Tunisia reform its drug policy to adopt the principle of progressive sanctions for crimes of drug consumption, particularly for first time offenders. In April 2017, the Tunisian parliament adopted an amended version of its national drug law; which now allows judicial discretion in sentencing for drug consumption, including the possibility of imposing alternative measures, such as suspended sentence or a fine. This constitutes a welcome development and is expected to have a significant impact on reducing prison a overcrowding in the country. OHCHR will continue to advocate for wider review of Tunisian drug law and policy; and provide technical support to Tunisian authorities for the further inclusion of human rights-based approach to the national drug law and policy.
The outcome document of the thirtieth special session recommended: (a) alternative and additional measures; and (b) proportionate sentencing. Both issues are relevant in addressing prison overcrowding. In regard to alternative measures, the United Nations Standard Minimum Rules for Non-custodial Measures -the Tokyo Rules- provide a set of basic principles to promote the use of non-custodial measures, as well as minimum safeguards for persons subject to alternatives to imprisonment. The Tokyo Rules are intended to promote greater community involvement in the management of criminal justice, specifically in the treatment of offenders, and to promote among offenders a sense of responsibility towards society. The Tokyo Rules provide that the dignity of the offender subject to non-custodial measures shall be protected at all times.
The Special Rapporteur on violence against women, its causes and consequences and the Committee on the Elimination of Discrimination against Women have called on States to develop gender-sensitive alternatives to incarceration, and to promote community-based sentencing for female offenders. In their submissions, stakeholders referred to several alternative and additional measures to incarceration.
- A person who voluntarily applies for treatment in connection with the consumption of narcotic drugs or psychotropic substances is exempted from “administrative responsibility” for this offence (Russian Federation).
- In some States, sanction for personal use of drugs is a fine, not imprisonment.
- In some countries in West Africa, there is a choice between imprisonment and a fine, for low-level offences.
- In other States, people who use drugs and drug traffickers have been sentenced to community service, given the serious overcrowding in prisons.
- Public Defender’s Office has sought to divert women who use drugs away from the criminal justice system and to offer them services such as counselling, drug treatment and job training.
- Probation has also been used in some countries.
In some States, “drug courts” offer people accused of drug use a choice between imprisonment and treatment. Drug courts are claimed to reduce incarceration rates and to represent a more humane approach than in the criminal justice process. The Special Rapporteur on the independence of judges and lawyers, and other stakeholders, noted in their submissions that there was no credible evidence to support such claims. Furthermore, they stated that the drug court system caused considerable harm to participants and frequently resulted in serious human rights violations. Such violations were exacerbated by racial and gender biases. Given that the decision to undertake treatment is made under the threat of imprisonment, coercion may influence such a decision. The Inter-American Commission on Human Rights considered that drug courts which offer treatment as an alternative to imprisonment fail to conform to a public health approach and do not tackle mistreatment and human rights violations that occur in treatment centres, which are rarely investigated. The propensity for human rights violations in the context of drug courts is such that the report cautioned against the continued roll-out of drug courts in countries where oversight and monitoring mechanisms are absent.
In regard to proportionate sentencing and decriminalisation of certain crimes, proportionate sentencing is an essential requirement of an effective and fair criminal justice system. It requires that custodial sentences be imposed as a measure of last resort and applied proportionately to meet a pressing societal need. The report found that in many States, low-level offences such as small-scale drug dealing or trafficking are punished with harsher penalties than other serious crimes, raising questions about proportionate sentencing. Furthermore, simple possession of drugs for personal use can result in significant terms of mandatory imprisonment. The principle of proportionality is also relevant to pretrial detention, which is mandatory in several States for drug offences. The Human Rights treaty bodies stated that “long periods of pretrial custody contribute to overcrowding in prisons” and that “from the standpoint of preventing ill-treatment, this raises serious concerns for a system already showing signs of stress”.
In regard to death penalty, a wide range of drug-related offences are punishable by death, in over 30 States. Amnesty International reported that drug-related executions accounted for approximately 30% of all executions recorded in 2017. In accordance with article 6 (2) of the International Covenant on Civil and Political Rights, States that have not abolished the death penalty may only impose it for the “most serious crimes”, which has been consistently interpreted as meaning intentional killing. The Human Rights Committee has consistently stated that drug-related offences do not meet the threshold of “most serious crimes”. The International Narcotics Control Board has encouraged all States that retain the death penalty for drug-related offences to commute death sentences that have already been handed down and to consider the abolition of the death penalty for drug-related offences. We welcome the recent legal amendments with regard to the use of the mandatory death penalty in Iran and Malaysia, and the new drug policy strategy of Myanmar that has announced the abolition of the death penalty for drug offences, but more is needed to fully abolished the death penalty in these countries. In order to meet the requirement of proportionate sentencing, States should revise their penal policies and legislation with the aim of reducing minimum and maximum penalties and decriminalizing the personal use of drugs and minor drug offences, which would also contribute to reducing the total prison population.
In the outcome document of the thirtieth special session, all States committed to “promote and implement effective criminal justice responses to drug-related crimes to bring perpetrators to justice that ensure legal guarantees and due process safeguards pertaining to criminal justice proceedings, including practical measures to uphold the prohibition of arbitrary arrest and detention and of torture and other cruel, inhuman or degrading treatment or punishment and to eliminate impunity … and ensure timely access to legal aid and the right to a fair trial”.
There are several findings and recommendation with regard to other issues, such law enforcement, alternative development and measuring the data from human rights perspective. I will reflect on these issues and in coming intersessional meetings.
However, let me make three general points regarding role of different stakeholders. (1) International and regional human rights mechanisms, including human rights treaty bodies and special procedures of the Human Rights Council, consistently address human rights issues related to drug control efforts. States and other actors involved in addressing the world drug problem, such as the Commission on Narcotic Drugs and the International Narcotics Control Board, should consider the findings, views and recommendations of these human rights mechanisms, and should encourage and assist States in the implementation of the recommendations. (2) At the national level, national human rights institutions and other independent State bodies, such as ombudspersons for children, also play important roles in monitoring the human rights aspects of drug control efforts. They can provide human rights guidance to national authorities for the development and the implementation of national drug policies and laws. The participation and capacity of national human rights institutions should be encouraged and strengthened in order to implement the joint commitments made in the outcome document of the thirtieth special session. (3) The outcome document of the thirtieth special session recognises the importance of including civil society and affected communities in the design, implementation and/or evaluation of drug policies and programmes. Civil society organisations and representatives of affected groups play a significant role in analysing drugs issues, in delivering services and in evaluating the human rights impact of drug policies. Civil society organisations should be protected from any intimidation, threat, harassment or reprisal.
Switzerland: We welcomed the recent report on implementation of joint commitment. Taking the recommendations of the UNGASS outcome document seriously means trying for a modern, holistic and evidence-based approach to drugs that is confined within the international applications. In particular we would like to hold to two points from your report. First, Switzerland fully supports of people who use drugs to be treated with dignity and humanity. Second, Switzerland would like to reiterate the protection of human rights and the right of law in all actions by law enforcement agencies to address drug related challenges. Also, what would be the next steps after this report?
Norway: Let me start by saying that we very much appreciate the cooperation between UNODC and the OHCHR and we are studying this report with great interest. You said that human rights are at the core of UNGASS document and the focus of MS should be on the implementation of these obligations. Which human rights obligations are not covered or not sufficiently covered by UNGASS and should be included in the future created documents of this Commission.
Austria: We also welcome the report of the OHCHR and the ongoing cooperation between OHCHR and UNODC and also AT deems the contributions of the OHCHR to our discussions at the CND is very important. We were also studying the report with a lot of attention. The recognition that the OHCHR has developed a set of indicators of the realisation of human rights and we would be interested in how the OHCHR could contribute to discussions here in Vienna on the implementation of the UNGASS outcome document in terms of development of those indicators for the chapter of the UNGASS outcome document.
USA: With regards to drug courts we would note that drug courts should not be considered as a treatment intervention on their own on in isolation but rather as one part of a comprehensive national treatment system which can promote evidence-based treatment, by encouraging people to enter treatment. In fact, this intervention falls under effective and evidence-based treatment services to which people can be referred which implement best practices. When these services are not at place, drug courts can be rendered ineffective. We would also note that offering treatment as an alternative to incarceration is not an example of compulsory treatment and should not be considered as such, as the active decision to remain on treatment with respect to whatever is offered is a critical component of the recovery process. Drug courts are one part of treatment maintenance and therefore should be considered an important part of a national strategy.
Russia: I listened with interest this detailed report. He touched on an issue on how mechanisms can assist on the implementation. How can the mechanism to controlled drugs based on the 3 conventions can assist the interactive mechanism of OHCHR?
OHCHR, Mahmood Zaved: First I would like to respond on to what will be the next step after this report. This report has been produced by the Office and has been submitted to the Human Rights Commission and also after the request of the Human Rights Council and will be shared for the intersessional meeting focusing on preparations for the 2019 Ministerial Segment. In this course we are planning to organise expert workshop on the findings and recommendation of the report here in December in cooperation with UNODC, only on the implementation of the recommendations.
With regards to Norway’s question, there are some shortcomings on the outcome document. One of the key shortcomings of the document was that there was not mention of the prohibition of the death penalty under the international human rights law. Death penalty for drug related offences in not permitted but that has not been appropriately emphasised. Also, the issue with the rights of indigenous people to use substances for their traditional and religious practices. There are a few other issues that are not adequately mentioned with regards to torture, mandatory sentencing policies in drug laws. We have noted that in many countries mandatory sentencing policies contribute to not only overcrowded facilities but also sometimes to violence, and violations of the fundamental right to fair trial and other principles as well.
Regarding Austria’s question I will refer to it on my intervention tomorrow.
With regards to US intervention on drug courts, we have noticed that in many other countries there is an over-monitoring mechanism, that created serious human rights violations. Even treatment centre that is established by the drug court and referred by the court there are not fully compliant with human rights. For that reason, in the report we caution the role of drug courts where there is no proper monitoring mechanism. I agree with your views on drug courts to some extent.
In regard to Russia’s question, I will refer to our collaboration with the INCB. They are looking at the human rights aspect as well as in the process, so we would like to continue that collaboration. I think that the drug conventions and human rights conventions work together – we now need to figure out how they can be implemented together in line with the UNGASS outcome document.
European Union: First of all, the EU promotes human rights in drug policy – that is why we have all those forums and such cooperation. On policy level, how can we further promote of human rights in the work of the Commission and also further progress from the work that you are doing? Where are we aiming and what is happening on the ground? What is the impact of your work on the ground?
Slovenia: We fully support the implementation of human rights in prisons and we also support your work. We are looking at today’s prison is not very hospitable for treatment of drug users. In the morning you have the nurses delivering the substitution substance for many prisoners. It is necessary to change this situation and to go to the way where we have the implementation of some alternative sanction oriented to the treatment and social rehabilitation of drug users in the prisons. And we want, and we wish and maybe we dream about a progress in this regard and we think is time to change the common situation in prisons today.
Netherlands: These presentations shows very clearly the collaboration between the human rights and the public health the outcomes, also the collaboration with civil society including people who use drugs. This is also what we try to implement in our development cooperation relating to HIV and drugs. At the AIDS conference in Amsterdam last July there were several reiterations that we will never reach the sustainable development goals without ending AIDS if we don’t address the enabling environment. There have been several presentations on Tuesday about prevention and about harm reduction – which is very important – and UNAIDS has stressed several times that this enabling environment is important, and we need to address stigma and discrimination but also think about decriminalisation and further policies. What is the UN collectively intending to do in the CND in 2019 to like-meet the UNGASS to promote this health and rights agenda and also perhaps give more insights of what would be the cost-effectiveness of changing policies more towards health and have also a better impact on health outcomes of people?
OHCHR, Mahmood Zaved: In regard to how the Commission can advance the human rights and in particular the UNGASS commitments on human rights. The Commission adopted the resolution not only based on the drug conventions but also on human rights principles. We encourage the Commission to look at this issue, whenever any resolution is submitted. To look at the human rights perspective and therefore in compliance with UNGASS outcome document and the 2009 Political Declaration. With regards to our work at the field, OHCHR in partnership with UNODC, WHO and other international authorities are finally working with Colombian drug law authorities for the inclusion of human rights and into evolving the participation of civil society, communities and others. Participation is key. How to ensure that? We are working with UNODC colleagues on that particular issue. Also, we are working with colleagues for the abolition of the death penalty in southeast Asia. The death penalty in not a proportionate sentence and it doesn’t help to tackle the issues.
I fully agree with Slovenia.
With regards to decriminalisation we raised this issue today and other get that access to treatment as we have seen that in many countries. Some report of a global foundation on drug policy [also] highlights this issue to provide some evidence.
Egypt: I wish to take a look on the matter from a different perspective. Given that fact that we all agree on the right of every human to receive medication when needed, I would like to know what is the OHCHR is doing when it comes affordability of medicines and are there any discussions on that matter?
China: I am very pleased to have the opportunity to listen to all of the presentations. I would like to share a true story. I was privileged to work in African countries. I learned there. Some criminals requested an appealed since they were infected with HIV from women they raped to get infected. The international community showed attention. At last the criminals were convicted. They were put in prison with good conditions. But the victims of the massacre many of women carrying the HIV die at very young age. When I read the report, I felt sorry for them. The reason that feels relevant is for the purpose of letting everyone know. We not talking only about the small minority of prisons. We are talking about the whole society. In this country the population hated the International Criminal Court. Because they don’t think justice was served. As a matter of fact, this organisation was unpopular and lost credibility. Each country should proceed with its own specificities. We should not judge or require other countries to provide the same conditions. This is a manifestation of social justice.
UK: The UK welcomes this collaboration between UNODC and OHCHR. The UK has a proud history of protecting the human rights including guaranteed access to treatment and harm reduction services. We will continue to advocate on drug policies across the world to place human rights at the core. The UK condemns the use of death penalty at all circumstances and in that regard, we are interested in the wide work on the ground of the OHCHR with regards to this issue.
OHCHR, Mahmood Zaved: In regards to the affordability of medicines and healthcare, and what OHCHR is doing. We are not a key health related organisation within the UN system which is WHO, but I would like to mention that we are interested in different perspectives; to look at health-laws and policies and how could they fit best under the human right perspectives: non-discriminatory access to medicines and non-discriminatory treatment; and how we can include these in health legislations and practices. We are in collaboration with our colleagues from WHO and also with civil society organisations that work on the issue. We also travel to countries with our special rapporteur providing with guidance on drug policies and human rights. We hope at some point the Commission will take a better look at this issue in the future.
In regard to the death penalty, just this year we addressed this issue with the strong recommendations of abolishing the death penalty on drug related offences as well as all offences. This year also we submitted one report on death penalty that shows that progress has been made since last year that indicated that more and more countries are moving away from the death penalty, including the abolition for drug related offences; Iran, Malaysia. We hope this issue is examined in next CND and we hope more countries will join our aforementioned efforts.
National Institute Fight Against Drugs Angola Director General, Ana Graça: When we speak about drugs from the human rights perspective we usually speak about harm reduction. The reason for this methodology arises from the health sector to being in this conversation as expands from the right to health to the right of citizenship. Harm reduction seeks to achieve political socialisation. This means the promotion of health gains with the help of the constituencies. As mentioned previously, harm reduction action today has a global perspective. Promoting the individual to social arise from the drug users. It is a community action that exist for years with positive results. This practice first of all consist of listening to the consumer -for example street children, young people or even women in drug use. On social measures, one can try to deal with this behaviour and to mitigate the damage that has arrived from the misuse of drugs and as a result drive the individual towards options. According to action it becomes clear that human rights perspective of drug use recognise the consumer as citizen with the right to life and health. Citizens suffering from these conditions have the right to seek treatment programmes that promote health. It is also important to highlight the principles of integrity that guarantee health promotion. It is imperative that we consider all citizens in their singularity expecting the inclination of difference between each one. Harm reduction stimulates the consumers to take care of themselves so that they can effectively take place in the society regardless of them achieving abstinence. It is intended that public social services are trained to assess the social damage caused by drug misuse. Harm reduction should focus on establishing controls of the use of drugs as well as assist in the formulation of interventions to reduce damage. Without impeding the role of free trial, health should be promoted with respecting the freedom, integrity, dignity of human being, thereby helping to eliminate neglect, cruelty and oppression. Reading through this perspective, drug addiction is considered a transitional pathology. We believe that the harm reduction model was born from the need to formulate a response to a growing problem in the public health worldwide by the dilemmas arising from the use of drugs and the contraction of HIV. Moreover, a new problem that has arrived due to the naive nature of some drug addicts is HIV.
UNODC Drug Prevention and Health Branch Chief, Gilberto Gerra: I would to have some clarification on the definition of transitional pathology.
National Institute Fight Against Drugs Angola Director General, Ana Graça: Transitional pathology refers to the measures we are taking to modify the whole picture.
Austria: How was the policy evolved over the last 2 decades in Angola? Which were the initial steps, which were the lessons to be learned and why are you now where you are?
National Institute Fight Against Drugs Angola Director General, Ana Graça: The measures we are taking is because we realised that the social measures would be the best ones. You start by tackling poverty, which -we believe- is the main reason for people to use drugs. We are building more schools, training more teachers, creating more police setting, making sure the health service is able to tackle all these issues. Most times they are offenders because they use drugs. By tackling all these previous issues the problem is getting smaller.
National Dangerous Control Board Sri Lanka Assistant Director, Pabasara Weerasinghe: The objective of my presentation is to make clear understanding of the system regarding community building. The drug problem also affects the social economic development of the counties, and the security and stability of the countries. Diversion of pharmaceutical drugs through mail is also an emerging critical issue. Mme Chair, we would like to emphasize that in order to address the emerging issues effectively and to protect the human rights there is a need to revisit the current policy framework and identify critical divisions. For that we propose we focus on various areas that need to be explored; 1) the need to assess current policies, 2) the need to examine the evidence – the root cause of the problem, 3) the need to develop measurable indicators to access the problem.
We are in the process of exploring how mindfulness practice would help address the root cause of this problem. First up on an individual level. With the support of “Mindful School” – a non-profit organisation of Sri Lanka in the inception of mindfulness for students- we teach at schools, universities and in the communities. Mindfulness is defined as a round of thoughts and sensations with acceptance and for non-judgmental purposes. There is enough evidence to suggest that the practice of mindfulness is addressing the root causes of the drug problem. Therefore, we believe the introduction of mindfulness to address not only drug related issues but also other important issues in the society. Before we continue let me show you a video on mindfulness: https://www.unodc.org/documents/commissions/CND/2019/Contributions/Panellists/27_Sept/4.ASIA_PACIFIC_-_SRI_LANKA.mp4
USA: I wanted to point out that there is a lot of evidence about mindfulness and its effectiveness in treating substance use disorders but also other mental disorders, such as post-traumatic stress disorder. Our own research agencies are doing a lot of research on this area with promising results. This is an attempt at using science to generate new evidence-based treatment methods.
Chair: I also wanted to thank you for presenting such an innovative method. I think it is a very practical one, a useful one. Thank you for sharing this with us.
Health Canada, Carol Anne Chenard: I have the honour to be here to have another opportunity to discuss Canada’s health approach to gender and substance use issues. The Canadian Drugs and Substances Strategy is a health focused approach to substance use issues in Canada. It is a comprehensive, collaborative and compassionate approach that is grounded in evidence. It includes harm reduction as a key pillar, alongside prevention, treatment, and enforcement. The federal strategy it was first announced in December 2016 and guides Canada’s policy approach to addressing issues that can rise with the use of a broad range of psychoactive substances, including alcohol, cannabis and opioids. Guided by the Canadian strategy, Canada has made progress on key files – particularly on actions to address the ongoing crisis over opioid related overdoses and deaths. The focus under the Canadian drugs and substances strategy on public health and on innovation has provided a strategic framework for the federal government to take important steps, including making naloxone available without a prescription, allowing medical care providers to bringing treatment options on an urgent basis that have not yet being proved in Canada and extending capacity across the substance use treatment system. The Canadian framework also provides the national structure for proving overdose prevention sites, -this is a minimal supervised consumption moral where sites can be temporarily approved in areas of high need to provide search capacity in the context of an urgent need for care for people who use drugs. Finally, our strategy and response has been guided by a strong focus to reduce stigma associated with substance use, which we know can impede the access to important services.
In Canada we are seeing that people who use drugs can experience stigma and discriminatory treatment when they are seeking or accessing healthcare or other social services, and this can lead to violations of their dignity and human rights. Reducing stigma is therefore key to effectively addressing problematic substance use. In March 2018 Canada led the adoption of a resolution on stigma at the CND and we will continue to prioritise addressing both stigma domestically and internationally.
One of the key factors that contribute to the maintenance of the spread of stigmatising attitudes and actions is the language we choose to use when we are speaking about substance use and about people who use drugs. Canada has developed a communications tool to help people choose the language they use. This tool recommends that medically accurate and objective terms should be used when speaking about substance use. In many other areas we have seen a successful transition from negative stigmatizing language to people’s first terminology.
Health Canada sex and gender plan aims to systematically integrates sex and gender considerations all in Health Canada research, publications, policies, programmes and services. Sex and gender are relevant factors in understanding problematic substance use. The available data suggests that all facets of problematic drug use are affected by sex and gender. This includes: the prevalence and patterns of substance use, types of substances used, physical impact of particular substances used, sub-populations affected, access to all substance use prevention and treatment programmes and social context abuse. As a first step, Canada has conducted an assessment of a key gender gap in accessing harm reduction services -the reliance of some marginalised women on peer-assisted injections. Canada has authorised a temporary 6-month pilot in six supervised consumption sites, to assess whether peer assistance will allow women and vulnerable populations to more readily access the wraparound services provided by supervised consumption sites. Canada opened a national public conversation on the next steps to the federal drug strategy on September, 5th 2018. One are where we hope to receive meaningful feedback is how we can develop new approaches for voluntary investments in substance use policy that would balance health and safety concerns for all Canadians.
There are 9 themes for the correct consultation on Canada’s strategic approach to substance use issues. These are the carefully selected areas where we have heard that modernised and innovative approach may be required: addressing root causes of problematic substance use, better addressing the needs of Canadians living with pain, reducing stigma around substance use, improving access to comprehensive, evidence-based treatment services Innovative approaches to harm reduction, applying a health lens to regulation and enforcement activities, supporting Indigenous peoples, addressing the needs of at-risk populations and grounding substance use policy in evidence.
OHCHR, Mahmood Zaved: A few years back a report has found that indigenous people and African Canadian people are disproportionately affected by Canadian drug policies. If you could reflect on that.
USA: A comprehensive approach has a significant effect not only on health but on social and economic factors and it is important to be considering measures to mitigate these effects. As we know worldwide a minority of people who compete that diagnostic criteria for substance use disorder ever remain distant to treatment service and we believe stigma is a big part of why they do that so what is a concrete/specific place where we can destigmatise the seeking out for treatment for substance use disorders?
Mexico: On a recent visit to Vancouver I got the impression of “tolerance” since there was drug use in the middle of the street, at the site of every person. I am wondering on the effectiveness of the communication – how you have communicated the existence of supervised injection sites.
Russia: A question to do with science. The “Amina” US clinic at the University of California has published a report suggesting that the consumption of cannabis leads to ageing of brain. Do you take this into account on your national deliberations on cannabis? This is also human rights matter.
Belgium: Regarding the supervised injection sites, can you elaborate more on the specific criteria to use those sites and do you have already evidence on the effectiveness of those sites? Regarding the stigmatising attitudes as an important barrier to seeking treatment/care what concrete actions have you taken to change this stigmatising language among service providers and the public, and did you have some evidence that shows this change?
Iran: Regarding prevention -the most important part of the strategy against the world drug problem-, I would like to know how Canada is working on prevention and how treatment and prevention can complete each other.
Health Canada, Carol Anne Chenard: Regarding the indigenous people -for sure is something that Canada is very invested in. On the opioid crisis we find that indigenous people in their communities are 3-5 times more likely to overdose, so Canada has invested a significant amount of money to trying to get culturally-sensitive treatment prevention services into those communities.
With regards to changing stigmatising attitudes, -some concrete ways- not only the language tools for Canadians but also raising awareness is a great key piece. Canadians are more and more aware of the opioid crisis and its impact. Training law enforcement and health practitioners and first responders.
On overdose prevention sites and on the criteria that are required. So Canada is split into several provinces, so in order to be eligible for the services, the ministry of each province has to declare a public health emergency with regards to overdoses and then Canada can issue through its regulations an exemption that allows the province to determine where and how many of these sites. Typically we see two types: to address an urgent need at an area where a full-time site may not be required in the long term or as a short-term solution until a permanent site is built. There is some important requirements regarding some basic information -filling up the evidence gap by gathering information on the opioid crisis or we reach out to those people. We started receiving some of these reports in and we hope to have a complimented picture relevantly soon.
With regards to communicating with people who use drugs -reaching out to the community- reading messages about prevention and treatment across. Mexico most definitely have visited East Hastings/Vancouver which is considered to be the epicentre of our opioid crisis. The approach we are taking is not just about on harm reduction; is about putting a house-focus on our activity, -so recognising that this is a health issue we have also taken control to prevent from substances to be illegally smuggled into Canada. In May 2017 we made some changes to our legislation, so our customs agents are able to open personal international shipping of less than 30g. We think that a large majority of fentanyl or their analogs are coming into the country -it’s no longer bulk shipments. We are also looking at ways to balance drug trafficking in way that balanced is looking and health and safety concerns. We are focusing on organised crime, on civil assets as a result of illegal drug trade. But the communication to the people that we need to get to is one of the most difficult things. We tried some innovative approaches happening in our province: establishing an emergency centre that crowds overdose data and disseminates them in a text message format to people who use drugs. Is about getting the information out anonymously and to people who need it immediately. We are still trying to find other innovative ideas.
On prevention, prevention is still a key pillar as well. We are investing significant quantities of money to our prevention programmes, into our treatment programmes, recognising that with harm reduction wrapped around services people need to be able to access the services that they need when they need it. Harm reduction by itself cannot curve the opioid crisis. We recognise the need for a comprehensive approach to this.
Morocco: On the availability of naloxone, this might be a good thing, but we believe that this can lead to a problem of abuse.
End of morning session
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Fourth Wave Foundation India, Dayana Vincent: I would like to thank the VNGOC and everybody who brought our case into such a high level discussions on policies. I wish to bring to the table a practical case, a very insignificant case to the matter of the world.
From a struggling place of the world that has sort of managed to engage communities to take ownership on this issue. What we are discussing here at an international level is rather abstract in a small little down south India. What I am presenting here is a classical case of drugs being pushed for many reasons, drugs trying to be legalised for many reasons, drugs and narcotics and opioids being the future revenue for governments. The reality on the ground shows that we are not ready for a crisis like this. We, as an NGO, work with children between the ages of 12 and 22. It is alarming that we are having -in epidemic numbers- evidence coming out of age-groups of 10 and 12 year-olds using narcotics. What we have done is to try to get the communities take ownership of the problem. As much as we are having discussions on drug policy at a country level -we work on the legalisation and on measures on rehab and care and for women, we care when it comes to enforcing the law in our communities. On to a typical batch of 100 kids that we train we get 8 or 10 coming back home or to our desks asking for help. 8 to 10% is high and the forecast of the next 5 years to come is bad. What we have done -at a cost of sounding controversial- is to build a fence. We teach them to take ownership of the problem by standing up on the issue. Although we talk with all stakeholders and the community, we focus on young adults and children. We are talking about children being exposed to risk, about drugs being delivered by gangs to your door. We are talking about an economy that is actually booming because of the startups. Kids from the age of 10 to 12 are mulling drugs to people with a high demand on this, -or it is part of their culture. If you go around and ask in the community you will find that everyone either knows a family member or a relative or a close friend who either suffers or has succumbed to the problem of drug use. This is not just the red flag areas we are talking about. This is becoming a state problem and the state is failing to address it because we don’t have the revenue of tourism.
Our community-analogy of putting up fences is very simple. First thing is to measure your problem -to know what you are putting up fences with. So we deal with denial. Everybody is in denial. Starting from the government, families of the victims or the people who take drugs. So we teach them to handle that reality. Second, we provide them with the tools to put up these fences. We teach them about the policies we are discussing in these rooms; about the right to treatment, the right to fair trial, the right to access to safe schools all in a language that they understand and can use. The challenge is that there was no already-made models for us to work with. We really didn’t have any reference from across the globe to take home as best practice cases, -to be contextually appropriately for us. We took a look at UNODC work and we are happy with all these high level discussions here but there is a lack of contextualisation. Third, we mobilize all stakeholders and we teach them to broach the problem and discuss this. We empower them to go out and take their stuff at their own levels. Fourth is to actually put up the fence. As much as we empower these communities to do it, it only fails in the face of the mafia. How we solve this? We have 5 departments in the state that they actually have the mandate to deal with this: the department of education, the department of women and children, of social justice, of narcotics etc. However, they don’t come together to discuss this problem. There is no convergence. So, we have been successful in bringing these together. We have hopes on a national-level cooperation. Last, when the community is taking ownership it is something visible. The numbers are coming down, but it’s too early to claim a success. The problem is on to how to take this into a future step? We are all doing our bits to enforce/ to ensure a safe future but I think we fair regularly in terms of translating these efforts for the future generations. Kids should know why we are putting up these fences. They should know that when they remove those fences -there is a reason why we putting up these fences. Somehow crack the problem of messaging. It is a long story of how we are implementing those steps but hopefully in a few years we will have a case for you to present our findings.
China: I fully share the views of the panelist on this presentation. We have to think about incentives – of the various social viewpoints. We should not restrict them to certain viewpoints.
Peru: We have police departments, which the state is giving large budgets, about 3 million dollars. This large division in civil security programmes working to raise awareness, -reaching out to abandoned children we meet by police-places and/or in homes of agreement. We focus in basic primary up to secondary education. These activities are focusing on citizens in involving all communities on a national level. We have sport programmes against juvenile violence and antisocial behaviour. Highly trained staff working on social inclusion. We also running programmes where people can meet the police and talk about illicit activities directly. This is the only government institution. We have the best knowledge of our country. We are trying to reach out to our communities. We try to turn children to safety. The issue of which drug consumption in not so serious offence in Peru. It is a social problem. The police is committed in collaborating with NGOs. We are working on a day to day basis trying to solve the issue.
Russia: We would like to thank the panelist for the very interesting presentations. We believe that protecting the children is a priority the main part of the work should be carried out by civil society. Taking into account that the panelist we initiative to involve young people. Russia supports this projects and we would be pleased to see youth and welcome them to the forum. What changes could be made of the state for assist the civil society? What can we change for the better?
Fourth Wave Foundation India, Dayana Vincent: Regarding our expectations from the state, it is a difficult task for us back home. One of the examples is to assure that there is a basic tobacco law, I don’t know if you have it elsewhere, the hundred meters vicinity of the school, no shop no places are supposed to sell tobacco. This is a basic load that needs to be enforced. these are the Gateway substances that lead these kids or youngsters to addictions. for such a simple law to be enforced we had to have community to stand up. it was not the police that the teachers who did. This is the tool I am talking about. So we involve all stakeholders, the whole community, and we sit them all down the table and tell them that there is a policy in place and how we enforce it. It is not the police but the community. It is sort of a treasure, the community treasure is immense. The kind of pressure they can actually put to enforce the law -because the problem is larger than we imagine.
Ministry of Health Brazil, Adele Benzaken: I am the National Director of HIV/AIDS. I want to discuss the role of women in the production, sale and use of drugs, as well as the impacts of drug use and drug policies in their lives. This is included in the UNODC World Drug Report for 2018. Women are more vulnerable to HIV than men who use drugs. On drug use, a study on smockable cocaine showed that women who use this substance in Brazil are in a greater situation of vulnerability than men. On HIV, prevalence among women is at 8.17% compared to 4.01% among men, and 0.6% among the general population. Its also important to show that this Brazilian experience is not unique, there are similar cases throughout Latin America. There should be a focus, within the health approach, on social determinants. For an effective response to HIV, we need complex, coordinated and intersectoral approaches with good coordination between researchers and civil society. Aunque antiretroviral treatment and NSPs are fundamental, they are not enough. We need sustainable economic and social development. The national and global response should be based in the principle of combined prevention with an articulation of bio-medical, behavioural and structural approaches. There is now sufficient evidence which shows that stigma, discrimination and criminalisation, racism and social inequality are as important as the lack of medication and prevention tools. The same can be said of gender inequalities. We need measures capable of breaking inequalities while treating and preventing HIV. Brazil is implementing a strategic network to increase access to comprehensive treatment for HIV, hepatitis and other diseases. This agenda was built with civil society, international organisations and different government agencies, which are fundamental to build the defense of key rights. Video of the whole speech available here.
Russia: We suggest that progress towards a world free of drugs abuse is a necessity. We are certain that freedom from drugs should be a basic human right. Protecting the children is a primary task of international community.
European Union: Madam Chair, The European Union and its Member States wish to thank you for organising this intersessional meeting in which we can continue the preparations for the Ministerial segment of the 62nd CND with a special focus on the promotion of human rights-based and proportionate drug policy approaches and share our best practices in this regard. May we take this opportunity to remind us all that in June 2017, the UN Secretary-General shared knowing “from personal experience how an approach based on prevention and treatment can yield positive results” and underlined “the flexibility afforded by the three international drug control conventions.” He also stressed that “Together, we must honour the unanimous commitments made to reduce drug abuse, illicit trafficking and the harm that drugs cause, and to ensure that our approach promotes equality, human rights, sustainable development, and greater peace and security.” May we also remind us all that this year, we celebrate 70 years of the Universal Declaration of Human Rights of 1948, which remains the universal standard for the promotion of human rights, and the adoption of the Convention for the Protection of Human Rights and Fundamental Freedoms, which calls for the commitment to respect, protect and promote human rights, fundamental freedoms and the inherent dignity of all individuals. It is against this background that the EU and its Member States strongly reiterate our commitment to respecting, protecting and promoting human rights, fundamental freedoms and the inherent dignity of all individuals and the principles of rule of law in the development and implementation of drug policies. We strongly support increased cooperation and information sharing between the UNODC, the CND and other relevant UN bodies on drugs, health, human rights, women, youth, children, vulnerable members of society and communities, as well as to the implementation of relevant UN conventions addressing these specific issues, especially the implementation of the Outcome Document of the 2016 UNGASS. In the context of international cooperation on drug policies we should not forget the crucial role of civil society in the defence of human rights and the condemnation of the death penalty.Bearing in mind the UNGASS outcome document and the lack of any reference to the abolition of the death penalty we would like to underline once more that the death penalty should be abolished globally, and we condemn the use of capital punishment in all circumstances and in all cases. We would also like to firmly stress the complete unacceptability of extrajudicial, summary or arbitrary executions under any circumstances. Extrajudicial executions constitute violations of human rights and the UN Conventions. Conduct of criminal investigations and judicial proceedings by the State with full respect for the process is a human right pursuant to the provisions of international law and in accordance with the principles of rule of law. In this respect, the EU and its Member States find the collection and collation of information related to the use of the death penalty for drug law and drug-related offences of utmost importance and consider that data collection and collation by the CND and other relevant UN bodies should be perceived as a crucial ingredient in the managing of the discussion in this subfield and the consequences of this violation of human rights. The EU and its Member States extensively promote proportionate national sentencing policies, practices and guidelines for drug law and drug-related offences, whereby the severity of penalties is proportionate to the gravity of offences and in line with States’ obligations under international law, including as they relate to upholding human dignity and human rights. We strongly believe that the world drug problem cannot be solved by only prosecuting individuals who need assistance due to their drug use and addiction. The principle of adequate, proportionate and effective response to drug-related offences has been highlighted in all UN drug control conventions which stipulate that States may provide, either as an alternative or in addition, measures of treatment, education, aftercare, rehabilitation, recovery and social reintegration to drug users who have committed offences enumerated in these conventions. A study conducted by the European Commission showed that all EU Member States were implementing at least one alternative to coercive sanctions, and most had more than one, related, respectively, to: • alternatives that involved only drug treatment, mainly through drug treatment orders; • suspension of sentence with a treatment or rehabilitative requirement attached; • suspension of investigation/prosecution with a treatment or rehabilitative element in place;. • alternatives with no drug treatment component, but which involved ‘non-action’ or diversion from the criminal justice system or from sentencing. The EU Action Plan on Drugs for 2017 to 2020 requests EU Members States to provide and apply, where appropriate and in accordance with their legal frameworks, alternatives to coercive sanctions for drug using offenders. The Action Plan also requests concerned parties to increase monitoring, implementation and evaluation of these measures. Acknowledging that it’s an effective tool, we are currently identifying what barriers still exist and discussing how to scale up the application of alternatives to coercive sanctions.In March 2018, the European Union adopted Council Conclusions on alternatives to coercive sanctions. The document stresses the need for alternative or additional measures to coercive sanctions for drug using offenders in order to prevent crime, reduce recidivism and enhance the efficiency and effectiveness of the criminal justice system, while also looking at a possible reduction of health related harms and minimisation of social risks. The Council conclusions encourage the Member States where appropriate and within their national legislation to provide and further promote the availability, effective implementation, monitoring and evaluation of measures provided as an alternative or in addition to coercive sanctions for drug using offenders. Beyond these Council conclusions, EU Member States also engage themselves to promote sharing best practices in this field. Moreover, the Council conclusions also invite the Member States to raise awareness, for example through training, on availability and effective use of these measures and to support cooperation and collaboration among national policy makers, law enforcement, criminal justice, public health, social and education professionals and, where appropriate, persons providing support to drug using offenders. Finally, the EU Action Plan on Drugs for 2017 to 2020 clearly incorporates population factors such as age, gender, education, and cultural and social factors, so that specific needs are taken into account when formulating drug policy throughout the EU. The EU and its Member States would like to underline that a gender perspective must be integrated into appropriate aspects of drug policy. It must not be treated as an isolated issue or a separate track, so that women’s and men’s specific needs and conditions permeate all activities and actions, where appropriate. Madam Chair, The EU and its Member States believe that national drug policies of UN Member States should fully respect all human rights and fundamental freedoms and protect the health, safety and wellbeing of individuals, families, vulnerable groups of society, communities and society as a whole. We encourage all regions to enhance their efforts not only in implementing alternative measures to coercive sanctions and ensuring that the principle of the proportionate sentencing is followed, but also in ensuring that education, access to health care, including treatment, suspension of investigation or prosecution, rehabilitation and recovery, aftercare and social reintegration as well as risk and harm reduction measures are available for those in need. Thank you.
USA: Our international drug control policy commitments promote protection of and full respect for human rights and the dignity of individuals. As we discussed in topics related to the world drug problem we must continue considering the human element associated with drug control policies with the views to advancing policies which protect and promoting the health of the human kind. Specifically we must take into consideration ways to be more effective in our efforts by tailoring the implementation of international drug control policies with the special needs of certain populations. The 2016 UNGASS outcome document highlighted the need for comprehensive drug policies to involve all relevant stakeholders from law enforcement to medical professionals, civil society and researchers and call for special attention to populations which special and critical needs, especially women, children and other vulnerable members of society. Additionally, the 2016 UNGASS outcome document offers operational recommendations related to alternative to incarceration for those individuals with substance use disorders but also involved the criminal justice system. To target these particular cases we must foster effective collaboration between the justice system and health professionals to enhance access to treatment for these individuals struggling with substance use disorders and are involved in the criminal justice system for low level drug offences.
Evidence based drug treatment interventions are proven to reduce illicit drug use and improve other criminal justice and health outcomes. To implement these recommendations the US encourages collaboration between national justice and public health sectors, in that increasing opportunities for treatment interventions for substance using populations under the jurisdictions of the justice system. For training and technical assistance the US supports the development of treatment alternatives to incarceration at all points in the justice sectors: from pre-arrest and pretrial diversion, to drug courts, and to reentry after incarceration. These interventions effectively help people to recover from substance use disorder and reduce the rate of recidivism. The US is supporting the evidence-based international curriculum on best practices in treating the special critical needs of women with substance use disorders. This year the curriculum is being updated to ensure that it continues to be an effective tool to treating substance use disorders. The updated curriculum will provide with more information related to frequent impediments to many women’s recovery, such as is domestic violence, sexual abuse, trauma and pregnancy. Within the US, we are increasingly focus on providing evidence-based treatment for pregnant and parenting mothers and infants born with a drug dependance. Mothers with substance use disorders face double the challenge. Personal shame and the social stigma become impediment to accessing treatment and maintaining recovery. In order to help these women the US supports increasing access to specialised treatment and into seeking care. This includes private information to health providers on evidence based strategies for caring for these women and their children.
One of most troubling impacts of the opioid problem within the US has been the increase of infants born dependant on opioids and the number of children exposed to these dangerous substances. The national institute of health has funded a study to evaluate treatment options for newborns with opioid withdrawal syndrome to help us curve this concern. In the US we found that the results of exposure to the illicit drugs and the toxic adulterants can result in lifelong problems. Illicit drugs and adulterants can cause rare harm at low dosages on children’s brain than on adults’. Children’s metabolisms and early nervous systems mean their body is less to get rid of the contaminants and they are more sensitive to the effects of drugs. This troubling phenomena caused for the development and dissemination of innovative solutions, including drug treatment protocols to mitigate the risk of loss of life, of lasting physical, mental and emotional detriment due to the destructive effects of illicit drugs and adulterants at such a young age. Internationally UNODC demand reduction training and technical assistance activities disseminate evidence based information to prevent and reduce drug use and related harms. The goal of training and technical assistance activities is to create drug demand reduction workforce that is professionally trained and credential. UNODC has also designed to train specifically tailored to guide the professional workforce in reducing substance use among populations with special critical needs, including women, children and justice involved persons with substance use disorders. Many of these effective evidence based prevention and treatment interventions are catalogued in the international standards of drug use prevention and the international standards for treatment drug use disorders assembled by UNODC and WHO.
We welcome UNODC and WHO’s role in developing and promoting these standards and we encourage the widespread dissemination of these standards within our national frameworks to promote evidence based treatment that works. Likewise, we support the development of quality assurance mechanisms that can assess the state of treatment services or national treatment systems relative to the standards and which can contribute to a culture of continual assessment and improvement in the treatment of drug use disorders. We commend UNODC and WHO for the work that they have done at the forefront of the international efforts to reduce the global demand for illicit drugs, including their pioneering work in developing the world’s first treatment protocols tailored to the needs of children, including infants born dependent on opioids. As we examine our strengths and weaknesses in addressing the world drug problem and where we should focus beyond 2019, -we must recognise the positive accomplishments we have made in developing specifically tailored drug treatment protocols and programmes to effective treat special drug using populations. Going forward we encourage MS as well as UNODC and WHO to focus on treating the special need of children particularly infants boned dependent on opioids.
Communities represent another important field onto prevent drug misuse and illicit drug use across all stakeholders of society. For example drug free communities support the establishment of effective drug free community coalitions that assist civil society and grassroots organisations in addressing drug use. The US currently fund 731 domestic public and private sector coalitions that are focused solely on preventing and reducing substance use among youth. Current use of alcohol, tobacco, marijuana, and prescription drugs among middle school and high school aged youth and drug free community funded community coalitions have some significant departments. Internationally since 2012 the US has also supported the establishment of 234 community coalitions worldwide in 22 countries with more that 6500 members trained around the world. The US remains committed to uphold in our international commitments to advance public health approaches with full respect for human rights and the health of in addressing and countering the world drug problem. We encourage MS to support interventions in the protecting of special populations, including youth, children and women by expanding the availability of the evidence based drug remand reduction programmes, targeting substance abuse treatment and prevention.
Norway: We attach great importance to ensuring that alleged drug offenders and drug users are treated with dignity, respect and in accordance with human rights and the rule of law. They should be presumed innocent until proven guilty, they should receive a fair trial, and punishments should always be proportionate to the crime committed. Extra judicial killing can never be aligned with the human rights we have all agreed to uphold. The International Criminal Court’s Preliminary Examinations into possible crimes committed in the context of the “war on drugs”; clearly show that the drug policies must respect human rights and fundamental principles as expressed in the Rome Statute. Human rights must permeate and inspire all our work on drugs. Norway was pleased to see human rights as a cross cutting issue in the UNGASS Outcome Document, albeit Norway would have liked to see stronger language in many areas and regret that it was not possible to agree on language on the death penalty.
The Human Rights Committee have constantly stated that drug-related offences do not meet the threshold “of most serious crime”. The International Narcotics Control Board has encouraged all States that retain the death penalty for drug- related offences to commute death sentences that have already been handed down and to consider the abolition of the death penalty for drug-related offences. Norway strongly opposes the death penalty under all circumstances, and is committed to the abolition of this practice. Norway calls on states to abolish the death penalty for drug related offences. We have noticed that one member state of this commission has revised their criminal law provisions – removing the death penalty for a number of drug-related crimes and replacing it with imprisonment or fines. This will save many lives and is an important step in the right direction.
We have ample documentation of the serious human rights gaps that exist in the implementation of drug policies. Access to health services is vital and often denied, causing unnecessary suffering for the individual, as well as costs to society. We see that persons suffering from drug addiction have a higher risk of HIV and hepatitis, as well as other serious illnesses. We need more focus on the health needs of women, as well as of youth. It is unacceptable that avoidable mother to child HIV transmission takes place. Key in this respect is harm reduction coupled with respect for the wish of the individual. The complexities of the drug problem, also results in persons suffering from drug dependency becoming victims of multiple forms of human rights violations and discrimination. They fall prey to ruthless criminals inflicting grave bodily harm, sexual exploitation, involuntary disappearances and even murder. Dealing with these challenges requires a cross-sectoral approach at the national and local level. Equally important, it requires a genuine change of mindset as to how we perceive persons with drug dependency. We need closer cooperation between the UN in New York, Geneva and Vienna to achieve human rights based drug policies. We as member states need to implement recommendations from the Human Rights Council and High Commissioner for Human Rights. We also have to continue to strengthen our cooperation with civil society and the scientific community. If we truly want to achieve the drug related targets of Sustainable Development Goals’ by 2030, we need to make some changes as to how we address the world drug problem.
We have been asking the wrong questions; therefore we have provided the wrong solutions. The question should not be how to punish people for using drugs. The question should be how we can best help people to receive the treatment they need for an illness they have lost control over. The question should be how to rehabilitate and reintegrate these people into society. The question should be how we can facilitate the help so that every man, women, youth, child, ethnic group or minority can receive the help they need. The answers to the right questions can only be provided by sharing and exchanging best practices, by doing research and including academia, by including non-governmental organizations, civil society and the affected communities, and by implementing and evaluating drug policies that are based on human rights.
Belgium: We believe in the importance of applying a gender perspective in drug policy and the development of gender-sensitive measures that are taking into account the specific needs and circumstances faced by women and girls who use drugs. Our government has funded the research project GEN-STAR on gender sensitive prevention and treatment for female substance users in Belgium. This research project has given us insights in the strengths and weaknesses of the current policies and programmes in our country. Recommendations for a more comprehensive and integrated approach, training and exchanging of practices, the intention for gender stereotypes and women’s responsibilities, targeted and gender-sensitive prevention campaigns, and evaluation and monitoring. Secondly and more broadly, Belgium is reforming its mental healthcare landscape. The aim of the reform is to establish a more community based mental healthcare. Bringing care as close as possible to the needs of people with mental health problems, including people with drug problems. Organisational efforts in both acute and chronic mental healthcare programmes by establishing stronger networks between service providers are at the core of this reform. The development of low threshold/ primary care to ensure that mental healthcare services would be more accessible and less stigmatizing. Mme Chair, allow me also to restate the position of my country to call on the abolition of the death penalty to all drug related offences.
Switzerland: In 2015 the international community adopted the SDGs. We all committed to achieving a better and a more sustainable future for all. These goals happen to address the global challenges we are facing today; one of them is the world drug problem. Figures from the most recent World Drug Report show that we need to address key-casts, facts and consequences. Figures from the same report show also that a lot of gaps still remain. We need to know what drug policies are effective and which one are not. This will help us maintain what we have earned so far and find new strategies to adjust to these challenges. The SDGs are interconnected therefore solutions to these challenges must be interconnected as well. In Switzerland, we have realised that drug policies have a stronger impact when we are taking into account the SDGs. In this respect, Switzerland promotes and supports the implementation of the harm reduction packages and of interventions as set out in the jointed WHO, UNODC and UNAIDS technical guide, as presented here 2 days ago. Ending the HIV/AIDS epidemic contributes without a doubt to the achievement of the SDG goals. In addition, drug consumption rooms are part of a comprehensive swiss approach to address the consequences of problematic drug use. Such interventions are key policy tools to mitigate some of the most devastating consequences of drug abuse, but also to support public safety and security. The 2016 UNGASS outcome document make operational recommendations in 7 areas. Today, two years after its adoption we would like to reiterate Switzerland’s support to these recommendations and the implementation. In addition, MS recognised that doing future drug policy operation within SDGs is crucial. We committed with the SDGs to leave no one behind when we formulate as well as when we implement policies. Let us not forget that. To achieve this we recall the need for interagency cooperation as well as between MS and civil society.
China: First I would like to thank all panellists for their presentations. China respects the fundamental rights of drug offenders as they are citizens. China ensures the world that there are not discriminated women and there is no discrimination over vulnerable members of the society. At the same time we need to pay more attention in the harmony for the well-being of the society as a whole. On the eve of this years international drug control day the Chinese government and the Alibaba Group launched the transnational digital platform for drug preventive education for adolescents and youth and this is a non-profit initiative. This is also an innovative model combining internet and drug prevention education which uses cloud resources to provide 3.464 schools nationwide with online drug prevention knowledge and education materials with 10.247 registered teachers and 430.000 registered students the platform aims to cover 90% of primary and secondary schools across the country. With such efforts the youth in China have great capability to say no to drugs.
China has also carried a lot more search in cross-border drug control education projects. This type of cross-border drug education projects produce immediate results. That is to say, if you see or if you feel the pain today then tomorrow if you encounter such temptation you would firmly say no to such temptation. China also worked tirelessly to explore feasible measures and models to address the issue of access to drug treatment for sick and disabled drug users.
Mme Chairperson, I would like to make a comment on the issue of the death penalty, as mentioned by some previous speakers. The reason for us not to be able to reach agreement on the death penalty in this Commision, -the fundamental reason is that this Commision is not the proper place to discuss death penalty. The principle of respecting sovereign rights and equality between States is the basis for the collaboration between countries.
Australia: We very much welcome the opportunity to participate in today’s intersessional meeting on cross-cutting issues. Australia as a member of the CND and the Human Rights Council is committed to upholding human rights in the context of the world drug problem as set out in the 2016 UNGASS outcome document. Australia considers that law enforcement efforts are best focused on disrupting the serious and organised criminal groups that drive the drug trade. Minor or non-violent drug related crimes demands a proportionate response. Out of many years, Australia has found that diversion to treatment and rehabilitation to be far more effective in reducing repeat-offences and reducing harm to individuals and communities. Australia’s national drug strategy recognises the importance of attention to specific groups and populations. While whole population strategies can reduce the adverse impact of illicit drug use, evidence tells us that there are specific population groups that are particularly vulnerable. This is a critical area that deserves more attention and we welcome the 2018 World Drug Report which highlights the importance of gender and age-sensitive drug policies, and also highlights particular needs and challenges of women and young people.
Consistent with that domestic approach Australia put forward a resolution at the 61CND on recognising the needs of vulnerable member of society and enabling a comprehensive and effective response to the world drug problem. The resolution builds on the operation recommendations on cross-cutting issues of the 2016 UNGASS outcome document, including drugs and human rights, youth, children, women and communities. It is also consistent with the 2017 INCB report in which SDG goals #1 and #10 on vulnerable populations, social inclusion and access to services. It is also consistent with the underlying principle of the 2030 agenda of leaving no one behind. AU strongly supports the commitment of MS in UNGASS to proportionate national sentencing and to consider alternatives to conviction. Legal guarantees and due process safeguards must be upheld for all individuals, including drug users, in line with the obligations of MS under the International Covenant on Civil and Political Rights. Extrajudicial killings of drug users is a clear violation of the right to life set out in that Covenant. Australia opposes the death penalty in all circumstances and for all people. The death penalty is a degrading punishment and completely ineffective in deterring drug use. We welcome the constructive dialogue on human rights with UN bodies as an opportunity for MS to reflect on progress achieved and to consider possible areas for improvement.
Colombia: Bearing in mind that the ultimate aim of the international drug conventions is as far as Colombia is concerned that the policies are people-centered, focusing on the welfare, safety and wellbeing. We believe that any legislative, administrative, social, economic, cultural or educational intervention in regards to tackling the world drug problem has to be based on scientific data and special and specific needs of age, gender and groups, and it should be specially adapted to them. We also believe that communities should participate in the design and the implementation of planned policies and programmes, as part of a comprehensive, balanced and multidimensional approach with full respect for human rights and basic freedoms. Regarding children and young people, we believe that although the 2019 Political Declaration and Plan of Action recognised the need to help specific vulnerable groups such as children and young people, -statistics seems to indicate the opposite. According to the WDR, drug consumption in general population shows that -apart from traditional drug such opium and chang- younger people are using more drugs than older people. Cannabis is the drug commonly used by young people as it is easy to access and it is not considered high risk. The same as for adults; one of the main characteristics of drug consumption in young people is simultaneous use of more than one substance. Evidence suggests that between say 12 and 14 or 15 years of age is when the risk is the greatest of starting abusing drugs, however in most countries and for most drugs maximum consumption levels occur from 18 to 25 years of age. For that reason it is important to better study INCB report which really reveals worrying figures all over the world.
On the subject of women, in the 2009 Political Declaration and Plan of Action the UN referred to the subject in the following way: in article 9 we acknowledge the important contribution of women in reducing the world drug problem and we are committed to making sure that drug control mechanisms would take into account the specific need of women with regards to drugs. We decided to adopt effective measures so that men and women would have access to drug control mechanism -with equality of access, free of all discrimination thanks to active participation throughout all phases of the development and the implementation of all these plans and policies. Although we acknowledge the role of women in tackling the world drug problem we do not have any available data on this. Even when in February 2018 we launched the Inter-American programme for gender equality, and different sub-programmes to combat drugs. The idea is to increase the capacity of MS so that they can dismantle drug trafficking gangs and focus on gender, which will boost the efficiency of anti-drug undercover operations. We must take into account the specific needs and circumstances of women -this is something that is often repeated but research into the role of women as suppliers of drugs is extremely limited- and focus on the role of young people and women in growing and trafficking drugs, according to the 2018 WDR. With regards to all of this Colombia welcomes the fact that for the first time the 2018 World Drug Report has devoted a full chapter to women and drugs. This chapter focuses on specific links to women abusing drugs with taking into account social and environmental factors which can make women vulnerable to drug abuse and the ensuing diseases, -usually mental health issues too. We have to consider the specific situation of women in drug related problems.
The 2018 report reveals figures of prevalence in some countries, although it does not highlight specific regions, those figures are used to draft policies which have gender approach. Additionally and with regards to personal, social and environmental factors that make women vulnerable to drug consumption, the report refers to the following: shows the importance of gender focus in drug policies. In global terms female consumers and only 20% of injectable drug users but they are much more vulnerable than men with regards to HIV or other blood-borne diseases. Women start to take drugs later than men, usually influenced or through intimidation. Once women start using drugs, they start abusing them at a much faster rate than men and this leads to problems with children who then suffer anxiety, depression, social problems and they too may have problems. Women they also tend to self-medicate. Women tend to receive their drug supplies from their partners, including injectable drugs. Women see their partner as uses injectable drugs and they do the same that leads to HCV and HIV. The fact that your partner takes drugs can increase the possibility of suffering from HIV/AIDS by 28% for female drug abusers. Economic deprivation, family instability, mental health issues and low levels of literacy -all give rise to the lack of economic and social resources which make women more vulnerable to drug consumption. Women are stigmatised more than men because this is against their traditional role in society as mothers and educators. Drug consumption in women can also lead to complications in pregnancy, such as in neonatal abstinence syndrome , low birth weight, etc.
With regards to criminal liability in young people, women tend to use different drugs while in prison. They use tobacco and alcohol whereas men smoke marijuana and take pain killers, cocaine, heroin, LSD and opioids. With regards to treatment and care, the 2018 report shows that women suffer systematic, structural, cultural and personal stumbling blocks with regards to treatment for their drug abuse. However, it is stresses the importance of a gender-focus as increasing evidence suggest that involving social services and covering women’s specific needs can improve women’s commitment to leaving drugs on a permanent basis. Now, for prison populations for women, the report says that there are no complete global data regarding trends in the number of women in prison for drug related crimes. However, it would seem that this is increasing all over the world, especially for women who are illiterate or have been victims of abuse or are economically deprived.
Regarding sentences, the proportion of women found guilty of drug related crimes is higher than that of men however the criminal justice system is designed to deal with male criminals and not to taken into account the specific circumstances of women; as carriers, victims of violence, mental health patients. Women can be more vulnerable and face gender stereotypes, stigma and social exclusion. Women in prison have even less access to healthcare to deal with their drug addiction as well as their sexual reproductive health. We believe that all interventions to tackle the world drug problem have to be evidence-based, based on real figures, specific needs of individuals, of families and communities so that measures adapted to them. It is also important for communities to participate in the design, implementation and assessment of programmes as a comprehensive, balanced, multidimensional approach that takes into account human rights and basic freedoms and to protect people’s health and welfare.
Portugal: The inclusion of a chapter on human rights in the 2016 UNGASS outcome document represented indeed a very positive development and in the lead-up to the 2019 Ministerial Segment it in fact crucial to discuss how its recommendations are being implemented at a national level and consolidated in the international drug policy. Mme Chair, we have been implementing a set of policies with directs relevant to the recommendations adopted in the Joint Commitment to effectively addressing and countering the world drug problem with regards to human rights: namely, proportionality of sentencing and alternatives to conviction or punishment. The Portuguese policies on drugs encompasses a model of decriminalisation as part of a broader approach designed to dissuade drug use and to promote measures directed to public health concerns with social benefits to all involved. In fact over the past 17 years, Portugal has been implementing a balanced, integrated and comprehensive drug policy, using as its main guidance the principles of humanism and pragmatism. Each individual’s personal circumstances are assessed in order to determine the best response to his/her specific needs, including prevention for those who have not yet been in contact with drugs. Dissuasion for those illicitly using them and treatment, harm reduction and reintegration for drug users. The implementation of a more healthy and evidence based approach was facilitated by the decriminalisation of consumption and possession of all drugs for personal use below legally defined quantities.
The Portuguese approach to drug policies is also rooted in the principle of alternatives to imprisonment for drug use and possession for personal use. As I am sure you are aware, in Portugal, drug use and possession for use remain illegal but they are not considered criminal offences, well within the spirit and the letter of the Conventions. That is to say that portuguese drug policy is based on the respect for human rights through an integrated, multidisciplinary comprehensive approach, ensuring that each component of the model re-enforces the other. 17 years after the approval of the decriminalization law in 2001, we identify several gates: 1) a decrease in drug use among adolescents, 2) the drug use level remains generally below the EU-average, 3) significant reduction of problematic users, 4) a considerable reduction in the prevalence of injecting drug use, 5) a strong reduction of overdose numbers and infectious diseases, 6) a reduced stigmatisation of drug users, 7) a reduced burden of drug offenders in the criminal justice system and finally 8) an increase in the amount of drugs seized as well as in the efficiency of police and customs. Decriminalisation is the most known component of our policy but our approach often includes prevention, treatment, harm reduction and social reintegration. Indeed, based on scientific evidence, the implementation of harm reduction measures, in particular needle exchange programmes and substitution programmes, are a key factor for policy in accordance with the right to the highest attainable standards of health. Mme Chair, our experience indicates that there are remarkable benefits to be gained from implementing policies to reduce the harm caused by drug consumption, and to socially integrate drug users. We believe that criminal sanctions for drug users are ineffective, counterproductive and do not address drug use consequences. In fact, for an addict in possession of drugs, prison is most of the times counterproductive, bearing a negative impact on health and possible new barriers for rehabilitation and reintegration in society with the risk of creating a vicious cycle of stigmatisation.
Another principle for which we have been standing for is the non-imposition of the death penalty for drug related offences, or in fact for any kind of offences. Indeed, we have been underlining Portugal’s unrelenting opposition to the death penalty in any circumstance and in all cases, -and not only for drug related offences. It is our belief that death penalty is a disproportionate and largely counterproductive instrument to achieve the aims of the national criminal justice system. It is also a violation of the basis human right to life. And there is no evidence of its value as a deterrent. Portugal has a pioneering role in the abolition of the death penalty in a path initiated more than 150 years ago. We therefore wish to take this opportunity to call on countries that retain the capital punishment to establish an immediate official moratorium with the view to its permanent abolition. In conclusion, Portugal firmly believes that the implementation of human rights anchored drug policies which are comprehensive and evidence based positive impacts on the efforts to achieve the objectives of the 3 International Drug Conventions of promoting the health and the welfare of humankind.
Iran: Mme Chair, my delegation attaches great importance to the observation of human rights of all members of the society, including drug users, and every effort should be done in order to protect the rights, including the right to health. It is our firm conviction to deal with world drug problem with a balanced comprehensive approach should we follow the human rights based on the society on its totality.
Chair: Now I would like to come back to our thematic debate.
UNODC Prevention, Treatment and Rehabilitation Unit, Giovanna Campello: I will focus this part of my presentation on the matter of what we do to support MS in providing services for children and adolescents, women -including pregnant women, on quality assurance treatment services and systems -a very strong mandate of this chapter, and on treatment as an alternative to imprisonment.
With regards to children and adolescents, a lot of what we do in prevention is completely relevant. Of course there are children and adolescents exposed to drugs at a very young age. This group is usually extremely vulnerable, needs special services and attention, and this where we come in. These are our standards on prevention, that cover all of the prevention work. The international standards on treatment have an entire chapter on providing services for adolescents but in addition we wanted to do something more for this very vulnerable group. We have developed a new psycho-social protocol to support services for very young children that have already starting to use drugs, or have even developed disorders. We have been able to pilot it in Afghanistan for instance and also providing support and training in 17 countries. This work has been taken over by our colleagues at the Colombo Plan but we are very much still involved at a national level by supporting networks of policymakers and professionals at a national level, to sustain the efforts. Once the funding and the training is finished we want those services to keep on going, therefore we help national stakeholders to network among themselves. We are also promoting a global advocacy effort. We are interested in creating a framework that would address drug use in children and adolescence in a comprehensive and coordinated strategy, but are really keeping in mind to have an approach that is inclusive, human rights based and evidence driven. We are starting to think on how to involve different stakeholders, -on different ways and as soon as we have our ideas clarified, we will invite you to join this advocacy effort.
On the services for women, including pregnant women, this has been mentioned already many times. Women with drug use disorders differ in many ways from their male counterparts. There are biological reasons, there are ways in which they are led into riskier behaviours, there are psychosocial differences with women having access to less resources, there are more partners with a substance use problem so they are more responsible for the care of their dependent children and they have a worse history of abuse and trauma. We have developed guidelines along the way and, although somehow women with substance use disorders may carry a reputation of being a difficult patient; severe cases -difficult to deal with-. If you put together a gender-responsive service, women can recover as well as men. Gender-responsive services means they are accessible, they are taking care of issues of childcare responsibilities, also supporting parenting skills, paying attention to the issue trauma, making women feel safe, addressing current mental health disorders and socio-economic marginalisation. For pregnant women with substance use disorder we know that they can sustain a poor health lifestyle that can affect the children to be. It is a very opportune time to open that door to recovery for the mother and for the child to be.
We have been honoured to support WHO in the development of their guidelines; a step to step support on developing gender-specific voluntary and non-judgmental services for treatment of pregnant women with substance use disorder. In addition there is a pharmacological perspective that needs to be considered to avoid opioid withdrawals and also further support the mother in taking care of the child when is born. Breastfeeding also needs to be evaluated on a case by case basis, there are basic parenting skills that would be of need to anybody but are also important in this case. We have been very fortunate to support work in Brazil, Mexico, in central America, Egypt and in Afghanistan. In Afghanistan we are supporting an entire mechanism to ensure the quality of the entire treatment system and we take focus on making sure that both the system and the service is taking into account the needs of women.
Regarding the promotion of quality assurance of treatment services and systems, we have heard already many times that treatment coverage is low, -but what about quality? Existing services are often not of high quality and this is why we have developed the standards but we wanted to start giving MS practical tools to use the standards and to really have drug treatment that is accessible, ethical, evidence-based, that responses to the needs of the individuals but also populations as a whole and integrating the healthcare and criminal justice sectors. We have started developing tools that guide and continue cycle of improvement, -where you look at the system, you look at the services, you make an assessment, you plan an improvement and then you start again. We also have a checklist of core standards for all of the systems and all of the services; -how is your management, how is your care, how is your taking care of patients rights and responsibilities, and then depending on the setting you are working with, the kind of substance you are working with, you will have the optional standards.
Also, treatment as an alternative is possible in the Conventions, -there is this flexibility and with very good reasons to. However, only very few MS actually put in practice these kind of measures. Sometimes the legislation is not there, sometimes it is but it is not applied and so there is a great scope for improvement. Last, if imprisonment cannot be avoided, treatment and care should be provided in prison settings.
Students for Sensible Drug Policy, Orsolya Feher: Let me begin by thanking the UNODC, the Commission and the Civil Society Task Force for this opportunity to speak to you on this issue, the cross cutting issues, today. I believe I was selected because my organizations is a truly youth-led international non-profit advocacy and education organization. We mobilizes and empowers young people to participate in the political process to achieve a safer future. We base our activities, and this speech today, on our experiences being embedded in communities that include children, teenagers and young adults who are exposed to drugs, drug abuse and are directly affected by the decisions that are made in this building about drug policies.
My name is Orsi, I am a Fellow at Students for Sensible Drug Policies and as a politically active young person, I have been in these rooms, in high level policy-making meetings for the last two years and I have heard a lot of talk about protecting young people and overcoming stigma, especially when it comes to vulnerable members of society. This made me really confused because at the same time, a very excluding language is enshrined in the conventions that are regarded as the “cornerstones of the international drug control regime”. I am here to tell you that however prohibited they are, the reality is that drugs are not absent from our societies – hence the existence of this institution; and they are definitely not absent from the lives of young people – hence the existence of SSDP. We are the youth whom drug policies effect, because we are the people who are exposed to drug use and abuse. With chapters on every continent and international allies in civil society and academia, we have accumulated precious knowledge about the people you wish to build a better future for and we are happy to share our experiences with you.
It is a general rule in commerce, that the less available something is, the more valuable it is, and for young people, the more exciting it is to be in the possession of this thing. So, that is why prohibition doesn’t work and hasn’t worked for young people for 60 years. It is because we are cynical, we are cavalier and we are curious. But you want us and you want children to be curious and to explore. You want them to want to learn and be open to new things because every kid should have the right to experience life for themselves and to make mistakes in their pursuit for knowledge. So, when it comes to the sensitive, and often risky, topic of drugs, we are all on the same page – we don’t want children and young people to make grave mistakes. That is why I am here to encourage you to direct efforts towards equipping young people with the knowledge, the skills and the sensitivity to avoid making risky moves about drugs. But also want to remind you of 4f of the 2016 UNGASS outcome document that stresses the importance of recognizing the specific needs of children and young people. As well as the 23 section of the 2009 Political Declaration that committed to work together with youth in a range of settings. We have found it extremely difficult to convey to the United Nations and its member states the specific needs that we’ve uncovered in the past 20 years of our work, so let me tell you what these are and what we have been doing to implement age- appropriate practical measures tailored to these specific needs in the cultural and educational sectors to complement the available services that national agencies provide. We organize community events and educational activities, where the audience is empowered to engage – such as documentary screenings, discussions with researchers on the latest findings about the various effects of substances or state of the art understandings of addiction and addiction treatment – we are creating a learning environment that makes us feel empowered to think for ourselves, to ask uncomfortable questions and to share difficult life experiences, then decide what is best for us in dealing with these. So, we are motivated to be competent, knowledgeable about the harms and possible benefits of consuming certain drugs – be it legal, illegal or pharmaceutical.
We have also developed a Just Say Know peer-education program. The significance of this project is that it was put together by mental health professionals, doctors, addictologists, and researchers together with students. So the curriculum combines knowledge and experience based on science, professional experience and the actual experience of the people that it is aimed at. Instead of teaching that the only acceptable strategy to respond to drugs is saying no, we are meeting young people where they are, in their understanding of the world, and we value their authentic experiences. We build trust, and that is the foundation of effective education and a true on-the-ground early warning system. From this place of trust, we can open a conversation to uncover what specific challenges these young individuals face, what could be the actual strategy for them to stay safe and healthy and how we can support them in making the right moves, as a community.
We are not be able to build this trust if we behave as we know better than them, if we keep information from them, if we assume things about them and we will not be able to build trust if we think that drug education begins and ends in the classroom with doctrines, with one adult positioning themselves above „the children” who consume information, facts about the dangers of some mysterious forbidden molecule. If we keep using stigmatizing language and label those who make choices that we don’t agree with, if we preach sobriety as the one and only way of staying safe, we will be excluding those who need our help the most and we will not adhere to the UNODC principle of “leaving no one behind”.
I think this logic should apply to policy making as well, -if we are aiming to protect a certain group of people, before assuming what’s best for them, let’s ask them. Let’s talk to them about their daily struggles and successes, let’s engage them in creating the systems that they will maneuver their lives within. This approach is what will keep us, the youth, safe, healthy and aware: opportunities for non-judgmental conversation, where we, individuals, are in focus and not some outdated ideology. I am grateful for this opportunity to be here today and to be listened to by you, to be able to put the experience of my peers in focus. However, I am only one of the thousand members my organization has all over the Globe and SSDP is only one of the many youth organizations who are in every day contact with young people who are exposed to drugs and drug abuse. We have actually formed a coalition of organizations that are led by young people: the Paradigma coalition represent thousands of young people in every region of the world. So if the distinguished member states and all the institutions that are empowered by the conventions to make the rules – WHO, INCB and CND, if you all really want to align yourself to your promise in 2016, creating a “A Better Tomorrow for the World’s Youth” you should provide meaningful ways for us to share more often. We are not only easy to find, we are eager to help you help us. We have actually prepared a document that we hope aids you in preparation for the HLMS next year, where we outline the three most important actions member states can take to really create that better tomorrow.
UNODC HIV/AIDS section, Monica Ciupagea: In regards to HIV for women who are injecting drugs, -we have very little data about women who are using/injecting drugs. What we know from various published studies is that about 11 million people who inject drugs -between 20 and 30%- are women. When it comes to HIV is about prevalence. Data presented by UNAIDS year after year shows that HIV prevalence is higher among women who inject than men. There are many explanations about this. Region by region these data are confirmed. When drug use is coupled with sex-work then the prevalence is even higher. What is to do to prevent HIV and HCV among women who inject drugs? There are 9 interventions that are called “The comprehensive package for HIV prevention, treatment and care among PWID”. There were described and published by WHO, UNODC and UNAIDS in 2009, almost a decade ago. They were presented in a number of other publications along with needle exchange programmes, opioid substitution therapy, and HIV testing, antiretroviral treatment and all the other interventions. We are working now more on the overdose prevention, because people have to stay alive.
To effectively implement these interventions for women you have to take into consideration their specific needs and therefore there are a number of key interventions that are recommended, that have to be coupled with the 9 interventions in order to effectively reach the women and address their needs. Among the these are the provision support for childcare, for a safer environment where women can feel safe so they can go and ask for treatment services, -preventing gender-based violence. Although we know very well what to do, the access to these services for women remains very low. According to data from UNODC and the WDR in recent years regarding the effective access to treatment, only 1 in 5 people accessing treatment is a woman. That occurs since -of course- women face certain gender-specific barriers: stigma, discrimination, violence, lack of availability and access to services. UNODC -when requested- is providing support for the revision, adaptation, development and implementation of effective legislation, policies and strategies to be able to address the needs of the women. Also, facilitates that HIV policies and programmes are gender-responsive, supports countries to consider effective and humane approaches like alternative to imprisonment for women, and involves and supports community-based organisation and civil society organisations working in response. Also, UNODC imprements measures to prevent violence, including sexual violence both in the community and in prison.
Together with our colleagues from WHO and UN Women, and the civil society and UNODC we prepared a practical guide on service providers on gender-responsive services. Based on this guide we have a training package which we are rolling out in high priority countries. Building the capacity of service providers and decision makers of how to increase women access to HIV services. We run projects for women who inject drugs -in communities or in prisons- in Pakistan, Nepal, Afghanistan and in Ukraine, also regarding the capacity building we had already have trainings in Afghanistan, Belarus, Egypt, Indonesia, Moldova, Nepal and in Vietnam, and while we are here participants from Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan are attending our workshop. We are also tackling the law enforcement attitude in regards to HIV services and how they should understand the need to facilitate women’s access to these services. Last, the community plays a very important role in scaling up services and increasing access for women to services.
Discussions on human rights end and revert back to the issue of ‘demand reduction’ – please see Blog entry on ‘demand reduction‘ for more information.