Statement of the International Harm Reduction Association at the demand reduction plenary

The following statement was delivered by Rick Lines on behalf of the International Harm Reduction Association.

‘Thank you Mr Chair.

I’m sure I speak on behalf of my two colleagues on my left when I thank you for enabling civil society to participate in today’s session, and ensuring time on the agenda for us to be heard.

I am here today representing the International Harm Reduction Association. Our statement is supported by the Asian Harm Reduction Network, the Caribbean Harm Reduction Coalition, the Eurasian Harm Reduction Network, Intercambios Asosciacion Civil, the Middle East and North Africa Harm Reduction Network, the Sub Saharan Africa Harm Reduction Network, the Canadian Harm Reduction Network, Colectivo por Una Politica Integral Hacia las Drogas, the Harm Reduction Coalition in the US, the International Network of People who Use Drugs, the International Nursing Harm Reduction Network, the Women’s International Harm Reduction Network and YouthRISE.

In June 1998, the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem adopted a resolution entitled ‘International action to combat drug abuse and illicit production and trafficking’. Despite the fact that the link between HIV transmission and unsafe injecting drug use was well-known at that time, the UNGASS political declaration was silent on both HIV prevention and on harm reduction.

Today, more than 10 years on from the UNGASS on drugs, it is estimated that 15.9 million people inject drugs in 158 countries and territories around the world. Since the 1998 political declaration was adopted, many regions of the world have experienced an explosion of injecting-driven HIV infection. In some regions, up to 80% of people living with HIV are likely to have acquired the virus through unsafe injecting. In countries as diverse as China, Estonia, India, Kenya, Myanmar, Nepal, Thailand and Vietnam, HIV prevalence rates among people who inject drugs reach over 50%.

During this same period, injecting-related hepatitis C infection has remained a major unaddressed health concern, with prevalence rates among injectors reaching as high as 95% in some countries. The vast majority of people who inject drugs in countries as far-ranging as Indonesia, Thailand, Pakistan, Mauritius, Estonia, Lithuania, Russia, Ukraine, Luxembourg and Switzerland are living with hepatitis C. Ultimately, death and disease related to hepatitis C may take a bigger toll on drug injectors than HIV infection.

Last week, a High Level Segment of the UN Commission on Narcotic Drugs (CND) adopted a new Political Declaration on drugs. It was apparent from the negotiations towards agreed language in this Declaration that a small number of countries are prepared to go to extreme lengths to block support for evidence-based, public health led approaches to drug use from appearing in CND resolutions. These obstructionist governments – including the United States, Russia, Japan, Italy and Sweden – blocked any reference to harm reduction in the Declaration, despite the fact that up to 10% of all global HIV infections occur through unsafe injecting drug use (and over 25% of all infections outside Sub-Saharan Africa), and the best evidence suggests that over 3 million people who inject drugs are living with HIV.

CND’s failure to embrace harm reduction, and the continued obstruction of a small number of governments to even non-binding statements of support for harm reduction programmes within the Political Declaration, clearly illustrate the degree to which the Commission is not only out of step with the scientific and medical evidence supporting harm reduction, but is also isolated from the mainstream of UN opinion on this key health policy issue.

Harm reduction is explicitly supported by the UN General Assembly, UNAIDS, the UN Office on Drugs and Crime, the World Health Organization, the International Narcotics Control Board, the UN High Commissioner for Human Rights and others. At least 84 countries around the world explicitly support, or allow the operation of, harm reduction programmes. Moreover, in 2002 the Legal Affairs Section of the UN Drug Control Programme affirmed the legality of harm reduction programmes – including opioid substitution therapy, syringe exchange and safe injecting facilities – under the international drug conventions. This finding authoritatively refutes the continued allegations by obstructionist governments and others that harm reduction is incompatible with treaty obligations.

Yet in spite of this broad and ever increasing support, CND – through its self-imposed ‘consensus at all costs’ working method – perpetuates a system that enables even a single government to block harm reduction language in its resolutions, and now in the Political Declaration. This now creates a situation where UNODC – the lead organisation on HIV and injecting drug use within the UNAIDS family – now has a governing board that refuses to support harm reduction measures. This is a problem that must be addressed.

It is inconceivable and indeed unconscionable that support for scientifically proven, evidence-based harm reduction programmes have again be blocked. States must show responsible leadership and act in the best interests of public health and human rights, rather than the narrow and failed language of ‘a drug free world’. In this regard, we commend the leadership demonstrated by the 26 countries who supported the declarative statement supporting harm reduction at the High Level Segment last week.

Mr Chair, this issue is much bigger than ideology, semantics and intergovernmental wordplay.

It is about saving lives.

Thank you.’

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