We tend to meet with government agencies, but also NGOs. Those we meet are advised by us. NGOs are an important link for us. They are important for drug prevention, treatment and rehabilitation.
Given the changes taking place in Uruguay, USA and Europe around drug policy, how can the INCB react to these changes in the future?
The INCB’s role is that of a monitor. We look in all the scope of our drug policies. Our role is not just law enforcement. We also deal with prevention and treatment as fundamental pillars of drug policy. We also advise agencies, and when there is a breach in the conventions we have the duty to advise states when they are no longer in line with the countries. Governments are fully responsible to establish their own drug policies. We always insist that effectiveness of prevention programmes depends on how balanced their strategy is. We can assist member states with our technical knowledge. NGOs help us on how to promote the best approach. Kazakhstan, Spain, and others, have different attitudes towards drug policy. We have to appear as independent as we cannot force countries to adopt cultural values or policies that are not in line with their cultural considerations.
We welcomed the INCB statement on the death penalty. Will the INCB also do the same for harm reduction?
There is a misunderstanding which may be only based on semantics and ideology. In your question you ask whether we would recognise harm reduction as under human rights. As if harm reduction were a human right! Human rights are access to health. The conventions do not contain or refer or define harm reduction. The conventions say that countries need to take measures for prevention, treatment, after care and rehab. Certain aspects of the so-called harm reduction measures are of course useful, but member states are not obliged by the conventions to adopt what some of you call harm reduction. Let’s be frank, harm reduction is ideological. They should not be carried out as an alternative to other interventions such as drug abuse prevention. To come back to pragmatism, let’s see what harm reduction is – we can really call them prevention measures. Some of these measures can be considered as useful – treatment measures can be useful. If you take NSPs, these are in line with the conventions. Those of you who were there when I presented the report, you will have heard me mention access to essential medicines, including methadone and buprenorphine. These are in line with the conventions – but are not required – member states have the power to allow for those or not. We remind governments of the fact that none of the conventions require users to be punished. But governments may choose to do so. Drug users should be considered as human beings, not outcasts and proportionate responses should be given.
VNGOC explains that harm reduction was never defined by us to be an alternative to other measures. We need to be clear on definitions.
How does the INCB work when countries’ proposals for estimates for access to essential medicines are clearly insufficient for their needs?
The use of drugs should be limited because of their addictive nature, to medical and scientific purposes. There are annual estimates made by every member state at the beginning of each year. Countries are also free to submit reports on statistics and trade on their needs for import, export, etc. If a country does not submit an estimate (e.g. on morphine), the INCB does it automatically so that the country would not be prevented to improve the medicine. We do it on the basis of a standard daily dose based on consumption in the region. If we consider that an estimate is too low, we suggest increasing the dose, but this is up to the country. The INCB advises but does not decide. We have drafted a global report on the availability of internationally controlled drugs where we give recommendations to member states.
How can NGOs be better supported?
We decided to upgrade our work with NGOs, in particular in West Africa. We ask them to provide the INCB information about the needs of people on the medical use of controlled substances so that the INCB can have more global information than the partial one (or scarcity) sent by governments.
Compulsory treatment – what is the position of the INCB on the use of these programmes?
We have to deal with the words in different political, traditional and cultural uses. INCB will support all member states in their way of tackling the drug problem as long as policies are within the framework of the three UN drug conventions. Concerning the example of Cambodia, after analysing the results of the Board’s mission, we urged it to continue developing community-based drug treatment programmes. We did that because there were two systems – camps being one of them, and the other being community-based treatment programmes. The results of the community-based treatment programmes worked better. In Kazakhstan, treatment was forced on people because there was no other alternative in the community. No doubt, we will promote community-based treatment there when it is possible to do so. But the INCB is not in a position to oblige countries to close down compulsory treatment if there is no other alternative. It was not the case in Cambodia where there are community based centres.
VNGOC: if the INCB could strongly encourage countries to set up community-based programmes, in line with other UN agencies, it would be appreciated by NGOs.
This is an ongoing dialogue. NGOs are invited to be in contact with the INCB Secretariat to provide the Board with analysis and data on the problems arising in individual countries. It is important for us as the whole drug control community is aware that governments are necessary, but the work of NGOs on prevention is essential. Drug users are human beings.