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5th Civil Society Hearing

Opening Session

Jean Luc Lemahieu, UNODC

I thank the NYNGOC for organising this event, as well as the respective governments for their support. UNODC greatly values the role of NGOs as we approach the 2016 UNGASS. We also support NGOs’ participation, their outreach to affected populations, and their role in events. NGOs’ role is key as stated in the Joint Ministerial Statement. 117 NGO staff received training from UNODC, 260 participated in discussions. NGOs remain a crucial part of the response to drugs. I thank you for your dedication and your work. UNODC also seeks to overcome the stigma associated with the stigma associated with drugs. UNODC supports the CSTF work and in particular its Global Survey. The essential services provided by NGOs on the ground present a significant resource and we hope will be presented at the UNGASS through the platform supported by UNODC. The platform serves as an e-bay or Match.com to link people and services. We hope that member states provide the funding necessary. We encourage CSOs to continue participating in the process through sharing their experiences on the ground. The UNGASS 2016 website has been designed to promote these contributions. UNODC looks forward to working with you towards the global response to illicit drugs.

Ambassador Antonio de Aguiar Patriota, Brazil

I believe there are diverting views on addressing the world drug problem. Serious challenges remain and we must continue multilateral efforts through shared responsibility – I want to point this out based on our discussions this morning around the development goals. In some areas, we have made considerable progress – in HIV/AIDS, in some countries new policies provide interesting lessons learned. I would recommend two recent articles in The Economist from this week for more reading on this. MERCOSUR, UNASUR and CELAC, as well as the OAS, have played an important role. UNGASS will contribute to improving our national policies and in the implementation of the drug control treaties. UNGASS should be open, inclusive and pragmatic. UN treaties remain relevant and are flexible enough, incorporating at the same time demand and supply strategies, as well as humane. In preparation for the UNGASS, Brazil is open to new possible approaches. We promote an integrated, balanced and multidisciplinary approach towards people who use drugs. In 2006, we established a balanced approach between demand and supply, and where people who use drugs are no longer sent to prison. The INCB pointed out: Brazil has invested heavily in drug prevention and treatment. Drugs are a public health issue, which necessitate reducing the stigma and discrimination related to drug use. We would like to discuss the death penalty – we have abolished it since the 19th century and we call on all countries to end the use of the death penalty for drug offences, and establish moratoriums. There is no causality between the death penalty and reduction in crime. There is a lack of clarity between what public security is about, and what threats to international peace and security are. Militarisation of drug control has been largely ineffective and is detrimental to human rights.

Eric Green, US Department of State

We value our partnership with civil society for several reasons: it provides education and influences the decisions around drug policy. Speaking personally as a newcomer in multilateral policy, I am impressed at the expertise on drugs issues at the UN. You are doing a great job at holding us accountable. NGOs have access to our governments in the USA. We don’t approve with all the recommendations coming from NGOs, but we approve of the open door to discuss and create constructive feedback. A second aspect of civil society participation is service provision. Many NGOs fill gaps that governments have difficulty in addressing. This is the case for WFAD for example. Other NGOs are very active, one that I met in Vienna is Slum Child in Nairobi, Kenya. Drug treatment relies heavily on NGOs. There is natural synergy between advocacy and service delivery. The HIV/AIDS issue is an example of this. For the UNGASS, we welcome the participation of the VNGOC and the NYNGOC. We were pleased to see NGO representation at the UNGASS Segment in Vienna in the panels and in the room. We also promote civil society diversity including both advocacy and service provision, as well as geographical diversity. In 2013, President Obama spoke directly about the importance of civil society: if you want strong, successful countries, you need strong and vibrant civil society. We understand the role of civil society both at the macro-political level and at the grassroots level.

Luigi Marini, Permanent Mission of Italy to the UN

The civil society dialogue forms an integral part of discussions. Under the decision of the High Court of Italy, the Parliament changed the drugs law, and adopted a system that takes into account all elements connected to health and human rights. Our system has some fundamental pillars: 1. personal drug use is not allowed, but is not criminalised, there is no legalisation but it is decriminalised; 2. when it comes to criminal conducts, the system provides for proportionate sentences that are different depending on the level of the crime; 3. we pay great attention to personal situations and drug-related problems – for example for people living with HIV, and people condemned for up to 3 years can benefit from suspended sentences or alternative sanctions, this is a system that pays attention to the individual. The new law was important because it brought 6,000 people out of jail – many people were addicted and sent to prison for selling drugs, and were released. The new law introduced better differentiation between use and trafficking, and introduced alternatives to incarceration. We can say that Italian policy is consistent with international standards and the 3 conventions, but within the conventions it is adopting concrete solutions responding to crime and to people. We have very important support from civil society to combat crime and mafia.

Esbjorn Hornberg, VNGOC

It is a privilege for me to be here in this civil society hearing which is NOT informal. We have the opportunity to support drug policy making. But we must not let drug policy development be hampered with legalisation debates on the one hand, or a war on drugs on the other. The polarisation of the debate is an obstacle limiting the debate to only two options. It constraints the main nuances in the debate and wrongly identifies prevention interventions as part of the war on drugs approach. There are many other approaches which we can call the third way, and which are promoted by many NGOs from around the world. On human rights, there is one convention that stands out – the convention on the rights of the child. We all know that drugs are a complex, multifaceted problem. As previous UNGA thematic debates have demonstrated, drugs are a threat to development. There is a chance to link the post-2015 development discussion with the drugs debate. For too long, discussions have been focused on Western positions, focusing on Western problems. The poor and marginalised people in the world must be protected from drug related harms particularly as drugs strongly affect them. The burden of the global drug problem will shift to countries that are ill equipped to respond to drugs issues. In too many countries, drug services are direly lacking. One must be realistic about our capacity to provide treatment, in particular in developing countries affected by many other diseases such as malaria and TB. There are two additional processes: the gender gap is deepening; and adolescents and young people are mostly affected by drug use. Women in the 21st century are the drivers of development, but they are still subject to human rights violations, inequality, etc. The international community should put a high priority that substance use in developing countries does not reach the high levels of developed countries. There is a need for a comprehensive approach to drugs – health services, harm reduction, treatment and rehabilitation, to protect specifically vulnerable groups.

Ambassador Khald Shamaa, UNGASS Board

I thank the NGOCs for inviting me today. It’s a pleasure for me to be with you and attend this meeting and previous successful civil society hearings. The high level thematic debate on the UNGASS organised by the President of the GA is a good opportunity for member states and other stakeholders to highlight successes and challenges in the world drug problem. It is timely to once again highlight the commission’s guiding principles for an inclusive and integrated system.

The important role played by civil society and the need for their involvement has been highlighted in resolutions on the UNGASS. The UNGASS Special Segment truly showed this. NGOs were present in the panels and many side events were organised by, or in collaboration with, NGOs. I worked in the establishment of the CSTF. In our preparations for 2016, it is crucial to hear from different perspectives and schools of thoughts to respond to different realities. We have heard some interesting examples of the work being implemented on the ground. We are interested in hearing all these views, experiences and lessons learned in preparation for 2016. We can ensure the contribution of the CSTF in the process. The CND and UNGASS Board are fully supportive of NGO engagement. We will organise additional informal meetings and events, which are crucial to ensuring an open dialogue. The 2016 UNGASS website will also be further expanded to ensure more space for open dialogue. I encourage you to visit the website and contribute to the debate.

Let me once more commend you for organising the event. I had a discussion today on the involvement of women, most importantly community structures. One of the most important roles that should be looked at and should be given additional emphasis is the role of women in community-based initiatives, in relation to drugs, specifically in what regards prevention. I would encourage you to tap into possibilities in this area, through the ever-increasing role of women and community based organisations and programmes.

Perspectives from civil society: Lessons learned and best practice

Shoshana Brown, Washington Heights Corner Project

I work in a harm reduction programme in the north of Manhattan. I want to start off by acknowledging that drug use has always been part of our society. Drug users are fathers, mothers, brothers, etc. our approach is therefore rooted in compassion. We understand that drug use impacts everybody in our society and harm reduction is a legitimate and successful response to drug use. After experiencing the approach towards active drug users, I can say that harm reduction is a tool that works to save lives. It can be the first or the last point in the spectrum of service provision where people can come to. It is a social justice movement where people are empowered to take decisions in their personal lives. We are meeting people where they are at.

Some of the challenges in responding to drug use are related to treating drugs as a punitive issue, rather than compassion and care. Looking at many of the responses to drug use, housing can be a very effective response. Simple access to mental health care can also be hampered by the economic machine that are hospitals. Another way that silence and shame impacts on the response is stop and search practices – possession of cannabis can still be used to put people through the system and charge them for drug offences.The vast majority of people in NY state are incarcerated for non-violent responses. Decriminalisation has been a response, but it is not working. Also, while NSPs have a good support in NY, other areas do not benefit from that support. Harm reduction modalities is not widespread in the USA or around the world.

We also face barriers to accessing harm reduction facilities or treatment. Again going back to healthcare being treated as an economic process rather than providing services for people who need them. Housing and employment services are also very important. Harm reduction overcomes these barriers. The first thing I have seen is increase in engagement in medical services by offering people with access to non-judgemental medical care. We were able to treat 8 people for hepatitis C in 2014 alone. New medications have been developed, but we don’t have access to them. Another success is medical training – providers at our agency are trained on how to work with drug users, and so people don’t face stigma they may face in general health care. We also offer low-threshold access to care – without going through the many barriers inside the medical care system (insurance, caring, etc.).

A second success I have seen is increased involvement in abstinence based programmes – we do referrals to treatment and rehab. There can be between 10 and 20 referrals a month. We have seen success because we have been able to meet people where they are at.

We have seen an increase in the ability of people to access housing. It is one of the basic needs that truly impact drug use. If you don’t have housing, it is difficult to manage other parts of your life. We have collaborated with other local housing programmes and have processed people into long-term housing.

Fourth, we have seen re-engagement in the workforce through our harm reduction and peer programme. We have helped people re-develop skills to engage in the workforce, having a job and more responsibilities, and being more accountable. We have achieved a number of goals. In the peer programme we have conversations about drug use, and how this drug use is affecting their ability to work, being responsible, on time, etc. All of that is possible because we take it one step at the time within our harm reduction strategy. Harm reduction is the ability to create space for people’s ability to address issues in their lives.

Elena Goti, Dianova International

I will speak on the experience of Nicaragua. We operate in 11 countries in Europe and America. Dianova Nicaragua are a member of Dianova International. 44% of people in Nicaragua live below the line of poverty. Dianova was founded in 1985. Illiteracy rates are very high in rural sector – this is where Dianova works. Banks offer credits three times more frequently to men than to women. 81% of young people think they won’t find employment in rural areas, and therefore move to the city.

After a quick view of the conditions of young people in the country, you will understand the role of Dianova. Dianova started an education programme in a rural area, we opened an elementary and secondary school for boys and girls, as well as a prevention programme. The schools were based on requirements for school in Nicaragua. We offered clothing, scholarships, books, money to come to the school. Parents have to come every two weeks to the school to attend workshops run by the school staff, we pay for transportation for parents to be able to come (address issues related to drinking, drug use, etc. at home,work around human rights, etc.). Parents also contribute to sports activities in the school. We established a prevention programme that is cross-cutting targeting both teachers (biology, history, etc.) and students.

People heat themselves and cook with wood so there was no more trees in the area. We taught people about plants, how to water them and grow them. We then adapted our environmental programmes to market needs and ensure that people could stay and live properly in rural areas. We offered them opportunities in coffee plantations, etc.

In terms of outcomes: 75% of our graduates went to university or secondary schools. Around 13,000 parents got some type of training, and communities around the schools used more environment friendly strategies. We need to be flexible, read the context and offer services according to the needs of the people.

Olga Guzman Vergara, Mexican Commission for the Defence and Promotion of Human Rights

It is difficult to talk about the Mexican case as best practice. We are facing a crisis in human rights. I want to share with you lessons learned. I am from a Mexican NGO that documents research and litigacy around human rights violations. We registered an increase in violence and impunity since the declaration of the war on drugs by Calderon.

Elements of the military systematically transferred civilians to military detention centres who suffered torture and enforced disappearances. Military elements dressed as civilians were also reported, conducting summary executions. This was done without any prior investigation, and many victims did not pause threats to society, or even belonged to organised crime. The violent confrontation of police and organised crime has increased. The fight for drug distribution routes intensified and cartels were fragmented. Forced internal displacement of thousands of people were not recognised by the Mexican state as a human right violation. There has been indiscriminate use of lethal force.

People can be deprived of liberty for up to 80 days pending investigation. The UN Special Rapporteur on Torture said that you detain to investigate, instead of investigating to detain. We need shared responsibility for responding to the impact of the war on drugs. Impunity is a cancer in our society. We have seen in our country that human rights perpetrators are not sanctioned, and even worse are sometimes protected by political elites. Torture is generalised in our country. The high number of complaints is not reflected in the high number of investigations.We need to learn from the lessons from Mexico – impunity is a barrier to the rule of law, and leads to countless human rights violations.

Nazlee Maghsoudi, Canadian Students for Sensible Drug Policies

I am bringing the perspective of youth here today. I worked extensively with people who use drugs and people who have been impacted upon by drug policies. I also work for ICSDP, seeking to bring science in drug policy. When evidence indicates that something is not working, we need to change it.

I want to go back to article 33 of the Convention on the Rights of the Child. We can all agree that protecting youth is of the utmost importance. But is a punitive approach the most relevant strategy? I will only focus on the negative health and social outcomes resulting from prohibitive drug policies, mainly supply reduction. These have been ineffective in reducing drug use among youth. Youth have unrestrictive access to drugs. For the past 39 years, youth have reported being able to access cannabis without restraints. Increased efforts to enforce cannabis prohibition has been unsuccessful in the USA, as well as in Europe. Other metrics of supply indicate that access to illegal drugs has not been limited by prohibition. Since 1990, despite increasing investment, illegal drugs generally decreased in price, while purity has increased. We can conclude that prohibition has not been the most appropriate policy for young people.

Given these results, it is time to consider alternative approaches by allowing governments to apply age restrictions, regulation. Age restriction can be more effective than current approaches. This does not discount the paramount importance of prevention. But as we have seen with tobacco control, education and control can have better outcomes. The framework conventions on tobacco show that regulatory measures are possible. This may not be appropriate for every state, but it can give states the tools to meaningfully limit access to drugs. strict legal regulation is therefore a promising alternative to prohibition.

Reducing availability is only one of the failures of drug control. WHO shows that the majority of drug injectors started to inject while being young. Scaling up harm reduction services continues to be limited. Legal age restrictions, parental consent, etc are also common barriers. HIV infections among youth worldwide are high. Prohibitive policies fuel HIV and hepatitis epidemics among youth. The experience in Switzerland is positive in this regard with scaling up harm reduction such as NSPs, OST, heroin treatment, etc. It has an impact in reducing infections but also increasing the age of initiation of injecting – it reduced the risks of young people starting to injecting drugs. Harm reduction has a significant impact in young people’s lives. Surely, article 33 of the Convention on the rights of people includes the provision of life-saving harm reduction interventions. This has been reaffirmed by the committee on the rights of the child. Based on my experience of working with young people, an approach based on science, compassion and health is a more effective model.

Thinking of how effective our policies are is especially relevant considering the UNGASS official slogan around “a better tomorrow for our world’s youth”. How can we think that a system that has created so many negative impacts be relevant to contribute to a better tomorrow for our youth?

Farah Diaz-Tello, National Advocates for Pregnant Women

It is a very exciting time to reevaluate our drug policies. Support has never been higher to the adoption of a health approach to drug policies. ONDCP is very much willing to promote public health. Also exciting is the debunking of the media myths around drugs such as the “crack babies” of the 1980s. As with many wars unfortunately, it is taking a very long time to end this war. We have seen stagnation and retrogration moving towards a more prohibitive strategy.

In 2009, Alabama punished people bringing children into areas where drugs are used or sold (in particular amphetamines). This led judges to consider that women who were pregnant and using drugs should be criminalised for endangering their child. Nearly 200 women have been incarcerated for this crime. Any person using any amount of a drug that is controlled has committed a crime and can be condemned to a prison sentence of up to 99 years.

In Arkansas, a woman gave birth to a baby who tested positive to a drug. She was condemned for introducing drugs into the body of another person. She was arrested and charged. Her son is 3 years old now, perfectly health, but will not see his mother for another 20 years. This has an impact on her life and on all the other women in Arkansas.

In 2013, Tennessee was the first state to pass a law that criminalised pregnant women who use drugs. It is very clear here that it is a crime for pregnant women to ingest drugs, while this is not a crime in Tennessee. The law passed due to the work done by a drug court judge and a prosecutor where they used the threat of a criminal charge to bring pregnant women to treatment. This drug court programme was not developed by service providers, it was designed by a judge and a prosecutor. It is set out on a 12 step model. It has not been very studied, it is based on total abstinence, it is not gender responsive, and it has led to an increase in babies being born with abstinence syndromes. The law will go into oblivion if it is not passed again in 2016 – it is a pilot experiment. Many prominent groups believe that arresting pregnant women for drug use is a bad idea because it creates a public health hazard with women no longer seeking help they need. The ONDCP director also spoke against the law. So has the law worked or not? It depends on who you ask. Prosecutors think it has worked due to numbers of arrests. But healthcare providers think not because of the health issues related to access to treatment, abstinence syndromes among children, etc. Treatment providers have seen a decrease in the number of pregnant women seeking care. Half of the women enrolled in the programme have been unable to stick to the programme. Some believed their chances were better behind bars.

I want to insert a footnote here. In the USA, we have a child care system which is punitive. Drug use is treated instinctively as child neglect. Families are needlessly separated, children are placed in the foster system. Child welfare can also coerce children into treatment. All of these disproportionately impact on vulnerable people, including people of colour and poor people.

What constitutes an effective intervention is that:

  • Treatment should be confidential, trust between the provider and the patient
  • Treatment should be voluntary and appropriate
  • Care should be evidence based – treatment in drug court programmes is not evidence based and adequate
  • Trauma-informed care should be provided
  • Childcare is also important – most women have at least one child and they need to be able to bring them with them when they access treatment
  • We need a law enforcement culture shift with respect for human rights and de-policing.

Ultimately, what is needed is healthcare and not handcuffs.

The Civil Society Task Force: Facilitating cooperation between governments and civil society

Elisa Rubini, VNGOC

The task force is a joint cooperation between the VNGOC and the NYNGOC. The objective was to bring together a working group of experts from across the world, working both in the field and on policy issues. 18 people are geographically representative – we identified 9 regions, each region having two representatives. We also looked at the debate on drugs and brought the voice of affected populations – illicit crop farmers, drug users, recovered users, families, etc. Global voices also needed to be heard – prevention, harm reduction and criminal justice. We asked people to nominate themselves for these positions, we conducted many interviews and worked hard to get the full spectrum of drug policy issues represented.

The work of the CSTF is to facilitate civil society participation in the UNGASS process, creating a synergy. Whenever there is an event (CND, Third Committee, etc.), we are engaged in securing civil society participation. Today’s event is one example. We also worked with governments to facilitate and promote nominations for civil society speakers.

Some of our own task force activities is the global UNGASS Civil Society Survey – this is in an effort to gather civil society inputs and identify areas in which we should focus to provide the best suggestions to move forward. The Survey was launched a few weeks ago, it is available on the websites of the VNGOC and the NYNGOC in English, and will be available in other languages in the coming weeks. The survey should be completed by the end of July. We look forward to the responses to the Survey.

We are also conducting regional or thematic consultations to mobilise civil society contributions. The questions addressed will be the ones reflected by the UNGASS preparations themselves, and to try and collect civil society input. We want civil society experience to be embedded as much as possible, to create a coherent input as the best way to move forward. We are not looking for a consensus paper. We are inspired by working in cooperation, we have the richness of NGO experiences and want to present and promote it. We want to identify key priorities to promote as a unified voice.

We are also facilitating participation in important UN events. The next event will be the Third Committee in New York, where we want to organise a high level debate with civil society. We look forward to coordinating this event. We will then focus on the reconvened session of the CND in December, then the CND itself in March 2016, and the UNGASS in April 2016.

We encourage all of you to have a look at the VNGOC and NYNGOC websites to participate in the survey and the regional/thematic consultations. Also feel free to ask questions.

I now want to mention our roadmap:

  • May to July: survey
  • May to August/September: regional consultations to provide food for thought to member states for the UNGASS as they establish their positions

Donald MacPherson, Canadian Drug Policy Coalition

Timelines are tight and resources are slim. The CDPC is a national coalition in Canada focusing on harm reduction, mental health and addiction. We are delighted to be working with a range of groups to raise the voices of civil society. We started our work in Canada, conducting programmatic work and gathering contributions in North America.

There is a tremendous amount of interest in the UNGASS, and we want it to be a successful and impactful event. We started an UNGASS working group in Canada and we are gathering members as we go. We have representation from health officers, young people, indigenous groups, etc. It is particularly important to involve indigenous groups as they are overly represented in criminal justice processes and their voices are not sufficiently heard. We are also in discussions with networks of municipalities on their drug strategies. There is a lot of action at local level in Canada so these networks are important.

We acknowledge in our work that drug policy is a very dynamic field. Drug policy is under the radar in many countries and many organisations are out there willing to engage. In Canada, there are vigorous discussions happening at local and national level, ranging from small technical proposal, to legislative review. Civil society is engaged in all of these processes.

There is a global shift in the debate. The term “health” approach is increasingly used, and this shift opens the door to systematic change in our policies. “Modernising legislative, regulatory policy frameworks” to address existing and emerging drug concerns.

As we engage civil society in Canada, the review of new approaches in drug policies is important. And we don’t only mean legalisation here! There is a wealth of experiences on the ground that should be brought to the table in the broader process. We ask civil society to reflect on the aspects that the UNGASS should be addressing. It is a key opportunity to work together across civil society to see what modernising our policy framework would look like. We agree that the system is broken and needs to change. The hard part is how to change it. This is hard, takes strong leadership and courage. Civil society has much to contribute to the discussions, share experiences from the frontline, and work together to achieving better policies that ensure the safety of our communities while ensuring respect for human rights.

Esbjorn Hornberg, VNGOC

How can we hear more about NGOs from the global south? How can we ensure a participatory process? We need money, and we need to tell that to member states. We depend on contributions from civil society to pay for our travel, salaries and other costs. We must show member states that we are important, to be able to take people from Kinshasa and other regions to New York and Vienna. And is New York more important? We haven’t seen a lot of member states here today. We must tell them we are here. People in their own country must be able to reach out to their governments to discuss policies. It is easy to say whether we are supporting some issues. But others are still contentious issues, such as harm reduction. What is the best solution? If we talk about health perspectives, I speak on my own now, we can talk about tobacco use and increases in use. Legal substances are the most burden of disease substance. I want to say that when we discuss the health perspective.

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