CND intersessional: 23 January 2017 – Operational recommendations on Demand reduction and related measures, including prevention and treatment, as well as other health-related issues

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CND Chair. There is no comment on the agenda of this meeting so the agenda is adopted. I give word now to the Portuguese Ambassador to chair the thematic discussion. We will continue with agendas 2 and 3 on Wednesday. I came back yesterday from New York. The key theme was how our commission is delivering the comprehensive follow up to the SDGs. I will report to you all from these meetings. We are on top of the agenda. The Ambassador of Mexico will be chairing CSW. I welcome the excellent work of UNODC.

Post-UNGASS Facilitator. It is my pleasure to welcome you all. At the first round of thematic discussions in October, we focused on sharing experiences and lessons learned on how to translate the recommendations of the UNGASS outcome document. This second round should not be a mere repeat of October. While the first round focused on implementing the recommendations, we should now focus on a forward-looking approach – focus on actions that can be taken by the CND including at the 60th session. Today we will continue our interactive discussions. A tentative agenda has been shared. I want to share a few points: all delegations are encouraged to limit their interventions to 5-7 minutes on actions that can be taken by the Commission on the implementation of the UNGASS outcome document. We can make longer presentations available on the UNGASS 2016 website. To enhance interactivity, we propose that governments raise their flags if they wish to talk. UN entities and specialised agencies, regional and international organisations and NGOs have also been invited to share their expertise. I extend a warm welcome to those who are here today, including a representative of OHCHR and the Department of Political Affairs.

I will now go into the first thematic chapter on demand reduction. Today, we have the UNODC health branch with us. In an effort to have an interactive discussion, I will ask Mr. Gerra to share the expertise of UNODC in prevention, treatment and HIV prevention.

Gilberto Gerra, UNODC. I want to focus on concrete actions here, not on philosophical matters. A top scientist in the US said we should focus on ‘early love’, which creates changes in gene expression and receptors in the brain. Early lack of love means abuse, neglect. So what should we invest in? My main issue is prevention first. Authoritative parenting reduces 30% of tobacco use. We must listen to children first, as was highlighted in a project launched by France and Sweden last year. We should invest in young people, not as targets only but also as partners. You see the results of an article here with development of awareness and leadership of youth in their community.

Looking at treatment, problematic patients don’t come to the doctor’s office. We need to invest in outreach. We must integrate medication-assisted treatment with psychosocial therapy. We must invest in treatment in communities, not in isolated areas.

We should not stop our HIV prevention efforts. We cannot let our guard down. We still have 57% of countries implementing NSPs, and only 51% of countries implementing OST. We should realise that not doing these things is like not doing vaccination for polio to children. It is sacrificing life. We need to invest in these tools. Only 14% of PWUD have access to ART, 8% to OST. And reach to these tools is not homogenous worldwide, Africa is lagging behind. We have also forgotten the risks of HIV linked to stimulant use such as cocaine and amphetamine. We must invest in this area of the population.

In conclusion, my branch is at your disposal to help adaptation of science based methods, support implementation of services, etc. We are ready to work with you in a concrete way. With your permission, I give the word to Ms. Giovanna Campello.

Giovanna Campello, UNODC Serbia. We have in depth presented the provisions of the outcome document and what should be done to make them a reality. Mr. Gerra gave you a condensed version of it. My presentation aims to inspire you to show you how these things are possible.

Let’s start with prevention. We all know the standards, we are in the process of updating these. More than 30 member states have sent word that they were going to participate in this process. The standards that have the highest rates of success include brief intervention, early intervention in schools, etc. Working with parents to be better parents is possible. We have successfully implementing these programmes in more than 20 countries, sometimes in difficult economic situations. This is a testimonial from a grandmother in Central America and elsewhere. We’re really proud of what we’ve achieved with these programmes. We’re trying to develop a new family-based programme in resource poor settings and we hope everybody can join.

Going back to education. Here we don’t really have an issue of coverage. More than 56% of member states continue to not report to us, but for those who respond, 92% report life-skills education. The issue here is not coverage, it is quality (interactive, structured sessions, with well-trained facilitators, using practice coping and decision making skills, etc.). Coverage of evidence-based prevention is much lower then. We are active in at least 5 countries and these are the results of our work in South East Europe. Prevalence of life-time use of cannabis and last month use did not change much for those countries where we acted, whereas in countries where we were not active, rates doubled or tripled.

I now want to move to treatment – the outcome document has amazing provisions on this, starting with drug use disorders defined as complex and multifactorial, need for outreach and overdose prevention, non-discriminatory access, ensuring quality, need for coordination of services, access for women and girls, and links to UNODC and WHO standards. There is something that is very easy for governments to do  to ensure quality – through accreditation and support by UNODC. I hope you will all join in here, it is low cost and has great impact. We need to ensure healthcare, social support and the involvement of people who use drugs. We need to see take-home naloxone everywhere. There is also a need to start developing treatment within a wider health system. This should include psychological and psychosocial services, and greater attention to community-based, outpatient services. You want to reach as many patients as possible. In Senegal, we’ve opened an outpatient service with methadone. With UNODC and WHO programmes, we have been able to improve treatment services for 45,000 patients, more or less. This is not much if you take into account all those in need of treatment. Especially for women, we are not doing well. We know that the coverage of treatment is one of the two indicators chosen by the statistical commission to track success. We do need to start using our existing resources to improve quality. We will ultimately need to increase resources to go to scale.

To conclude, we still have a lot to do, but it is worth it and evidence based prevention and treatment can really save lives. If we can help in a particular way, please get in touch.

Post-UNGASS Facilitator. WHO is not here today, but they have their executive board meeting today and it was impossible for them to come to Vienna, but they send their best wishes and expressed their wish to continue working with CND on this matter.

Malta, on behalf of the European Union.

Chair,

The European Union and its Member States wish to thank you once again for organising this intersessional meeting in which we can share our views in reply to the three suggestions put forward by yourself as the CND facilitator for post UNGASS matters at the reconvened 59th session that covered the thematic discussions on the UNGASS follow-up in October, between the 10—11th and then again between the 27—28th October.

In regard to items 44 to 46 of your remarks, which in effect are a proposal for a way forward, the EU and its Member States fully support the three recommendations pertaining to:

  • action that could be taken by the CND to support Member States in the implementation of the UNGASS operational recommendations;
  • reviewing the work of the UN subsidiary bodies in order that they are able to better support the implementation of operational recommendations of the outcome document at regional level;
  • strengthening the use of the CND post-UNGASS website.

The EU and its Member States consider that the CND should examine how its subsidiary bodies can better contribute to the implementation of the UNGASS outcome document, including through the regular exchange of information, good practices and lessons learned among national practitioners from different fields. We should also consider additional measures to further facilitate meaningful discussion among those practitioners. The EU and its Member States also welcome the fact that already a few additional working groups dealing with children and youth, gender issues and access to controlled substances had been created in this context following the UNGASS outcome.

UNGASS tasked the CND to strengthen coordination with other relevant UN bodies. In this context the EU and its Member States would welcome the organisation of joint CND events with the World Health Assembly as well as the organisation of coordination meetings with UNODC, WHO and UNAIDS, as the most appropriate partners, which would allow us to keep the focus on public health issues in drug policies so as to achieve truly balanced drug policies, as we were mandated by UNGASS. The EU welcomes the initiative of developing a memorandum of understanding between UNODC and WHO to establish a renewed and more complete framework of collaboration in promoting the public health approach to drug policy.

In line with these three recommendations to move the process forward, the EU and its Member States, would in relation to the first chapter of the UNGASS outcome document, (that of demand reduction), suggest that the CND, in its efforts to further the effectiveness and impact of interventions in the field of demand reduction, advocate fully for the use of internationally recognised standards as have been recently developed by the UNODC and then monitor the outcomes of the use of the said standards. These are programmes which seek, for example, to reduce drug use in the first place or delay its onset. 

In so strengthening the measures under demand reduction, that in part address the world drug problem, that include prevention, early detection and intervention, treatment, risk and harm reduction, rehabilitation, social re-integration and recovery, the CND keeps itself appropriately updated so that it can provide, through its portal, the most recent and updated information to better enable countries to implement the   operational recommendation of the UNGASS outcome document. Thus the EU and its Member States fully support promoting the use of the CND post-UNGASS website which can function as a platform for the exchanges of the ideas and best practises as regards the implementation of the UNGASS outcome document. The European Monitoring Centre for Drugs and Drug Addiction’s “Best practice portal” is a good example of the successful online information sharing on best practises in different fields, including in the field of drug demand and risk and harm reduction.

Chair,

We stand ready to closely cooperate with the CND to provide information related to the standards and best practices currently in use. We also stand ready to share our experience and our best practices, which we presented in more detail at the previous intersessional meetings but may be made available through the CND portal.

Finally we also recommend that the CND keeps abreast with latest developments with regard the indicators to be put in use to measure the SDG in which it appears that under Goal 3, ensure healthy lives and promote well-being for all at all ages, and 3.5 strengthen prevention and treatment of substance abuse, the indicator suggested is that related to the coverage of treatment as has been proposed by the inter-agency and expert group on the sustainable development goal indicators.

Thank you, Chair.

Russia. Time has come to implement the UNGASS outcome document. Our mission is not the main intellectual force behind the outcome document, but also its implementation. We aim at reducing demand for drugs, including via prevention and treatment. Among the recommendations, we have the implementation of evidence based prevention measures. My delegation submitted a proposal to the CND, on the development of a scientific network through which the scientific community will be able to develop scientific measures for reducing demand and for prevention and treatment. We support the work of UNODC in updating the international standards of drug use prevention, including with a new thematic section on prevention of NPS and new technologies. We hope WHO will make its contribution to develop a drug prevention best practice guide. We should organise special segments and special programmes on prevention targeted at special groups. We must develop mechanisms and social partnerships among specialised bodies, practitioners and NGOs. Focus should be on developing methodologies for preventing drug use. We should coordinate global efforts to enhance access to and quality of treatment. We hope that the scientific community will develop scientific solutions to improve diagnosing and treating patients. We must improve training systems for law enforcement.

Peru. I thank you for your work in chairing this session and the Secretariat for its work. First, it’s important for CND to address implementation of UNGASS issues as a supplement of what we already have. It’s necessary for CND and UNODC as well as the INCB among other bodies to be called upon implementation, according to respective mandates. Peru is seeking to improve access to care and rehabilitation for drug abusing individuals. We will promote quality of treatment services and therapeutic communities. Along these lines, to work effectively, the international community and UNODC and CND should pay attention to persons who have substance abuse issues, for early detection, treatment, care and recovery. We will need mechanisms for exchanging best practice to ensure quality of treatment. We must also focus on therapeutic aspects.

Norway. We’re grateful for your work. We look forward to presenting forward-looking ideas. We support the need to strengthen the post-UNGASS website. Coherent actions should be in place. Effective prevention takes more than good intensions. it needs adequate resourcing. We support the development of international prevention standards and are contributing to its update. This is an excellent example of how to provide the best available guidelines and tools and stick to them. There are other standards for best practices such as treatment, OST and overdose prevention within the UN. Norway supports strengthening of cooperation between CND and other bodies, especially WHO and UNAIDS. We also support UNODC’s cooperation with other UN entities and welcome a MoU between UNODC and WHO. Finally, we reiterate the importance of effective prevention, health protection, especially among children and youth. The SDGs provide a framework to tackle poverty and health. The SDGs also provide targets to measure progress. The time is right for CND to create indicators to track drug control success and the SDGs. We should deliver mostly on SDG 3 and 5, but also SDG 1 and 10. Drug control is about saving lives.

Colombia. I would like to refer to some general aspects having to do to UNGASS and the follow up, and make comments on operational recommendations on demand reduction. In Colombia, the follow up sessions from last year were very useful. The resolution calling on CND to continue these discussions on the outcome document should be used to put together a regular mechanism in this regard, with 7 working groups focusing on the implementation of each of the 7 thematic chapters of the UNGASS. They should also provide information on topical aspects and items to be achieved. This needs to be on the agenda of all the bodies, as was done by the 2009 Political Declaration. Colombia will make recommendations at each session as to what CND could do in connection with the 7 pillars of what should underpin drug policy.

On demand reduction, I wish to say the following. The UNGASS outcome document and omnibus resolution point to better consistency within the UN drug control system, to ensure cooperation with all specialised UN agencies so that countries are better prepared to respond to concrete health challenges and provide technical assistance to countries that so desire to base this on the UNGASS outcome document and achieve the SDGs. We recommend that CND establishes guidelines to bring about better coordination between our part of the activities and WHO setting up programmes for the purpose of supporting states to better implement UNGASS recommendations for health purposes. In a special manner as to gather information and disseminate good practice for prevention and treatment, especially for youth, women, children, and eliminating stigma and discrimination to facilitate access for people with particular problems. We should be prepared to improve coverage in treatment, rehabilitation and harm reduction, increase training for staff, increase access for people in custody and prisons. WHO and others should regularly share joint activities.

Mexico. I want to focus on how best to coordinate our efforts to implement the UNGASS outcome document. It is of the essence for me to have this exchange of national experiences and do so in a full fledged action-oriented manner. At the 60th session, we will come forward with he Mexican experience in organising national dialogues for UNGASS implementation. We should bring forward the experiences and good practices gathered by groups like CICAD and the Pompidou Group. Experiences from other regions would also be important to share. We also need the experience of other UN bodies. We will seek the CND and follow up to the omnibus resolution calling on specialised agencies in the UN to turn the operational recommendations in line with their mandate into actions with UNODC and INCB and inform them of results achieved. The CND in March will be an excellent occasion to assess how subsidiaries will be able to make a contribution to the implementation of the outcome document to reflect cross-cutting issues from the UNGASS outcome document.

Argentina. Thank you for your presentations. We need to reinforce coordination and consistency throughout the system. Your presence in New York and here are important steps in the right direction to have consistency. There are no misunderstandings in terms of what is being done here. We fully support this approach. As we did in our national capacity, we want to contribute here on the outcome document. Along these liens, I want to point out that we have redoubled our political efforts to counter the world drug problem since September. We inaugurated a national programme of an Argentina free from drug trafficking via prevention and an integrated approach. We’ve set up a national drug council to improve and bolster interaction between government authorities at all levels, in line with the outcome document. In line with this as well, the prevention secretariat for drug abuse in Argentina changed its title, reflecting a shift in the spirit of how we approach drugs. It is now a full fledged drug policy secretariat. The change is obvious. We have declared a national emergency to address drugs until 2018 including prevention and social inclusion. SEDRONAR is preparing programmes to come to grips with this emergency. We have preventive and integrated approaches in place within SEDRONAR, we have ‘Municipios en action’ and an orientation centre that provides advice to communities. It is a topic envisaged in item 1 of the outcome document. We have territorial coverage for this and we have stepped up the campaign for the summer. There are thousands of young people on vacation at that time, and it is when we have chosen to intensify our efforts. We have special staff there with emphasis on young people. The labour ministry has two programmes underway – drug consumption avoidance in the labour context, the social and labour reactivation programmes, early action programmes in place on drugs, especially NPS and new consumption patterns to reduce impacts on health. Focusing on items 2 and 5, we will implement the recommendations on precursors and pre-precursors. We will disseminate all this information at the upcoming CND.

Chile. In the UNGASS debates, we took a commitment in relation to drug control. Our purpose and tools we have in place to do so is to contribute to the health of mankind. We are using the following guidelines to balance supply and demand, international cooperation, provide a human rights perspective and prioritise the public health approach including prevention and rehabilitation, as well as sustainable societies. We wish to design policies with a gender approach so the service for the prevention of drug dependence and alcohol dependence has sought to design programmes to rehabilitate women. At this point in time, the body is preparing a programme entitled ‘drug-free summertime’. We’re now enjoying the summer break right now, as is the case in Argentina, and people are partying. We would like to reinforce the efforts by parents with youth to lower the likelihood of drug consumption. At the domestic level, the Chilean Ministry is coordinating an interdisciplinary group on drugs issues. We’ve brought on board the recommendations of the UNGASS outcome document. We are addressing specific responsibilities for different working groups to identify shortcomings and come up with solutions. We’re also developing a roadmap to fully implement the UNGASS outcome document. We’re working on cooperation at bilateral, regional and international level to give prominence to the UNGASS. At the end of January, we will have a meeting Chile/Bolivia to discuss drug control between the two countries (border control in particular). We have similar programmes with Argentina and Peru. Having in mind our commitments from uNGASS, we must consolidate present mechanisms to avoid duplication and bolster synergies. The UNGASS outcome document is an excellent basis for discussion. We must also focus on the 2009 political declaration and 2014 Joint Ministerial Statement.

Fabienne Hariga, UNODC HIV/AIDS Section. Here i will focus on funding for HIV and PWUD. The UNGASS outcome document reiterates the commitment to end AIDS by 2030. The targets in the SDGs is a 90% reduction by 2030. We’ve missed the target in 2015. Drastic efforts will need to be made. We need to best use available funding to have the best possible health impact with better allocation, not necessarily with new funding. We need to invest in priority interventions to implement the comprehensive package of 9 interventions of the UNODC/UNAIDS/WHO. NSPs and OST are numbers 1 and 2. I want to show an example of how to increase efficiency in allocation of HIV funding, with an example of Belarus – it has an HIV epidemic among PWUD, and distributed 20 million USD invested in NSPs in 2014. World Bank analysis optimised allocation of funding and advised for an increase in funding towards services for PWUD and reduce funding on management. The last column shows how Belarus reallocated funding based on these recommendations. The results of this funding allocation are as follows: a reduction in new HIV infections: 26% were averted, 1,800 deaths will be averted by 2018, just thanks to this funding allocation.

In line with SDG 3, we need to integrate HIV services for PWUD within health coverage, and this will reduce the cost of the services. Here I go back to the example of Belarus, with funding that will enable it to reach its 2030 target. Another study shows how to reduce the costs of drug treatment in Eurasia. Variations in costs focus on lack of economies of scale. The way methadone is procured can also reduce costs of treatment. Also important is the implementation efficiency. Services should be available and also accessible to have a good return on investment.

Justice and prison legislation and practices, also have a massive impact. People will not go to OST, ART, NSPs if they are a target of the police. Reaching zero new infections means that a large number of PWUD should be able to access NSP, OST and HIV testing and counselling. It’s critical to have supportive laws and policies, as well as community mobilisation and engagement. To increase efficiency, we must identify where the breaking points in access.

To conclude, we wanted to highlight the tools to better fund the operationalisation of the implementation of the UNGASS outcome document to address the HIV epidemic among PWUD with NSP, OST and ART. We focused on efficiency, versus austerity, with examples showing that reallocation of funding is possible. We must implement efficiently.

Katherine Pettus, VNGOC. We represent over 200 organisations working on the ground in communities. What you will hear from the different NGOs here is a wide spectrum of views. We do not have a particular line, we represent our member organisations on the ground. We would like to serve as a resource for you, member states, to help you implement the outcome document and interface with the SDGs agenda. We will ask all of our members in the next few years to adopt one of the targets and make that their own, and see how they can work towards achieving those targets. Thank you.

Nicolas Vako, UNICO, Ivory Coast. We are a network of 40 NGOs based in Ivory Coast. Our network works on HIV and we are trying to learn how to work together with drug users. Our focus is a balanced approach, shared responsibility, proportionality and the upholding of human rights. We see the challenge that we face as two levels of difficulties. We first work on prevention, working with drug users to help them reintegrate with communities. We also work with harm reduction among young people, focusing on OST. We have a double fight here: access to OST and access to essential medicines. In Ivory Coast, we are trying to develop centres where PWUD can come and use less potent drugs so as to reduce the impact of the drugs on their health. This is a major challenge as OST is not yet permitted in the law in Ivory Coast. We are also told that the problem is the risk of unsupervised use. Together with yourselves, we want to maintain the momentum we have created. We must have standardised approaches from country to country so that, in every country, we can move towards achieving the goals we have set ourselves.

Canada. As my delegation has explained before, we are experiencing a growing opioid crisis. In November 2016, our Minister cohosted a series of meetings with the release of a joint statement to address the crisis. Through this statement of action, we’re implementing an opioid action plan – better information on risks, better prescribing, reducing access, supporting better treatment options, improving evidence, and reducing availability and harms. Our actions are guided to a commitment to drug policy that is compassionate and evidence based. The new Canadian drugs and substances strategies will fully restore harm reduction as a full pillar of drug policy. It will better enable the government to better address the opioid crisis, including via supervised safe injection sites and naloxone access. The policy will be supported by amendments in laws and acts. These are still subject to adoption by the Parliament, including for supervised injection sites, removing an exception from opening small male packages including controlled groups, supporting the safer disposal of seized chemicals and substances. These policies should all be based on evidence, to better identify trends and target interventions with evidence based decisions. The CND is aware that Canada is supportive of the UNGASS outcome document as the UNGASS reoriented the international community towards human rights and health. The challenge now is to ensure implementation is going ahead. We commend you for your efforts at CND. We support more forward reporting. CND is well placed to produce formal reports every two years on the UNGASS progress, and the report should focus on each of the 7 thematic chapters of the document.

The Netherlands' representative highlighted the importance of developing relevant indicators of success in line with the recommendations of the UNGASS Outcome Document.
The Netherlands’ representative highlighted the importance of developing relevant indicators of success in line with the recommendations of the UNGASS Outcome Document.

Netherlands. We associate with the EU statement. I’ve stated many times before, the Dutch policy is based on a balanced approach. We consider demand reduction as a broad public health concept with prevention, early detection, treatment and harm reduction. We made a significant step with UNGASS towards balanced policy and now have a clear way forward. CND has a key role for monitoring implementation. In the Netherlands, a clear set of indicators is a key aspect. This principle should be key for UNGASS implementation. CND can play a leading role if it has meaningful data and statistics to follow up on UNGASS implementation. We should look at current indicators and align new ones with the outcome document and the SDGs. We welcome UN interagency cooperation to achieve common UNGASS commitments. Our delegation welcomed the joint event between CND and the CSW. We should have more frequent events as this one with respective governing bodies. It is important to coordinate our efforts, we must be innovative. UNODC and WHO can work together very effectively. A number of joint initiatives already exist. Last year, a combined report was established on standards for treatment services. We believe that we can expand more on this example of excellent cooperation. We must expand our knowledge and propose to have more regular updates on interagency cooperation within CND. We appreciate efforts how the UNGASS outcomes can be better implemented. We welcome the commitment in the omnibus resolution to better assess implementation. We look forward to discussions during the next CND meeting.

Ecuador. We welcome the work carried out in the form of interactions with states, CSOs and the secretariat on this matter. We ensure these interests and the protection fo human rights come first. The promotion of human rights and the environment are a priority. The ultimate purpose is to ensure the safety of health and promotion of human rights, in keeping with the spirit to safeguard human rights in the context of the drug control conventions with full compliance with the sovereignty of states. We give significance to this and it is the focus of drug policy in my country. We have a community and family approach to public health, recreational activities and in universities. The technical secretariat for drugs and the Ministry of Education and the Statistical Institute are planning a national call on drug prevention at school, to study drug use trends and everything associated with this issue among the urban population. We had samples selected by INEC and 23 cities were selected for this study. We will have inputs from our provincial governments, we will have cooperation agreements, there are inter-school programmes applied to leisure time. These policies are to be seen within the broader context of overall prevention programmes in the country. This is an inter institutional approach, with committees all coordinated on drug related issues. This has integrated measures being implemented to prevent drug use.

We recommend, for the 60th CND, the provision of more technical assistance to include relevant players more, and sustained programmes to implement the specific chapter of the UNGASS on demand reduction – with the establishment of 7 working groups to reinforce public policies. We are in favour of close coordination with relevant organisations including WHO, UNPD, UN Women, UNAIDS, OHCHR, etc.

Indonesia. We have continued to adopt and implement international standards for prevention, rehabilitation and aftercare to achieve a society free of drug abuse and promote a healthy society. In the area of cooperation, Indonesia has developed books from kindergarten to high school for education and prevention. The books have been posted on the ASEAN narco website and been recognised as best practice by ASEAN member states. We also promote treatment in particular for women and youth. We have undertaken measures to ensure effectiveness of after-care programmes, using applicable international standards. This is not to only cure addiction but also to integrate drug users in society. Based on our experience, we believe that the implementation of the UNGASS outcome document should be implemented in an integrated and balanced manner taking into account the capacities of each member states. We also believe that these recommendations should be implemented in accordance with national legislation and within the UN drug control conventions.

Portugal. We align our statement with that of the EU. Let me address first some issues common to all 7 chapters to carry out implementation. The UNGASS gave a positive contribution to the improvement of our collective responses to drugs. It reflects the most recent consensus. But it was not meant to capture consensus only. The time has come to adapt our activities to the new framework of UNGASS. We don’t have to start from zero. The outcome document incorporates many good practices form states and organisations. Our tasks should be to correct shortcomings and preserve evidence based measures and build upon them. The document also covers experimentation which we should build upon, and provide data. We should provide data for CND to explore those options. The outcome document is our present and future. It will come a time when it becomes our past and when we can move beyond and improve it, it is the nature of our multilateral dialogue. But I dare say that this is still far from us and we must concentrate in the implementation of the UNGASS outcomes. This part is not evident, it requires a conscious effort, extending beyond 2019. The SDGs have also set a framework towards 2030. We must link the implementation of the UNGASS outcome document with that of the SDGs to ensure a coherent approach. CND and UNODC should lead in this effort. But Vienna will only be relevant if it continues to liaise with other UN agencies. The 60th CND will be the right time to consolidate options. As we lean towards 2019, we should not contribute to a fragmentation of drug control and its implementation.

Now focusing on demand reduction, activities should progressively focusing on public health and favouring treatment and care over punishment. UNODC and CND in cooperation with other relevant partners such as WHO, UNAIDS and INCB should give their contributions towards promoting risk and harm reduction and disseminate knowledge and research on the positive impacts of alternatives to punishment for PWUD.

China. China believes that the UNGASS outcome document, the 2009 political declaration and the 2014 Joint Ministerial Statement are complimentary and integrated. The most recent consensus on drugs issues should be implemented in a comprehensive manner. The objective of the 2009 political declaration are far from realised. The CND and UNODC should continue to counter the world drug problem via the 3 drug conventions and a comprehensive approach. Equal importance should be placed in demand reduction, supply reduction and international cooperation. We have the following comments to make. The CND and UNODC should take drug prevention as an essential means to address the world drug problem from the root. Prevention is the most cost effective. UNODC should assist countries in carrying out targeted prevention education focusing on high risk groups such as youth to make them deeply conscious of harms. China supports updating international drug prevention standards and has offered experts to UNODC in the consultation process. We expert the new version of standards to give better guidance on education. We support the efforts of UNODC and WHO to explore scientific addiction treatment and recovery models. Treatment and rehabilitation are important, but we are against regarding drug taking as a symptom of health, addicts are at once victims and criminals, and should be sanctioned and taken care of and helped by the government and families and societies. Both sides are indispensable and complimentary. China is implementing management of drug users, including community based services. Government agencies assume different responsibilities covering all aspects such as routine monitoring, medical service, post treatment care and rehab. These measures have yielded good results. Voluntary treatment should be encouraged. However, under specific circumstances mandatory treatment is indispensable. Voluntary treatment with informed consent yields better results. But we should realise the negative impacts of use on families and communities and the necessity of mandatory treatment for relapsed drug users. We have also improved treatment facilities to ensure effectiveness. We hope that UN bodies concerned are better informed of laws and regulations of specific countries and support diversified attempts at addiction treatment.

Louise van Deth, AIDS Fonds. We are a Dutch organisation working in many countries, with evidence driven programmes in and with the community. We work on HIV and AIDS and are talking about the end of AIDS by 2030. But this is only possible if we are focusing on the immediate years ahead of us, with many things that need to happen. One of those is decriminalisation of drug use. Fear of imprisonment and human rights abuses will force people to share unsterile equipment making them more vulnerable to HIV. It is a matter of more money, but also of political will. Effects are clear: 30 million people inject drugs worldwide, and so many are infected with HIV. In the Netherlands, harms eduction has been part of drug policy since the 1980s and has prevented many infections. We have a comprehensive approach to addressing human rights and social challenges. We work through in country projects in Eastern Europe and the rest of the world. I was recently in Eastern Europe and met many people. We realised we often meet children, ex drug users whose goals in life are to become sports players thanks to the community centres they are going to. Current international agreements justify the criminalisation of drug use, increase HIV and hep C infections, and many die. POssession of clean needles is also criminalised. This is affecting the health of PWUD and fuels epidemics. PWUD face obstacles when accessing healthcare. Decriminalisation of drug use will facilitate access to healthcare, improve public safety. We must include human rights of people who use drugs. Human rights violations are most severe among PWUD, forced to live on the fringes of society, with unacceptably high risks of contracting HIV. PWUD like all citizens have the right to receive care, support and protection. Harm reduction should be part of the drug response budget. Harm reduction interventions are inexpensive and reduce costs considerably. It is a matter of political will.

Panama. We must work on prevention programmes with parents and children. We have other programmes with the ministry of security. ‘Safe Barrios’ is one of these programmes to prevent crime and trafficking in narcotic drugs. The programme gives preventive attention to all the institutions of the state that should come on board together with the communities affected by high crime rates. Safe Barrios covers all these high risk neighbourhoods, via law enforcement, job opportunities, trainings, exercises, workshops, problem solving, respect for individuals, etc. Over the years we have reduced by about 10% crime rates. Our ministry is involved in primary prevention as well. Youth are the future of the country after all. We privilege sports and leisure activities. We work together with civil society to implement many of these programmes.

United States. We agree with UNODC that prevention and treatment should get special attention. The international standards on prevention and treatment are good examples of how UN agencies can pool their expertise. The CND should do all possible to encourage this cooperation on all drug policy matters. We welcome the work of CND to extend invitation to other agencies such as WHO in intercessional meetings. We look forward to extending this as regular practice. The USA recommends that CND provide all relevant UN entities including WHO a roadmap on how to keep CND informed about UNGASS implementation. The CND should reach out to other UN entities. Finally, I want to express our support for the establishment of an MoU between UNODC and WHO to facilitate future work.

Romania. We align with the EU statement. I want to make some remarks. In matters of precursors, we fulfil the provisions we participate in a number of projects to avoid the diversion of precursors. We also participate in European legislation in this matter to prevent diversion of controlled medicines, and monitor substances classified in new EU legislation. We have implemented the guide of cooperation with industry with cooperation agreements. On demand reduction, the recommendations of the outcome document have been included in the new drug strategy adopted in 2016. The anti-drug agency has organised several campaigns on prevention at national and local levels on the dangers of drugs. The campaign is conducted in schools and communities. The agency has implemented programmes such as early intervention targeting groups at risk. We focus on internet and online platforms including social networks. To consolidate the cooperation with the national coordinator on the implementation of drug policies and law enforcement and ministry of justice, penitentiary, we have adopted a number of protocols.

Sweden. We align with the EU statement. The expectations for a health perspective have increased during the UNGASS. Agenda 2030 and the SDGs also show commitment to a public health approach. International cooperation between different UN agencies is key. We welcome ongoing cooperation. A MoU between UNODC and WHO would play an important role for improved cooperation and contribute to the operationalisation of the UNGASS outcome document.

Pakistan. We are pleased to know that the implementation of the UNGASS continues to be a priority. We want to present a few developments of relevance since October. Recently, Pakistan has finalised with UNODC is new country programme. One sub-programme is on demand reduction and we look forward to implementing this programme. The outcome document rightly emphasises the need for data collection. We are planning a fresh drug use survey across the country, with a focus on drug use among youth. We also want to assess drug trafficking and its impacts. We will focus on treatment and rehabilitation facilities, strengthen partnerships with UNODC and CSOs. We expect UNODC to support efforts for prevention and treatment. Implementation of operational recommendations set up in the 2009 political declaration is also an ongoing process. CND should continue to play its leading role in this regard, so that all three documents from 2009, 2014 and 2016 are treated as a whole. We should continue to promote a society free of drug abuse. There are still many gaps in implementation and we should continue to address those gaps with support from CND and UNODC. CND should continue to promote international cooperation, with special attention placed on transit and producing countries. What is really needed now is more action. The CND should play a more active role. There are 19 specific operational recommendations, we should hear more about the CND on how to implement those operational recommendations and what fresh science is required to do so.

Malaysia. The outcome document is a clear commitment to address the world drug problem, collectively and in solidarity. We reiterate our goal of creating a drug-free Malaysia. We focus on eliminating demand and supply, via prevention strategies. We implemented 3 categories of prevention activities: Information sharing, school based programmes and raising awareness among the community. In Feb 2016, a national anti-drugs strategy was adopted to stress the need to address the drugs issue among different ministries. We focused on prevention and promoting healthy lifestyles. We have transformed 262 hotspots of drug users into healthy communities. We educate children to reject drug use. Turning to treatment, our national anti-drugs agency has stepped up efforts for treatment, focusing on abstinence and reintegration as drug-free individuals. We have also increased the capacity of cure and care vocational centres. We underline that the existing international drug control conventions are the cornerstone of drug control and we support the role of the CND as the central policy making body in drugs. We want to promote 3 steps: build more coordinated efforts and other UN agencies to build positive momentum for implementation of the outcome document via different target groups; more regular cooperation between CND and other UN entities via informal or specific working groups coordinated by CND to identify measures to contribute to capacity building for member states; development of a more comprehensive database for information sharing (including online training, statistics from clients who benefited from treatment) to share best practice.

Thailand. The world drug problem continues to pose a threat worldwide. We must promote judicial cooperation and counter money-laundering. This requires more efforts from all countries. We should focus on targeting new trafficking routes and trends, including of NPS which are not internationally controlled. We also see as a challenge precursor trafficking, online markets, etc. We are committed to an interdisciplinary, balanced approach with international and regional cooperation. We support the mandate of the CND as the central policy making body of the UN on international drug control and its work in coordinating international efforts in line with the 3 drug conventions. Thailand welcomes the adoption of the outcome document which contains recommendations to address multiple cross cutting dimensions of the world drug problem. The UNGASS was an important milestone of progress of member states since 2009. Addressing illicit trafficking in precursors in the Golden Triangle is one of our priorities. A joint cooperation in the Mekong subregion is also a priority and was established to stop illicit flows of drugs and precursor chemicals. This has yielded positive results. Finally, we are in the process of reviewing our drug laws which include alternatives to punishment for certain drug offenders.

Subhan Hamonangan, Rumah Cemara. My name is Subhan Panjaitan, the advocacy officer at RUMAH CEMARA, a community based organization in Indonesia, working in Drugs and HIV-AIDS Prevention, Treatment and Advocacy. I will take this opportunity to share our operational recommendation to the Joint Commitment to Effectively address and counter the world drug problem. First of all, I would like to appreciate International forum and especially Indonesian Government who has already done the progress to work the drugs policy related to rehabilitation program so well. I believe, that we have the same goals to do the best for a better human being today and in a future. However, working directly with people directly affected with drugs on a daily basis, gives us an edge in compiling and analyzing the needs of these communities. Thus, herewith are the additional points needed in the operational recommendations. These points are measurable and can be monitored on a regular basis by both the Government and/or the Community. They are as follows:

  1. Improving the quality of evidence-based treatment services (government or community managed). The quality services include: (1) Competent human resources, (2) Evidence based methods; and also (3) implementing the values and professional ethics.
  2. Evaluation on drugs policies and regulations based on effectiveness and implementation as well as the public understanding of these policies.
  3. The active participation of communities in planning, strategic decision making forum, implementation and monitoring evaluation in rehabilitation programs.
  4. Encourage the Government and Communities to synchronize the perception of the definition of substance use disorder, as a chronic relapsing disease. And to consistently internalize this definition into international and national policies, thus increasing access to health services and minimizing the negative impact of substances use disorder. This is important as Indonesia’s progress in increasing universal access to health, including drugs users has been hampered by state supported raids and continued criminalizing towards people who use drugs.
  5. To minimize the miscommunication and mis-coordination between stakeholders and government agencies by applying a one gate policy in handling of drugs treatment. Therefore, it is important to strengthen treatment services as a comprehensive service and not as separated partial services spread throughout agencies.

Candelaria Aráoz Falcón, Intercambios. We’ve worked for 20 years in Argentina in drug policy. First, states should reconsider their investment priorities to cover the funding of social and health services. Item 1o of the document of the UNAGSS refers to the commitment to take measures to address the consequences of drug abuse. harm reduction was removed from the document – this shows the lack of prominence of these policies globally. The document does invite authorities to assist states with OST and prevent the transmission of blood borne diseases, but this also should mention harm reduction. In Latin America, because of the absence of harm reduction in the 1990s we have seen a whole generation die. 30 years later we still see this happening. We must move away from criminalisation. There was a rave party last year in Argentina, where 5 people lost their lives because of an absence of regulatory framework. The governments and UN need to promote harm reduction. This can include NSPs. In several countries of the region we have experiences in providing harm reduction. We wonder how many people must lose their lives before we take action.

Post-UNGASS facilitator. Thanks to you all for your valuable contributions. We had hoped wed wouldn’t have that many interventions on this second round but it seems like this is not the case! We thought we would start on the second chapter now but this will be done in the afternoon. There were also good interventions on the follow up process in general which was very positive. We will start again at 3pm on Chapter 2.

2 comments

  1. Bangyuan Wang says:

    I am very suprised to see China’s blog. I hope it is now written by the delegation colleagues or someone from the ministry. People who use drugs in China are not criminals by law. Drug use is an legal offence, but it is NOT against the criminal law (xingfa, 刑法) and therefore are only offence against the law (weifa, 违法), not criminals (fanzui, 犯罪). There are big difference in these terms.

    • marienougier says:

      Hi, these are notes taken from the statement delivered by China today, so there might have been a problem with the translation, but this is what we noted when the Chinese delegate spoke…

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