Committee of the Whole (Thursday Afternoon) – Resolution L11. Removing stigma as a barrier to the availability and delivery of health, case and social services for people who use drugs

L11

Chair: We may not move in chronological order. I want to mention I intend to continue our session in the evening because we have very little time left. I invite us to focus on L11.

China: Regarding the night session we have some concerns because we have many experts who wish to speak in their own mother tongue. If we have a night session our ability to attend will be undermined.

Chair: That concern is understood and I know many delegations are uncomfortable in the official language, but we have a lot of work we have to complete in the timeframe. I ask delegations to bear with the chair.

Canada: We are presenting a draft resolution with Uruguay. I would like to thank our co-sponsors. We have achieved some progress but there is work ahead of us.

Chair: The title.

Russia: I have something I would like to share with you. I have instructions from our government to make the following statement about the draft resolution on alleged stigma. In our country we do not have the concept of stigmatisation, we do not understand what it is or what is being referred to. We can guess it is a trait belonging to saintly people but unfortunately, we cannot say that drug users fall into that category or that drug addiction is in that category either. Attempts to make this part of the resolution is something that we interpret as aspiration to impart to drug addicts a new status or quality. To impart drug addicts with an immunity to criticism levied against them. The end purpose of this concept is actually to permeate people’s consciousness that awareness that addiction is normal. It is standard. Use of heroin is the same sort of thing as quaffing a glass of beer. If the international community would agree on the concept of stigma, this would restrict our potential elbow room to prevent drug addiction from arising. In taking appropriate measures to prevent drug addiction. The very idea on which L11 is based in contradictory to the very approach of treating drug addiction as a syndrome as a work of principle. We will not be able to support this resolution in the COW or in the plenary.

Canada: I invite other delegates not understanding stigmatisation to read the draft resolution or the agreed language in many other UN agreed documents, including CND resolutions from the 57th session, the UNGASS document and the 2009 plan of action. Stigmatisation and stigma have been included. I believe we have engaged transparently with all delegations and I suggest we continue with the concerns of Russia noted.

Chair: I request the delegations to air the views of the title.

Australia: It is not my place to argue Russia’s responses but I would like to give a couple of illustrations of what stigmatisation is. In relation to mental health it has been recognised that stigma reduces the likelihood of individuals coming forward for treating. The intention for users of drugs is exactly the same. For mental health it was to ensure proper access to high quality treatment. The intention is not to normalise drug use or suggest that people continue with problematic use. IT is to ensure that more people want to access treatment and able to access it. It is the exact opposite of normalisation or encouragement.

Chair: With those remarks made I invite the committee to look at the title of the text as we begin.

China: We listened to the previous statements. It is very clear that the fundamental question regarding the resolution and whether it is necessary to have it. There are still varied opinions which are fundamental. I highly doubt we will make any progress on the adoption of the resolution. I agree with your proposal that we should utilise the session. We hope that Canada can hold more informal consultation. Maybe we can discuss another resolution now?

Chair: Canada any response?

Canada: All 3 delegations who have taken the floor have had several opportunities to express their views. The importance of the COW is partly to give smaller delegations to weigh in on resolutions. I know during informal discussions that the title should match the content and as China noted there are still some ways to go until the text is agreed. Perhaps we could begin with PP3?

Uruguay: Given the work we have been doing, including those currently present delegations we would like to proceed with the analysis of this resolution as Canada said. During the informals these delegations highlighted their issues with the term and subsequently we would work on the term.

Iran: I want to echo the sentiments of Russia.

Chair: I suggest we start with PP1.

Iran: To keep in line with UNGASS 2016 we would like to add ‘countering’ before addressing on the first line.

Pakistan: Include ‘and’ before countering.

Czech Republic: We would like to propose an amendment. We should not talk about drug abuse when we are considering a resolution on stigmatisation. Drug abuse evokes stigmatisation.

China: We think we can utilise the existing text, therefore in the last line we propose that ‘can result’ can be changed to ‘resulting’ from drug abuse.

UK: I would like to echo the remarks made by the Czech Republic about the term drug use rather than abuse

Belgium: We echo the UK

New Zealand: We also prefer the term ‘use’

Sweden: We also support the term ‘use’

Netherlands: Also support ‘use’

Denmark: Also support ‘use’

Chair: I think we should leave that in square brackets and move to the next paragraph, PP2.

Canada: We learn through consultations that sticking to agreed language and I would like to point out the source of this paragraph from the CND last year.

Pakistan: We can go along with this.

Chair: Can we adopt this paragraph? Adopted. Let us move to PP3.

Canada: The note here is an alteration to the previous paragraph.

Iran: The last part of the agreed language can be used for the above one. We can use ‘resulting from the abuse of narcotic drugs’

Chair: Iran has proposed we used the language from PP1.

Canada: I think we agreed to move on from PP1.

Chair: Let us proceed to PP3. There is a note there.

Pakistan: I believe the language is simple and I would like to listen to other colleagues.

Belgium: We think the other of the 3 conventions is already reflected in the former paragraph so we propose it is deleted.

China: We believe this paragraph is very important and should be kept.

Canada: PP2 as approved contains some agreed language. This paragraph is a useful reference to the conventions. Addressing concerns that addressing stigma is part of trying to change the legal status of drug laws. We would support the delegations asking for this removal.

UK: We agree it is important to comply with the 3 conventions and that this additional paragraph is irrelevant.

Ecuador: Despite the fact that this text is surplus to the requirements and ask it to be deleted.

Chair: I suggest we bracket it and move to the next one, PP3. Any comments? Adopted. PP4.

China: We suggest the deletion of this paragraph.

Malaysia: I would like to go along with the proposal of China and we focus on PP1. Every member state has its own approach to address this issue.  We would prefer to go back to PP1.

Chair: Can we have the paragraph deleted as proposed?

Canada: I think perhaps if delegations are expressing their preference for PP1 perhaps we should consider that first.

Chair: We go to PP5.

China: We also recommend the deletion of this paragraph.

Iran: We support China to delete.

Malaysia: We also support the deletion of this paragraph.

Canada: Major objections were raised about adopting the INCB report and we reflected on this and decided this paragraph could reference the report. My next proposal is that the second set of brackets can certainly be deleted. If delegates are not comfortable with the reference we can go along with that.

China: Regards to this paragraph not only inappropriate cited the report of the INCB. We fundamentally disagree with the conclusions of this report. I do not know where they got their conclusions. In accordance with the situation in our country, we do not have this kind of situation. It is about whether we can accept the conclusion of the report.

Uruguay: I want to help developing on China’s thoughts. We cannot share further the view of China. We would propose we include ‘note’ of the existence of.

US: There has been much debate on whether to cite the INCB we would like to speak up in support of the concept it aims to raise. Being connected to a barrier to accessing services.

Egypt: The problem is not merely with the reference to the report itself. We support deletion.

Argentina: We believe this paragraph has merit and would align ourselves for it being kept as it is.

Chair: We bracket and move on.

China: This is linked to the PP5. If we deleted 5, we can agree to the retention of this para with some editing: “concerned” replaced by “noting”, and we should not use stigmatisation but instead use the word proposed by Egypt. And “people who use drugs” we are opposed to this wording and is a fundamental concern, we prefer to use the word drug abusers.

Canada: He’s right to observe that 5 is linked to 1. Some suggestions could be a way forward. If we entertain the possibility for replacing the paragraph, we would say “people who use drugs” at the end.

Austria: We could go with that.

Pakistan: We could say that “noting that stigmatising attitudes may affect”.

Cuba: We support Canada.

China: Our biggest concern regards the phrase “people who use drugs” and recommend “drug abusers” or “drug users” in line with the UNGASS outcome document.

Canada: I’m feeling optimistic. One way forward would be “attitudes affect access” and deleting “for people who use drugs”.

Iran: We go along with Pakistan, and support China.

China: we can add at the end of the paragraph after social service “in addressing and countering the drug problem”.

Canada: I don’t think we’re closer to consensus as China’s addition isn’t helpful, so maybe we can move to informal.

Pakistan: We can bracket this paragraph and find a solution.

Chair: Bracket that as well and move on to the next para.

Canada: This constitutes agreed language.

China: I still require to bracket this even if it’s agreed language, and wait until we have decided with paragraph 1.

Chair: PP6

Canada: We can take the phrase from PP1 and apply it here too. It’s not our preferred, but i the interests of moving on.

Chair: Can we approve PP1? That is agreed. Let’s move to the other one – ca we approve? It’s agreed. Now onto PP6. No objections so it is approved.

Pakistan: Are we agreeing to “people who use drugs” or “drug users”?

Canada: We’ll stick to the agreed language, “drug users”.

Chair: PP7. Adopted. PP8.

Canada: The 3rd line the “previous, recovery, USA” was in brackets.

Colombia: Add “Bilateral cooperation”

Canada: Bilateral is important and we would prefer to stick to the agreed language.

Colombia: We withdraw the proposal.

Chair: Can we adopt?

South Africa: We are willing to go with the adoption only if “ensure” is replaced with “promote”.

Canada: Checking the UNGASS text and “ensure” is correct and agreed language.

Chair: It is approved. Next is 8bis

Australia: We’d like to highlight how stigma is a barrier to housing and accommodation as well as prevention and recovery. We are flexible on our comments, also.

US: We understood 8bis as a placeholder, so with your permission I have language to present from OP1 of the UNGASS document: “Noting also the importance of prevention, early intervention, treatment, care, recovery, rehabilitation and social integration efforts for individuals with drug use disorders as components to help prevent social marginalisation and promote non-stigmatising attitudes”.

Belgium: We’d like to add “as well as initiative and measures aimed at minimising the adverse public health and social consequences of drug abuse”. And delete“for individuals with drug abuse disorders”.

Canada: Replace “drug abuse” with “drug use disorder”

China: It is not necessary to have this paragraph here and cannot support it, so delete it.

Egypt: We agree with China, if not we prefer a briefer paragraph.

Canada: I suggest to focus on the element of this paragraph based on informals: remove “treatment and care” as they are mentioned above.

US: We support Canada.

China: Can you repeat the adjustments of the paragraph?

Canada: We are acknowledging the duplication, we can delete ‘treatment’ and ‘care’

Chair: Can we move on after that explanation.

Malaysia: Can we bracket this paragraph? It could be a repetition.

Chair: We have PP9. Agreed. PP10. Approved. PP11.

Belgium: We agree but there is a slight technical issue at the end of the para, what we really mean is ‘challenges faced by those who use drugs’

Canada: Of course we agree there seems to have been an error in the typing of the text.

Chair: Can we adopt PP11?

China: We do not have comments in principles however regarding people who use drugs we should use pr agreed terminology. Based on the proposal from Malaysia, it seems like this paragraph has adopted the proposal of the US.

Egypt: We prefer the phrase drug users.

Chair: Can we approve?

Canada: In this instance based on the reference we are able to accept drug users. The UNGASS document also uses the term people who use drugs.

Chair: Can we adopt? PP11 adopted. PP12.

China: We propose the deletion of heads of state and government.

Chair: Can we adopt?

Canada: I know this wording was agreed in informals but we can be flexible in this instance.

Chair: Can we adopt it? PP12 adopted. PP13.

China: Before we discuss we propose there is a new PP. I will read ‘also acknowledging that the gradually removing of negative effects of stigmatisation towards drug users should be achieved through long-term  comprehensive and multidisciplinary efforts by member states according to their national circumstances and cultural tradition and in a way that does not undermine any legitimate and necessary measures for crime prevention and protecting public interest.’ We propose this because the so called ‘stigmatisation issue’ must consider different national cultures and conditions. One language might constitute it one country but in another country there might not be any problem or vice versa. In the same vein, while we take measures we must consider the fact they are law breakers. According to science based evidence might have potential negative impact to the society, they might even bring risks to themselves. While taking measures we must consider public acceptance and crime prevention, especially drug related. I believe that by having this proposal, the resolution has a very good balance, thus addressing a major concern of many countries. The issue of the concern of normalisation of drug using.

Canada: Thank you China. This paragraph would not be acceptable to the co-sponsors. This is brand new language. I request we bracket and postpone this for a discussion in informal. We should focus on the text already on the screen.

Chair: We have this in square brackets and we move on to the next.

China: This is the first time we have proposed this text. During informal consultations we proposed the text and we agreed we could later discuss this proposal. Are we going to check PP13?

Chair: PP13

China: We propose the deletion of this paragraph. We are not sure of the source. Regarding the 2030 SDGs I don’t think we should be selective in choosing some texts related to SDGs. We propose the deletion.

Chair: Can the committee go along with the deletion?

Canada: We are favourable of insertion of the relevant paragraphs.

Chair: I propose we bracket and move on to informals. PP14.

Canada: For transparency this is from the 59th CND resolution.

Iran: We would like to propose the changing of drug use to drug abuse.

Canada: Can we recall to our agreeing of pre agreed language. We request the original version of this document be retained.

Chair: Can we approve the text?

Belgium: We support this para but there is a word missing after gender perspective, add ‘in’

Chair: Can we approve?

China: We have no problem with the language but the text is too complicated. It is repetitive. We should not refer to resolution 59/5, not naming it. Part of the second line should be deleted.

Chair: PP14 adopted. We move to PP15. Any comments?

China: We do not think the citation of the high commissioner report is appropriate. It is not negotiated by member states and much of the content is controversial. I have read many articles critisicing the report by the high commissioner. I propose the complete deletion of the paragraph.

Canada: It is always relevant to take into account expert opinions. I understand the concerns of China and I think we should bracket the text and move on.

Chair: PP16.

Canada: After discussion in informals, there was some discussion of PP16 and PP17 being merged and I suggest we could consider that note para first and we may not need to consider 16 and 17. It is important to note our colleague from Portugal suggested this text.

Portugal: In reality during informals it was our idea to merge the two paragraphs. I would like to point out where the aspect is focuses on the other PPs. We want to say here that the reintegration into the labour market is essential for helping people who use drugs. To be encompassed it should be in resolutions.

Chair: PP18

China: this paragraph has need to exist. PLease delete.

Egypt: Agree with China. Running the risk of repeating ourselves.

Canada: We take note, so we’ll that under consideration for informals. If there are no objections, we can delete this paragraph and move onto the other OPs.

Chair: It is deleted. OP1

China: In informals some delegations pointed out that this paragraph provides a definition for stigmatisation possibly describing the situation in which the drug user is confronted. We are no sure what this paragraph achieves. Can we improve the text? Bracket for now.

Canada: It accomplishes 3 things: OP links the use of agreed language with the rest of the OPs – it provides clarity; 2 it reinforces the purpose of the resolution, to remove the effect of stigmatisation when seeking help; 3 a reference point for the further OP to encourage training, policy and cohesion.

China: For the time being the text is not clear for us. In the text if a drug user who wants to seek healthcare suffers from stigmatisation then they are seen to be suffering from discrimination. Discrimination and stigmatisation may happen due to other factors other than drug use. It is not clear enough.

Canada: We are doing our best to improve language. Looking at some suggestions: Australia suggested using the word “can” to satisfy China’s suggestion. Also a suggestion from Egypt to return to agreed language on this. Add “Member states to recognise that stigmatising attitudes can occur are manifest when a person who uses drugs…”. We’re building on existing language and evidence. I remind the room of this potential forumation for OP1.

China: The current text is clearer than before, however we still see that there is much space for improvement: first change “can” to “may”, and then change “when the person” to “when the drug user”, and then add “on the sole basis that the person has used or is using drugs.

Canada: We can move with this “when a person who uses drugs” will be best.

Egypt: Replace “calls up” with “invites”.

Iran: We propose “consider” instead of “recognise” and add “inter-alia” before “may occur”.

Canada: We can live with “invites” and “inter-alia” confuses the sentence.

Iran: We can only go along with “consider”.

China: I support Iran’s proposal. We need to cautious about this paragraph. This is the first time we’re trying to define this. I suggest to bracket this paragraph for the moment.

Spain: All of these amendments, we need to make sure the sentence makes sense!

Chair: If we bracket all of these, we will have wasted a lot of time. Look at the clock! Let’s move to OP2.

South Africa: We propose a simplified version: “Invites member states to abstain from language and conduct that may encourage or lead to discrimination of exclusion of drug abusers in society.

Iran: We propose “consider” instead of “recognise”.

Canada: We would propose replacing “drug abusers” with “people who use drugs” particularly because of language leading to discrimination.

Egypt: We don’t police language, so remove “language” and keep discussions to conduct. And keep “drug users”

Austria: We support Canada

Colombia: We welcome the word prejudice and would like to see that included at the end of South Africa’s suggestion.

Iran: Replace drug abusers instead of people who use drugs.

Malaysia: This is similar to OP1, so can we focus on OP1 with the possibility of merging them.

Chair: Can we bracket and move onto OP3

Canada: A modification of OP3: add “attitudes and actions”.

Egypt: Remove “language” and “the use of”.

Belgium:  We support Canada while adding “the access to these services”

China: We should be cautious as these are not perfect and cannot provide clear guidance to member states. I suggest using a new paragraph to replace OP1 to OP3: “Encourages member states within the national and regional context to promote among their relevant agencies and social service sectors the non-stigmatising attitude and the use of non-stigmatising language in the development and implementation of policies related to the availability and deliver of health, care and social services for drug users, and to reduce possible discrimination, exclusion or prejudice those people may encounter.”

Canada: We had a very helpful suggestion to add “availability, access and delivery”

Iran: We don’t feel comfortable with “non-stigmatising language” so remove it.

Canada: Just a couple of typos to correct. ANd add “attitudes and actions”.

Iran: Add “as appropriate” after “member states”.

Belgium: Insert “of evidence-based policies”

US: Add “scientific” before “evidence-based”

Iran: Change to “drug abusers”

Canada: That is not agreed language, so I ask Iran to use agreed language.

Iran: We are talking about drug abusers, though.

Belgium: We cannot support Iran.

Austria: We echo Belgium

Czech Republic: We echo Belgium

UK: We echo Belgium

Argentina: We echo Belgium

New Zealand: We echo Belgium

Iran: In all PP we have used drug abusers, so it is consistent.

Canada: Words matter, and he will find drug users when describing people. We prefer people who use drugs. It’s odd to come this far, and then trip over two letters.

Iran: We will go along with the consensus.

Chair: We can adopt it. OP4 now.

Iran: Replace “drug use” with “drug abuse”.

Canada: In the spirit of compromise can we say “inclusion of people who use drugs and other affected by drugs, people who support them…” and delete “people who use drugs” at the end.

When talking about people who support them, we’re talking about friends, family and support networks.

Iran: Add “contribution of organisations who are working with and support people who abuse drugs.”

Canada: Add “to continue to enhance relevant programs and strategies” for clarity. Again, “abuse” is not in the spirit of this resolution.

China: It’s still not clear. It could be streamlined: “enhance the inclusiveness in making relevant programs and strategies, to get opinions and contributions from drug users and organisations…” and deleted the final sentence.

Belgium: We would ask to include that last sentence with the inclusion of people who support them.

Iran: The language is not acceptable from Belgium so we need to go back to China’s suggestion.

China: If translated into Chinese we cannot understand the sentence. Therefore I support the deletion of the proposal made by Belgium.

Canada: Add “family and community members who are working with them…”

Chair: Can we adopt? It is adopted. OP5

Canada: Can we look at 5bis.

Iran: We already agreed we’d use “stigmatising attitudes” which is in the UNGASS document.

Canada: On 5 bis we are comfortable with how it is on the screen, and end it after “services”.

China: We need to include “drug users”

Iran: Replace “urges” with “invites” and we agree with China.

Canada: We can bracket this paragraph and move on. Erase 5 and 6, and move onto 7

China: OP6 has meaning so we insist OP6 to be retained.

Egypt: We cannot accept “stigmatising attitude” be paired with “actions” in any paragraph.

Chair: 6 is undeleted. Can we look at OP6?

Egypt: Delete the whole paragraph

China: We’d like to retain the first half, and make include “drug users”.

Canada: We’ll have to work on this in informals. 5bis is now a repetition of OP6.

Chair: We’ll bracket for now. OP7

Egypt: Add “Stigmatising attitudes”, and delete mention of law enforcement as it is not relevant.

US: Would we urge UNODC or would it be requesting?

Iran: We request the merging of OP7 & 8.

Canada: We can live with those, so delete law enforcement.

Iran: I do not have language to merge the paragraphs yet.

Egypt: We insist on removing “other relevant officials” or bracket.

Belgium: We propose add “attitudes and actions”

Egypt: If we add “actions” then we’d bracket the whole thing.

China: We will not go along with actions

Norway: We support Sweden, and add “as appropriate with tasks…”

Netherlands: We support Norway.

Egypt: No consensus so let’s bracket and move on.

Belgium: Add actions and then bracket

Chair: We’ll bracket and move onto 8

Sweden: We support the mention of the High Commissioner’s Office on Human Rights and UN AIDS.

China: We will not go along with that. And can’t go along with “actions”

Egypt: We can’t go with “actions”

South Africa: We support China.

Iran: We support China and other colleagues.

Canada: We have accepted OP1, so delegates that are now raising concerns forget that we have already agreed language.

Chair: Let us bracket it and the matter will be resolved. OP9

Egypt: We cannot agree on the topic we are discussing – attitudes or actions – se would like to bracket this for the time being.

China: Same as Egypt

Chair: So that goes into brackets. Last paragraph OP10

US: We just want to confirm what is the standard formulation?

Secretariat: We invite member states and donors to provide resources in according with the rules and procedures of the UN.

Chair:  Can we adopt that? It is adopted. We will take a break, then onto L10 followed by L4.

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