Committee of the Whole (Thursday – Morning) – Resolution L.7 – Promoting measures to prevent transmission of HI and other blood-borne diseases associated with the use of drugs from mothers to babies during pregnancy, birth or breastfeeding

Chair: L7 followed by L11 – L9, L4, L10, L6. Can we be conscious of the clock please and maintain spirit of flexibility.

Norway: A brief presentation of this resolution. Without any intervention a large number of pregnant women will transfer the virus to their babies. Providing antiviral drugs has a dramatic reduction in transmission – from 1 in 3, we can get down to 2 in 1000. Hepatitis B C and syphilis can also be transferred. Women who use drugs have less access to care. Being born of a mother who uses drugs poses significant risks to the baby. From a personal memory  met a woman in an asian town, covered in flies and using drugs, heavily pregnant, and it moved me tremendously. I wonder what happened to them. We should take this opportunity to do something! It’s about saving babies. A similar resolution was on pregnant women in prisons by Sweden.

Armenia: We want to co sponsor

Australia: We want to co sponsor

Belgium: We want to co sponsor

Secretary: Please sign the co sponsor sheet.

New Zealand: We want to co sponsor

Kenya: We want to support the resolution

CHair: Let’s move to the resolution now. Ay comments on the title?

NOrway: We proposed a title that is similar to last year, and informals we haven’t gone in depth, but it’s important to keep it short to ensure focus with this original title.

Pakistan: We retain our proposal on the title.

Australia: We support the retention of the title

Brazil:  We support the retention of the title

Iran: We support Pakistan proposal with regard to adding demand reduction

Russia: We support Pakistan proposal with regard to adding demand reduction.

Germany: Retain the title

China: We support Pakistan

Holy See: It’s important to stress this is a CND resolution so to make it clear the topic, so we would support Pakistan’s proposal.

Chair: No Consensus. On to PP1. No comment so we are ready to endorse as it is. Agreed. PP2 now.

Iran: Fine with language, but during the informals we asked is that the language from 60/8?

Norway: It is the same, yes.

Chair: That is adopted. PP3. Any comments? That is agreed. PP4

Norway: This was a paragraph that was proposed by Pakistan and lot of delegates did not support. It needs to be lean, and this is not relevant. Please follow the majority and delete it as it doesn’t need to appear in every resolution.

Pakistan: We should not lose focus in any resolution frankly. We are trying to reduce demand, and it would be fair to remove this paragraph.

US: We also wonder about the relevance of this paragraph. This deals with pregnant women and that must be the focus.

Australia: We would prefer this paragraph be deleted.

Bulgaria: We would also like it deleted.

France: We’d like it deleted.

Pakistan: Can we leave it in, while I talk to colleagues?

Russia: We believe this paragraph has merit – it talks about reducing demand, but also health issues. Transmission of HIV from mother to child to one of the drug related health issues, so we would like to retain this paragraph.

Chair: We are divided, and Pakistan has requested informal consultation. Let’s bracket and go to informals for this paragraph.

UK: We would like it deleted.

Chair: PP5

Russia: We would like to delete the final sentence.

Norway: This is the text we also had in 60/8, so we would ask to retain original text.

Germany: We are with Norway

Australia: We agree with Norway and keep the paragraph as it is.

Russia: We need to either keep it general or not. Add “in accordance with national legislation and the three international drug control conventions”

China: We are with Russia

Iran: We support Russia.

Norway: Since this is agreed language, it seems odd to repeat when it’s already in PP1, so let’s keep it in brackets.

Chair: PP6. That is agreed. PP7

Iraq: On the 2nd line to add “ where consistent with national legislation as appropriate” to ensure it translates into arabic.

Norway: My knowledge in arabic is weak so I won’t argue with that one. If we delete all the red in lines 2 and 3, and ‘undelete’ “mainstream” and that will hopefully serve the purpose.

Singapore: I do not think this addresses the issue, as you don’t allow flexibility if it’s mainstreamed. So the previous text would be “in global or where consistent with national legislation” and delete after “other people”.

NOrway: What Singapore just read was not agreed in informals.

US: We need to faithful to what the resolution says. Could we delete the addition from Iraq, and say “consistent with domestic legislation”

Singapore: Back to the clarification: we can be flexible with either suggestion from Iraq or from informals. If neither are agreeable, then we can go along with the US’ suggestion.

Norway: This is about women and gender issues, so we should be bold and maintain “recalling”.

Chair: Can we go along with that as it is on the screen?

Iran: We prefer to have domestic.

Norway: “Of other people” should be maintained.

Ecuador: Remove “abuse”

Iran: We can’t go along with that since it blurs the lines between drugs and medicines.

Norway: We agree with Ecuador.

Australia: We did come to this agreement yesterday and adopt as it is on the screen.

Chair: I see no objection. That is adopted.

Chair: PP8. Comments? Adopted. PP9.

Iran: We should consider this paragraph with OP2 and we would like to park it for the time being and come back with OP2.

US: We do not think it is appropriate for the CND to approve something not previously agreed upon.

Iran: Our major concern is about OP2, we do not have a strong objection, but it should be discussed together.

Chair: We bracket and move on.

Norway: When we talk about mother to child health it is relevant to have a reference on the rights of the child. We are looking for healthy babies which is why it is relevant to include the CRC reference here.

Chair: Ok, so we move on to PPbis.

US: we would like to delete this paragraph.

Australia: We would like to retain this paragraph.

Holy Sea: Delete

Poland: We would like to delete.

Norway: We are happy about it. We could say noting instead of recalling.

Canada: We find it very relevant.

Chair: With the amendment would the delegations be willing to go along.

US: It would not be acceptable. Introduces the idea there is a right to sexual and reproductive health and this makes it unacceptable.

Holy Sea: We would echo the US comments. It does not change our position.

El Salvador: We would like to echo the deletion of this paragraph.

Iran: The change does not make a difference, and this is beyond the mandate of the CND.

Pakistan: I suggest we delete and move on.

Malta: I would like to echo the US position on this to remove this paragraph.

Chair: It is in brackets.

El Salvador: We would like to delete the paragraph.

Chair: No consensus so we move on.

Pakistan: I suggest we keep this paragraph in brackets.

Iraq: We lost a lot of time debating the use and abuse, so I suggest interested countries might give their explanation, so we could have a clear picture about the concerns with using the terms.

Chair: We have specific resolutions in the COW, so those explanations could be considered in a separate forum.

Pakistan: I requested that PP7bis be placed in brackets. No concern on the following one.

Chair: Ok noted so we move to the next one PP9.

Russia: I am afraid we come back to our discussion about drug use and abuse. This more generic formulation could be interpreted as lack of treatment of HIV.

Chair: Is the committee ready to adopt it with the amendment? PP9 Adopted. PP10?

Iran: We have a grave concern about using different terminologies in different forums. We assist to use UNGASS terminology as it is the most recent consensus.

Germany: I understand delegations insist on repeating agreed language but often it does not fit the context. When we talk about key populations it could mean people with disabilities. We would support the original text.

Malaysia: We would prefer to keep the original language of the UNGASS and delete ‘key populations’

Turkey: We understand the concerns of Germany here instead of opening a new discussion of terminology we need to stick with the pre-agreed terminology from previous meetings and we prefer the use of ‘vulnerable members of society’ used in UNGASS ad why we support Iran.

Australia: Advancements in science and technology make retaining terminology obsolete. We need to adapt with scientific explanations so as not to limit ourselves. This is fraught with us not keeping up with what we can achieve in the world today.

Pakistan: I support Iran and Turkey.

US: Where we normally would be supportive of using agreed language, we agree that since this is referring to evidence we should stick to what it was looking it which is key populations. This language in this context was accepted last year. With that explanation we can accept the key population in this context.

Russia: I do not understand the formulation ‘key populations’ are there less important populations? It reminds me of some features of racism and discrimination. Secondly the substance of the para does not represent HIV in my country because the majority of cases are from heterosexual contexts and it does not reflect the situation in my country. To add ‘in some countries’

Ecuador: This is a matter of principle. Regarding this language is a feeling that right here we are talking about a specific population suffering from transmission specifically mothers and babies. We should talk about key populations rather than vulnerable people in society. We might need to go beyond UNGASS language and keep key populations in.

Venezuela: we were not going to take the floor because we did not want to open debate on agreed language. However, given the Russian delegation has touched upon the second part we will express out position. We have no problem of the substance of information, but we would like to know the source, how do we know these are global percentages. I think we need a footnote.

Norway: This is agreed language. It is from a resolution last year. Since we have strong opinions we need to take it back to informal. But people who inject drugs are 24 times more likely to get HIV. When drug users share needles, they have this. It is more like a biological fact and we should take ‘some countries’ out.

Chair: Let us bracket and move on to PP10?

Russia: We propose to put ‘health services’ instead of sexual and reproductive health.

Norway: We have agreed in informals that this paragraph has already been used in resolutions. We should include Hepatitis B and C. We cannot accept Russia’s language. We agreed upon this 9 months ago.

Holy Sea: We agree with Russia.

Australia: it is essential to have sexual and reproductive health care engaged in this because it is the context of the whole resolution. IF we just speak of corresponding health care it is too broad. We must keep sexual and reproductive health care services.

Egypt: We support the proposal to add Hep C. We see merit in the proposal from Russia. We think it fits more with the CND context and again it covers the concerns of Norway and it gives the meaning each member state would like to interpret it with.

Canada: We would like to keep the original formulation already agreed a year ago. We are not sure why the delegations are opposing sexual and reproductive health care services.

Germany: We were already strike out women and prison and there is already a compromised consensus. We are surprised they do not accept this language in the context of other discussions. I urge us to accept the original and we also ask for returning to the original text.

Norway: this is the resolution of the CCB and we are surprised, it is Thursday almost noon. The 3 delegations who spoke against this text were part of our informal sessions and we have agreed already, this was agreed to 9 months ago. We would like to go back to the original text.

Russia: I would like to remind Norway that the principle is still valid and the process of getting instruction is a life process.

Norway: We would like to put this in brackets.

Chair: It is clear there is no consensus, so we put it aside.

Chair: I see no comments so this is adopted. Next one – any comments? No comments, so it is adopted. Next one – any comments?

Singapore: We’d like to add our voice to delete the second last 2 lines and replace with agreed language from the UNGASS outcome document.

Egypt: We’d agree to delete the rest of the paragraph.

Holy See: We agree

Germany: Same as before, why should people get treatment on HIV AIDS if they’re not affected by it. The agreed language doesn’t make sense.

US: This is one place where “vulnerable members of society” could work as a substitute, and we’d like to keep “such as women who inject drugs” and take out the rest after that.

Norway: After the first line add “to provide services to groups and individuals that are hard to reach or experience discrimination from public services, including women who use drugs or are involved in transactional sex”. Thank you.

Russia: I would like some explanation on purchasing sex, and how to do it

Everyone:  Laughing and audible gasps (!!!!)

Egypt: We can do away with explanation here, as we do not know how old everyone is in this room. We should stay away from controversial issues and stay away from new terms. It is better to go back to consensus language here.

Norway: It is defined as exchanging money for sex services. There’s a big overlap between these groups. I thought it was a defined and understood term. We tried to find a term that describes the reality faced by these women.

Chair: Let’s bracket it and allow for further informals. Next paragraph on the screen.

Norway: In Sub saharan Africa the main mode of HIV transmission is heterosexual sex. Outside here 20% of all new infections take place among people who use drugs. In the informals wherever we have a figure we have a footnote.

Chair: With that explanation I see no objections and it is adopted. Next paragraph. OP1

Russia: I have doubts we should achieve gender equality – equality in what? We’re all for gender equality, but I don’t understand the context.

Norway: These are linked to the 3 SDGs mentioned at the end of this paragraph.

Egypt: Can someone explain why replaced Hep B & C with viral Hepatitis, and can we go back to the original.

Norway: I apologised we should replace “viral” with “B & C”. My apologies.

CHair: No objection so it is adopted. OP2

Russia: I doubt family planning and education exist everywhere, so I’d like some explanation.

Norway: The text comes from article 24 from the ‘rights of the child’. It’s agreed language that we have ratified.

Iran: I’m afraid it’s not a direct quote. There are serious differences. Article 24 in CRC is a long article, it has an opening part in paragraph 1, but there are issues in paras 2,3 and 4. The summary here is not good enough.

US: We are concerned that this is put in the negative, and wonder to improve “also urges member states to ensure that all children provided access to healthcare services in order to obtain the highest standard of health”

Norway: We added “for women who use drugs”, we have taken parts out. And we’re happy with US’ suggestion, but we should change to “develop appropriate”.

Canada: We’re not getting consensus, and our resolution hasn’t been heard. We would like to move this to informals and move to Canada’s resolution.

Norway: We waiting a long time for L7 and we’re making good progress.

Chair: Let’s cooperate and get L7 done in full.

Iran: After the comma we have “and”, but we believe we should stop after “health” and we need to accommodate the whole argument there, so we urge to stop after “health”.

Norway: We need to take this to informals, so we’ll stop here.

Chair: OP3

Russia: I have an impression we are in the hospital. I have one proposal to replace this paragraph with another one.

Norway: We agree with the first proposal to add SG3.5 and we think it would be better to keep that. We could also move along with the others, but it would be leaner as it is proposed.

US: In the CND we cannot address the harmful use of alcohol as a drug. We have a problem bringing that in. The reason you see in the quoted text that the 3.5 title is in quotes is because it was the title of the target. It is not within the mandate of the CND.

Norway: Please delete ‘harmful use of alcohol’

Chair: Can we agree now? OP3 adopted. We move on to OP4.

Holy Sea: As reflected on screen it has been subject to significant discussions during informal discussions. The overly broad use of the term sexual and reproductive health and rights and has cause many proposals. The preambular and operative part go together and should mirror each other. We would suggest in the third line ‘sexual and reproductive’ should be deleted to mirror the preambular paragraph and end the paragraph after ‘and syphilis’

Norway: There is no mention of sexual and reproductive rights in this document. The only one who wanted this out was the Holy Sea.

Russia: I would like to support the proposal of the Holy Sea. The commission should avoid any actions that could be treated as provocative considering the public opinions on this issue.

Chair: Is the paragraph acceptable?

Holy Sea: What exactly are we looking at in terms of the final inclusion? What would the rest of the text be?

Norway: The text on the screen without the brackets.

US: We support the original proposal made by the Holy Sea and would like it amended.

Chair: We have to bracket it for further consultations. We move to OP5. Comments?

Russia: change national contexts to in accordance with national legislation.

US: Our preference at this time is to bracket this paragraph to be included with discussion of the other sensitive issues.

Norway: It is surprising because we agreed on these paragraphs during informal but we are willing to do that.

Chair: We bracket and move on to OP6.

Russia: I would like to get clarification regarding the mandate of the commission regarding women and prisons. It is under the mandate to include women in prisons?

Secretariat: UNODC has the mandate to work on HIV prevention treatment for people who inject drugs and people in prisons. Also, we are the leading agency on these two groups and things are overlapping, people who go in and out of prisons, they crossover between these two groups.

Russia: Should we distinct women in prisons in this case?

Norway:  A lot of drug abusing women end up in prison and we think it is important to show the links. If it helps to progress, we can remove ‘women in prison’ at this point because it is agreed elsewhere.

US: We would appeal to keep this paragraph as it is. When we delete the reference to women in prison it raises a question of the necessity of providing health services to women and we ask to please keep ‘and women in prison.’

Ecuador: We would advocate the mention of women in prison, they are a specific vulnerable group. HIV is more prevalent in prisons and that is why it should be emphasised here. We know that some states are particularly impacted by this issue and that is why we support the text.

Australia: What we are speaking about here is ensuring confidentiality and informed consent. Why do we have to remove that from those who are in prison? That is a discriminatory concern for me. You must retain ‘women in prison’ because they are also entitled to confidentiality and informed consent.

Chair: Can we approve the paragraph? Approved. We go to OP7.

Iran: Here in the first line we believe we need to use the word ‘abuse’ instead of ‘use’

Russia: We would like to get a clarification on the relevant guidelines regarding the treatment of Hepatitis.

Norway: I have a number of footnotes here. Let me see because we are referring to WHO guidelines perhaps we should have repeated that. After ‘relevant’ add ‘WHO’ because we are talking about the treatment of illnesses.

Russia: Could we add ‘as appropriate’ at the end of this paragraph?

Chair: Can we wrap it up with that addition? Adopted. We go to OP8.

Russia: We are not comfortable mentioning prisons because in the Russian federation there is no drug abuse in prisons and it does not relate to the mandate of the CND.

Egypt: We support Russia and we want to point out we understand the importance of many of the actions in this draft resolution we have concerns that some countries will not have the resources to implement this. We should have some caveat that this should be related to availability of resources.

Norway: It is the staff we want to train not the people who use drugs. I hope that helps. It would be a bad signal that we should say ‘if we have money to save children’ we should not say that we do not give priority to our children.

Spain: We to would like to keep this mention. Any drug use, indeed in prison, continues to be an individual although they are in prison and should be treated as such. If prison was a way to treat drug use I am sure there would be a lot of people in prison.

US: This could be an appropriate place to reflect the title. Could include ‘and other blood borne diseases’ and we support the paragraph to stand as it is.

Norway: When it comes to the title that was left in brackets from the beginning. We need to clarify the medical reasons for choosing that.

Chair: I propose we bracket the text and go to informals on it.

Norway: If prisons is a concern we could add ‘prison settings’ would anyone object to that?

Chair: I see objections so we bracket it and move on.

OP9

Chair: no comments on OP9 – it is approved. OP10, any comments?

Russia: The word “prisons” is here too, what do the co sponsors mean by it? In Russian prisons there is no drug-use.

Norway: We have deleted the words “persons in prisons”. We are asking that WHO that they include drug use in prisons, for example when a pregnant mother goes to prison.

US: We find “calls up” a bit strong and would prefer “urges”

Australia: We need to keep “In prisons” in, and Norway has clearly explained its use.

Chair: Can we adopt the text now?

Egypt: We’d like to propose a 10bis.

Chair: Let us adopt this first. It is agreed. So Egypt…

Egypt: “Requests international donors to support member states, upon the request, in implementing the commitments made in this resolution.” we do understand that our children are our priority. SO instead of pointing fingers at each other we should let those who can support, to support.

Norway: That’s fine. Perhaps we should invite rather than request. Donors have always been involved in this work.

US: We would agree with Norway, and this resolution doesn’t have commitment, so perhaps we could say “in implementing this resolution”. And this should be moved the to 2nd to last paragraph.

Germany: what is meant by international donors?

Secretariat: It is interested donors

Ecuador: We support Egypt’s proposal. And amend it “and provide technical assistance upon request” after “member states”.

Iran: We have an amendment : “Invite interested donors to support the efforts of member states, in a non-discriminatory manner and without political considerations…”

Egypt: We’d prefer to have “urges” but we can work with “invites”

US: The last change really doesn’t seem relevant here. The member states should be put conditions on the donation, not us.

Iran: We should retain that language, so move to informals.

Chair: OP11.

Russia: My delegation cannot agree with “prisons” and would to delete it.

Norway: I need to ask the question: Do you say that UNODC don’t have the responsibility to HIV AIDS in prisons? If so, that’s news to me!

Russia: There is some mandate for the UNODC to engage in prisons, but in this case we are trying to agree a CND resolution so we should not fully replicate mandates from the particular UN entities. We should accentuate what we really need here, and my delegation doesn’t need this. We insist on our amendment.

Germany: It’s good news that Russia doesn’t need support in this, but there are other countries that do need help. It’s global problem and initiative, so in the sense of solidarity we need to keep the text as it is.

Russia: Nobody uses drugs in our prisons, so it doesn’t reflect the situation in our country.

Norway: It’s not about drug use in prison, it’s about HIV in prisons.

Russia: The text is very ambiguous here.

Norway: Change to “HIV in prisons”

Russia: With one comma after drug use.

Chair: No comments, it is adopted. OP12 now.

Norway: We have alternative proposal to this OP taken from 60/8.

Chair: Any comments on OP 12 alt?

Russia: We love commas, and there should be one here.

US: We would like some time to consult, please bracket this.

Chair: Bracket it and move on. OP13. Any comments? It is approved.

Norway: Sorry for taking the full morning session

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