CND Thematic Discussions on Strengthening Public Health Responses to Drug Use
Session 3: High Rates of Transmission of HIV, Hepatitis C Virus and Other Blood-Borne Diseases Associated with Drug Use
Evidence Snapshot for the topics of the day – Ms. Chloe Carpentier, Chief, Research and Knowledge Production Section, UNODC: Drug-related infectious diseases – we estimate 14 million people inject drugs, half of them live with Hep C, 1 in 8 with HIV. The risk is 14 times higher than general population – very high, injecting is a significant driver of global epidemic. Women are at increased risk. Vulnerability stemming from gender power structures. Prisons and closed setting also a high risk environment. Risk of being infected in closed setting and bringing it to outside community.
New psychoactive substances are substances that are psychoactive and that are not controlled by the conventions. In 2024 had 688 new substances. Use of NPS remains lower than traditional drugs. Threat caused by NPS seems to be contained. When a single NPS has become a sizeable threat, it was placed under international control and largely disappeared from global market. But new substances emerged, manufacturers are very innovative to replace substances. Last few years, new synthetic opioids, including nitazenes and we’ve seen poisonings in Europe. They appeared 2019 in the US. Now they are often mixed with other substances, increasingly detected in other regions. Another example is Kush in Sierra Leona and other places – reported it first in 2024 – some kush has exhibited nitazenes. Ketamine has been illicitly manufactured for two decades especially in Southeast Asia and at some point was the dominating drug. 2015 some controls placed, especially in China, so illicit use has been declining. There has been reports of manufacturing in Germany.
CND Chair: Thank you. Any questions? No question, will begin expert panel.
SESSION 2: DRUG TREATMENT AND HEALTH SERVICES FALLING SHORT OF MEETING NEEDS;
INCREASE IN DEATHS RELATED TO DRUG USE
Intro & Expert moderator: Ms. Fariba Soltani, Chief, HIV/AIDS Section & Global Coordinator for HIV/AIDS, UNODC – … hepatitis – particular attention should be given to women who use drugs, who continue to be underserved despite evidence. In prisons, prevalence can be many times higher then the general population. Decades of evidence have identified a comprehensive package of interventions to prevent transmission – NSP, OAT, peer outreach, vaccination, overdose prevention with naloxone. Where these are implemented, public health improves. 93 countries provide NSP in community, 94 provide OAT. In prisons, services remain very limited, 11 provide NSP, and 60 provide OAT. The gap between community and prison settings requires urgent attention. Several factors contribute – regulatory restrictions might prevent interventions or limit availability. Stigma and discrimination can deter people from accessing services. The current financial climate places further strain. This is not about feasibility, it is about political will. What we lack is the commitment to act. Reform laws and reduce stigma and discrimination. Integrate in a comprehensive health response. Track progress to close gaps. Most importantly, prioritize involvement of people who use drugs – people who use drugs, both in prison and the community, are entitled to the highest standards of health.
Expert panel:
Moderator: Could you share successful strategies to measure outcomes of policies aimed at reducing transmission rates?
Prof. Gregory Dore, Program Head, Viral Hepatitis at the Kirby Institute; Infectious Diseases Physician, St Vincent’s Hospital Sydney, NHMRC, Australia (online): People who inject drugs are highly marginalized. Australian government funded NSP surveillance since mid-90s. PWID have a higher uptake of therapy than general population. Screened around 50.000 people at risk of Hepatitis C since … Linkage to care studies … The situation in Fiji is a contracting situation, experiencing an HIV epidemic. In 2024 it was 1500 new infections, a 10-fold increase over 5 years in a country of 1 million people. There is no significant harm reduction infrastructure, compared to Australia. There is a need to develop surveillance systems, parallel to harm reduction systems.
Moderator: Great to hear how cost-effective expanded harm reduction programs have been for Australia. For Fiji, still being developed, but UNODC has a package of services, including harm reduction services that can be offered to people who use drugs, especially stimulant drugs. The urgency of starting harm reduction programmes is clear.
Moderator: For the next panelist, what recent advancements have been made in treatment?
Dr. Hamid Vega Ramirez, National Psychiatry Institute Ramón de la Fuente Muñiz (online): Since 90s, highly effective ART enables people with HIV to have a quality of life similar to general population. Thanks to efficacy of ART, undetectable viral load can be reached, reduces risk of transmission to nearly zero including during pregnancy and breastfeeding. Early detection and early ART initiation are difficult among some populations, for example injecting drug users. This is often due to structural vulnerabilities. New injectable ART could offer an opportunity. From HIV prevention, such as oral, injectable and vaginal PrEp provides significant progress – daily oral PrEP provides 90% efficacy. Recently, monthly or semi-annual injectable PrEP has similar efficacy to oral prep. Currently available only through clinical trials. Rollout of oral Prep and implementation has been slow in all regions, the coverage target set by UNAIDS by 2025 will not be achieved in any region. Key populations have low adherence to oral prep, due to criminalization and stigma, and laws that hinder access. A phenomenon that occurred last few years in North of Mexico – emergence of fentanyl is replacing heroin as substance of choice. Transformed consumption patterns. 2020-2023, Tijuana and Mexicali detected fentanyl in 20% of heroin samples. There has also been a rise in HIV in this population. Community-based harm reduction organizations used strategies, but we are under international pressure to combat organized crime, restricting users mobility due to the fear of imprisonment. International commitment is needed to ensure sustainable financing.
Moderator: Despite all the advances, the issue of stigma and criminalization is a barrier to access.
Moderator: What are the key challenges to integrate HIV and Hep C services to national health services?
Dr. Ibtissam Khoudri, Specialist in Clinical Epidemiology, National Program for the Fight against HIV/AIDS, STIs and Viral Hepatitis, Ministry of Health and Social Protection, Morocco (in person) Brief overview of Morocco – Morocco has an integrated national strategic plan in accordance with WHO recommendations and international guidelines. HIV services operational for many years. PWIDs benefits from HIV care. Regular updates of national treatment protocols and following recommendations of national technical committee. HIV and HC testing and prevention services are fully integrated, NGOs and healthcare facilities including harm reduction services. The most important challenge is supply – availability is very important. Tests, ARTs etc. Moroccan government ensure free supplies as part of national program. Recently, included HIV self-testing. Integration in all sectors is a challenge – CSOs, Ministry of Health and inside prisons, all need to be involved. 3000 centers provide integrated services, 25 center for harm reduction for PWIDs. Point of care technology available. Community support and harm reduction services. Measuring stigma – recent survey showed level of stigma dropped to 8%. Sustainability of services also a challenge – Morocco aims to achieve micro elimination among PWIDs. This is a priority in our program to achieve international targets.
Moderator:
[…] UNAIDS, (online) We support countries and communities with evidence-based human rights norms. Multilateral places have a powerful role to play here. We are in danger of losing the progress we made so far, let alone ending AIDS by 2030. International funding for the HIV response has been declining and plummeted in last year, donor countries reducing or ending funding. There will be 6 million new infections and 4 million additional aids-related deaths by 2030. This is a crisis. 80% of funding comes from international sources. Even when funding is available, people who use drugs are left behind. Harm reduction programs work and are cost effective. Access to housing and social benefits essential to ensure access to harm reduction. Removing criminal penalties on drug use. Many of these were dependent on international funding. We need bodies like CND, WHA to focus on this. International cooperation focused on public health and evidence-based approaches – health, human rights, development and other lens, including HIV lens. The voices of those affected – We need multilateralism now more than ever. The joint program is one example we must learn from, recognizing HIV is multidimensional. 20 member states, and 5 civil society on PCB formally included. Important innovation that should form part of the UN80 reform agenda. Organizations … child rights and women’s rights. Provides an excellent model.
Moderator: What are the most urgent gaps for people who use drugs?
Mr. Aditia Taslim Lim, International Network of People who Use Drugs (INPUD) (in person): We are not speaking the same language. Yesterday, we talked about prevention. But in Vienna, prevention means something different than Geneva. If we are talking different languages, how can this discussion be taken forward into action? The abrupt funding cuts have been disruptive and cost the lives of many people who use drugs. Harm reduction services – and please note when I say this I refer to prevention – have been reduced. In LMIC, they have always been underfunded – 6% of what is needed. Governments haven’t created an enabling and safe environment. Prohibition and the drug free world agenda created barriers. How can HIV, HC and blood borne virus program be effective if PWUD are criminalized and if prevention commodities ar eused to detain and arrest PWUD? Some countries it is not even available due to lack of population estimates. This is a matter of political will. Hether you like it or not, there are people who use and inject drugs all around the world. Since 2022, INPUD in collaboration with INHSU launched Jude Byrne Award – she has shaped the global movement for women who use drugs. Received over 100 applications, and 11 women who use drugs have been awarded the leadership award. But lack of female leadership also continues to leave women who use drugs behind. Until we speak common languages, we will continue to see an increase in infections and drug-related deaths.
CND Chair: Open the floor for member states questions.
Mexico: ….we committed to reduce by 2015. Clearly, we failed to implement that commitment. Can you include in your report of this session? Hasn’t been implemented and had . What would be the implications of UNAIDS disappearing? Particularly for joint program? What would be your estimate of person with HIV and … to my colleague in Mexico – if they are starting to see same pattern we saw decades before with AIDS that border communities started registering cases and went back to Mexico with AIDS and brought contagion to families.
Colombia: this is not a self-contained discussion. This is deeply linked to development issues – women, gender issues. Deeply linked with 2030 agenda, where we have a clear target to reduce HIV infections. There is a role we can play at CND. How can drug policies become a tool to achieve SDGs? Mr Chair you travelled to New York to inform HLPF on work of the CND – for anyone who would like to participate, how can we reinforce the role of CND in development discussions? What else can we do from here in Vienna to reinforce this in different fora?
Oman: harm minimization program or oat. The problem is the way it is presented. Sometimes difficult to convince policymakers if you present it as a package with condoms and needles. It should be tailored to the sensitivity of each country when presented.
Moderator: UNAIDS – the commitments are for the member states to discuss… for the implications of UN80 report, will ask … online to give some thoughts.
UNAIDS: important to recognize the report is a set of recommendations for discussion – among the member states, including those in the room today. Recommendations came just before the GA and a Board meeting next week discussing reforms. The discussions about the proposal to sunset UNAIDS has been addressed by the PCB burea that is publicly available. Board is fully engaged in question and abide by discussion in previous meeting about a different timeline. Human rights and voices of communities must remain at the center.
Moderator: this has been ongoing, UNAIDS is a joint program. Since last year, there has been a process to decide on the way forward and how the UN should respond to HIV. Review recommended number of co-sponsors and size should be reduced. Losing 55% of staff by the end of this year. Co-sponsors have been reduced to 6. Already streamlining the joint program. There is still a great need for multilateralism. This is not a biomedical response, it needs to have a gender, development, human rights etc. dimension. PCB is meeting, NGO delegation included is unique in UN system. Communities worried if UNAIDS disappears, how will their voices be heard.
INPUD: Community are involved, can work with member states to make sure voices from community are heard. Re Mexico and Colombia, it is very important to state this. Yes we have failed to meet the target. Moving forward, the CND resolution that was passed this year to review the machinery, we need to make sure the voices of people who use drugs are included in that process.
Moderator: On CND and these discussions feeding into bigger picture on Agenda 2030 – what we discuss here has implications for broader level. I’d give the floor to Greg –
(…)
Greece: Interesting discussion on harm reduction today. Things work and we have results. In Greece we have a micro-elimination program for HCV among people in opioid substitution programs. This is accomplished through rapid diagnosis. Therapy goes to the patient and not the other way around. We work with rapid testing. 130 practitioners have been trained to use this methodology. In terms of numbers, we have examined over 6,000 patients. 95% were tested, surpassing the WHO target. This was done without additional funding, from our own budget. This means it can be accomplished. We have safe consumption rooms in Athens and Thessaloniki, and will have mobile units later this year in these two cities. 96,000 safer, supervised drug uses took place. Imagine if these users were outside. 500 lives saved through naloxone overdose treatment. Harm reduction programs work. We have to adopt harm reduction in our entire philosophy. We learned very valuable lessons; this is a very achievable reality. We have to support all these initiatives and integrate them into daily practice.
Russia: NPS use has increased in recent years. People who use NPS… Parenteral hepatitis indicates high prevalence. Since 2025, the federal project combatting Hepatitis C is a targeted early detection tool. Significant activities on prevention – national prevention center based on national research conducted. These measures are used to reduce risk of drug addiction and support the social wellbeing of the population.
Canada: We know PWUD are at higher risk. Canada’s new action plan aims to reduce infections by 2030 and meet global commitments, including harm reduction, treatment and care for people who use drugs, with specific support for women, including those involved in sex work. These programs are designed to be culturally safe and free of stigma. Those who test positive are referred to treatment and care options. Programs are also offered in prisons. Stigma remains a powerful barrier. Targeted interventions to address stigma and discrimination are key.
Malta: The national strategy issued earlier this year will be implemented over the next 5 years, ensuring services are tailored to women, youth, MSM and migrants. Supporting telemedicine and decentralization of services. This complements the national drug strategy 2023–2033. NSP, OST and mobile outreach are crucial. HIV testing is being introduced in drug treatment settings. Together these strategies reflect Malta’s commitment to system resilience and equity. Malta builds a health system that empowers vulnerable communities to leave no one behind.
UK: The HIV Action Plan 2021 is the cornerstone of efforts. England met the 95-95-95 target. Injecting drug use accounts for 1.1% of new infections due to longstanding interventions. Stigma is a profound barrier to support and also to long-term recovery. The UK supported targeted local pilots, including “people first” language, building self-worth and self-efficacy. The UK is a world leader in ending AIDS, including substantive support to WHO and the Global Fund. We know COVID-19 impacted the global AIDS response. The UK pledged over £5 billion to the Global Fund. Deeply concerned transmission among PWID remains alarmingly high in most countries. We must combat HIV among PWUD and thus meet global goals. What delivers is money spent on OAT, NSP and ART—we have evidence. But there is more to do.
EU: 27 Member States, plus Albania, Bosnia, Georgia, Iceland, Montenegro, North Macedonia, Norway, Moldova, Serbia and Ukraine. Many EU members struggle to meet SDG targets, particularly on early diagnosis and viral suppression. The situation calls for scaling up integrated and stigma-free prevention and treatment. Scarcity of harm reduction services continues to expose people who use drugs. Pre- and post-exposure measures must be scaled. We need to ensure access to pharmaceutical interventions. One example is the guidance on prevention published by EUDA and the EU Centre for Disease Control, providing guidance for community-based testing and treatment. Groups needing focus include women and men who engage in sex work, people experiencing mental health challenges. Over 20 million euros have been allocated to vaccine-preventable diseases. We all need to create a non-discriminatory legal and social environment.
Brazil: Sustained, science-based efforts do work. Our HIV trends show progress, but there is still much to do. People who use drugs face risks from overlapping sexual transmission networks. The 2025 national bulletin reports a downward trend, showing the positive impact of integrated strategies. Daily oral PrEP has been offered since 2017. Harm reduction counselling, linkage to care, and services in prisons are also in place.
South Africa: Whilst challenges with scaling up remain, we have made notable progress. Much of this has been driven by civil society and donors, as well as government initiatives. Scientific studies are being conducted to inform treatment guidelines in an evidence-based, people-centred, participatory, human-rights-based way. Reliable data is critical for targeted interventions and policy formulation. Training for healthcare workers was conducted to build local capacity for evidence-based care. South Africa will host INHSU in Cape Town.
Belgium: We ensure interventions are grounded in the lived experiences of affected communities. We evaluate the impact of interventions. We remain committed to harm reduction, prevention and treatment to uphold human dignity and leave no one behind.
Australia: A longstanding priority has been progress in communicable diseases under a strong national policy framework. This consists of several national strategies on Hepatitis B, Hepatitis C, HIV and others. We launched our national HIV strategy to eliminate HIV by 2030. A core principle of our national framework is harm reduction. Needle and syringe programs, peer support and navigation programs have all demonstrated effectiveness. Special attention must be given to PWID, people in contact with the criminal justice system, LGBTQIA, and Indigenous peoples. We are rolling out equitable access. Australia remains concerned by the impact of drug use in the Pacific, particularly amphetamines, which pose a high risk of transmission. We are supporting Fiji’s national outreach.
China: We attach great importance to drug control and AIDS prevention. Currently, the proportion of HIV transmitted through drug use is extremely low. We make full use of World Drug Day and World AIDS Day, integrating information through the internet and media. Comprehensive drug prevention education includes youth drug education and awareness of AIDS. Behaviours are dealt with according to the law. Drug users with illness or disabilities receive timely treatment. Since 2004, methadone has been provided for individuals severely addicted. There are 760 methadone maintenance clinics nationwide, with over 9,000 individuals receiving daily medication.
Zimbabwe: Intravenous drug abuse has emerged, with some individuals practising “bluetoothing” – injecting contaminated blood. Leaks from health institutions have worsened risks. Regional socio-economic challenges, including limited job opportunities, particularly for young people, and limited awareness contribute to the problem. Inadequate health infrastructure remains a challenge. Zimbabwe has met the 95-95-95 targets, with adult ART coverage at 97%. With this and other responses, an estimated 84,000 deaths were averted in 2024 alone, highlighting the success of the response. Three percent of people in sub-Saharan Africa have been infected with Hepatitis C. Zimbabwe has a multisectoral National Committee on drug use.
Germany: We align with the EU and reaffirm Germany’s commitment to harm reduction. We support harm reduction as a central pillar of a balanced drug policy. Our position is guided by the recognition that drug use is a multifaceted phenomenon. Supervised consumption, drug checking and naloxone consistently demonstrate effectiveness in reducing preventable deaths and facilitating access to healthcare and social support. These interventions contribute to health. Harm reduction is not an alternative to prevention, but an essential complement, fostering pathways to recovery and reintegration.
Colombia: Drug-related matters are development matters. The use of injectable drugs is a growing challenge in Colombia, with 8,000 people estimated in main cities. Vulnerability, social exclusion and multiple barriers persist. There is an urgent need for effective public health and harm reduction interventions. SRHR stressed that stigmatization and criminalization represent barriers to accessing services, leading to poorer health outcomes. For this reason, Colombia prioritises harm reduction services, including low-threshold services. The Global Fund project reached more than … For Colombia, the reduction of HIV-related funding at the UN is particularly concerning, as it would undermine decades of progress.
United States: We note the high prevalence as well as treatment and recovery support systems. Over the last decade, the US has seen multiple local outbreaks of HIV, in particular related to injecting drug use and transmission of gonorrhoea and other infections. Actions can be taken to reverse these trends. Substance use preventionists, treatment providers and healthcare providers are central. Examples of US action include HHS programs to improve treatment and care, enhancing infrastructure and behavioural health integration across multiple settings.
Thailand: (…)
France: (…)
The Netherlands: We align ourselves with the EU statement, and wish to add a few remarks from a national perspective. We reiterate the EU’s points on harm reduction, highlighting the importance of services to prevent the transmission of bloodborne and other infectious diseases. Harm reduction has been part of Dutch policy for a long time. Over the years, we have introduced comprehensive measures and ensured that accurate, evidence-based information is available to empower people to make safer choices. Our services include needle and syringe programmes, opioid substitution therapy, and heroin-assisted treatment. Our approach also includes drug checking and drug consumption rooms. We underline the importance of addressing stigma, discrimination and the criminalisation of people who use drugs. Removing these barriers is key to ensuring the availability and accessibility of services. We remain committed to collaboration and shared responsibility in strengthening harm reduction and facilitating access to services for those who need them most.
Iran: For more than two decades, we have implemented harm reduction initiatives through centres across the country that support individuals with drug use disorders. We provide essential services through mobile teams and fixed centres, including sterile syringes and needles, food, access to basic supplies, and low-threshold methadone treatment for homeless and vulnerable people who use drugs — particularly those at risk of sexually transmitted diseases. These efforts have been successful in controlling the spread of HIV among people who inject drugs. As of October 2023, there are approximately 24,000 people living with HIV in Iran, the majority aged 25 to 40, and 76.6% of them are receiving state-provided medical treatment. The implementation of harm reduction measures has reduced HIV transmission among people who inject drugs by 11% in the past year. We operate around 600 addiction treatment and harm reduction centres, where we provide agonist drugs. Specialised psychiatric and other hospitals also treat people who use stimulants, including both adults and children. One of our centres has been recognised by the United Nations as a regional hub on harm reduction. NGOs and the private sector are also involved in these efforts. We remain strongly committed to ensuring that all individuals in need of treatment have access to the services they require. Our main activities can be summarised in six categories: methadone maintenance treatment; needle and syringe programmes; training for people who inject drugs and their sexual partners; prevention, diagnosis and treatment of tuberculosis; HIV testing and counselling; and access to antiretroviral therapy.
Israel: (…)
Sudan: Due to our location in Central and East Africa, Sudan shares borders with seven countries. The movement of people across these borders is constant, and with it comes the spread of many diseases, particularly bloodborne diseases. Most neighbouring countries have high rates of HIV and hepatitis. Out of our population of 50 million, around 48,000 Sudanese are living with HIV. Of these, 19,560 are aware of their status, and more than 6,000 are receiving treatment. In the case of hepatitis, only 10% of those infected are aware of their condition. They also face high medication costs, given the current circumstances in our country. Hepatitis is now the seventh leading cause of death in Sudan. In response, the Government of Sudan has developed a strategy to combat and treat bloodborne diseases, with the aim of eradicating their spread by 2030. This strategy seeks to facilitate access to treatment, limit transmission through a range of measures, and raise awareness of the dangers. One of its key elements is tackling drug use associated with bloodborne infections. The Chairman of the Sovereignty Council has established a ministerial committee, including the ministries of security, social affairs and justice, to address the spread of drugs, particularly non-traditional drugs that are a major cause of transmission. Yet Sudan faces severe resource constraints that limit our capacity to implement anti-drug programmes and sustain disease treatment. The rebellion of militia groups in many states has destroyed resources, increased the prevalence of drug use, and caused extensive damage to hospitals, addiction treatment centres, and research laboratories. With the retreat of rebel militias from eight states, we are beginning to reconstruct state institutions. However, international and regional support is urgently needed to help us combat drugs and the diseases associated with them.
International Federation of the Red Cross (IFRC): Humanity has made extraordinary progress in responding to communicable infections. A cure for hepatitis now exists, and HIV is a chronic but manageable condition through treatment and prevention. These are historic achievements of modern medicine, proving what is possible when science, political will, and human rights come together. Despite this, transmission rates remain high in some countries. HIV and hepatitis continue to spread where harm reduction and treatment are not sufficiently available. This paradox should concern us all. At a time when we should be consolidating progress, declining investments and reduced attention are deeply worrying. They risk reversing decades of achievements, with consequences not only for people who use drugs, but for public health and society as a whole. Infectious diseases do not affect only one group. Protecting people who use drugs is protecting society as a whole. We must sustain our collective efforts by ensuring access to evidence-based harm reduction, universal health coverage, and the enjoyment of human rights. These are the foundations of effective public health. The world cannot afford to lose the progress achieved so far. We must safeguard these gains and recommit to a future where science and compassion guide our common response.
World Health Organization (WHO): The high burden of HIV and hepatitis among people who use drugs remains a serious concern. Health systems and ministries of health are central to turning this around. Evidence-based interventions such as opioid substitution therapy, needle and syringe programmes, naloxone distribution, and access to HIV and hepatitis treatment and prevention services are essential. Yet the reality is that funding for harm reduction and HIV/hepatitis is shrinking. This reduces the capacity of national health systems, as well as technical agencies such as WHO and UNODC, to sustain the support that is urgently needed. Health sectors must be given the leadership and resources required. Stronger collaboration is also vital — among UN partners, technical agencies, civil society, and communities — who bring complementary skills and knowledge to the table. Member States, UNAIDS, UNODC, and community partners must continue to be enabled and supported to work together.
YouthRISE: In many countries, UNAIDS has reported rising new HIV cases among 15-24-year-olds. While youth account for one quarter of people who inject drugs globally, studies consistently find that their relative risk of HIV and Hepatitis C is 1.5 times higher than that of adults. Still, every day, young people who use drugs face barriers to accessing health and support. Such barriers are documented in the 2025 Youth Statement on the new Global AIDS Strategy and Future High-Level Political Commitments on the AIDS Response, created by organisations led by young key populations worldwide. This statement will be released on October 21st, and we invite you to read it. As other speakers have highlighted, prevention, harm reduction, and treatment for drug use remain scarce for all age groups. The outlook for young people is even grimmer, with age and other legal restrictions leaving youth caught between criminalization and adult-centered services. New generations of young people are starting to inject drugs, and they are being failed by the very systems meant to protect them. Last year, Youth RISE, in collaboration with the International Network of People who Use Drugs and the Global Fund, conducted a study on youth-friendly health services. We found that a large proportion of participants in pilot needle exchange programs are young, highlighting the importance of scaling up youth-friendly services. However, many young people who use drugs face considerable barriers to accessing harm reduction and treatment, with access rates often lower than for adults. Requirements such as parental consent deter young people from seeking support, especially when drug use is criminalized. Several international guidelines provide a blueprint for member states to implement drug policies that don’t undermine the development opportunities of new generations. Leading UN reports and experts emphasize that many drug-related harms are preventable with accessible services that fit people’s real needs—not punitive and criminalizing policies that foster stigma and push key groups away from life-saving care. And this can only happen when you include the perspectives of young people, particularly those with lived experience, in policymaking. In last year’s Pact for the Future, Member States have pledged to protect the rights of all young people and include them in policy decisions. We urge Member States to scale up comprehensive and stigma-free peer-led services for youth, remove age barriers to health and harm reduction programs, and meaningfully involve youth in all policy decisions. Youth is not a problem to be solved. They are experts in their own lives, ready to partner in building evidence-based programs that reduce inequality, improve wellbeing, respect autonomy, and save lives.
VNGOC: (technical problems)
UNODC: To summarise, We have the tools, and we know what works. Harm reduction measures are effective when implemented at scale. To succeed, we must allocate sufficient resources — not only from international donors, but also from domestic budgets — to expand programmes at the country level and truly impact the epidemic. I would also underline the importance of including people with lived experience. Meaningful engagement with affected communities is not optional; it is essential for effective and sustainable harm reduction.
Chair: Australia reporting back on its Pledge4Action.
Australia: At the High-Level Segment in 2024, Australia pledged to continue taking scientific, evidence-based action to eliminate the transmission of HIV, hepatitis, and other bloodborne diseases. We strongly prioritise the response to communicable diseases. Our National HIV Strategy, developed jointly by people living with HIV, government, academia, and a broad range of stakeholders, seeks to virtually eliminate HIV transmission in Australia. It includes maintaining and expanding access to safe injecting equipment, peer-led services, “U=U,” PrEP, condoms, and needle and syringe programmes. Under our Sixth National HIV Strategy, we are further increasing access to sterile equipment, and expanding peer-led awareness and harm reduction campaigns. Australia provides funding to the Australian Injecting & Illicit Drug Users League (AIVL), our national community-led network, to strengthen the lived and living experience workforce through its network of drug user and harm reduction organisations. AIVL also maintains and updates a national directory of harm reduction services. At the international level, Australia continues to lead in limiting the transmission of communicable diseases. We have a 12 million dollar funding agreement with UNAIDS to support organisations in Asia and the Pacific to improve prevention, treatment and testing, while reducing stigma and discrimination. We have also contributed 266 million dollars to the Global Fund, reflecting Australia’s commitment to tackling the spread of disease by investing in health infrastructure and supporting countries across the Asia-Pacific. In addition, we have provided 3.9 million dollars to support Fiji’s national outbreak response plan. We remain firmly committed to our 2024 pledge, and to ensuring access to services that are gender-responsive, evidence-based, inclusive, and free from stigma and discrimination.
Chair: 1st Vice Chair will support this afternoon’s session. The 3rd Vice Chair will support tomorrow’s session. There’s also a UNODC briefing to member states on chemical disposal on room CR3.