The impact of drug policy on public health
Side event organised by UNAIDS, OSF and Harm Reduction International12 May 2015
See below for extracts from the side event discussion:
Simone Monasebian, UNODC New York Office
'UNODC supports member states to achieve availability of essential medicines, we also promote HIV prevention interventions as well as drug prevention and treatment. One of the ways to place health at the centre of drug control is by showing work being done on the ground, sometimes in partnership with other UN agencies and CSOs. In Cambodia for example the government is moving away from compulsory detention and we promote community-based treatment in collaboration with NGOs. In Ghana we have a pilot programme with WHO on how to promote access to controlled medicines while preventing abuse and diversion.'
Kasia Malinwska-Sempruch, OSF
'For overdose, we have effective interventions but people continue to die. So here again, what is going wrong? We often talk about how Western Europe has managed to deal with the issue of HIV among IDUs. We often look at the global south with more worry because harm reduction is less available. But the issue is more complicated. If you look at Eurasia, OST continues to be unavailable in Russia. In the USA, the federal government voted against funding for NSPs. So there is something happening politically that creates barriers to harm reduction.
We always hear a dichotomy between health and criminal justice. But it is important to define health because we are learning that what health means in Switzerland is different from what it means in Vietnam. There are many publications documenting treatment facilities where people are in forced labour. We must be clear and articulate what is health and what is an abusive practice.'
Maria Phelan, Harm reduction International
'We must see strong leadership around the UNGASS to talk about why health is so important. We need success indicators that match this. We know that harm reduction is effective, promotes dignity and human rights, have achieved consistent outcomes across the world with reductions in HIV and mortality and in crime. But full recognition of HR at international is still not achieved. This affects our capacity to reach critical health and development goals.'
Mandeep Dhaliwal, UNDP
'One of the things we found was that cultivation and involvement in the drug trade had a strong link to poverty, for groups who don't have other opportunities. Racial and ethnic minorities are particularly vulnerable. Incarceration in turn fuels vulnerability and social exclusion. It has a negative effect on health and human rights.We see that women are too often involved in the drug trade because of limitations to their education and inclusion. Incarceration has a significant impact on them and their children. And for harm reduction, most services are targeted at men. We need to look at the impact of policing and incarceration. By UNGASS we should have a document that draws a picture of these impacts.'
Werner Obermeyer, WHO New York Office
'We are in agreement that addressing the world drug problem requires a multidisciplinary approach. WHO has worked in the field since the mid-1980s. We aim at limiting illicit drug use, limiting harms, end stigma and violations of human rights. We also focus on the protection of young people and youth from health problems. UNESCO, UNODC and others are working with WHO to disseminate prevention and substance use interventions among youth.
Drug policies always need to be guided by the scientific knowledge we have collected to deal with health consequences. We must evaluate the impact of drug use and disorders, this is key to lead on our policies.'
Ninan Varughese, UNAIDS
'We reaffirm our commitment to public health. Our call for a fourth pillar focused on health is in line with this objective. A public health approach to drug control saves lives and produces a return in investment and promotes human rights. Life-saving harm reduction measures should be implemented and scaled up. Decriminalising drug use can free up prisons and remove obstacles to access to services. Supply and demand reduction as well as international cooperation are important, but public health is the missing link.'
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