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24th November 2008
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Harm Reduction Networks Make Submission to UN on Human Rights
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In November 2008, IHRA’s HR2 programme authored a submission to the Office of the UN High Commissioner for Human Rights. The submission – entitled ‘Harm Reduction and Human Rights: The Global Response to Injection-Driven HIV Epidemics’ – was prepared following a call by the High Commissioner’s office for input in preparing a biennial report on HIV and human rights for the Human Rights Council meeting in March 2009.
The submission provides a global overview of the injecting-driven HIV epidemic worldwide, with a particular focus on several key regions. It also examines the human rights implications of the failure to scale-up harm reduction services worldwide, which includes a specific focus on the needs of women and young people. The submission concludes by making a series of recommendations to various UN human rights bodies to increase their engagement with harm reduction and drug policy issues.
The IHRA submission received formal endorsements from a number of harm reduction networks and organisations from around the world – including Actions pour la Citoyenneté et l’Education à la Santé (France), the Asian Harm Reduction Network, Auto Support des Usagers de Drogues (France), the Canadian Harm Reduction Network, the Canadian HIV/AIDS Legal Network, the Caribbean Harm Reduction Coalition, the Eurasian Harm Reduction Network, the Global Drug Policy Program (Open Society Institute), Human Rights Watch, Intercambios (Latin America), the International Harm Reduction Development Program (Open Society Institute), the International Nursing Harm Reduction Network, the International Network of People Who Use Drugs, the Middle East and North African Harm Reduction Network, Psicotropicus (Brazil), the Sub-Saharan African Harm Reduction Network, the Thai AIDS Treatment Action Group, the Women’s International Harm Reduction Network and Youth RISE (the youth-led international harm reduction network).
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21st November 2008
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UNODC Launch New Paper on Women and HIV in Prison Settings
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The UN Office on Drugs and Crime (UNODC) – in collaboration with UNAIDS – recently released a briefing paper entitled ‘Women and HIV in Prison Settings’. The paper describes the factors which contribute to an increased risk of HIV for women in prison settings and the importance of a comprehensive approach to HIV prevention, treatment and care which responds to their particular needs.
Globally, prison settings are high-risk environments for HIV transmission. HIV prevalence is often higher among prison populations than outside prisons. Women represent about five per cent of the global prison population, although UNODC note that this proportion is rapidly increasing, particularly in countries where levels of drug use are high. Prevalence of both drug use and HIV is more pronounced among female than male prisoners. Despite this, most prison services and programmes are developed with men in mind and are failing to address gender-specific needs.
Several factors contribute to a greater vulnerability to HIV transmission for women in prison settings. A larger proportion of women are in prison for drug-related offences than men and many will use drugs while in prison. Women injecting drugs are more likely than men to become infected with HIV, as a result of limited access to HIV prevention information and services. Women also face a greater vulnerability to gender-based sexual violence in prison settings, particularly where they are held close to or within male prisons, or are supervised by male prison staff. Other factors such as unsafe tattooing and a physical vulnerability to HIV further exacerbate the risk of HIV transmission for female prisoners. Women living with HIV in prisons often have no access to antiretroviral therapy (ART) and those who are pregnant often do not receive medication to prevent mother-to-child transmission (PMTCT).
The briefing recommends a comprehensive list of HIV prevention, treatment and care measures for women in prisons, including the provision of HIV prevention information and commodities (e.g. condoms, sterile injecting equipment and safe tattooing equipment), opioid substitution therapy and other drug dependence treatment, VCT, STI diagnosis and treatment, access to reproductive health services, access to ART, PMTCT and post-exposure prophylaxis (PEP), among other measures.
In addition, UNODC recommend several interventions and strategies in order to address the particular vulnerabilities experienced by women in prisons. Alternatives to imprisonment for women have committed non-violent offences, particularly during pregnancy, or when they have young children, would reduce overcrowding and help to reduce violence. Specific interventions to prevent violence, in particular sexual violence should also form part of a comprehensive response. Prisoners should have access to safe and appropriate health services, equivalent to those available in the community, which seek the participation of women prisoners in all aspects of programming, including peer education. To ensure prisons are responding with the up to date, effective programmes, capacity building as well as programme monitoring and evaluation is necessary. At a national level, a collaborative effort from ministries and national AIDS programmes is essential in addressing the health, social and other particular needs of prisoners in general, with specific attention to gender-specific issues.
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21st November 2008
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INPUD Hold General Meeting and Launch Call for Members
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On Friday 31st October 2008, the International Network of People who Use Drugs (INPUD) held a ‘General Meeting’ in order to follow-up from discussions at Harm Reduction 2008 in Barcelona and agree a plan for the future of the organisation. The meeting was hosted by BrugerForeningen – the Danish Drug Users' Union – to coincide with a series of events to commemorate International Drug User Day on November 1st and the 15th anniversary of BrugerForeningen on November 3rd. It was attended by around 100 people from over 25 countries around the world – including representatives from IHRA, the World Health Organization, Release and Gadejuristen (the Danish street lawyers organisation) – and was funded by BrugerForeningen and IHRA amongst others.
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The meeting was held at the wonderful BrugerForeningen building in Copenhagen, Denmark. The organisation – one of the most established drug user groups in the world – boasts facilities such as a kitchen, a fully equipped music room, a games room, classrooms, offices and a designated drug user space. There was even a ‘drug museum’ of historical and interesting artefacts and paraphernalia from around the world – including antique needles and syringes! The venue – and the BrugerForeningen staff – represented an excellent example of best practice for drug user organisations.
At the meeting itself, a wide range of topics were discussed (either by the larger group or by smaller working groups) in order to agree a plan for INPUD’s future – including the Board, the network’s aims and objectives, representativeness and communications. There were also discussions about Harm Reduction 2009: IHRA’s 20th International Conference in Thailand. Paisan Suwannawong from the Thai Treatment Action Group (TTAG) addressed the group and stated that the conference was a “crucial event” for local people who use drugs and represented a great opportunity to engage with the Government and others in order to advocate for harm reduction and the protection of their human rights. He also stressed that Thailand was safe for others to visit for the conference. IHRA then confirmed that there would be a number of scholarships for drug users to attend the event (around 50 paid registrations – dependent on donors such as IHRD and UNAIDS), that there would be drug user representation throughout the conference programme (as in previous years) and that there would be a designated space provided for INPUD – who will be making a formal announcement about their engagement in the conference soon.
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As a result of the General Meeting, INPUD has also issued a new call for members from around the world. As the network has been significantly restructured over 2008, all previous members are asked to re-register their details. Also, any new members are welcome to submit their details and join the network. These details will then be entered into the INPUD membership database in order to ensure that all members are kept informed about the network’s progress, news and development. To join (or rejoin), please send your name, email address (or other contact details), user group affiliation (if any), location and any other relevant information to the INPUD Membership Secretary – and please encourage your peers and colleagues to do likewise. Every name that is added to this database makes INPUD a stronger, more representative and more credible organisation that speaks for all people who use drugs.
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20th November 2008
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Harm Reduction 2009: An Open Letter from the Conference Director
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 Dear Friends,
Over the past few months, there has been a lot of hard work behind the scenes in planning for Harm Reduction 2009: IHRA’s 19th International Conference. With this letter, I would like to update you on some of the significant developments with what promises to be a landmark conference for harm reduction in Thailand, across South-East Asia and internationally.
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Conference Venue
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The conference will now be held at the Imperial Queen’s Park Hotel (which was already the official conference accommodation) – and not the ‘Queen Sirikit National Convention Centre’ as had been previously planned. This venue move offers us a greater flexibility in terms of the programme. There is a wide range of facilities and opportunities available at the hotel for sessions, workshops, satellite meetings and side events. There is also the added advantage that participants will not have to travel from the conference hotel to a separate venue.
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Conference Dates
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The conference will now take place over four full days (Monday 20th April –Thursday 23rd April) as opposed to three full days and two half days – as has been the case in previous years. The Opening Session – which will include high-profile speakers, local dignitaries and community representatives – will now take place on the morning of Monday April 20th. The Closing Session will take place on the afternoon of Thursday April 23rd. This structural change provides us with more space in the conference for sessions and workshops – and also leaves the whole of the Sunday April 19th available for Satellite Meetings and other events (which can be accommodated in the hotel).
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Conference Programme
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The Executive Programme Committee has been working hard to develop an excellent programme for Harm Reduction 2009. The abstract deadline passed on November 10th 2008, and we have received nearly 900 abstracts from around the world. This means that there is space in the programme for approximately one in five of these abstracts to be presented – with further possibilities for others to present in workshops or to exhibit as ‘poster presentations’. The abstracts are currently being reviewed by our ‘International Programme Advisory Group’.
Three Plenary sessions are being planned:
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- Injecting Drug Use and HIV: A Comprehensive Review of the Situation and Response in Asia
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- Harm Reduction and Human Rights (the conference theme)
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There are also currently plans for up to fifteen Major Sessions (an increase on previous conferences) and around thirty Concurrent Sessions. Major Sessions have been developed to cover a wide range of topical harm reduction issues that should be of interest to researchers, policy makers, advocates and frontline workers alike. These topics include Alcohol, Tuberculosis and HIV Services, Nursing, Drug Wars, Gender Roles and Women, Evidence for Harm Reduction, Young People, Law Enforcement, Prisons, Drug Treatment, Legal Interventions, Sex Work, Poverty, Risk Environments, and Employing Drug Users.
The final decisions about the programme will be made at the Executive Programme Committee’s ‘Marathon Meeting’ from the 9th – 11th December in Bangkok. Feedback will be provided as soon as possible to abstract authors and delegates via email and the conference website.
For 2009, we have also been working hard to accommodate more interactive sessions, skills-building workshops and community events and we anticipate that there will be a great deal of space for these valuable activities in addition to the abstract-driven programme. It is hoped that this will further help to promote harm reduction in Thailand and across South-East Asia as well as providing opportunities to key local and international civil society groups. More details will be made available soon.
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Translation
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All of the Plenary Sessions and Major Sessions will have simultaneous translation in English and Thai – as will half of the Concurrent Sessions. A Thai version of the conference website will also be operational soon.
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Scholarships
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As in previous years, there has been a huge demand for scholarships and waived registrations for Harm Reduction 2009. This is a positive thing, as it indicates widespread interest in the event – particularly from civil society, people who use drugs and NGOs in Thailand and South East Asia. Scholarship support is entirely dependent on contributions from international donors such as IHRD and UNAIDS. Unfortunately, donor support for this conference has not been as good as in previous years, but we still hope that there will be a good number of scholarships available to speakers and delegates from the host country and region. We cannot make any formal announcement about scholarships at this stage until we have agreements in place from donors.
IHRA will never be able to meet the demand for scholarships for our conferences, so we strongly recommend that those seeking support to attend the conference approach their regional and national UN organisations, international NGOs, governments and other potential funders. Of course, IHRA is happy to provide any letters of support necessary as part of this process.
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Conference Price
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The delegate fees for Harm Reduction 2009 are either frozen or reduced compared to the two previous conferences – dependent on the fee category. There are discounts available for group bookings, delegates from lower or middle income countries, students, people who use drugs, IHRA members, Thai nationals, and those who pay before January 22nd 2009 (the ‘early bird’ deadline).
In addition, however, the global currency fluctuations also mean that – for many delegates – there has been a substantial reduction in the cost of attending the conference due to the fall in the value of the British Pound (£). We strongly urge delegates to take advantage of this situation by registering and paying as soon as possible.
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Conference Support and Advocacy
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We now have over thirty organisations who are Conference Partners or Supporting Organisations. Many of these groups – and others – are already using the conference to advocate for harm reduction and human rights. Many also already have plans to bring substantial numbers of participants in order to gain from this unique opportunity to learn about advances in harm reduction policy and practice.
Over the last few months, there have been a number of consultations between NGOs, people who use drugs and civil society groups in Thailand, the region and elsewhere. These have all indicated support for the event and recognised the opportunities for promoting harm reduction.
With respect to Thailand specifically, the conference coincides with a prospective and significant national grant from the Global Fund to fight AIDS, Tuberculosis and Malaria. Meetings have also been proposed at Harm Reduction 2009 to discuss Thai drug policy, a new national harm reduction policy, the Global Fund grant, and the future of harm reduction in Thailand. These will involve government, NGOs and civil society.
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Medical and Harm Reduction Services
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The health, safety and security of all conference participants is always our prime concern. As such, we are committed to facilitating the engagement of people who use drugs. There will be a dedicated drug user space in the venue. Plans are also underway – in collaboration with the Thai Government and other key stakeholders – to allow for the personal import of essential medicines such as methadone and buprenorphine, and for methadone prescribing in Thailand. Arrangements are also being discussed for the provision of safer drug use equipment, naloxone (for overdose prevention), first aid and other medical support services. A ‘Medical Sub-Committee’ of the ‘Local Organising Committee’ has been established to lead on this area of the conference, and more details will be available on the website as soon as possible to assist delegates.
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Entry to Thailand
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All delegates are urged to check the visa entry requirements well in advance of their trip to Thailand. Please visit http://thailand-visa.net for more information. There will also be a Welcome Booth at Bangkok Airport and we will do everything we can to ensure that the conference is a safe and welcoming environment for all of our participants.
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Overall, this is shaping up to be an excellent harm reduction conference and one which will be significant in taking forward harm reduction in Thailand and South-East Asia. I, and the staff of the International Harm Reduction Association, the Conference Consortium and our partners, look forward to welcoming you next April in Bangkok.
Professor Gerry Stimson
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10th November 2008
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EMCDDA Launch ‘The State of the Drugs Problem in Europe’
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In November 2008, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) launched their ‘Annual Report 2008’ – addressing the latest facts, figures and trends on drugs in Europe. The report – entitled ‘The State of the Drugs Problem in Europe’ – offers an overview of the current situation across the 27 European Union Member States, Croatia, Turkey and Norway – including details the current legal, political, social and health responses.
The report found that opioid drugs are still at heart of Europe’s drug problem and represent a “stable but no longer diminishing problem” – with between 1.3 and 1.7 million problem opioid users in the EU and Norway. Opiates are also responsible for Europe’s largest drug-related health and social costs – accounting for between 50% and 80% of all treatment demands and around 80% of the 7,000 to 8,000 drug-induced deaths that occur in Europe every year. The report also warns of a “glut” in heroin markets – due in no small part to record opium production in Afghanistan – and increases in synthetic opioid use.
In terms of stimulant drugs, the latest European data suggest a stabilising or even declining trend in the use of amphetamines and ecstasy, but a continued rise in cocaine use – with around 3.5 million young Europeans (15–34 years) having used cocaine in the last year. In some countries – such as Denmark, Spain, Ireland, Italy and the UK – as many as 5.5% of young adults have used cocaine in the last year. The report calls for a ‘holistic response’ to stimulant drugs – which have often been overlooked by harm reduction efforts.
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The EMCDDA is the hub of drug-related information in the European Union. Its mission is to provide the EU and its Member States with an evidence base on the European drugs problem to inform policy making and practice. In a public statement at the report launch, the EMCDDA Director, Wolfgang Götz, stated that “although drug use levels remain historically high, we appear to be entering a more stable phase. Treatment availability, although still insufficient, continues to grow in Europe… [and] rates of new [HIV] infection attributed to drug use have fallen”. He also hailed the “greater cohesion” across Europe in terms policies and revealed that first estimates indicated that state expenditure on illicit drugs costs each EU citizen an average of €60 per year.
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7th November 2008
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Australian Police Chief Calls for ‘New Approach’ to Drugs
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In October 2008, the Australian Federal Police Commissioner, Mick Keelty, stated that the existing law enforcement approaches to illicit drug use have not worked and that a new approach is required, one which combines demand reduction, supply reduction and harm reduction.
Speaking on the ‘ABC PM’ programme on Australian TV, Mr. Keelty quoted the “enormous seizures” of drugs that have been made in Australia, which he described as “beyond belief”. However, he then stated that “We [Law Enforcers] can’t just keep quoting statistics and feeling good about ourselves… it can’t be just as simple as saying no to drugs”. According to Greg Denham – the co-ordinator of the Coalition Of Police Supporting Harm Reduction (COPS HR) – “This is a significant moment in history that Australia's top police officer has made these statements. Whether this signals a change in approach by the police force and also by the Federal Government, time will tell”.
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5th November 2008
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Good Practice in Harm Reduction
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At the UK’s National Conference on Injecting Drug Use (NCIDU) in October 2008, the National Treatment Agency (NTA) launched a new publication entitled ‘Good Practice in Harm Reduction’. The report is aimed to help and guide those who manage, work in, fund and commission services for people who use drugs, and is the result of interviews with the leading service providers across the UK.
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The report is part of a co-ordinated campaign to improve harm reduction services across the UK in the light of rising blood-borne virus prevalence and overdoses amongst people who use drugs. Last year, the NTA and the UK Department of Health published Reducing Drug Related Harm: An Action Plan and, more recently, they have also commissioned Exchange Supplies – the leading harm reduction social enterprise in the UK – to develop materials as part of a Harm Reduction Works campaign (which was also launched at the NCIDU conference in London).
In the same session as this report launch, IHRA’s Catherine Cook also presented on the ‘Global State of Harm Reduction’.
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5th November 2008
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UK Report Documents Preventable Harms amongst Injecting Drug Users
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In October 2008, the UK’s Health Protection Agency released the latest in a series of annual ‘Shooting Up’ reports documenting the wide range of harms experienced by injecting drug users – including blood borne viruses and bacterial infections. The report found that one third of injecting drug users have reported abscesses, sore or open wounds –representative of bacterial infections that are thought to cost the UK health services around £47million per year.
The report documented a range of bacterial infections amongst injecting drug users – including MRSA, streptococci, wound botulism and tetanus and ranging in severity from irritation and minor skin infections to blurred vision, slurred speech, muscle weakness, paralysis, respiratory failure and death. These infections may be fuelled by recent increases in crack cocaine injection (associated with higher daily injection frequencies) and groin injection (associated with poor hygiene). Yet these harms are easily preventable if the injection site is cleaned before and sterile equipment is used.
The report also found that around one in 90 injecting drug users in England and Wales have HIV (but as many as one in 20 in London), one in six are thought to have been infected with hepatitis B at some stage, and almost half currently have hepatitis C (with a fifth becoming infected within three years of starting to inject drugs). However, there were some encouraging signs – such as a notable increase in the uptake of hepatitis B vaccines amongst injecting drug users, and high rates of needle exchange access.
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The Health Protection Agency was established in 2003 to protect UK public health through the provision of support, evidence and advice to the relevant Government bodies. Their annual 'Shooting Up’ reports are produced (in collaboration with Health Protection Scotland, National Public Health Service for Wales, CDSC Northern Ireland, and the London School of Hygiene and Tropical Medicine) to provide insights into the infection risks among injecting drug users across the UK.
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