In recent years it has become increasingly clear that international human rights monitors and mechanisms view harm reduction services as components of the right to the highest attainable standard of health for people who use drugs.
But what about children and young people who use drugs?
The UN Committee on the Rights of the Child is the independent monitoring mechanism of the UN Convention on the Rights of the Child. Ratified by 193 States, the CRC is the only core UN human rights treaty to refer to drug use, requiring ‘appropriate measures’ to protect children from the illicit use of narcotic drugs and psychotropic substances (article 33).
As far back as 2003 this Committee had recognised the importance of reducing the harms for children and young people who use drugs, in particular in relation to HIV. The Committee’s recommendations to individual states had, however, often been vague, and had never explicitly recommended that harm reduction services be put in place.
Consistent recommendations, however, were that children and young people had the right to ‘accurate and objective’ information and to specialised treatment, and that children who use drugs should not be criminalised.
In recent years the Committee has become much clearer in its view that youth-focused harm reduction services for children and young people who use drugs are a requirement of the Convention. This began with Sweden in 2009, the same year when a member of the Committee spoke at the International Harm Reduction Conference in Bangkok. (PDF, 30 KB)
It developed with the Committee’s recommendations to Ukraine in 2011 (every State that has ratified the CRC must report to the Committee every five years on what it has done to implement it). In Ukraine, the situation of injecting drug use among this age group is very serious and strong recommendations to the government of Ukraine emerged. The Committee called for the decriminalisation of children who use drugs, and for the development of youth-focused harm reduction services (something the UN Committee on Economic Social and Cultural Rights had done a year earlier in relation to Mauritius).
In its most recent session, which concluded last month, the Committee has confirmed its view that harm reduction is a child rights requirement by recommending that both Austria and Albania “develop specialized and youth-friendly drug-dependence treatment and harm reduction services” in the context of adolescent health.
This is an important development. It reaffirms that drug use is to be viewed as a health issue under the Convention, and further solidifies evidence-based harm reduction services as a component of the right to health. But further, this reasoning is directly applied to those under the age of 18. Harm reduction has firmly entered the child rights lexicon.
It is important to bear in mind, however, that the CRC is a holistic document (just as all human rights are interdependent). The Committee, in turn, does not recommend harm reduction in isolation, and nor should it be read in this way. Child rights will affect the way in which harm reduction services should operate, and can help locate such services within broader development, health, protection and safeguarding efforts.
Even in the recommendations specific to drug use, the Committee’s recommendations are clear that when it comes to treatment and harm reduction, it is not an either-or debate. A range accessible, acceptable and sufficient quality (evidence based) options must be available that can help realise the child’s right to health and work in their best interests. What the Committee is clear about is that harm reduction has a vital role to play.