• Joint Fellowship Programme for HIV and Drug Use Research

• Announcement: IHRA Annual General Meeting 2009

• IHRA Makes Statement at UN Commission on Narcotic Drugs

• IHRA Launches Report on Civil Society Engagement at CND

• March 2009 Article of the Month

• ‘Direct Action’ Protests at CND in Vienna

• IHRA Launch Three Fact Sheets for CND ‘Regular Segment’

• Update from Day 2 of the CND High Level Meeting in Vienna

• ‘Talking Drugs’ Website Launches

• Update from Day 1 of the CND High Level Meeting in Vienna

• IHRA Urges Nations to Reject the New UN Drug Policy

• WHO, UNODC and UNAIDS Launch Target Setting Guide for Injecting Drug Users

• OHCHR Biennial Report References Harm Reduction Networks

• CLAT5: The 5th Latin Conference on Harm Reduction

• Developing an International Directory of Naloxone Programmes

• IHRD Launch Two New Resources

Joint Fellowship Programme for HIV and Drug Use Research

This fellowship programme consists of two awards: US$ 75,000 to be awarded to a junior scientist for 18 months of post-doctoral training, and US$ 75,000 to be awarded to a well-established HIV researcher for eight months of professional development training – both at leading institutes excelling in research in the HIV-related drug use field.

The closing date for applications is Friday 17th April 2009.

• Click here for more information

Announcement: International Harm Reduction Association’s Annual General Meeting 2009

• To confirm the minutes of the last Annual General Meeting held on 13th May 2008.

• To receive a report from the Trustees (Directors) of IHRA for the year ending 31st December 2008.

• To adopt the audited accounts of the Association for the year ending 31st December 2008.

• To appoint auditors for 2009-10.

• To confirm the Board of Directors for the period between the 2008 and 2009 AGM.

• To elect directors to fill three vacancies on the Board of Directors from nominations received as per Section 33 of the Articles of Association.

• To transact any other business of which at least seven days notice in writing has been given.

Current financial members who wish to vote (and are unable to attend the AGM) must complete the proxy form on the website by clicking here. The form must be returned by email to [email protected] or fax to +61 3 9328 3008 by Monday 6th April 2009.

IHRA Makes Statement at UN Commission on Narcotic Drugs

“Thank you Mr Chair.

I’m sure I speak on behalf of my two colleagues on my left when I thank you for enabling civil society to participate in today’s session, and ensuring time on the agenda for us to be heard.

I am here today representing the International Harm Reduction Association. Our statement is supported by the Asian Harm Reduction Network, the Caribbean Harm Reduction Coalition, the Eurasian Harm Reduction Network, Intercambios Associacion Civil, the Middle East and North Africa Harm Reduction Network, the Sub Saharan Africa Harm Reduction Network, the Canadian Harm Reduction Network, Colectivo por Una Politica Integral Hacia las Drogas, the Harm Reduction Coalition in the US, the International Network of People who Use Drugs, the International Nursing Harm Reduction Network, the Women’s International Harm Reduction Network and Youth RISE.

In June 1998, the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem adopted a resolution entitled ‘International action to combat drug abuse and illicit production and trafficking’. Despite the fact that the link between HIV transmission and unsafe injecting drug use was well-known at that time, the UNGASS political declaration was silent on both HIV prevention and on harm
reduction.

Today, more than 10 years on from the UNGASS on drugs, it is estimated that 15.9 million people inject drugs in 158 countries and territories around the world. Since the 1998 political declaration was adopted, many regions of the world have experienced an explosion of injecting-driven HIV infection. In some regions, up to 80% of people living with HIV are likely to have acquired the virus through unsafe injecting. In countries as diverse as China, Estonia, India, Kenya, Myanmar, Nepal, Thailand and Vietnam, HIV prevalence rates among people who inject drugs reach over 50%.

During this same period, injecting-related hepatitis C infection has remained a major unaddressed health concern, with prevalence rates among injectors reaching as high as 95% in some countries. The vast majority of people who inject drugs in countries as far-ranging as Indonesia, Thailand, Pakistan, Mauritius, Estonia, Lithuania, Russia, Ukraine, Luxembourg and Switzerland are living with hepatitis C. Ultimately, death and disease related to hepatitis C may take a bigger toll on drug injectors than HIV infection.

Last week, a High Level Segment of the UN Commission on Narcotic Drugs (CND) adopted a new Political Declaration on Drugs. It was apparent from the negotiations towards agreed language in this Declaration that a small number of countries are prepared to go to extreme lengths to block support for evidence-based, public health led approaches to drug use from appearing in CND resolutions. These obstructionist governments – including the United States, Russia, Japan, Italy and Sweden – blocked any reference to harm reduction in the Declaration, despite the fact that up to 10% of all global HIV infections occur through unsafe injecting drug use (and over 25% of all infections outside Sub-Saharan Africa), and the best evidence suggests that over 3 million people who inject drugs are living with HIV.

CND’s failure to embrace harm reduction, and the continued obstruction of a small number of governments to even non-binding statements of support for harm reduction programmes within the Political Declaration, clearly illustrate the degree to which the Commission is not only out of step with the scientific and medical evidence supporting harm reduction, but is also isolated from the mainstream of UN opinion on this key health policy issue.

Harm reduction is explicitly supported by the UN General Assembly, UNAIDS, the UN Office on Drugs and Crime, the World Health Organization, the International Narcotics Control Board, the UN High Commissioner for Human Rights and others. At least 84 countries around the world explicitly support, or allow the operation of, harm reduction programmes. Moreover, in 2002 the Legal Affairs Section of the UN Drug Control Programme affirmed the legality of harm reduction programmes – including opioid substitution therapy, syringe exchange and safe injecting facilities – under the international drug conventions. This finding authoritatively refutes the continued allegations by obstructionist governments and others that harm reduction is incompatible with treaty obligations.

Yet in spite of this broad and ever increasing support, CND – through its self-imposed ‘consensus at all costs’ working method – perpetuates a system that enables even a single government to block harm reduction language in its resolutions, and now in the Political Declaration. This now creates a situation where UNODC – the lead organisation on HIV and injecting drug use within the UNAIDS family – now has a governing board that refuses to support harm reduction measures. This is a problem that must be addressed.

It is inconceivable and indeed unconscionable that support for scientifically proven, evidence-based harm reduction programmes have again be blocked. States must show responsible leadership and act in the best interests of public health and human rights, rather than the narrow and failed language of ‘a drug free world’. In this regard, we commend the leadership demonstrated by the 26 countries who supported the declarative statement supporting harm reduction at the High Level Segment last week.

Mr Chairman, this issue is much bigger than ideology, semantics and intergovernmental wordplay.

It is about saving lives.

Thank you.”

• Click here to visit the CND blog

IHRA Launches Report on Civil Society Engagement at CND

The CND is required to engage with civil society by the Economic and Social Council of the United Nations (ECOSOC), and has made a number of resolutions recognised the importance of civil society engagement. However, in practice, the involvement of civil society at CND is extremely limited. At the 52nd Session, for example:

• Non-governmental organisations were prevented from being put on the list of speakers at the ‘High-Level Segment’ – contrary to ECOSOC rules

• Antonio Maria Costa (Executive Director of UNODC) arrived for an ‘Open Dialogue’ meeting with civil society flanked by a dozen bodyguards (after civil society delegates had already been searched before entering the room)!

• Click here to visit IHRA’s new ‘CND blog’

March 2009 Article of the Month

The data shows a marked geographical divide in Europe – with rates of newly diagnosed HIV infections among injecting drug users remaining stable or decreasing in most ‘Western’ countries (ie, those in the European Union or the European Free Trade Association), but increasing in many ‘Eastern’ countries. In Ukraine, there were over 7,000 new cases of HIV reported among injecting drug users – the highest in the region (although data were not available for the Russian Federation in 2007, but there had been over 11,000 new cases there in 2006).

The report estimates that over half (57%) of all new HIV infections in this region are due to injecting drug use, and expresses grave concerns about the continuing increases. The authors comment that the stable HIV rates in the ‘West’ “may partly follow from the increased availability of prevention, treatment and harm reduction measures, including opioid substitution treatment and needle and syringe programmes”, and warn that existing public health measures in the ‘East’ “are likely insufficient and need to be reinforced”. The report concludes by urging European countries to collaborate in order to tackle this major problem.

• Click here to view the full article

• Click here to view a guide from WHO, UNODC and UNAIDS on Target Setting for Injecting Drug Users

‘Direct Action’ Protests at CND in Vienna

From within a series of ‘prison’ cages, campaigners set out to lobby the government delegations, attendees and the media about the need for ‘peace’ in the ‘war on drugs’. Protesters carried banners proclaiming “Harm Reduction Saves Lives”, “Prohibition Does Not Work”, “Stop the Global War on Drugs” and “Youth Can’t Wait Ten More Years”. Some protesters even distributed fake bank notes with images of Antonio Maria Costa on them to demonstrate how the global prohibitionist drug policies have turned drugs into a billion dollar illicit global industry.

The actions – led by HCLU – were timed to coincide with the High-Level Segment of this year’s CND meeting, at which Member States agreed a new Political Declaration on Drugs to shape international policy for the next ten years. This Declaration omitted any mention of harm reduction – much to the disappointment of many governments and civil society organisations – but the protests were a timely reminder for us all that the current global drug control regime is not working and needs to be changed.

• Click here to view the INPUD campaign website

• Click here to view a HCLU video report from the protests

• Click here to view the Youth RISE website with further updates from CND

• Click here to view IHRA’s ‘CND Blog’ from Vienna

IHRA Launch Three Fact Sheets for CND ‘Regular Segment’

The fact sheets each describe ten main points related to a key area of drug policy – how drug policy affects human rights, why human rights are an issue for the delegations at the CND meeting, and why access to controlled medicines is an issue. They are designed to be accessible summaries of the key arguments in order to advise and influence the numerous government delegations and other attendees at the meeting.

These fact sheets are just part of the presence that IHRA has in Vienna for this important meeting – alongside other key civil society and harm reduction organisations. IHRA and other harm reduction networks presented during the ‘High-Level Segment’, launched a press release alongside Human Rights Watch and the International AIDS Society urging countries to reject the Declaration, and also recorded the meeting proceedings through a new ‘CND blog’. For the ‘Regular Segment’, IHRA’s Damon Barrett will be on the UK Government delegation for the second year running (alongside, for the first time ever at a CND meeting, an open drug user from the International Network of People who Use Drugs). Again, the proceedings (which are not otherwise made available to civil society or the general public) will be recorded every day through the ‘CND blog’.

• Click here to view IHRA’s press release for the CND High-Level Segment

• Click here to view a summary from March 11th at the CND High-Level Segment

• Click here to view a summary from March 12th at the CND High-Level Segment

• Click here to visit the CND blog

• Click here to visit the IHRA blog

Update from Day 2 of the CND High Level Meeting in Vienna

Much of the day was taken up with national statements from the country delegations, including a statement from the St. Lucian Government – delivered by their sole representative at the meeting, Dr Marcus Day (a member of the IHRA Board of Directors) – which explicitly supported harm reduction, acknowledged the need to protect the human rights of people who use drugs, and lodged reservations about the manner in which the Declaration was drafted without the input of smaller nations.

• Click here to view the full St. Lucian statement

IHRA and several other harm reduction networks have played an active role in the discussions in Vienna. IHRA, Human Rights Watch and the International AIDS Society launched a press release urging countries to reject the Political Declaration, and these three organisations were joined by Youth RISE – the international harm reduction network for young people – in holding a satellite event to highlight the failings of the past decade of international drug control. At this event, Craig McClure (Executive Director of the International AIDS Society) condemned the new Political Declaration as “fundamentally flawed” and Professor Gerry Stimson (IHRA’s Executive Director) called into question UNODC’s role as the lead UN agency on harm reduction.

Elsewhere, Rick Lines from IHRA, Mat Southwell from the International Network of People who Use Drugs (INPUD), and Caitlin Padgett from Youth RISE all formally presented in roundtable discussions during the two days. Both INPUD and Youth RISE have been highly active in Vienna – with Mat Southwell being the first open drug user to be on a Government delegation at CND – and both receive core funding from IHRA.

• Click here to view Mat Southwell’s speech

• Click here to view Caitlin Padgett’s speech

• Click here for the full statement from IHRA and Human Rights Watch

‘Talking Drugs’ Website Launches

The website aims to reach out and engage a wide variety of people who may, up to now, never have given this subject much thought. It will allow for the sharing of stories, narratives, videos and photographs from around the world, and in any language. As a result, geographically and linguistically separated communities will be able to communicate and interact about issues that they may have in common.

• Click here to visit www.talkingdrugs.org – a unique participatory mechanism for global dialogue and action on drugs and drug policy

Update from Day 1 of the CND High Level Meeting in Vienna

Opening the meeting, Antonio Maria Costa (Executive Director of the UN Office on Drugs and Crime) commented that “Humanity has made measurable progress” in terms of drug policy in the last century, and stated that harm reduction (which has been omitted from the new Political Declaration as things stand) should be integrated into the response to drugs. One of the highlights of the day, however, was a passionate speech from the Bolivian President Evo Morales, who spoke about the issue of coca leaf chewing in his country (which is currently outlawed by the UN conventions). Holding up a coca leaf and popping it into his mouth, he explained that he has used coca regularly and that he would not have been elected President if there had been any adverse affects!

Various countries and country groupings have also read their statements. The European Union (EU) made a strong defence of harm reduction, and Brazil’s powerful speech claimed “The aim of a world free of drugs has proven to be unobtainable and in fact has led to unintended consequences… Brazil enforces the need for recognition of and moving towards harm reduction strategies… [and] securing the human rights of drug users”.

From the 11th to the 20th March 2009, the CND Blog will be regularly updated on the developments, speeches and discussions from Vienna – where IHRA continues to have a large presence.

IHRA Urges Nations to Reject the New UN Drug Policy

This new Political Declaration – designed to guide global drug policies for the coming decade – omits harm reduction despite this approach being endorsed by key UN agencies such as UNODC, UNAIDS and the World Health Organization on the basis of a wealth of scientific evidence. This omission from the Political Declaration comes despite interventions and direct advice from UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, the UN Special Rapporteur on the Right to Health, the UN Special Rapporteur on Torture, and the International Drug Policy Consortium.

According to Professor Gerry Stimson (the Executive Director of IHRA), “Governments could have used this process to take stock of what has failed in the last decade and to craft a new international drug policy that reflects current realities and challenges. Instead, they have produced a declaration that is not only weak; it actually undermines fundamental health and human rights obligations”.

The press release urges the international community to recognise that the current approach to international drug policy is failing, and to support evidence-based harm reduction measures. It also calls on the government delegations in Vienna to refuse to support the declaration – a similar call to the one recently made in a press release by the International Drug Policy Consortium (IDPC).

• Click here to view the IHRA, Human Rights Watch and International AIDS Society press release

• Click here to view the IDPC press release [PDF:91KB]

• Click here to view the new CND Blog documenting the latest developments from Vienna

WHO, UNODC and UNAIDS Launch Target Setting Guide for Injecting Drug Users

The Technical Guide aims to equip countries with a framework and process for setting national targets in order to create more consistent methods of measuring progress towards the ultimate goal of universal access to HIV prevention, treatment and care, which was adopted by the United Nations and it’s Member States at the High Level Meeting on HIV/AIDS in 2006. This goal means that evidence-based interventions must be physically accessible, affordable (if not free), equitable and non-discriminatory, not rationed or restricted, and “offered voluntarily in an enabling environment created by supportive legislation, policies and strategies”.

The Technical Guide explicitly describes the “comprehensive package” of nine “core interventions” that are recommended for injecting drug users – including needle and syringe programmes and opioid substitution therapy – and is the first UN document to do so. The guide states that “These nine interventions… have the greatest impact on HIV prevention and treatment. There is a wealth of scientific evidence supporting the efficacy of these interventions in preventing the spread of HIV”.

The Technical Guide provides countries with a set of indicators for measuring the availability, coverage, quality and potential impact of interventions, as well as benchmarks and examples of relevant data sources. This guide should assist countries around the world in setting monitoring, evaluating and improving the services that they provide for their injecting drug users. It will be regularly reviewed and revised to reflect the latest information and evidence – with the next review due in 2010.

• Click here for list of countries which currently support harm reduction and employ some of the ‘core interventions’

OHCHR Biennial Report References Harm Reduction Networks

The IHRA submission – entitled Harm Reduction and Human Rights: The Global Response to Injection-Driven HIV Epidemics – provided a global overview of the injecting-driven HIV epidemic worldwide and examined the human rights implications of the failure to scale-up harm reduction services worldwide. It made a series of recommendations to various UN human rights bodies to increase their engagement with harm reduction and drug policy issues.

In the OHCHR report, paragraph 46 (page 17) states that “The International Harm Reduction Association (IHRA) indicated that although an estimated 15.9 million people inject drugs in 158 countries and territories, the global state of harm reduction is poor, especially in countries where such services are needed most. Detailed information was provided on human rights abuses against people who use drugs, and which impede HIV prevention, treatment and care efforts, which include denial of harm reduction services, discrimination in accessing antiretroviral therapy, abusive law enforcement practices, disproportionate criminal penalties, and coercive and abusive drug dependence treatment. The submission also drew attention to the fact that drug control entities rarely discuss human rights and the human rights bodies and mechanisms, in turn, rarely focus on drug policy… this has resulted in an international system and policy environment where significant human rights violations, many impeding HIV-prevention efforts, fall between these two separate regimes, unaddressed and largely ignored”.

In conclusion, paragraph 51 of the report (page 18) comments that “those vulnerable to HIV infection or to human rights violations related to the disease include children and youth, indigenous populations, injecting drug users, men who have sex with men, migrants and other mobile populations, prisoners and persons in detention, sex workers, and women”.

• Click here for the OHCHR Biennial Report on HIV

• Click here to view the IHRA submission to the OHCHR (in English and Polish)

CLAT5: The 5th Latin Conference on Harm Reduction

The event aims to rethink the future of harm reduction from the trans-national perspective and to question the current consensus on policies and interventions. It will focus on the concepts and practices associated with harm reduction, human rights, the inequalities between North and South, East and West, and the social dialogue between key international actors. A global dialogue among nations is vital in order to tackle these issues, which is why this conference will have five official languages – Portuguese, Spanish, French, Italian and English.

The CLAT5 Organising Committee is currently accepting proposals for articles and posters etc for the event. A list of thematic ‘circuits’ has been created to guiding any proposals:

• Circuit 1 – The Drugs on the Street
• Circuit 2 – Parties: Pleasures Management and Risk Reduction
• Circuit 3 – Alcohol and Risk Reduction
• Circuit 4 – Sex: Pleasures, Risks and Sexual Work
• Circuit 5 – Other Addictions
• Circuit 6 – Human Rights and Penal Control

Click here to visit www.clat5.org for more information about this event

Developing an International Directory of Naloxone Programmes

Naloxone is a drug which reverses opioid overdoses – a common risk associated with the use of drugs such as heroin. One of the key factors in the outcome of an overdose is the effectiveness of the response by those who witness the incident – including peers. Naloxone is a short acting antagonist drug, and works on the central nervous system by counteracting depression of the respiratory system. By instantly counteracting any opioid drugs in the system, Naloxone can bring about sudden and acute withdrawal symptoms, but will keep the individual safe until further medical help can be sought.

It is available in a range of forms (including pre-prepared injections and nasal sprays) and is used around the world – often by emergency service personnel. In some countries, it is also routinely distributed to people who use drugs through needle and syringe programmes, medical services and/or pharmacies (often through research pilots). In Italy, for example, Naloxone ‘key rings’ were developed as early as 1995 for people who use drugs and drug-related deaths in the country have fallen from 1160 in 1997 to 516 in 2002.

If you or your service provides Naloxone to people who use opioid drugs (or their carers, family or friends), please complete the short form below and return it to Duncan Hill. Please also forward this short form to any of your contacts around the world who are delivering this intervention.

• Click here to download the short Naloxone survey WORD:31KB]

IHRD Launch Two New Resources

The first is a book entitled At What Cost?: HIV and Human Rights Consequences of the Global War on Drugs, which examines the “descent of the global war on drugs into a war on people who use drugs”. From Puerto Rico to Phnom Penh, Manipur to Moscow, the scars of this ‘war’ are carried on the bodies and minds of drug users, their families, and the health and service providers who work with them. A decade after the international community pledged to achieve a “drug-free world”, there is little evidence that the supply or demand of illicit drugs has been reduced. Instead, aggressive drug control policies have led to increased incarceration for minor offenses, human rights violations, and disease. This book covers issues such as police abuse in Indonesia, arbitrary detention in Cambodia, forced drug testing in China, drug control policies in India, the effects of United Nations and Russian influences in Central Asia, the impact of the drug war in Latin America and the Caribbean, drug control in Myanmar, Thailand, and Vietnam, and the ‘twin epidemics’ of drug use and HIV/AIDS in Pakistan.

The second resource is a guidebook entitled Human Rights Documentation and Advocacy: A Guide for Organizations of People Who Use Drugs. This report – written by Karyn Kaplan from the Thai AIDS Treatment Action Group – aims to help activists recognise and record human rights abuses, harassment and discrimination that are systematically conducted in the ‘war on drugs’. These abuses often go unreported due to fears of physical, mental, social or legal consequences, and investigations into rights violations against people who use drugs are rare. This guide focuses on providing activists with the necessary tools to develop a human rights advocacy plan, and includes topics such as how to start human rights documentation, guidelines for documenting violations, guidelines for conducting interviews, and how to monitor legal systems.

• Click here to view the ‘At What Cost’ book

• Click here to view the ‘Human Rights Documentation and Advocacy’ Guide