Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Drug policies must protect people from HIV


Isaiah Wabwire, an outreach worker with DARAT, an Alliance partner organisation, sits with injecting drug users 'Niko' and 'Omar.' © Nell Freeman for the Alliance.

Injecting drugs is the most effective way to transmit HIV. Outside of Africa it is the biggest driver of the HIV epidemic. Yet despite this, global drug policy is still not focusing on efforts to protect people who inject drugs from HIV.

March 2012 saw the 55th session of the Commission on Narcotic Drugs (CND), the UN policy making body responsible for international drug control. The CND matters to the Alliance, and to HIV and harm reduction efforts more generally, because it is this UN Commission that oversees the implementation of the international drug conventions that shape national drug laws.  National governments will be influenced, or bound by, these conventions.  These conventions, it is argued, are outdated and not relevant in a world where drug use patterns are constantly changing, and where HIV epidemics are driven by injecting drug use.

Discussions at this year’s CND, like every other year, focused on stopping the supply of drugs and advancing law enforcement efforts.  A focus on the health and safety of people who use drugs was largely absent from this agenda.

It therefore falls to civil society representatives to speak out about the rights of people who use drugs and to point to the negative consequences of current approaches to drugs. Routine criminalisation and incarceration of people who use drugs fuels HIV transmission and undermines efforts to get treatment and care services to HIV positive drug users.  We know that a harm reduction approach to HIV and drug use works, and it is vital therefore that global drug policy reflects this.

But progress at the CND is slow.

Ann Fordham, Executive Director of the International Drug Policy Consortium (IDPC), attended this year’s meeting.  IDPC are a partner in the Alliance’s Community Action on Harm Reduction project, bringing expertise in drug policy reform to our work.  Ann provided an account of this year’s meeting:  “This year there were no HIV-specific resolutions.  However, after much effort on the part of harm reduction-friendly member states, a resolution on women and drug use was passed that included language on HIV, gender and health.  There was also a progressive resolution on preventing overdose.  This felt like progress, despite much rhetoric about ‘winning the war against drugs’”.

Voices silenced

HIV civil society organisations have expectations about equal status and fair participation in UN fora, arising from our involvement in the UNAIDS Programme Coordinating Board and in the governance of the Global Fund.  The CND however has a very different culture and practice.  Ann describes this difference:  “There are very few opportunities for civil society to have a voice in this meeting, and this year in the rare moments when we could speak, our efforts were constrained and censored”.  Ann described how a statement delivered by the International Network of People who Use Drugs (INPUD) on behalf of the Alliance, IDPC, Harm Reduction International (HRI), and the Eurasian Harm Reduction Network, which called on clearer leadership from the UN Office on Drugs and Crime (UNODC) on HIV prevention for people who use drugs, was rejected at first then censored. Revisions had to be made to ‘tone down’ the statement before it could be delivered.

Support, don’t punish

In this environment it’s important that civil society demands a focus on HIV prevention and the rights of people who use drugs to harm reduction services. That’s why the Alliance and its partners IDPC, INPUD and HRI have launched the ‘Support, Don’t Punish’ campaign. The campaign calls on governments to bring an end to the criminalisation and punishment of people who use drugs. It aims to ensure that legal barriers to the most important and effective HIV prevention interventions - needle and syringe programmes and opioid substitution therapy - are removed.  You can read more in the campaign statement, which was launched at the CND.

Community action on harm reduction

The Alliance takes a harm reduction approach to addressing HIV and drug use. This means providing services and programmes that prevent HIV transmission by providing information and commodities to promote safe sex and safe injecting. It also means providing services to HIV positive drug users, such as HIV treatment, counselling, family support and sexual and reproductive health services.  We provide services for drug users in their communities as well as in government health clinics.

Community Action on Harm Reduction (CAHR) is an ambitious project which aims to expand HIV and harm reduction services to more than 180,000 injecting drug users, their partners and children in China, India, Indonesia, Kenya, and Malaysia. You can learn more by visiting the project’s brand new website.

Read more about drug use and HIV

Download the Alliance's Good Practice Guide on drug use and HIV