UNGASS on drugs: we won’t end AIDS without “harm reduction.”

If just 7.5% of the estimated $100 billion spent annually on the war on drugs was instead directed to spending on harm reduction, we could practically end HIV among injecting drug users

If just 7.5% of the estimated $100 billion spent annually on the war on drugs was instead directed to spending on harm reduction, we could practically end HIV among injecting drug users. That’s the conclusion of research by Harm Reduction International published in the Lancet recently ahead of the 59th Commission on Narcotic Drugs in Vienna and next month’s UN General Assembly Special Session on Drugs (UNGASS).

Yet member states’ commitment to the concept of harm reduction keeps being contested in global drug policy. Why?

Russia is rumoured to have been active behind the scenes in Vienna this week blocking all attempts at putting “harm reduction” on the agenda.

Russia’s HIV epidemic continues to grow quickly. It has the highest number of newly diagnosed HIV cases among Council of Europe members. And more than 93,000 new infections were diagnosed in in 2015, 53.6% of them attributable to unsafe drug injection.

By contrast, neighbouring Ukraine managed to halve HIV prevalence among injecting drug users between 2008 and 2014, in large part because of harm reduction programmes. Yet Opioid Substitution Therapies (OST) are under threat in areas of east Ukraine annexed by separatist fighters.

Alliance for Public Health, a Ukrainian NGO recorded an additional 495 cases of HIV last year in areas where harm reduction programmes are now effectively banned.

Yet all reference to harm reduction, clean needle sharing and OST were removed from the outcome document in Vienna.

The prospect of the UN system continuing to promote the fantasy of a ‘drug free world’ is real despite the need to move towards more harm reduction.

Globally, around 12.7 million people inject drugs and 1.7 million of them are living with HIV.

On average, one in ten new HIV infections are caused by the sharing of injecting equipment

We won’t meet the target to end AIDS by 2030 unless states implement harm reduction programmes and reform drug policies.

The case for the effectiveness of harm reduction interventions, like needle and syringe programmes and OST is irrefutable according to UNAIDS. And all the relevant UN agencies agree and endorse a harm reduction approach to HIV and drug use.

It’s nearly 20 years since the last UNGASS declared its intention to bring about a world free of drug use. Its goals and aspirations were not met.  The harms that arise from many of its goals and aspirations have been toxic: mass incarceration, the death penalty for drug offences, brutal and enforced ‘treatment’ in detention centres. Today many countries continue to take a punitive approach to HIV and drugs, using arrests, incarceration, criminal penalties and compulsory detention to criminalise and punish users.

Drug use is predicted to rise by 25 per cent by 2050, and without harm reduction it is unlikely we will meet the 2030 target to end AIDS.

 

 

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