HIV and illicit drug use -- a new way forward?

May 29, 2008

The United Nations needs to rethink its strategy on dealing with HIV and illicit drugs this year, concludes a Comment published in this week's edition of The Lancet, authored by Joanne Csete, Canadian HIV/AIDS Legal Network, Toronto, ON, Canada, and Daniel Wolfe, Open Society Institute, New York, USA.

This year, member states of the UN have been asked to engage in a year of reflection to gauge progress since the 1998 UN General Assembly Special Session on the problem of drugs worldwide - held under the banner 'A drug-free world - we can do it'. The declaration from that meeting aimed for complete eradication of opium poppy, coca, and cannabis, with a focus on policing and criminal law. However, the declaration was largely silent on measures to address HIV infection and other health problems for people who are unable or unwilling to stop using drugs. The authors say: "In 2008, the UN must do better. Epidemics of HIV and hepatitis C driven by injected-drug use should weigh heavily in the considerations of member states on whether they really can - or should try to - achieve a drug-free world."

The authors analyse the role of The International Narcotics Control Board (INCB), a UN-funded body of experts meant to enforce international drug control treaties, which they say undermines recognition of the importance of HIV prevention measures for those who use drugs. Further, they say that the INCB fails to criticise countries such as Russia where addiction medications such as methadone are illegal - despite the board's remit being to ensure that member states have such medication available. They say: "Nor has the board spoken out about the many instances where addiction treatment - required under the UN conventions - is incarceration by another name, including forced labour, prolonged institutionalisation, and unproven and punitive procedures, such as partial lobotomy or flogging...Indeed the INCB congratulates countries with repressive practices for their commitment to cracking down on the drug problem."

The authors call for a complete rethink of the role of the INCB, concluding: "The INCB is a relic of time when criminal law and crackdowns were deemed sufficient to deal with the public-health challenge of illicit drug use. In 2008, an ideal way for the UN to show that drug policy needs another look in the era of HIV would be for the UN Secretary General to commission an independent assessment of the activities of the INCB. The UN should also require that the deliberations of the INCB, which are held in secret, be opened to member states and civil society. Such measures would contribute to making 2008 a milestone of real global progress toward dealing with the health consequences of drug dependence."

Daniel Wolfe, Director, Open Society Institute, New York, USA T) +1 212 548 0195 / +1 917 969 7139 E)

Joanne Csete, former executive director, Canadian HIV/AIDS Legal Network, Toronto, ON, Canada T) +1 831 425 7917 / +1 415 283 7845 E)


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