Rapporteur reports
KC 3: Intensifying involvement of affected individuals and communities report by Konstantin Lezhentsev
This session was focused on highlighting the devastating effect of repressive drug policies on HIV/AIDS epidemic. The key message of the meeting was “without advocacy for protecting basic human rights of IDUs any attempts to address HIV/AIDS crisis in this community will fail”.
Ralf Jurgens made a breakthough presentation on greater involvement of drug users in the response to HIV/AIDS. The involvement of IDUs into decision making process, effective use of their expertise in planning and implementation of HIV programs is significantly limited. Very limited experience of effective IDU involvement shows that IDU community is critical for effective response, ensuring ethical standards in any interventions and reforms in policy and public health approaches. “It is a matter of quality of life, dignity and human rights of IDUs”,- Ralf concluded in his speech.
Ted Hammett underlined the negative effect of inconsistent drug policies on prevention programs for IDUs in China and Vietnam. Conflicting messages, constant police crackdowns and repressions on IDUs leads to fueling HIV epidemic in this population.
“Thailand model of effective prevention of HIV is not for IDUs”, - stated Leila Khondkar. HIV remains main killer of IDUs in Thailand with one quarter of all new infections happening in this community. National populist anti-drug policies led to one of the most dramatic violations of human rights with more than 2000 IDUs murdered by police. Stigma and discrimination and police harassment withdraw IDUs from any possible assistance, including ARVs. “Healthcare workers behave in a way they are owners of our lifes”, Leila quoted IDU activist from Thailand.
Andrey Tolopilo from Ukraine presented facts on how national repressive policies and practices violate basic human rights of IDUs in the country with the fastest growing HIV epidemic in Europe. Tortures, sexual violence from police are common. “Without advocacy for reforming drug policies, establishing effective legal aid for IDUs it is impossible to prevent an epidemic”, Andrey said by the end of his presentation.
A.Klein spoke about lack of political will and effective strategies to scale up Harm Reduction services in Canada where only 4% of IDU population are reached by HR services (example of Ontario).
Discussion was mainly focused on how to scale up best models of legal aid for users, prioritize the issue of reforming drug plicies and protect human rights of IDUs.
Science Track E: Policy report by Christine Stegling
This session addressed key legal, policy and human rights issues related to injecting drug use.
Ralf Juergens, in his presentation on ‘Nothing about us without us: Greater meaningful involvement of people who use drugs in the response to HIV/AIDS’ reported on a study undertaken in Canada that highlighted the importance of including people who use illegal drugs in the planning of services that are indented to respond to their needs. He commented on the many unique contributions that drug users have made in advocating for harm reduction programmes, noting that due to such advocacy that Canada now has a [single] safe injection site.
Dr. Hammett described the inconsistency in policies with regard to injecting drug users in China and Vietnam. While both countries increasingly recognize the importance of harm reduction programmes, there are still reports on the continued repression of drug users through mass arrests, crackdowns and compulsory rehabilitation. He noted that in Vietnam, for example, currently 60.000 drug users have been compulsory confined to rehabilitation centres with an indication that the relapse rate after release from such programmes is higher than 90%. Governments need to recognized that repressive policies have a negative impact on HIV prevention programmes aimed at drug users who will be reluctant to identify themselves in an environment which otherwise does not respect their needs and dignity. It therefore is crucial that harm reduction strategies are incorporated in HIV prevention strategies in a supportive legal and policy environment.
L. Khondkar emphasized the theoretical and empirical links between human rights abuses and increased vulnerability to HIV infection. Her study discussed effects of the ‘war on drugs’ by the Thai Government since 2003. About a quarter of all new HIV infections in Thailand can be attributed to injecting drug users, however, there is very little collaboration between the drug control and the HIV prevention programmes. In unison with other speakers she noted the importance of including drug users in the planning and provision of services aimed at harm reduction and HIV prevention and emphasized that systematic discrimination and human rights violations of drug users add to their vulnerability to get infected with HIV.
Similar to China, Vietnam and Thailand, the government in Ukraine has adopted a repressive approach to counteract drug addiction. A. Tolopilo gave a vivid account of the many human rights violations suffered by drug users, sex workers and other marginalized groups in Ukraine through the police force. A project aimed at protecting the rights and interests of vulnerable social groups, resulted in training for drug users, sex workers, People Living with HIV and institutions such as the police. The programme also avails legal services to affected communities and has to this date provided assistance to over 3600 clients. It was noted that while many programmes involved with marginalized groups are focusing on service provision, there is a definite need to engage them in advocacy on the human rights of drug users and other vulnerable groups.
While Canada established needle and syringe programmes twenty years ago, barriers to access these programmes have had impeded their effectiveness. Some of these barriers are programme related such as limited operating hours of needle and syringe programmes, their geographic coverage and the lack of awareness by drug users of the existence of such services. However, Alana Klein noted the impact of Canadian drug laws that criminalize the procession of used injecting equipment on the confidence of drug users in utilizing needle and syringe exchange programmes. Needle and syringe programmes have proven to be effective in preventing HIV infection in drug users and therefore urgently need to be scaled-up, especially considering that 14% of new HIV infections in Canada in 2005 occurred within the drug user community with a disproportionate infection rate among First Nations People.
The discussion noted the importance of meaningfully including drug users in HIV programmes in order to achieve Universal Access for All. Presentations pointed out the special vulnerability of ethnic minority groups globally with regard to drug use and HIV infection and the crucial need to address minority rights.
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