30 March 2022
Organised by the International Network of People Who Use Drugs (INPUD), this side event for the 65th Commission on Narcotic Drugs explored the Global AIDS Strategy 2022-2026 and the 2021 Political Declaration on HIV and AIDS and how they could positively impact the health and wellbeing of people who use drugs.
Featuring advocates from across the globe the session discussed how all stakeholders (Member States, UN agencies and civil society actors) can work alongside people who use drugs to integrate targets from these strategies into policies.
The event was co-sponsored by Médecins du Monde, UNAIDS, UNODC HIV/AIDS Section, the Netherlands Ministry of Foreign Affairs and Australia Department of Health. The event was funded by the Robert Carr Fund and Love Alliance. INPUD also extended its thanks to the incredibly brave peers from the Ukrainian Network of People who Use Drugs and the Ukrainian Network of Women who Use Drugs for opening the event.
1. Crisis kills when it comes to people who use drugs
A spokesperson from the Ukrainian Network of People Who Use Drugs and the Ukrainian Network of Women Who Use Drugs shared the devastating impact of the Russian invasion on people who use drugs in Ukraine. As INPUD’s Judy Chang shared in the session introduction, “Nowhere is discrimination against people who use drugs more prominent than in crisis and emergency situations.”
Despite years of effort from Ukraine to build a sustainable system of HIV care and treatment for people, the crisis has exposed the vulnerability of communities of people who use drugs.
“The criminalisation of people who use drugs is one of the biggest obstacles to the safe movement of people from dangerous areas,” the spokesperson said. “There is fear that they will not have access to OST and other services in the places they may be relocated to.”
In the occupied territories, medical services and OST are all closed and it’s near-on impossible to access prescriptions drugs such as methadone in pharmacies, as they are closed or the drugs are not getting delivered.
“We urge everyone working in the global HIV response to know that without strong solutions to decriminalising people who use drugs then people will be in constant danger,” it was concluded. “Every crisis will kill them because of their inability to access care.”
2. Community-led initiatives are at the heart of HIV elimination targets
Suki Beavers, Director Gender Equality, Human Rights, and Communtiy Engagement at UNAIDS shared the new strategy for global HIV elimination. But first, the light was shone on the discrepancies between HIV elimination between people who use drugs and other key populations. “There has been a 23% decrease in HIV cases globally since 2010, yet there has been an increase in HIV in people who use drugs,” explained Suki. “Low access to HIV care for people who use drugs is one of the largest gaps in the global HIV response.”
One of the responses to this is the ’80-60-30’ targets that aim to bolster funding and support for community-led responses at national and global levels.
Suki explained that community-led specifically means peer-led with key population prevention programs being run by key populations themselves. Organisations of people who use drugs and other civil society organisations will be integral in making this happen.
Suki also echoed the call for help for people in Ukraine. “People who use drugs face life-threatening consequences of the attack,” Suki said. “They need uninterrupted access to methadone, naloxone, HIV treatment, and syringes in Ukraine and in neighbouring countries that have opened their doors.”
3. Countries need to be held accountable if the targets are to become reality
The Global AIDS Strategy outlines the 10-10-10 targets for 2025:
- Less than 10% of countries have punitive legal and policy environments that deny access to justice
- Less than 10% of people living with HIV and key populations experience stigma and discrimination
- Less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence
These targets, if met, will have an immeasurable impact on the health and wellbeing of people who use drugs, as they will tackle the root cause of a lack of access to healthcare – stigma, discrimination and criminilisation.
But, although the strategy has been developed with the voices of people who use drugs, thanks in part to the International Network of People Who Use Drugs (INPUD)’s extensive community consultation and reporting that fed into the strategy, we are not there yet.
Aditia Taslim, INPUD’s Advocacy Officer, discussed how there was still pushback from some UN representatives around issues related to human rights and the health of people who use drugs including harm reduction and law reform that will ultimately undermine the efforts to eliminate HIV as a global health threat by 2030.
“We need to turn these targets into actions,” explained Aditia. “Otherwise they will remain just on paper.”
The accountability of counties was also discussed, and how only very few countries have decriminalised drugs, with many still pushing abstinence.
4. There is positive change happening
But it’s not all doom and gloom. Fariba Soltani, Chief, UNODC HIV/AIDS Section, shared some of the positive actions being taken by countries towards decriminimlation of drug use, harm reduction and removing stigma and discrimination.
- Mozambique just introduced its first harm reduction program
- In Egypt, after many years of advocacy, OAT has now been approved and is being implemented
- In Vietnam take home OAT was approved in 2020 and expanded in 2021
“There is a lot of positive implementation happening around the world,” said Fariba. However, it was also noted that many countries continue to hold discriminatory and punitive drug policies and how criminalisation of drug use have been shown to block HIV service access.
5. Solutions need to be local and state-based
Aniedi Akpan – Executive Director, Drug Free and Preventive Healthcare Organization (DAPHO) in Nigeria shared statistics around the 14.5 million people in Nigeria who are using drugs including the fact that this community has a 10.9% prevalence of HIV now compared to 3.4% in 2014.
“The attitude towards people who use drugs in Nigeria has remained largely discriminatory with attempts at widening the scope of discrimination to include drug screening for employment, marriages and holding of political office,” explained Aniedi.
This discrimination is undoubtedly linked to the rise in HIV infections among this community and Aniedi shared various actions that could be taken to help solve these problems including developing and strengthening collectives of people who use drugs, and increasing state funding. This state-based funding and support will be integral in ensuring uncovered geographic space can become covered. “In Kenya, only 16-18 of the 36 states have programs for people who use drugs,” concluded Aniedi.
Thank you to INPUD and all partners involved for organising such an influential and informative session.