Position Statement and Recommendation for the United Nations General Assembly Special Session on Drugs 2016

On April 19-21, 2016 leaders from around the world gather at the United Nations General Assembly Special Session in New York to discuss global drug control priorities. We, representatives of people living with HIV, would like to take this opportunity to ensure any declaration of commitment that results from this Special Session advances the rights and wellbeing of those most affected by HIV and Hepatitis C (HCV) co-infection—including people who use drugs. The policies and practices of countries that perpetuate the ongoing stigmatisation and criminalisation of drug use significantly impacts and disenfranchises people affected by HIV and HCV. Despite the considerable progress made in strengthening understanding of and support for evidence based harm reduction practices, more is required to ensure that the 2.3 million people currently living with HIV and HCV co-infection receive the treatment, care, services and human right protections they deserve.

a)     Too many countries still have laws that criminalise and incarcerate people who use drugs. In some countries, drug use is even punishable by death. This response towards drug use and people who use drugs not only violates human rights in the harshest way possible, it also further stigmatises and marginalises active and former people who use drugs and prevents them from receiving the essential health care, social, legal and support services they need

b)     For HIV-positive people who use drugs, living in a country that criminalises drug use often means facing double stigma and discrimination that further cuts off access to health care; they face stigma and discrimination on the basis of their drug use and from their HIV status.

c)      HIV and HCV co-infection among people who use drugs is often neglected and severely underestimated. Surveillance on this co-infection has been done only in a limited scope and in an inconsistent manner in a handful of countries. Lack of data makes it difficult to understand how best to address HIV and HCV co-infection.

d)     Despite opportunities for cost-efficiency and intervention effectiveness, most countries have not yet integrated services related to prevention and treatment of HCV into existing HIV services. Further, all too often, people who currently use drugs are prohibitively banned from accessing the lifesaving HIV and HCV treatment and care services they desperately need. This shortsightedness only leads to increased incidence of HIV and HCV co-infection.

e)     Donor support for harm reduction programmes and to support advocacy on issues of importance to people who use drugs has historically been low, in part because there are currently no dedicated global funding mechanisms that support the treatment or advocacy needs of HIV and HCV co-infected people. Support for the work of HIV and HCV advocacy is essential to communities in low and middle-income countries that are fighting to drive down the costs of lifesaving HIV and HCV drugs for those most vulnerable. 

The challenges in the “drug control” response are multiple and complex. Here are the essential changes the community of people living with HIV, including those who use drugs, request that Member States commit to making when they gather at the 2016 UNGASS on Drugs in New York:

a)      Clearly express strong commitment to promoting, protecting and fulfilling the human rights, including the right to health, of people who use drugs.

b)      With the full and equal engagement of organisations and networks of people who use drugs, people living with HIV, and people affected by HCV, commit to reviewing national legal frameworks to ensure these promote the human rights, including the right to health, of people who use drugs.

c)      Recognise HIV and HCV co-infection as a priority issue and commit to addressing it urgently through an evidence-based public health approach. This includes collecting the necessary data to design effective strategies, policies and programmes, allocating sufficient (domestic and international) funding for services related to HIV and HCV co-infection, and addressing regulatory barriers to providing prevention and treatment services for HIV and HCV co-infection.

d)      Provide political, financial and programmatic support for organisations and networks of people who use drugs, people living with HIV, and people affected by HCV to engage fully in local and national harm reduction strategies and interventions.

We express our gratitude to the Chair and members of the UNGASS on Drugs 2016.