Looking at the issue on an international level,
Michel Kazatchkine, a member of the Global Commission and the UN Special Envoy
on HIV/AIDS in Eastern Europe and Central Asia, spoke at both the high-level
panel and Monday's special session.
"The war on drugs has failed in its original
purpose of reducing drug use," Kazatchkine said. "Not only has it
failed in that objective, but it is harmful in several respects." Drugs have become cheaper and more widely available, and new synthetic
drugs are coming onto the market every year. In addition, prohibitionist
policies have brought about large-scale violence (as in Mexico), corruption
and human rights abuses, and have encouraged a parallel underground economy.
Drug prohibition and punitive policies have also
"fueled and exacerbated" the HIV, hepatitis B and C, and TB epidemics,
he added. Fear of arrest and harassment prevents people from accessing services
like needle exchange, many countries have legal restrictions on harm reduction,
and large-scale incarceration contributes to the spread of these diseases. As a
result, it is estimated that worldwide one-in-five people who inject drugs is
infected with HIV, and in some regions up to 90% are infected with hepatitis C
is time for the debate to be open, for the taboo to be broken,"
Kazatchkine concluded. "It is time
for drugs to be seen as health problem and not a criminal problem."
Kerr of the British
Columbia Centre for Excellence in HIV/AIDS provided more data on the global
situation. In many
areas where the HIV epidemic is growing – including Eastern Europe and the Russian Federation – it continues to
be driven primarily by injecting drug use. According to UNAIDS, in 49 countries
the HIV prevalence among people who inject drugs is 20 to 50% greater than that in the
prevention and treatment for drug users exist, but access remains unacceptably
low," he summarised. "The barriers are primarily social and
structural, in particular discrimination against drug users."
Asma Jahangir, a lawyer and human rights activist
from Pakistan, noted that another barrier is the vested interests that have been
created by prohibitionist policies, ranging from bloated criminal justice and
prison bureaucracies to players in the underground drug economy. "Victims of
drug policy are basically vulnerable people," including children
introduced to drug use and women who act as drug carriers, she said. "Punitive
action against direct or indirect victims has to be changed to a policy of
bringing them back into mainstream society."
Shiba Phurailatpam of the Asian Pacific Network
of People Living with AIDS offered a perspective as a person who has used drugs
at Monday's special session, as did Azahari Said at Sunday's high-level panel.
Phurailatpam also stressed the importance of wide availability of naloxone to
prevent opiate overdose.
we don’t stop [current drug policies], what we've seen over the last 15 years
will continue," Phurailatpam
said. "We must stand up and not worry too much about what our
governments say, because we will save lives. It is madness and we've got to
Chris Beyrer of Johns Hopkins nicely summed up the message from both sessions: "It's pretty
clear that the war on drugs is unwinnable, the war on drugs users is terrible and
also unwinnable, but the war on HIV, HCV, and TB can be won with evidence-based
policy," he said.