Tag: INPUD

Key harm reduction messages for the replenishment conference

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In advance of the Global Fund Seventh Replenishment Conference to be hosted by President Biden in New York on September 19, 2022, the Network of People who use Drugs (INPUD), the Eurasian Harm Reduction Association (EHRA) and Harm Reduction International (HRI) developed key harm reduction messages for the Global Fund Replenishment Conference, implementation of the new Global Fund Strategy and the Global Fund’s New Funding Model (NFM4) cycle.

Harm reduction investment from international donors and governments in low and middle-income (LMI) countries totalled US$131 million in 2019 – just 5% of the US$2.7 billion UNAIDS estimates is required annually by 2025 for an effective HIV response among people who inject drugs. The Global Fund is the largest donor for harm reduction, providing at least 60% of all international donor support. The outcome of the replenishment will have significant consequences for harm reduction. The protection and scale-up of harm reduction programmes in low- and middle-income countries requires a fully funded Global Fund. An underfunded Global Fund will result in service closures, a reversal of gains made in HIV prevention among people who use drugs and ultimately, lives lost.

INPUD, EHRA and HRI urge the Global Fund and the wider donor community to be proactive in protecting harm reduction within all replenishment scenarios, in implementation of the Global Fund Strategy 2023-2028 and during the NFM4 cycle. Their recommendations centre on the following five areas:

  1. Harm reduction funding must be protected from any replenishment shortfall
  2. Catalytic investments for harm reduction and key populations must continue regardless of replenishment outcome
  3. Funding for community-led responses must be prioritised within NFM4, both for harm reduction and pandemic preparedness and responses
  4. Funding for efforts to increase domestic investment in harm reduction, and broader key population programming must be increased
  5. Funding for harm reduction in crisis must be protected and prioritised

The document with full explanation of the recommendation is available following this link>>>.

 

A report on the global qualitative study

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The International Network of People who Use Drugs (INPUD) has collaborated with the World Health Organization (WHO) Department for Global HIV, Hepatitis and STI Programmes on a global qualitative study examining the values and preferences of key populations, including people who inject drugs, for HIV, Hepatitis and STIs services. The findings of this study will inform the update of the WHO 2016 Consolidated Guidelines for HIV prevention, diagnosis, treatment and care for key populations. These Guidelines will be used to inform countries on the design and implementation of health packages for key populations, making it extremely important that they take into account the specific values and preferences of each key population included in the study (people who inject drugs, gay and bisexual men and other men who have sex with men, female, male and trans sex workers and trans people).

Across the globe, people who inject drugs continue to be at increased risk of HIV, viral hepatitis (HCV, viral hepatitis B (HBV) and tuberculosis (TB). In order to reduce HIV, HCV and HBV transmissions along with overdose deaths, a comprehensive package of harm reduction interventions must be made available to people who inject drugs. Although such interventions are considered by the WHO and other UN agencies as essential to achieve global targets, access to harm reduction is still limited or non-existent in many countries, with less than 1% of people who inject drugs having sufficient access to services. Structural barriers caused by the criminalisation of drugs and the accompanying stigma and discrimination directed towards people who inject drugs are among the biggest contributors to this problem.

As one of the four key population networks included in the study, INPUD conducted eight regional focus group discussions and ten semi structured interviews with people who use drugs from 27 total countries. This report is a summary of our key findings that will be used to update the Consolidated Guidelines with the values and preferences of people who inject drugs.

The findings of this research emphasise the critical importance of listening to the values and preferences of people who inject drugs to guide services and interventions and ensure there is a primary focus on delivering genuine person centred care.

The report is available following this link>>>.

 

UNAIDS calls for action against the criminalization of people who use drugs

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1 November is International Drug Users’ Day, when the global community of people who use drugs comes together to celebrate its history and affirm the rights of people who use drugs. The International Network of People who Use Drugs (INPUD) marks this day with a celebration of its diverse, vibrant communities’ accomplishments, while also acknowledging their work is more critical than ever.

On International Drug Users’ Day, UNAIDS is calling for urgent action against the criminalization of people who use drugs, for the redress of criminalization’s negative effects on HIV, viral hepatitis and other health issues, for the respect of human rights and for more funding for community-led harm reduction programmes.

People who use and inject drugs are among the groups at highest risk of acquiring HIV but remain marginalized and often blocked from accessing health and social services. In 2020, 9% of all new HIV infections were among people who inject drugs. Outside of sub-Saharan Africa this rises to 20%. Although women represent less than 30% of the number of people who use drugs, women who use drugs are more likely to be living with HIV than their male counterparts. Less than 1% of people who inject drugs live in countries with the United Nations-recommended levels of coverage of needles, syringes and opioid substitution therapy, and the funding gap for harm reduction in low- and middle-income countries sits at a dismal 95%.

Even where harm reduction services are available, they are not necessarily accessible. Punitive drug control laws, policies and law enforcement practices have been shown to be among the largest obstacles to health care in many countries. Criminalization of drug use and harsh punishments (such as incarceration, high fines or removal of children from their parents) discourage the uptake of HIV services, drive people underground and lead to unsafe injecting practices, and increase the risk of overdose. Women who use drugs face higher rates of conviction and incarceration than men who use drugs, contributing to the increased levels of stigma and discrimination they face in health-care settings. In effect, criminalization of drug use and possession for personal use significantly and negatively impact the realization of the right to health.

 

Drug Decriminalisation: Progress or Political Red Herring?

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From the INPUD website

Over the past decade there have been increasing claims that the world is moving towards a critical turning point in international drug policy, based on a growing recognition that governments must consider alternative approaches to drug policy which include decriminalisation. While this shift has been hailed as a sign of progress by many, INPUD believes there are still important and overlooked questions regarding the extent to which the needs and rights of people who use drugs are being prioritised in countries that have decriminalised drug use. In 2018, INPUD published a ground-breaking analysis of the Portuguese decriminalisation model – Is Decriminalisation Enough? Drug User Community Voices from Portugal – which for the first time assessed the impact of decriminalisation of Portugal from the perspectives of people who use drugs. The report noted how “interactions with the state and the police, and issues of violence, social exclusion, stigmatisation, and discrimination, are often entirely omitted from discussion and analysis of decriminalisation”.

INPUD is excited to present Drug Decriminalisation: Progress or Political Red Herring? This report, like our previous report on Portugal, is intended to open up the debate on decriminalisation and make clear the expectations people who use drugs have for future action on drug policy reform. Most importantly, it includes a call for full decriminalisation without sanctions as the new baseline for measuring progress on decriminalisation in the future.

Decriminalisation is often discussed as if there is only one model, leading to a view that decriminalisation anywhere equals progress. However, there are many different models of decriminalisation in operation, all with different impacts. This report was published because we believe current reforms have not gone far enough. This situation means that in the overwhelming majority of countries, people who use drugs continue to be criminalised, punished, and stigmatised despite decriminalisation. Furthermore, no existing reviews of decriminalisation models have specifically included the perspective of people who use drugs in their analysis, a glaring oversight which reflects the historical exclusion of the voices of people who use drugs within policy discussions.

INPUD believes it is time to disrupt the misconception that decriminalisation efforts unquestionably represent progress when they have been developed with little or no consultation with people who use drugs. This report amplifies the voices of people who use drugs through a series of interviews conducted with members of the community and their representatives in countries that have implemented various approaches to decriminalisation. Our hope is that this report can support peer-led advocacy efforts towards more inclusive, progressive, participatory and transparent drug policies which fully recognise the human dignity of all people who use drugs.

To read the report, please follow this link>>>.

 

Community Matters

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The International Network of People who Use Drugs (INPUD), Mainline, King’s College London, AFEW International, the South African Network of People who Use Drugs, AFEW Kyrgystan and Rumah Cemarah shared the results of a three year research programme exploring how community involvement impacts the quality and accessibility of harm reduction services for people who use drugs. The research Community Matters: Lessons from a Bridging the Gaps research programme, supported through the Bridging the Gaps II programme, was completed from 2018 through 2020 as part of a community-academic partnership across Indonesia, Kyrgyzstan and South Africa which were linked to a ‘rapid review’ of the literature on low and middle-income countries.

Evidence from the report shows how difference forms of community involvement across these three countries impact harm reduction access and quality, especially in low and middle income settings. This evidence base can guide the scaling-up of community involvement efforts globally in support of harm reduction targets.

The report has four core messages:

  1. More ambitious support is needed for expanded community involvement in harm reduction services
  2. Community involvement can support increased access and quality of harm reduction services
  3. Community leadership delivers research with impact
  4. Research agendas need to expand and methodologies need to adapt

To read the report, follow this link>>>.

 

Tool for Gender-Responsive Harm Reduction Services for Women who Use Drugs

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The International Network of People who use Drugs (INPUD) and the International Network of Women who use Drugs (INWUD), in collaboration with the United Nations Office of Drugs and Crime (UNODC) HIV/AIDS Section and Koalisi Satu Hati, a community advocacy group in Indonesia, developed On the A-Gender: Community Monitoring Tool for Gender-Responsive Harm Reduction Services for Women who use Drugs. It aims to be a resource for community advocates to begin documenting, evidencing and addressing this state of play. The tool acknowledges the diversity and intersectionality of women who use drugs – including sex workers, lesbian and transwomen.

Worldwide, women who use drugs are vastly underserved within health and social services and programmes. National and international research, services, guidelines, and training programmes are either gender-neutral or male-focused. As harm reduction services are primarily tailored to men, women who use drugs often find their specific needs being unacknowledged and unaddressed, leading to non gender-responsive harm reduction services.

This resource can be a useful and a practical first step towards developing advocacy strategies to introduce and scale up gender-responsive harm reduction services in various settings around the world. In this way, the right to health of women who use drugs can be respected and better promoted.

To read full and download the tool, follow this link>>>

Instructions on coronavirus in Serbian

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Together with our member organisations Prevent and Re Generation, DPNSEE have prepared information and instructions for protection against coronavirus in Serbian for people in risk from vulnerable populations we support. We used several sources: INPUD, Leafly, Crew and BesD.

The instructions are printed in 500 – 2.000 copies to share to the key populations.

These instructions will be available in various institutions and civil society organisations in Serbia. We expect that they will be adjusted to local languages in some other countries of South East Europe.

General harm reduction tips for people who use drugs
General prevention measures against coronavirus COVID-19
Instructions for people who take drugs snorting
Instructions for people who use cannabis
Instructions for people who go clubbing
Instructions for sex workers

Full speed CND

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Side events

The media, a key actor in the field of drugs

Organized by Canada, and Association Proyecto Hombre, Canadian Centre on Substance use and Addiction, Dianova International, The Interest Organisation for Substance Misusers and Turkish Green Crescent Society.

Role of social networks to take action is to:

  • Reach bigger audiences
  • Promote initiatives
  • Mobilize support
  • Organize campaigns to end stigma
  • Fund more research
  • Authorities should monitor for dangerous content
  • Encourage influencers to promote a healthy life style

An interesting source is Addictionary, produced by The Recovery Research Institute.

Kristina Stankova presented “The role of social networks and alternative media in the field of drugs”. The threats identified include misleading information and fake news, peer pressure, the influence of advertisement in social networks, famous people and influencers promoting unhealthy lifestyle as fun and cool, etc. Tips on how to use social networks and alternative media in a positive way include use of social networks as a tool to access information for research, use them as a tool to raise awareness and promote a healthy lifestyle, reach hidden populations, to end stigma, to spread accurate and understandable information, etc. Studies have found that as many as 75% of teens felt pressured to drink alcohol and use drugs after seeing their friends post these activities online.

Communities at the centre: Barriers and opportunities for community led interventions

Organized by International Drug Policy Consortium, International Network of People who use Drugs, Joint United Nations Programme in HIV/ AIDS, Office of the High Commissioner for Human Rights and UNODC HIV/AIDS Section.

Since 2018, only one new country started needle exchange programme, while no new country started OST – despite all evidence base that these are important services for people who use drugs.

Mick Matthews from INPUD: We are not the enemy, work with us.

11 million people in the world inject drugs. Every eight has HIV, every second Hep C. 84% of those who have HIV also have Hep C. UNAIDS is clearly ready to work with and for people who use drugs (and they introduced this denomination to UN documents).

Harm reduction and rehabilitation program for inmates in prisons with mental and behavioral disorders due to use of psychoactive substances
Organized by Spain and Ukraine and European Union

Spain and Ukraine presented a cooperation project implemented in the context of EU cooperation program. Both countries used it to implement measures planned by their drug strategies.

Spain performs a survey on health services in prisons every 5 years. 75% inmates used illegal substances in their life. “Incarceration is an opportunity to improve health of inmates”.

Drugs are present in prisons in Spain and make serious problems resulting in fights between internal gangs.

Relapse after treatments in Spain is at 31,5%, while at those who go through treatments in prisons it is around 16%.

In Ukraine, with the support from the Global Fund, condoms are shared free of charge in prisons. There was a programme to evaluate syringe exchange programme. Results of the programme are discussed now, but the measures shall wait for the reform on the prison system. Civil society organisations are involved in the programme and discussion.

Unfortunately, a few Ukrainian CSOs were very critical and presented completely different view.

Shared responsibility in addressing the cocaine threat along the supply chain

Organized by European Union, UNODC CRIMJUST, UNODC Regional Office for West and Central Africa and UNODC Research and Trend Analysis Branch

Chloé Carpentier, Chief of the UNODC Drug Research Section in her presentation mentioned that the “new kids on the block” in the cocaine trade chain in Latin America are the Balkan cartel which holds 34% of the transfer of cocaine from Latin America to Europe and almost all street distribution! Production of cocaine is on the historical maximum, there are more organised criminal groups and purity is very high. More regional and international cooperation is needed to fight the problem.

UNODC-WHO Community Management of Opioid Overdose – initial results from the S.O.S. study
Organized by Australia, Kyrgyzstan and the United States of America, and UNODC Prevention, Treatment and Rehabilitation Section, Vienna NGO Committee on Drugs and World Health Organization

Representatives of UNDC and WHO expressed their dissatisfaction that we have to fight for Naloxone, as this is a medication that has no controlled substance. Stigma associated with opioid use disorders is so potent that it extends to naloxone itself. Every day, week, year of inaction means that persons are dying due to opioid overdose when there are medicines that could save their lives. Naloxone is officially registered as a medicine across 51% of all countries, but most countries don’t provide data on the availability of Naloxone.

The research they prepared and showcased by this event also serves as an assessment of the WHO’s own Guidelines on Community Management of Overdose Overdose.

The WHO-UNODC S.O.S. programme (S.O.S. for Stop Overdose Safely) is a peer-distribution programme in which we attempt to provide take home naloxone to likely witnesses of overdoses. The goal at the launch of the SOS Initiative in March 2017 was to have 90% of those likely to witness an overdose are trained to implement Naloxone; 90% of those trained to provide naloxone are provided with a supply; and having 90% of provided with Naloxone are actually carrying it with them.

Meetings

Ms Leigh Toomey, member of the UN Working Group on Arbitrary Detention attends the 63rd session of the Commission on Narcotic Drugs. For the occasion, she was willing to meet with selected IDPC members and partners to discuss the Working Group’s activities, including its upcoming report on the use of arbitrary detention in drug policy.

Cases presented to Ms Toomey mainly came from countries which have harsh approach to drugs. DPNSEE Executive Director added a couple of issues from the region.

We participated in the Vienna NGO Committee Annual General Meeting. Half of the Board have been elected, all from recovery organisations which have obviously well prepared for the elections.

What does Universal Health Coverage mean for People Who Use Drugs

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On 23 September 2019, world leaders adopted a high-level United Nations Political Declaration on universal health coverage (UHC) at the United Nations General Assembly. In adopting the declaration, U.N. Member States have committed to advance towards UHC by investing in four major areas around primary health care.

These include mechanisms to ensure no one suffers financial hardship because they have had to pay for healthcare out of their own pockets and implementing high-impact health interventions to combat diseases and protect women’s and children’s health. In addition, countries must strengthen health workforce and infrastructure and reinforce governance capacity. They will report back on their progress to the U.N. General Assembly in 2023.

The International Network of People who Use Drugs (INPUD) published a Technical Brief which explains how UHC can be both an opportunity and a concern for the health and rights of people who use drugs.

Through sustained diplomacy and negotiation at the political level and strong and concerted advocacy from civil society and communities, UHC is now prominent in the Sustainable Development Goals (SDGs). The principle of the SDGs is ‘leave no one behind’; this should be taken to mean that those on the fringes of society are accorded the same rights to health and wellbeing as the most privileged. People who use drugs, along with other criminalised and marginalised populations, clearly fit into this category.

To read the Technical Brief, follow this link>>>

62nd CND Session – Day 2

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The second day of the 62th CND was full of side events and sharing with participants.

An overviews of the side events we participated in today includes:

Psychoactive substances and the Sustainable Development Goals – Towards a comprehensive approach in the era of the 2030 Agenda

Organized by the Government of Slovenia, Utrip Institute for Research and Development, the Pompidou Group of the Council of Europe and IOGT International. Jože Hren started his presentation reminding that for 20 years already the approach in Slovenia is that drug use is primarily a health problem and that possession of small quantities is a misdemeanour also since 1999. Those who are caught in possession of drugs get a fine of 40 Euro, but there is a process to change it to an oral warning or referral to treatment in more complex situations. Representative of the Pompidou Group spoke about the bi-annual prize the Group awards to innovative prevention programmes created by young people for young people. Another Slovenian representative presented their work emphasizing the need to invest in mental health programmes for adolescents. Cost of mental health disorders in Europe take 3 to 5 percent of GDP. There is a need for a reallocation of resources for more sustainable and impactful outcomes in tackling harmful substances and behaviours. Medical help is not enough – it has to be combined with comprehensive and long lasting prevention. They have a programme called “This is me”, which is in line with the Goal 3 of the SDGs. Kristina Sperkova, president of the IOGT International (international network of Templar organisations) works on prevention of alcohol and other drugs harm world-wide. Sanela from Utrip Institute advocated for a community approach to prevention. Notes from the side event are available at the CND Blog following this address>>>.

Leaving no one behind: People at the centre of a harm reduction, human rights and public health approach to drug use

Organized by the Netherlands and Norway, UNODC, UNDP, UNAIDS, WHO, IDPC, AFEW International, Harm Reduction International, INPUD, Open Society Foundations, Aidsfonds and Frontline AIDS. Ann Fordham from IDPC highlighted that the new UNADIS report indicates that 99% of people who use drugs doesn’t have a proper access to health services. WHO representative reminded that half a million people worldwide die of drug related deaths, mainly overdose and blood borne diseases HIV/AIDS and Hepatitis C. People also suffer because they can’t access the medicines they need. The Netherlands has “put people first” in their approach to harm reduction. The right to health is fundamental to all people irrespective of whether they are using drugs. Drug policies should seek to reduce violence, promote the rule of law, support the most marginalized and vulnerable, lift up human rights. Prohibition and criminalization means a continuation of armed conflict supported by disproportionate spending. Naomi Burke-Shyne from HRI reminded that funding for harm reduction has flat lined from 2007 to 2016, which stands in shocking contrast to the estimated funding need by UNAIDS: existing funding represents only 13% of this estimated need. Judy Chang from INPUD stated that “Existing drug policies threaten security, democracy and the well-being of all, especially those most marginalized and vulnerable. The war on drugs and drug-free agenda undermines the SDG agenda.” Zaved Mahmood from ‎UN Office of the High Commissioner for Human Rights estimates that People who use drugs are not just left behind, they are kept out. The right to life includes the obligation to take measures where peoples’ lives might be threatened, including in relation to the use of drugs and HIV and hepatitis.

Drug prevention approaches that make a difference

Organized by the Governments of Iceland and Serbia, and the Pompidou Group of the Council of Europe. Serbian representative to the OSC made an introduction speech. The same like the Minister of Health on Thursday 14 at the Ministerial Segment, he said that the Drug Strategy has 5 chapters instead of 7, avoiding to say that Harm Reduction is one of them. Jelena Janković from the Ministry of Health presented the latest developments, including information about overdose deaths in 2018 and creation of the Ministerial Commission (for fighting narcomania in schools). She also presented the project the Ministry did with experiences and support from Israel. Iceland presented their project with are seen as the flagship project on prevention. Almost 2% of the alcohol and tobacco taxes go to prevention programmes! They see as the main risks and protective factors family factors, peer group effect, general well-being and extra-curricular activities and sports. Their learning is that the multidisciplinary collaboration is the key to success. The change thy achieved is different attitude of parents and society – don’t buy alcohol for children. It is not OK for adolescents to be drunk in public. It is not the amount of time that parents spend with their children – it is the quality of time. There are no unsupervised parties. Pompidou Group emphasised the role of police in prevention. Interventions from the floor were on offering more than just sports and having campaigns that cover illicit but also legal substances.

Other side events held today that may be of interest are:

Other events

The Vienna NGO Committee on Drugs (VNGOC) held regular Annual General Assembly. The Committee welcomed new members, reviewed and approved the VNGOC annual report and reflected on activities for 2018/19 including those of the Civil Society Task Force (CSTF), got information about the annual accounts for 2018, the latest financial status and audited accounts for 2018, Strategic Plan 2019-21 and Budget for 2019 and Voluntary Code of Conduct for NGOs at the CND and received an update on developments within UNODC. The Committee discussed the future organisation of the VNGOC, based on the background paper presented by the Board.

Following a governance review process undertaken in 2017, VNGOC agreed to stagger the elections for the VNGOC Board to ensure greater stability and continuity. In order to do this, three of the positions elected last year were given one-year terms, the other three positions were given the standard two-year terms. This year, the following three positions were up for re-election: Chairperson, Deputy Treasurer, Deputy Secretary. Our friend fro International Drug Policy Consortium Jamie Bridge was re-elected for the Chairperson. Congratulations!