World Health Organisation released first guideline on digital health interventions

The World Health Organisation (WHO) released new recommendations on 10 ways that countries can use digital health technology, accessible via mobile phones, tablets and computers, to improve people’s health and essential services.

Over the past two years, WHO systematically reviewed evidence on digital technologies and consulted with experts from around the world to produce recommendations on some key ways such tools may be used for maximum impact on health systems and people’s health.

One digital intervention already having positive effects in some areas is sending reminders to pregnant women to attend antenatal care appointments and having children return for vaccinations. Other digital approaches reviewed include decision-support tools to guide health workers as they provide care; and enabling individuals and health workers to communicate and consult on health issues from across different locations.

The guideline emphasizes the importance of reaching vulnerable populations, and ensuring that digital health does not endanger them in any way.

The guideline demonstrates that health systems need to respond to the increased visibility and availability of information. People also must be assured that their own data is safe and that they are not being put at risk because they have accessed information on sensitive health topics, such as sexual and reproductive health issues.

The guidelines also makes recommendations about telemedicine, which allows people living in remote locations to obtain health services by using mobile phones, web portals, or other digital tools. WHO points out that this is a valuable complement to face-to-face-interactions, but it cannot replace them entirely. It is also important that consultations are conducted by qualified health workers and that the privacy of individuals’ health information is maintained.

This guideline represents the first of many explorations into the use of digital technologies and has only covered a fraction of the many aspects of digital health.

In 2018, governments unanimously adopted a World Health Assembly resolution calling on WHO to develop a global strategy on digital health to support national efforts to achieve universal health coverage. That strategy is scheduled to be considered at the World Health Assembly in 2020.

To support governments in monitoring and coordination of digital investments in their country, WHO has developed the Digital Health Atlas, an online global repository where implementers can register their digital health activities.

To get more information follow this link>>>

International Guidelines on Human Rights and Drug Policy

Responding to the harms associated with drug use and the illicit drug trade is one of the greatest social policy challenges of our time. All aspects of this challenge have human rights implications.

Drug control intersects with much of the 2030 Agenda for Sustainable Development. In line with the 2030 Agenda, the UNDP Strategic Plan 2018 – 2021 and the HIV, Health and Development Strategy 2016 – 2021: Connecting the Dots, the International Guidelines on Human Rights and Drug Policy provide a comprehensive set of international legal standards for placing human dignity and sustainable development at the centre of UN member states responses to illicit drug economies. The guidelines cover a diverse set of substantive issues ranging from development to criminal justice to public health.

The guidelines were developed by a coalition of UN Member States, WHOUNAIDSUNDP and leading human rights and drug policy experts. The Guidelines are an example of the support provided to practically integrate international human rights commitments into national, regional and global policy and programmes.

The drugs issue cuts across the 2030 Agenda for Sustainable Development and multiple Sustainable Development Goals, including ending poverty, reducing inequalities and, of course, improving health, with its targets on drug use, HIV and other communicable diseases. Goal 16 on peace, justice and strong institutions is particularly important, requiring attention to human rights across the Sustainable Development Goals. Since the late 1990s, UN General Assembly resolutions have acknowledged that ‘countering the world drug problem’ must be carried out ‘in full conformity’ with ‘all human rights and fundamental freedoms’. This has been reaffirmed in every major UN political declaration on drug control since, and in multiple resolutions adopted by the Commission on Narcotic Drugs.The reality, however, has not always lived up to this important commitment.

The Guidelines are based on both ‘hard law’ and ‘soft law’ sources – those that are legally binding and those that are authoritative but not binding per se. With very few exceptions, the general descriptions of rights are drawn from binding treaty provisions.

However, since very few human rights treaty provisions address drug control directly and since the application of general rights to specific groups requires a more in-depth analysis, much of the guidance presented throughout the document is based on UN resolutions and declarations, the general comments and concluding observations of UN human rights treaty bodies and the work of UN human rights Special Procedures. Findings of regional human rights courts and national courts are also cited. Such jurisprudence, which is binding for the relevant countries, is cited in the Guidelines as being persuasive of a particular application of a right.

The Guidelines are not a ‘toolkit’ for a model drug policy. The Guidelines are a reference tool for those working to ensure human rights compliance at local, national, and international levels, be they parliamentarians, diplomats, judges, policy makers, civil society organisations or affected communities.

This longer version of the Guidelines will be available on an interactive website where readers may search by specific rights, drug control themes, and other key words, as well as follow links to source material.

To read and download Guidelines on human right and Drug policy follow this link>>>

UNODC launched toolkit on synthetic drugs

UNODC launched the United Nations Toolkit on Synthetic Drugs, a web-based platform with a wide range of electronic resources that offer innovative and practical tools on how to approach challenges related to synthetic drugs and particularly opioids.

The toolkit is part of UNODC’s Integrated Opioid Strategy that was launched last year to deal with the deadly opioid crisis. UNODC is the lead UN Secretariat entity in providing assistance to Member States in addressing the world drug problem and in collaboration with the World Health Organization (WHO), the International Narcotics Control Board (INCB) and other international and regional organizations is coordinating the development of this toolkit to support countries in addressing the threat of synthetic drugs.

The Toolkit offers a selection of different topics critical in addressing the key challenges presented by synthetic drugs. Generally, these topics range from legislative approaches, forensic capacity, prevention, treatment and rehabilitation, and access to medicines to regulation, detection and interdiction. Currently, three modules are complete and accessible: Legal, Forensics and Precursors. The remaining modules are in development and will become available soon. Moreover, the toolkit will be frequently updated and complemented with additional resources.

The toolkit was formally presented by Justice Tettey, Chief of UNODC’s Laboratory and Scientific Section, at a side event during the 62nd session of the Commission on Narcotic Drugs (CND), co-organized by the governments of Canada, Columbia and the United States of America.

Justice TetteyMr. Tettey, Chief of UNODC’s Laboratory and Scientific Section, underlined, “the toolkit has been developed in an interactive and user-friendly way for the benefit of Member States. You can have a toolkit in your pocket.”  The U.S. Head of Delegation to the CND’s 62nd Regular Session, Mr. James A. Walsh highlighted the fact that “as an online platform, the toolkit will serve as a self-assessment tool that allows countries to identify and address the specific synthetic drug challenges they are facing.”

Over the past 150 years, humanity has experienced several opioid crises, but none as devastating as the present one. Opioids remain one of the most important classes of medicines, providing essential pain relief and palliative care for many millions of people in need. But the deadly consequences of non-medical use pose some of the greatest drug challenges we face today.

The Toolkit is available following this link>>>

62nd CND Session – Day 2

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!

CND opening day

NGO briefing by the Vienna NGO Committee

The briefing was a useful orientation, especially for the newcomers, to what will happen and the annual UN Commission on Narcotic Drugs and the role and involvement of civil society organisations.

Opening of the sixty-first CND Session

The opening session was held in plenary, with all national delegations and civil society representatives present and transmitted to other rooms. It included welcome messages of the CND 61 Chairperson Alicia Buenrostro Massieu, UN Secretary-General António Guterres, International Narcotics Control Board President Dr Viroj Sumyai, UNODC Executive Director Yuri Fedotov, WHO Director – General Tedros Adhanom Ghebreyesus and introductory speeches of country groupings: Group of 77 and China, Africa Group, Asia Pacific Group, Latin American and Caribbean Group (GRULAC) and European Union Group (including accession countries). The Session then continues with general debate.

It should me mentioned that Deputy Minister of Health of Bulgaria Svetlana Yordanova spoke on behalf of the European Union (Bulgaria holds presidency of the EU). She underlined that current UN Drugs Policy has been an utter failure and that EU expresses deepest regret that the UNGASS Outcome Document does not mention a moratorium on the death penalty. She said that “In 2009, we set 2019 as a target date for ourselves to eliminate cultivation of opium, coca and cannabis plants and social risks, trafficking and money laundering related to illicit drugs. We have not achieved this target: today we have an equally severe and diversified situation. The problems are evolving. We have never seen such a complex set of challenges in the drug area: NPS, the internet, trafficking, new players and increased production. EU supports bringing public health and human rights to the core of the drug policy by balancing law enforcement with equally firm health and social services and evidenced based actions.

Side events

Bringing human rights to the forefront of drug policy: Development, implementation, monitoring and evaluation

The event was organised by the governments of Malta (represented by Ambassador Keith Azzopardi), Germany (Ambassador Friedrich Dauble), Norway, the Pompidou Group of the Council of Europe (Jan Malinowski, Executive Secretary). Speakers were also Damon Barrett, Director of the International Centre on Human Rights and Drug Policy, University of Essex and Zaved Mahmoud, Office of the UN High Commissioner for Human Rights. This event was an attempt to move beyond highlighting human rights problems by examining the impact of the world drug problem on the enjoyment of human rights and exploring the application of human rights standards and tests as a basis for national and local led initiatives to incorporate human rights into drug policy development, monitoring and evaluation.

In the outcome document of the 2016 UNGASS on the world drug problem, UN member states reiterated a “commitment to respecting, protecting and promoting all human rights fundamental freedoms and the inherent dignity of all individuals and the rule of law in the development and implementation of drug policies”. In drug policy – as in all other policy areas – human rights are not a choice, they are an obligation.

Interesting points from the presentations include:

  • Human rights start in small places, close to home – Eleanor Roosevelt
  • Jan Malinowski: There is no discussion about death penalty and extrajudicial killings. CoE is condemning inhuman treatments. There must be mechanisms in place to bring to light rights issues arising from drug policy
  • Damon Barrett: There is no universal prescription due to diversity in country situations, but we have universal standards! The challenge for policy makers is to resolve the tension between human rights and drug policy in favour of human rights. Health services should be available, accessible, acceptable (by different populations) and of sufficient quality. Consider harm reduction in funding decisions.
  • Zaved Mahmood: Wrong policy decisions influence various segments of life. For instance, punishing legislation leads to overcrowded prisons. Until we address the human dimension of drug policies, those policies will fail.

The world drug perception problem

This event was organized by the Governments of Portugal, Switzerland and Uruguay and the Global Commission on Drug Policy to discuss the current perceptions but also progress already made in some countries to fight negative perceptions, stigma, discrimination and criminalization of people who use drugs, as well as possible further steps.

Speakers included Pavel Bém, Commissioner, Global Commission on Drug Policy (GCDP), Michel Kazatchkine, UN Special Envoy on HIV/AIDS for Eastern Europe and Central Asia, João Goulão, National Drug Coordinator, Portugal, Martín Rodríguez, Executive Director of the Institute for the Regulation and Control of Cannabis (IRCCA), Uruguay, Nora Kronig-Romero, Ambassador for Global Health, Switzerland and Judy Chang, Executive Director, INPUD.

The latest GCDP report on the issue The World Drug Perception Problem: Countering Prejudices About People Who Use Drugs was published in 2017.

Interesting points from the presentations include:

  • Michel Kazatchkine: presented an interesting fact from the report that “UNODC estimates only 11.6% of those who used drugs in 2016 are considered to suffer problematic drug use or addiction. The most common pattern of drug use is episodic and non-problematic.” and that “Legal status of #drugs rarely correspond to potential harms, not based on scientific evidence.”
  • Martín Rodriguez: “There have been no episodes of violence between the people who use or in the surroundings of the sale places” (in Uruguay, who legalised sale of cannabis) and “Before the sale of recreational cannabis in pharmacies started, almost ¾ were against it; 6 months later and due to the positive experiences, this has fallen to 43%”
  • Nora Kronig-Romero: The main factors leading the Swiss population to approve drug policy reform was failure of law enforcement only approach and experiences with small projects of harm reduction. Direct democracy contributed to an informed discussion about drugs, drug perception and drug policy in Switzerland.
  • João Goulão: “Problematic drug use reached all parts of society and that led to a change in the popular view of drug use – changing perceptions about people who use drugs”
  • Judy Chang – We don’t believe in reducing a behaviour to an identity. We prefer the phrase “people who use drugs” to more stigmatising language but emphasise drug dependency is not incompatible with a person living a happy and fulfilled lives

A note from this side event is available at the CND blog.

UN agencies statement on ending discrimination in health care settings

Discrimination in health care settings is widespread across the world and takes many forms. It violates the most fundamental human rights protected in international treaties and in national laws and constitutions. People we work for and with experience it very often.

The World Health Organisation (WHO) had issues a Joint United Nations statement, signed by 12 UN agencies, on ending discrimination in health care settings. Recognizing that discrimination in health care settings is a major barrier to the achievement of the Sustainable Development Goals, United Nations entities commit to working together to support Member States in taking coordinated multisectoral action to eliminate discrimination in health care settings.

The Statement is available at http://www.unaids.org/sites/default/files/media_asset/ending-discrimination-healthcare-settings_en.pdf.

Among a number of measures, the statement called for the “reviewing and repealing punitive laws that have been proven to have negative health outcomes” by member states, which includes “drug use or possession of drugs for personal use”.

The DPNSEE Office, in cooperation with SUPRAM – The Association of Lawyers for Medical and Health Law of Serbia, analysed the situation in the country and prepared a document which highlights some of the basic international documents and national legislation on discrimination, especially in the area of health care. Those who can understand Serbian can download the document presenting the situation following this link. We are in communication with our member organisations in Serbia, with the idea to make a public event to present the Statement and the document produced and call for full respect of the legislation and fight against discrimination. For this, we plan to partner with The Commissioner for the Protection of Equality and UN representatives in the country.

For others, we prepared the set of excerpts from the international documents which is in another document. Please feel free to have a look at the document linked here and if you think you can start a similar campaign like we plan for Serbia, analyse your national legislation which deals with discrimination, access to health and social care, quality of health protection, patients’ safety as well as strategies in these areas. Should you need any support, please don’t hesitate to contact us.