An open letter signed by AIDS organisations, human rights groups, scientific researchers, policy analysts, and influential individuals from 56 countries urges delegates at next week’s meeting of the United Nations Commission on Narcotic Drugs in Vienna to stand up to the US, which appears to have recently pressured the influential UN Office on Drugs and Crime (UNODC) to reverse its support for needle/syringe exchange and methadone programmes – known under the umbrella term of ‘harm reduction’.
“As you gather this year to debate HIV/AIDS prevention and drug abuse, we respectfully urge you to support syringe exchange, opiate substitution treatment and other harm reduction approaches demonstrated to reduce HIV risk; to affirm the human rights of drug users to health and health services; and to reject efforts to overrule science and tie the hands of those working on the front lines,” write the letter’s signatories, which include Human Rights Watch, the Canadian HIV/AIDS Legal Network, the Directorate-General for Justice, Freedom and Security at the European Commission, the National AIDS Trust, AMFAR and former MP, Marjorie 'Mo' Mowlam.
“No less than the future of the HIV epidemic is at stake,” the letter concludes.
The letter outlines how the United States – the only country in the world to explicitly ban use of federal funds for needle/syringe exchange – has recently intensified pressure on the United Nations to do a u-turn on its promotion of harm reduction strategies for injection drug users (IDUs).
Last year, the World Health Organisation, UNAIDS and the UNODC released joint statements confirming their support for harm reduction for IDUs, including education, treatment and needle/syringe exchange. However, following a meeting with Robert Charles, the head of the narcotics division of the US State Department last November, UNODC executive director, Antonio Costa, wrote to Mr Charles stating that "we neither endorse needle exchange as a solution for drug abuse, nor support public statements advocating such practices.” He also promised to "review all statements... and will be even more vigilant in the future." A senior staff member at UNODC later emailed other employees to "ensure that references to harm reduction and needle/syringe exchange are avoided in UNODC documents, publications and statements."
The UN Office on Drugs and Crime, which counts the US as its biggest donor, is currently the chair of the joint United Nations Programme on HIV/AIDS, which, according to Kasia Malinowska-Sempruch of the Open Society Institute, another of the letter's signatories, makes the US pressure on the UNODC “reprehensible.”
The letter points out that “injection drug use accounts for the majority of HIV infections in dozens of countries in Asia and the former Soviet Union, including Russia, China, all of Central Asia, and much of Southeast Asia. In most countries outside Africa, the largest number of new infections now occurs among injection drug users.” It goes on to say that harm reduction approaches are “affirmed as an effective and essential part of HIV prevention by UNAIDS, WHO, and UN member nations,” and that, in contrast to the US-led abstinence approach, “programs such as syringe exchange and opiate substitution...both prevent HIV infection and can provide a bridge to other health services. Restricting these programs is a blatant infringement of drug users’ human right to health.”
The full text of the letter can be found at the Human Rights Watch website.