A new United Nations declaration on drug control policy will significantly undermine harm reduction and HIV prevention, professional groups and human rights activists warned this week.
The Political Declaration on Drug Policy under negotiation this week in Vienna omits any mention of harm reduction measures including needle and syringe exchange and opiate substitution that most international public health experts endorse as essential for successful HIV prevention and treatment.
"This political declaration fails public health," said Craig McClure, executive director of the International AIDS Society. "Coming less than 12 months after UN member states convened a high level meeting in New York to restate the international commitment to fight HIV, the denial of any reference in the declaration to life-saving harm reduction programs is unacceptable and unconscionable."
The exclusion of harm reduction from the drug control policy has been achieved by an international coalition of nations opposed to harm reduction, including Sweden, the US and Russia. They favour continuing an international approach to drug control established in 1998 that focuses on restricting supply.
In a review of drug control published this week, the European Commission noted that there was no evidence that global drug problems have declined since 1998. The report estimates that the market for cannabis alone in Europe, North America and Australasia is worth at least 70 billion euros a year.
"We are very concerned. There is an opportunity here to tackle HIV rates amongst injecting drug users but because of a conflict in policy public health is being put at risk.
"UNAIDS advocates for harm reduction strategies such as needle exchange schemes to prevent the spread of HIV. But some governments are blocking a more progressive approach and the UN Office on Drugs and Crime (UNODC) despite endorsing harm reduction does not actively support it, claiming it perpetuates drug use," said Susie McLean, senior advisor on HIV and drug policy at the International HIV/AIDS Alliance.
"This fundamental split in the policy approach is hampering efforts to contain the spread of HIV. All the available evidence points to the fact that harm reduction strategies do not increase drug use."
Human rights activists have also highlighted the extent to which human rights are being attacked in the 'war on drugs'.
"The global war on drugs has devolved into a war on individual drug users and their communities. While the drug trade continues to thrive, families across the globe are being torn apart by HIV, draconian prison sentences, and wholesale police abuses," said Daniel Wolfe, Director of the Open Society Institute’s International Harm Reduction Development Program.
In its book At what cost? published this week, Open Society Institute documents the HIV and human rights consequences of the war on drugs, which were also drawn to the attention of UNODC by the UN special rapporteurs on human rights and health.
"Given the widespread human rights abuses around the world directly resulting from drug enforcement, human rights must be placed at the heart of UN drug policy," said Joseph Amon, director of Human Rights Watch's health and human rights division.
"But the political declaration makes scant reference to the legal obligations of member states under international human rights treaties, nor does it insist on respect for human rights in drug policy."
The UN Office on Drugs and Crime, which has drafted the declaration, rejects this view. "The crime and corruption associated with the drug trade are providing strong evidence to a vocal minority of pro-drug lobbyists to argue that the cure is worse than the disease. This would be a historical mistake, one which United Nations member states are not willing to make," UNODC director Antonio Maria Costa said this week.
The political declaration is due to be ratified this week, but in a statement released on March 10th the International AIDS Society, Human Rights Watch and the International Harm Reduction Association called on UN member states not to lend their names to the declaration, and instead to press for a new way forward.