HR2 - Harm Reduction & Human Rights

Thailand: Convictions of Police in Drug Campaign Abuse a ‘First Step’

2009-12-15T10:42:00.000Z

Human Rights Watch, 14 December 2009: (New York) - The conviction of eight police officers for crimes in anti-drug operations should be a catalyst for the Thai government to end police abuses, Human Rights Watch said today.

On December 8, 2009, the Talingchan district court in Bangkok found Police Captain Nat Chonnithiwanit and seven other members of the 41st Border Patrol Police (BPP) unit guilty of assault with weapons, illegal detention, and extortion. Each was sentenced to five years of imprisonment.

"The trial of Captain Nat and his team revealed just how casually police commit abuses," said Elaine Pearson, deputy Asia director at Human Rights Watch. "This conviction needs to be followed up by clear action to put an end to police abuses once and for all."

Nat and his BPP team were arrested in Bangkok in January 2008 for serious offenses committed over a period of three years. To date, 61 people have filed formal complaints that they or their family members were abused by BPP police under Nat's command.

In the case that led to the convictions, Nat's squad arbitrarily arrested Jutaporn Nunrod in Bangkok on February 8, 2007, and then took her to a "safe house" at the Green Inn Hotel. She was stripped half-naked, subjected to electric shock, severely beaten, and had a plastic bag placed over her head for two days in order to extract a confession that she was involved in drug trafficking. Jutaporn and her family were also forced to give cash and a gold necklace worth 100,000 Thai baht (US$3,000) to Nat.

Other victims of Nat and his squad claim they were subjected to electric shock, had plastic bags placed over their heads, and were severely beaten. Many also claimed they were forced to pay bribes in order to be released or to have lesser charges filed against them.

"These convictions were not an isolated case of rogue officers, but part of chronic problems in police operations that use violence and illegality to fight crimes," said Pearson. "Police in Thailand have long had sweeping powers and have rarely faced punishment for often horrendous misconduct."

Thailand saw the worst police abuses after then Prime Minister Thaksin Shinawatra launched his notorious "war on drugs" campaign in 2003. During this campaign, Thaksin openly pushed police to adopt unlawful measures against drug traffickers.

"There is nothing under the sun which the Thai police cannot do," Thaksin said on January 14, 2003, adding, "You must use iron fist against drugs traffickers and show them no mercy. Because drug traffickers are ruthless to our children, so being ruthless back to them is not a bad thing...If there are deaths among traffickers, it is normal."

In January 2008, a special committee chaired by former Attorney General Khanit na Nakhon found that 2,819 people were killed in 2,559 murder cases between February and April in 2003 as part of Thaksin's "war on drugs." But despite many promises by Prime Minister Abhisit Vejjajiva to bring those responsible for the "war on drugs" murders and related abuses to justice, no action has ensued. Many police officers implicated in this inquiry and follow-up investigations by the Justice Ministry's Department of Special Investigation remain in office. Many have even been promoted. The failure to hold abusive police accountable makes it more likely that killings, torture, and extortion will happen again, especially in the context of drug suppression operations, said Human Rights Watch.

Thailand continues to face a boom in the use and trafficking of methamphetamines. For that reason, harsh measures against traffickers are politically popular. On December 3, Interior Minister Chavarat Charnvirakul launched a new nation-wide campaign, called "Clean and Seal." This campaign will initially go on for three months and seek to thoroughly "clean up" 16,106 communities of drugs users and traffickers. While traffickers will be arrested and prosecuted, those caught using drugs will be sent to a rehabilitation program at military-style camps run by the Interior Ministry.

"Unrealistic targets set by politicians, combined with deep-rooted police brutality and impunity raise grave concerns about this ‘Clean and Seal' campaign," said Pearson. "To prevent his government from going down the same road as Thaksin, Prime Minister Abhisit should set a new standard by ensuring that abusers will be prosecuted."

'Methadone in prison is the best practice' - A letter from IHRA to The Times

2009-12-14T13:35:00.006Z

Sir,

The provision of methadone in prisons is considered best practice by the World Health Organisation, the UN Office on Drugs and Crime, and UNAIDS, among other esteemed national and international expert bodies. Yet in her column Melanie Reid finds cause to criticise the provision of this evidence-based health intervention (“Get prisoners off drugs? Don’t be silly”, Opinion, Dec 10).

While she characterises prison as “an ideal opportunity to wean people off drugs”, she expresses outrage that apparently 20,000 prisoners “were put on methadone in jail as a form of detox”. As the purpose of detox is to medically reduce a person’s opiate intake to the point of stopping, the reason for her objections are a mystery, unless she prefers that drug users go through the painful and often life-threatening symptoms of “cold turkey” withdrawal rather than being medically assisted in detoxifying.

She also claims the above figures on methadone to be “astronomical”. As there were more than 130,000 people admitted to English prisons in 2008, a significant proportion of them with a history of drug use, the fact (assuming her figure is correct) that 15 per cent required some form of medically assisted detox from heroin is hardly surprising. Nor indeed is it out of step with the methadone figures from many other European prison systems.

Ms Reid calls the prison service the “drug-dealer-in-chief”, and describes a system in which “the State hands out opiates willy-nilly”. This characterisation was directly contradicted only two days ago in the report of the European Committee for the Prevention of Torture. In its report detailing the findings of its inspection of UK prisons, the committee found that “the evidence supporting methadone maintenance therapy in prison is strong (both for criminological and health outcomes)”.

Rather than methadone being dispensed “willy-nilly”, the committee found “that prisoners were being forced off methadone maintenance or being offered low doses without reference to clinical needs” and “that the rapid reduction in the daily doses of methadone offered to inmates was being done for administrative reasons rather than based on clinical needs, and the reduction was being done without the consent of the patient”. As a result, the committee recommended “that the United Kingdom authorities consider introducing long-term methadone maintenance”.

Professor Gerry Stimson
Executive Director
International Harm Reduction Association

Letter published in The Times, 14 December 2009

European human rights monitors contradict BBC's 'methadone madness' reporting

2009-12-10T15:08:00.019Z

Yesterday, the BBC's Mark Easton did a series of reports that criticised the provision of methadone in UK prisons. Using interviews with a narrow selection of commentators, primarily from abstinence-based drug service providers and 12-step groups, the reports described an allegedly chaotic situation in which the prison system was 'doling out methadone', where prisoners were 'being prescribed the addictive heroin substitute methadone instead of being encouraged to get drug-free' and that 'voters would be shocked by how few prisoners are given the chance to get off drugs'.

The BBC report has prompted a bit of a firestorm in the UK press, leading many commentators to uncritically adopt the conclusion that methadone is being given out 'willy-nilly' in prisons, without actually doing any research of their own.

Ironically, the sensationalised scenario painted by Easton and others was directly contradicted only 24-hours earlier by the European Committee for the Prevention of Torture (CPT).

The CPT is an independent human rights body based out of the Council of Europe in Strasbourg. Its mandate is to visit places of detention in Council of Europe countries to see how persons deprived of their liberty are treated and, if necessary, to recommend improvements to States. Visits are carried out by independent delegations of experts, accompanied by members of the Committee's Secretariat.

The CPT report on its mission to the UK prisons was released 8 December 2009. It paints a very different picture than that reflected by the BBC.

Rather than a system giving out methadone hand over fist, the CPT instead found that prisoners were 'being forced off methadone maintenance or being offered low doses without reference to clinical needs'. It found that 'the rapid reduction in the daily doses of methadone offered to inmates was being done for administrative reasons rather than based on clinical needs'.

In contrast to the BBC's reporting that prisoners 'desperate to get off drugs...are still put on methadone', the CPT found instead that 'the reduction [in methadone dosage] was being done without the consent of the patient'.

As a result of its investigation, the CPT report 'recommends that the United Kingdom authorities consider introducing longterm methadone maintenance'.

The CPT's findings on the problems of methadone provision in UK prisons are indeed cause for concern, especially given their conclusions that the 'evidence supporting methadone maintenance therapy in prison is strong (both for criminological and health outcomes)'. Unfortunately, the findings from these independent external experts fail to slot neatly into counter-narrative being constructed by some opponents of harm reduction in the UK, and as a result did not receive the attention even of those news outlets claiming to be investigating methadone services in prisons.

The relevant section from page 37 of the report is reproduced below:

'[T]he CPT noted that prisoners were being forced off methadone maintenance or being offered low doses without reference to clinical needs, whereas the evidence supporting methadone maintenance therapy in prison is strong (both for criminological and health outcomes). The doses of methadone (or buprenorphine) need to satisfy the individual’s addictive needs, and respond to the additional risks of disease transmission while in custody, and immediately after release. Instead, it appeared that the rapid reduction in the daily doses of methadone offered to inmates was being done for administrative reasons rather than based on clinical needs, and the reduction was being done without the consent of the patient. Further, prisoners taking methadone were apparently not offered work opportunities, although there is no reason why they should not work The CPT understands that a new programme, Integrated Drug Treatment Services, will tackle some of these concerns.

The CPT recommends that the United Kingdom authorities consider introducing longterm methadone maintenance, and that the new Integrated Drug Treatment Services programme takes into consideration the above remarks.'

Human Rights Day 2009: International Centre on Human Rights and Drug Policy launched

2009-12-10T10:56:00.007Z

Today, Human Rights Day, is the occasion for the launch of the International Centre on Human Rights and Drug Policy.

The Centre is dedicated to developing and promoting innovative and high quality legal and human rights scholarship on issues related to drug laws, policy and enforcement. It pursues this mandate by publishing original, peer reviewed research on drug issues as they relate to international human rights law, international humanitarian law, international criminal law and public international law, and fostering research on drug policy issues among postgraduate law and human rights students at universities and colleges around the world.

The Centre’s work is supported by a prestigious International Advisory Committee as well as two Institutional Partners. At present, the Centre has established two ongoing projects:

• The International Yearbook on Human Rights and Drug Policy is the first and only international peer reviewed law journal focusing exclusively on human rights and drug policy. We are now accepting submissions to the first edition of the Yearbook to be published in late 2010.

• The Human Rights and Drug Policy Project is a joint initiative with the Irish Centre for Human Rights, Faculty of Law, National University of Ireland, Galway. This Project will establish a Doctoral Studentship in Human Rights and Drug Policy, as well as a programme of activities designed to promote research on drug policy issues among other university human rights programmes. Applications for the Doctoral Studentship are being accepted until 18 December.

For more information, please visit www.humanrightsanddrugs.org

International Advisory Committee: Dr Massimo Barra (founder, Villa Maraini Foundation, IT); Dr David Bewley-Taylor (Swansea University, UK); Prof Neil Boister (University of Canterbury, NZ); Richard Elliott (Canadian HIV/AIDS Legal Network); Anand Grover (UN Special Rapporteur on the Right to Health); Prof Paul Hunt (University of Essex, UK); Dr Ursula Kilkelly (University College Cork, IRE), Prof Manfred Nowak (UN Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment); Rebecca Schleifer (Human Rights Watch); Prof William A Schabas (Irish Centre for Human Rights); Baroness Vivien Stern (International Centre for Prison Studies, UK); Prof Gerry Stimson (International Harm Reduction Association)

Institutional Partners: International Harm Reduction Association; Irish Centre for Human Rights

UN Security Council debates drug trafficking

2009-12-09T12:47:00.003Z

As reported earlier, the UN Security Council took up the issue of drug trafficking as "a threat to international security" on 8 December. A press release of what came out of the the discussion has been posted below.

United Nations Office on Drugs and Crime, 9 December 2009: States have been called upon to strengthen international cooperation "on the basis of a common and shared responsibility to counter the world drug problem and related criminal activities."

The Security Council, on 8 December, focused on the issue of drug trafficking as a threat to international peace and security. Burkina Faso's Foreign Minister Bedouma Alain Yoda, whose country holds the Presidency of the Council in December, stressed the "devastating impact" of drug trafficking, particularly in Africa.

The Security Council unanimously adopted a presidential statement that called for greater action to combat drug trafficking as a threat to international security. It stressed, in particular, the need for regional cooperation to counter this transnational threat. In the statement, "the Security Council invites the Secretary General to consider mainstreaming the issue of drug trafficking as a factor in conflict prevention strategies, conflict analysis, integrated missions' assessment and planning a peacebuilding support".

Secretary-General Ban Ki-moon warned that "drug trafficking is evolving into an ever graver threat that is affecting all regions of the world", not least in areas where the United Nations is involved in building peace (like Afghanistan, Guinea-Bissau, Haiti, Liberia and Sierra Leone).

"Drug trafficking does not respect borders", said the Secretary-General. He stressed that "the transnational nature of the threat means that no country can face it alone". However, "so far, cooperation between Governments is lagging behind cooperation between organized crime networks".

The Secretary-General also called for a more balanced approach to drug control characterized by "reducing demand for drugs and the harm done by them; promoting alternative development and the rule of law at the source of the supply; and disrupting trafficking routes".

In his address, UNODC Executive Director Antonio Maria Costa focused on the growing threat of drug trafficking to Africa. "Today, under attack from several sides, the continent is facing a severe and complex drug problem: not only drug trafficking, but also production and consumption. Serious consequences in terms of health, development and security are inevitable," said Mr. Costa.

He described how cocaine trafficking from the West and heroin from the East are creating instability and spreading addiction. He said that "we have acquired evidence that the two streams of illicit drugs - heroin into Eastern Africa and cocaine into West Africa - are now meeting in the Sahara, creating new trafficking routes across Chad, Niger and Mali." He warned that, like in the Andean countries and in West Asia, "terrorists and anti-Government forces in the Sahel extract resources from the drug trade to fund their operations, purchase equipment and pay foot-soldiers." He also said that drug trafficking in the region is taking on a whole new dimension - becoming larger, faster and more high-tech.

He urged Member States to create a trans-Saharan crime monitoring network to improve information, monitor suspicious activity, exchange evidence, facilitate legal cooperation and strengthen regional efforts against organized crime.

During the debate, there was strong endorsement for the work of UNODC, and calls for its work to be properly resourced.

Security Council presidential statement.

Secretary-General Ban Ki-moon's speech to the Security Council.

UN Security Council to discuss drug trafficking as a threat to international security

2009-12-07T23:59:00.001Z

Tomorrow, 8 December, the UN Security Council - under the Presidency of Burkina Faso - will debate "Peace and Security in Africa: Drug trafficking as a threat to international security".

UN Secretary-General Ban Ki-Moon as well as UNODC Executive Director Antonio Maria Costa will address the meeting.

The debate will be webcast from 10am New York time.

Trinidad and Tobago and Belize propose the inclusion of the Crime of International Drug Trafficking in the Statute of the International Criminal Court

2009-12-05T22:34:00.009Z

The proposal, presented on October 29th, in the lead up to next year’s Review Conference in Uganda (which will consider amendments to the Rome Statute of the International Criminal Court), would place “The crime of international drug trafficking” alongside genocide, crimes against humanity, war crimes and crimes of aggression. (Something the Indonesian Constitutional Court did in 2007 as part of its decision on the legality of the death penalty for drug offences)

This proposal, if accepted, would significantly change the legal status of the crime in international law. It does not, however, appear have much support from States parties to the ICC and is unlikely to go forward for review.

This proposal itself is interesting, despite its lack of popularity for two reasons.

First is its rather candid acknowledgement of the limitations of the current international legal framework for drug control. According to the submission “Notwithstanding the provisions of the 1961 Single Convention on Narcotic Drugs, the 1961 Single Convention on Narcotic Drugs, as amended, the 1971 Convention on Psychotropic Substances, or the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, drug barons continue to operate with impunity within the international Community”

(Some would argue, of course, that organised criminals involved in drug trafficking operate with such impunity as a consequence of the power and money gifted them by the current international drug control framework, not despite it)

Second is the definition of the crime of drug trafficking that was proposed. It is very problematic, and it is fortunate that the proposal has not received widespread support. See, in particular, sub-paragraph (a) which is sweeping, even with the opening proviso.

We've added some comments in square brackets.

For the purposes of the present Statute, crimes involving the illicit trafficking in narcotic drugs and psychotropic substances mean any of the following acts, but only when they pose a threat to the peace, order and security of a State or region [This is intended to focus on very serious crimes, obviously, but what is the threshold for this? Moreover, the threat of the floodgates opening for a range of offences looms. What this appears to say is not that drug trafficking of itself if a crime so serious as requiring inclusion under the jurisdiction of the ICC - it is that a threat to the peace order and security of the State or region is. By that rationale, any crime that poses such a threat could sit alongside drug trafficking.]

(a) Undertaking, organizing, sponsoring, ordering, facilitating or financing the production, manufacture, extraction, preparation, offering for sale, distribution, sale, delivery on any terms whatsoever, brokerage, dispatch, dispatch in transit, transport, importation or exportation [That is a lot of activities, and what constitutes undertaking, organising, sponsoring, ordering, facilitating, or financing them? Where does this place, for example, poppy or coca growers?] of any narcotic drug or any psychotropic substance [Any narcotic drug or psychotropic substance? Where is the scale of harm?] contrary to the provisions of the 1961 Single Convention on Narcotic Drugs; the 1961 Single Convention on Narcotic Drugs, as amended; the 1971 Convention on Psychotropic Substances, or the 1988 United Nations Convention against Illicit Traffic in Narcotics Drugs and Psychotropic Substances [Does this refer to the substances or the activities being contrary to the terms of the drug conventions?] when committed on a large scale [How might this be defined for each activity?] and involving acts of a transboundary character;

The proposal is available on the ICC's website. While it is unlikely to result in a review next year, it is, nonetheless, an important debate to watch. It is not the first time the inclusion of drug trafficking into the ICC statute has been proposed. (See Resolution E adopted in 1998 by the United Nations Diplomatic Conference of Plenipotentiaries on the Establishment of an International Criminal Court)

Thanks to Prof William Schabas' Phd in human rights blog for drawing our attention to the proposal.

'First of its kind' stay of execution for drug offence in Singapore

2009-12-03T10:19:00.004Z

In what is being reported as an unprecedented decision, the High Court of Singapore has granted a stay of execution to a convicted drug trafficker who was scheduled to be hanged on Friday.

Yong Vui Kong – who was just 19 when he was arrested in 2007 – was convicted of carrying 47 grams of heroin. Drug offences entailing heroin in excess of 15 grams carries a mandatory death sentence in Singapore.

Mr. Yong was reported to have broken down in tears after the stay was announced.

As stated in IHRA’s 2007 report “The Death Penalty for Drug Offences: A Violation of International Human Rights Law,” capital punishment is reserved only for the “most serious crimes.” Both the UN Human Rights Committee and the UN Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions have argued that drug offences do not constitute “most serious crimes.”

Mr. Yong’s lawyer, M Ravi, said that the mandatory death penalty – especially for cases not involving murder – is “contrary to international law because it is both arbitrary and cruel,” Singapore-based Channel News Asia reported.

Mr. Ravi said he will now have a chance “to protect his client from execution until the full Court of Appeal has heard his application for an extension of time and full appeal on the merits.”

At the time of his arrest, Mr. Yong said that he was unaware he was carrying drugs when he drove into Singapore. According to Amnesty International, “He had been working as a messenger for a man in Malaysia who often asked him to collect money from debtors or deliver packages as ‘gifts’ to people in Singapore and Malaysia. At his trial, Yong Vui Kong said he had not known what was in the packages, and when he asked, he had simply been told not to open them.”

The Online Citizen reported that Mr. Yong’s mother had not been told of her son’s pending execution until recently. The 24-year-old brother of the accused said, “We’ve kept this from her for almost three years. Because his execution date is coming soon, we felt that she needed to know.”

World AIDS Day: Punitive Drug Laws, Policing Practices Impede HIV/AIDS Response - A joint press statement from IHRA and Human Rights Watch

2009-12-01T10:04:00.011Z

(London) Governments worldwide should take urgent action to reform punitive drug laws, disproportionate penalties, and harsh and discriminatory law enforcement practices as part of their efforts to address HIV among people who use drugs, Human Rights Watch and the International Harm Reduction Association said today, World AIDS Day. Current policies also cause needless suffering among people living with HIV/AIDS, the two groups said in a joint briefing note released today. “The ‘war on drugs’ is fueling HIV epidemics among people who use drugs around the world, and condemning millions of people with terminal cancer and with HIV/AIDS to needless suffering,” said Professor Gerry Stimson, Executive Director of the International Harm Reduction Association.

In many countries, drug control efforts block lifesaving HIV services to people who use drugs, even where they are legal, Human Rights Watch and the International Harm Reduction Association said. Overly strict, complex drug laws and regulations block access to cheap, effective pain medications, like morphine, relegating hundreds of thousands of people living with HIV/AIDS, and millions with terminal cancer, to suffer severe pain.

Outside of sub-Saharan Africa, as many as 30 percent of all new HIV infections occur among people who inject drugs and within sub-Saharan Africa, injection drug use is increasing. In some countries, in particular in Central and Eastern Europe and East Asia, injecting drug use is the primary driver of HIV epidemics.

International health and drug control agencies – including the UN Office on Drugs and Crime, UNAIDS, UNICEF, the United Nations Development Program, and the World Health Organization – all endorse comprehensive harm reduction services as the best ways to address HIV among people who use drugs, including those in detention. These services include needle and syringe exchange, medication-assisted therapy (for example, with methadone), and peer outreach and education programs, notwithstanding broad endorsement and overwhelming scientific evidence that these approaches work, they are out of reach for the vast majority of people who need them.

In the joint briefing note, Human Rights Watch and the International Harm Reduction Association also expressed concern that criminal laws, disproportionate penalties and law enforcement practices drive people away from lifesaving HIV services that do exist, and impede access to pain treatment for tens of millions of people who need it. Some laws concerning the possession and use of drugs, and the possession of drug paraphernalia can keep many people who use drugs from carrying sterile syringes or other injecting equipment, even where it is legal to do so, and cause them to avoid drug treatment or harm reduction services altogether, out of fear of arrest and conviction. Laws creating criminal penalties for incitement to use drugs or facilitating/encouraging drug use likewise interfere with peer outreach services. The pressure on police officers to meet arrest quotas as a measure of success exacerbates police abuse of drug users by encouraging them to seek out easy targets, like drug users, for arrest.

In some countries, people who are identified as or suspected to be drug users are detained, sometimes for years, in locked facilities for “drug treatment,” regardless of whether they need treatment, and without due process of law. Basic medical services are often unavailable, and “treatment” often consists of forced, unpaid labor, and in some cases, physical and psychological abuse. The impact of drug control is often disproportionately focused on vulnerable groups and marginalized communities, such as African Americans in the United States.

Human Rights Watch and the International Harm Reduction Association also expressed concern that laws concerning drugs and syringe possession, together with associated policing practices targeting people who use drugs, may increase HIV risk. The organizations called for greater discussion among governments and relevant United Nations agencies on these issues.

"Of course these are complex and controversial issues," Rebecca Schleifer, advocacy director of Human Rights Watch’s Health and Human Rights Division said. "But we must have the courage to discuss them openly if we are to fully understand what is needed to halt and begin to reverse drug-related HIV/AIDS."

How the UN drug control system sets back harm reduction in Hungary

2009-11-30T14:22:00.007Z

A very interesting piece from the Hungarian Civil Liberties Union on how lawmakers are exploiting a UN Political Declaration to scuttle progressive, evidence-based drug policies.

As many readers of this blog will remember, a small number of obstructionist governments managed to block any reference to harm reduction in a Political Declaration on drugs adopted last March. Now, that omission is playing out in Hungary’s national system, as some officials argue against harm reduction citing the declaration as proof of a lack of commitment.

The Drug Policy Web Site of the Hungarian Civil Liberties Union, 27 November 2009:

Hungary is to adopt a progressive national drug strategy in December 2009, but the opposition is using the UN Political Declaration to prevent its adoption

The “National Drug Strategy to Tackle Drug Problems 2010-18” was submitted to the Hungarian parliament by the Ministry of Social Affairs and Labour. Tamás Heintz, an MP from the largest opposition party, Fidesz, attacked the document saying that the Socialist government, with its fading popular support, has no legitimacy to adopt a long term strategy at the end of its 4-year term. According to Mr. Heintz, the new strategy is a threat to communities and leads to the atomization of society, because it promotes a harm reduction approach to drug use that is not supported by the UN …

“Why should harm reduction be a priority, if it does not even appear in the Political Declaration adopted by the High Level Segment of the UN in March 2009? … The UN does not support harm reduction as a self-sufficient policy because its definition is controversial, it violates the principals and rules of conventions signed by all member states since the goal of member states is to promote prevention and abstinence, not to maintain drug use,” said Mr. Heintz.

[Mr Heintz is, of course, wrong in every point he makes here.

1. Almost every relevant UN body, including the General Assembly, the Economic and Social Council (the parent body of CND)and the Human Rights Council have expressed support for harm reduction. As have every relevant programmatic agency, fund or programme.

2. Harm reduction is not contrary to the international drug conventions, as confirmed by the UN Drug Control Programme's Legal Staff (and INCB in relation to aspects of it)

3. Not all UN member states have ratified the drug conventions. Most, but not all.

4. Regular policy statements from the CND refer to obligations to reduce the negative consequences of drug use alongside prevention and abstinence

5. Harm reduction is not aimed at maintaining drug use]

After the UN Political Declaration on drugs was adopted back in March, Mr. Costa, the head of the UN Office on Drugs and Crime (UNODC) said the debate on harm reduction was “little more than a storm in a teacup”. The recent parliamentary debate in Hungary seems to confute this observation …

Government MPs rejected the claim that the drug strategy places too much emphasis on harm reduction, pointing out that the text contains more than 7 pages on prevention, with many targeted interventions geared towards schools and families …

The Parliament will proceed with a second debate on the draft strategy next Monday and it will be probably passed by the Socialist and Liberal majority. However, parliamentary elections are scheduled to next spring in Hungary and according to public polls the current conservative opposition will win a landslide victory. The previous national drug strategy, that also endorsed harm reduction, was adopted by a full consensus of all parliamentary parties. It seems this common understanding of drug policy is a thing of the past. Professionals are worried that the drug strategy will lose government support after the elections. The national budget line that funds social and health services has already been cut back due to the financial crisis. In addition to limited funding opportunities, harm reduction service providers also face growing stigmatization, as Hungarian society witnesses the rise of virulent nationalism and intolerance. In transitional and developed societies where negative public attitudes to harm reduction and drug users abound, a strong and supportive CND position on harm reduction and human rights could save many lives in these hard times.

Click here for the full stor y.

UN Committee Calls on Poland to Ramp Up Access to Substitute Drug Dependence Treatment and ARV to Drug Users

2009-11-27T11:04:00.014Z

The United Nations Committee on Economic, Social and Cultural Rights (CESCR) urged Poland to scale up access to antiretroviral therapy for drug users living with HIV and to increase the availability of substitute drug dependence treatment, especially for people in detention. The recommendations come on the heels of advocacy from IHRA and the Open Society Institute.

Last month, IHRA submitted a briefing to the committee that urged Poland "to improve access to [Opioid Substitution Therapy] in the country, and in particular in places of detention." The briefing highlighted Poland's obligations under Article 12 of the International Covenant on Economic, Social and Cultural Rights, which recognises "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health."

In its concluding observations, the CESCR stated, "The Committee is concerned at reports that only a small number of drug users have access to substitute drug dependence treatment, and that such treatment is even more limited for those in detention. (art 12) The Committee calls on the State party to adopt measures to ensure that effective treatment of drug dependence is made accessible to all, including to those in detention."

It went on to state, " While noting the programme on ‘Antiretroviral therapy for persons living with HIV in Poland (2005-2006)’, the Committee expresses its concern at reports of limited access to treatment by HIV patients, particularly among drug users, and at the absence of information on provision of treatment following the closing of the above-mentioned programme. (art. 12) The Committee recommends that the State party take measures to ensure that treatment and care be available to and accessible by persons living with HIV/AIDS and to provide alternative treatment possibilities after the ending of the programme on ‘Antiretroviral therapy for persons with HIV in Poland (2005-2006)’."

Anand Grover, the UN Special Rapporteur on the right to the highest attainable standard of health, paid a visit to Poland at the beginning of May to examine ”sexual and reproductive health rights, HIV and harm reduction, drug dependence treatments and relevant laws, policies and practices, and their impact on the enjoyment of the right to health.” Following a series of field visits and meetings, the special rapporteur raised a number of concerns including the lack of available methadone maintenance treatment and some practices that restrict access to treatment.

Excellent article in the New York Times Magazine on needle exchange

2009-11-26T16:52:00.002Z

The following article appeared recently in the New York times Magazine and is well worth a read and forwarding to anyone new to HIV prevention among people who inject drugs. The author has done a great job of mixing the large scale problem with personal experiences and the very human face of the pandemic, and how this is not about 'other' people, but about all of us.

The Needle Nexus

By TINA ROSENBERG

Published: November 17, 2009

Of all the mysteries posed by AIDS, perhaps the deepest and most damaging is a human one: why have we failed so utterly to stop its transmission? Most people with H.I.V. in the world, including a vast majority of the 22 million who are infected in sub-Saharan Africa, caught it from a sexual partner. Despite billions of dollars spent to slow this form of transmission, only a few countries have had significant success — among them Thailand, Uganda and Zimbabwe — and their achievements have been unreplicable, poorly understood and short-lived. We know that abstinence, sexual fidelity and consistent condom use all prevent the spread of H.I.V. But we do not yet know how to persuade people to act accordingly.

Then there is another way that H.I.V. infects: by injection with a hypodermic needle previously used by an infected person. Outside Africa, a huge part of the AIDS epidemic involves people who were infected this way. In Russia, 83 percent of infections in which the origin is known come from needle sharing. In Ukraine, the figure is 64 percent; Kazakhstan, 74 percent; Malaysia, 72 percent; Vietnam, 52 percent; China, 44 percent. Shared needles are also the primary transmission route for H.I.V. in parts of Asia. In the United States, needle-sharing directly accounts for more than 25 percent of AIDS cases.

Drug injectors don’t pass infection only among themselves. Through their sex partners, H.I.V. is spread into the general population. In many countries, the H.I.V. epidemic began among drug injectors. In Russia in 2000, for example, needle-sharing was directly responsible for more than 95 percent of all cases of H.I.V. infection. So virtually all those with H.I.V. in Russia can trace their infection to a shared needle not many generations back. Though it has been scorned as special treatment for a despised population, AIDS prevention for drug users is in fact crucial to preventing a wider epidemic.

Unlike with sexual transmission, there is a proven solution here: needle-exchange programs, which provide drug injectors with clean needles, usually in return for their used ones. Needle exchange is the cornerstone of an approach known as harm reduction: making drug use less deadly. Clean needles are both tool and lure, a way to introduce drug users to counseling, H.I.V. tests, AIDS treatment and rehabilitation, including access to opioid-substitution therapies like methadone.

Needle exchange is AIDS prevention that works. While no one wants to have to put on a condom, every drug user prefers injecting with a clean needle. In 2003, an academic review of 99 cities around the world found that cities with needle exchange saw their H.I.V. rates among injecting drug users drop 19 percent a year; cities without needle exchange had an 8 percent increase per year. Contrary to popular fears, needle exchange has not led to more drug use or higher crime rates. Studies have also found that drug addicts participating in needle exchanges are more likely to enter rehabilitation programs. Using needle exchange as part of a comprehensive attack on H.I.V. is endorsed by virtually every relevant United Nations and United States-government agency.

All over the world, however, solid evidence in support of needle exchange is trumped by its risky politics. Harm reduction is thought by politicians to muddy the message that drug use is bad; to have authorities handing out needles puts an official stamp of approval on dangerous behavior. Consider the United States. In 1988, Congress passed a ban on the use of federal money for needle exchange; President Clinton said he supported needle exchange but never lifted the ban, and it remains in effect. It not only applies to programs inside the United States but also prohibits the U.S. Agency for International Development from financing needle-exchange programs in its AIDS prevention work anywhere in the world. The administration of George W. Bush made the policy more aggressive, pressuring United Nations agencies to retract their support for needle exchange and excise statements about its efficacy from their literature. (Today, U.N. agencies again recommend that needle exchange be part of H.I.V.-prevention services for drug users.) Despite Barack Obama’s campaign pledge to overturn the ban, his first budget retained it. The House of Representatives recently passed a bill that would lift the ban — but it includes a provision that would make using federal money for needle exchange virtually impossible in cities, where it is needed most.

There are some parts of the world — Western Europe, Australia, New Zealand — that do widely use harm-reduction strategies, including needle exchange. And programs have begun even in Iran, of all places, which offers needle exchange and methadone; its program of giving prisoners methadone is now the world’s largest. China is now taking AIDS seriously, beginning to institute government-sponsored harm reduction nationwide. But the overwhelming majority of drug injectors around the world still have no such access. Because government financing is so politically unpopular, in most of the 77 countries that offer needle exchange, the programs are run by nongovernmental groups. As a result, these efforts are small, isolated and often undermined by uncooperative police and health departments. The world is casting aside the single most effective AIDS prevention strategy we know.

Russia needs needle exchange more than any other country: its H.I.V. epidemic is large, one of the fastest-growing in the world, and perhaps the most dominated by injecting drug use. Yet the needle-exchange efforts that do exist are scarce, small and under siege. I traveled there recently to see what lessons they hold. At 9 p.m. on a May night, in a tough neighborhood in Moscow’s north, I joined two young men as they climbed the stairs from the Metro. Arseniy and David were in their late 20s, wearing jeans and baseball caps. They had arrived to give out clean needles and promote harm reduction — but theirs was a guerrilla effort

Needle exchange is legal in Russia — sort of. It must follow federal regulations. The catch is that these regulations don’t exist: the Federal Drug Control Service, whose top officials have called needle exchange “nothing more than open propaganda for drugs,” has been sitting on them for five years. As a result, no new harm-reduction programs have started during that time. Old ones continue where local authorities tolerate them, but Moscow’s government disapproves of needle exchange. So like their clients, Arseniy and David avoid the police. One of their clients was Masha, who, like every other drug user I interviewed, talked about police extortion. It is every addict’s main fear, but avoiding police shakedowns means only more dangerous injecting: if you fear being caught walking around with a needle, you use the community needle your dealer provides.

Arseniy told me that he started doing harm reduction as a volunteer with an organization working with the homeless. “Most of my clients used drugs, and I understood we couldn’t do anything without needle exchange,” he said. So the workers began buying needles with their own money and giving them out. Now he, David and another pair of outreach workers get financing from another Russian group. The city of Moscow, then, has only a handful of people doing needle exchange. An extremely conservative estimate of Moscow’s drug injectors puts the number at 240,000.

Moscow’s drug policy could be called harm augmentation: discourage drug use by making it as dangerous as possible. Arseniy and David, for example, can’t direct addicts to methadone clinics, since methadone — the global gold standard rehabilitation method — is illegal in Russia. Nor can they bring users into the health system: beyond the most basic health services, public health care in Moscow is only for officially registered residents; many drug injectors are homeless or from other cities and are unregistered in Moscow. The only thing Arseniy and David can do is give out the card of a drop-in center, called Yasen, across the city from the clients they were serving.

When I visited Yasen, staff members told me stories of ambulances refusing to pick up an overdosing drug user and hospitals turning away people who come in with the afflictions of a violent life on the streets. Russia does have free detoxification clinics, but they use harsh, outdated methods, and less than 10 percent of their clients stay drug-free for a year. Checking in lands an addict on the official list of drug users — a designation that can affect opportunities for jobs, housing and privileges like driver’s licenses.

While the city of Moscow treats drug users purely as potential criminals, St. Petersburg is different. The main reason is the work of Humanitarian Action, among Russia’s first needle-exchange programs, which started its work in 1997. The heart of Humanitarian Action is its mobile clinic, a blue bus that visits 10 neighborhoods a week on a regular schedule. On a Friday afternoon when I visited, the bus was parked on the side of a busy street in front of a block of apartment towers. There was a line out the back door of people returning bags of used needles and getting clean ones.

Lena Porechenkova, a skinny, grizzled woman with tinted glasses, was running the bus’s needle-exchange counter. She spoke to a fresh-faced woman of 22, also named Lena. She was planning to quit, Lena said. “But I don’t want to get onto the state list of addicts and have problems getting a job later.” She said she might consider buying methadone (often sold illegally by heroin dealers) and trying to quit on her own.

“Well, it’s possible to overcome this on your own,” Porechenkova said, but she added that it is possible to pay $200 and be anonymous. “Why don’t you talk to our psychologist?” She called over Nikolai Yekimov, who took Lena into a tiny office in the bus. Yekimov has a database of rehabilitation centers. The bus also offers a case manager, who helps the client assemble the necessary papers and test results and will even pick her up and accompany her to the clinic. When Lena left, I asked her where she would go for advice if the bus didn’t exist. “Nowhere,” she said.

Humanitarian Action is a model program. It has everything harm reduction needs — save the most important thing: size. The group estimates that it has 4,000 repeat clients — a tiny proportion of St. Petersburg’s drug injectors, who number as many as 150,000.

In a few Russian cities needle-exchange programs run by the municipal or regional governments have kept H.I.V. rates among drug users relatively low. But most of the country’s 75 harm-reduction programs — almost all of which do needle exchange — are run by Russian nongovernmental groups with money from the Global Fund to Fight AIDS, Tuberculosis and Malaria. These programs run on $20,000 to $30,000 a year, which is far too small to have an impact. And they are imperiled. Russia is now too rich to accept Global Fund grants for H.I.V. prevention, so these programs will lose their financing over the next two years. Russian officials are resisting requests from international AIDS advocates to keep needle exchange alive.

The future of harm reduction does not reside in small programs carried out by internationally financed groups, however stellar their quality. Such programs have proved that harm reduction works, but they cannot make it epidemiologically relevant. Only a government can ensure that the police and hospitals will respect drug users’ rights to health care. Only a government can do needle exchange on a wide scale. This is what is needed to reduce H.I.V. rates — not just for drug users, but for us all.

The Effects of Drug User Registration Laws on People’s Rights and Health

2009-11-24T10:26:00.002Z

Key Findings from Russia, Georgia, and Ukraine

Open Society Institute: In the former Soviet Union, drug user registration laws restrict the civil rights of people accused of using drugs and impede their access to drug treatment. These laws also leave drug users vulnerable to extortion and abuse by police. This report features the findings of three groundbreaking studies conducted in Russia, Georgia, and Ukraine on the impact of registration laws on civil rights and public health.

Click here for the full report.

Doctoral Studentship in Human Rights and Drug Policy at the Irish Centre for Human Rights

2009-11-14T12:47:00.003Z

The Irish Centre for Human Rights is currently accepting applications for a Doctoral Studentship in Human Rights and Drug Policy.

The successful candidate will pursue doctoral research on a subject related to human rights law and drug policy at the Irish Centre for Human Rights at the National University of Ireland, Galway.

The Studentship is part of a new specialist research cluster at the Irish Centre for Human Rights dedicated to developing and promoting innovative and high quality legal and human rights scholarship on issues related to drug laws, policy and enforcement. In addition to the doctoral research, the holder of the Studentship will be expected to participate in, and assist the cluster with, various activities related to its mandate.

The successful candidate must have a high proficiency in verbal and written English.

This Studentship is currently available for a period of 12-months, with a stipend of €16,000 plus tuition fees and some money for research travel, and a possibility for extension dependent upon funding. The Studentship is scheduled to begin 1 February 2010, and the holder is expected to reside in Galway, Ireland and work full-time at the Irish Centre for Human Rights.

Please submit a covering letter and curriculum vitae, as well as a 250-word outline of the proposed area of research, no later than Friday, 18 December 2009, to:

humanrights@nuigalway.ie

The successful candidate will be required to submit a full application for the doctoral programme, and the final award is conditional on admission by the University.

Transform launch new guide to legal regulation of drugs in the House of Commons

2009-11-13T10:37:00.005Z

Transform TDPF, 13 November 2009: Transform is pleased to announce that our latest publication, 'After the War on Drugs: Blueprint for Regulation' has been launched at an event in the House of Commons on the 12th of November, with simultaneous launches taking place in the US (at the Drug Policy Alliance conference in Albuquerque), Australia and Mexico. December will see further launch events in Brazil and the EU parliament.

There is a growing recognition around the world that the prohibition of drugs is a counterproductive failure. However, a major barrier to drug law reform has been a widespread fear of the unknown just what could a post-prohibition regime look like?

For the first time, 'After the War on Drugs: Blueprint for Regulation' answers that question by proposing specific models of regulation for each main type and preparation of prohibited drug, coupled with the principles and rationale for doing so.

We demonstrate that moving to the legal regulation of drugs is not an unthinkable, politically impossible step in the dark, but a sensible, pragmatic approach to control drug production, supply and use.

Click here for the executive summary.

Click here for the full report.

Below is a small sampling of the news coverage of the launch.

The Guardian Online: The jaw-jaw after the war on drugs

BBC News: Sell drugs in shops - think tank

Daily Record: Legalise drugs and save Scotland £2bn a year, says think-tank

Legislative Innovation in Drug Policy

2009-11-12T13:52:00.004Z

Transnational Institute, 12 November 2009: This briefing summarizes good practices in legislative reforms around the world, representing steps away from a repressive zero-tolerance model towards a more evidence-based and humane drug policy. The examples provide lessons learned in practice about less punitive approaches and their impact on levels of drug use and drug related harm to the individual and society. Evidence suggests that legislation lessening criminalization combined with shifting resources from law enforcement and incarceration to prevention, treatment and harm reduction is more effective in reducing drug-related problems. Fears that softening drug laws and their enforcement would lead to sharp increases in drug use, have proven untrue. The examples cited below, in spite of their differences in scope and objectives, can be regarded as improvements on an ineffective overly repressive drug control model and they indicate a direction for more substantial reform and paradigm shifts in the future.

The center of gravity for these reforms has been Europe, as the European Monitoring Centre on Drugs and Drug Addiction (EMC DDA) sums up: “The analysis of national drug strategies, legal literature, laws, and judicial practice, suggests that in several EU countries public action is based on a) a more powerful focus on treatment rather than on criminal punishment; b) on a sense of disproportion between custodial sentences (often involving a criminal record) and illicit use of drugs; and c) on the perception that cannabis is less dangerous to health compared to other drugs." Similar reforms have also taken place in Australia, Canada and within several states in the United States and increasingly in Latin America, the region potentially becoming a new center of gravity for advancing this type of reform in the near future.

Click here for the full report.

"Congress is set to stick it to clean-syringe programs"

2009-11-10T13:25:00.005Z

US Congress is giving a long overdue look at its 20-year ban on federal funds for needle exchanges - but may actually find a way to make a bad situation worse.

A bill before Congress would remove the ban on federal funding but include a prohibition on financing needle exchanges within 1,000-feet of a school, park, library, college, video arcade - or in other words - anywhere the vast majority of needle exchanges are currently situated according to a story in The New York Times.

"This 1,000-foot rule is simply instituting the ban in a different form," the executive director of the AIDS Action Council, Rebecca Haag, told The New York Times.

An editorial in today's Washington Post says: "Programs that allow drug addicts to swap used needles and syringes for sterile injecting equipment are effective in reducing the transmission of HIV. A 2008 report from the Centers for Disease Control and Prevention notes that an 80 percent reduction in the incidence of HIV in intravenous drug users over the past 20 years can be attributed in part to such programs funded by private organizations and localities. But Congress appears intent on gumming up the works."

Click here for the full editorial.

Sound advice for Sweden’s lawmakers

2009-11-10T11:30:00.008Z

Leading health officials in Sweden have called for an expansion of needle exchange programs – which represents an encouraging potential shift for the country.

The position taken by the general directors of the National Board of Health and Welfare, the Institute for Infectious Disease Control and the National Institute for Health, was published today in Sweden’s largest newspaper. The statement is in Swedish but a (somewhat rough) version in English is available on Google Translator.

The health officials state what experts have pointed out for years – that needle exchange reduces the spread of HIV and hepatitis. A translation of the piece (which was slightly edited by us) reads, “[For] 20 years [there has been] an ongoing heated debate about needle exchange in Sweden.During these years, too many drug users [were] infected with hepatitis or HIV, chronic diseases [that] have greatly impaired their quality of life after they have ceased to abuse [drugs] … There are many roads to public health and … various actions needed to promote health, especially among those who are most vulnerable. It's about everyone's right to equal health and even drug addicts are entitled to health care.”

One reader commented that it may be the first time all three health authorities have taken such a stand.

This is a welcome position. IHRA has noted here for some time that Sweden needs to reconsider its position towards harm reduction. At the Commission on Narcotic Drugs plenary session earlier this year, IHRA deputy director Rick Lines, noted Sweden was among a group of obstructionist governments who “blocked any reference to harm reduction” during negotiations on a new Political Declaration on drugs.

Last year, it was written here how official figures show that in 2007, almost 30% of new HIV infections, 52 out of 178 that occurred in Sweden (as opposed to figures including migrants being diagnosed in Sweden) were through injecting drug use. At the time, there were only two 'experimental' needle exchanges in Sweden, with none in Stockholm. In 2005, new legislation was adopted which legalised local needle exchanges. But the legislation was so restrictive that no new needle exchanges had materialised.

Mixed Nutts

2009-11-05T10:58:00.002Z

The “string of questions about politicians' right to pick and choose which scientific advice they heed” continues in the wake of the ridiculous firing of drugs advisor, Professor David Nutt, for suggesting that alcohol and tobacco are more harmful than cannabis or LSD.

Writing in the Times Online, Lord Martin Rees, President of the Royal Society, warns of the dangers of turning a blind eye to scientific advice – as the government has on drugs for quite some time, Nutt argues. In an article for the New Scientist, he writes, “The current British government has said repeatedly that it wants its policies to be evidence-based, but actions speak louder than words. On ecstasy, for example, it made policy first, sought advice second – and cynically rejected the advice it was given. The result is shambolic policy-making which gives great cause for concern if that is how governments operate more generally.”

Continuing on a similar theme in a piece for the Guardian, Simon Jenkins sums up the debate by writing, “It is not the mistakes politicians make that matter, but why they make them. The Labour government's drugs policy must qualify as the worst confection of unreason even in Whitehall's copious canon. This is not for want of advice or research. Few subjects have been more rigorously investigated, not least by Nutt and his collapsed committee … Researching drug use is pointless since policy on the subject has nothing to do with evidence, only emotion. It has to do with fear of the unknown, the taboo of other people's escapist narcotics (or worse, those of one's children). Politicians could not care less what experts say…”

Who knows where all this will lead? Professor Nutt is now talking about setting up his own drugs advisory group citing that the “drug advice body is ‘fatally flawed.’” But what all this ideally highlights is simply how badly sensible, evidence-based drugs policy is needed.

Just Plain Nutts

2009-11-03T14:44:00.004Z

Pick your description of the ludicrous sacking of Professor David Nutt – “despicable,” “ridiculous,” “unwise,” "absurd," an "over-reaction" or "an extraordinary and unforced error." They have pretty much all been used in the daily papers describing the nutty dismissal of former chief drugs advisor for merely suggesting that cannabis was less harmful than tobacco and alcohol. His firing has led to a revolt from scientists and government advisors and spurred an inquiry into the role of drug advisors.

You’d swear Labour had political capital to burn. But, of course, it was political capital they were trying to secure with this move. There is no obvious concern for the kids or for people who might choose to use drugs at some point. It is about getting tough on drugs, which is the end in itself. The government knows full well that it can play about with cannabis as a political tool to score points because this move will have little impact on use, harms or on policing in practice. They know they can do this because they did accept Nutt's advice - cannabis is not all that dangerous compared with other drugs, so if they're going to score points off any drug, why not that one?

What is a surprise is that the Tories didn't see the exposed jugular and go for it. Instead they too went for the tough on drugs line and agreed with the sacking.

Other countries ignore scientific advice on a much more lethal level. Russia has recently stated again that it is emphatically against Opioid Substitution Treatment despite the country’s outrageous injection driven HIV epidemic, and the proven effectiveness of OST, time and again, in helping to prevent HIV among people who inject. How far would Labour or the Tories take this scientific freeze-out? Roll back HIV prevention because it looks tough on drugs? Any political points score would be squarely in the minus faced with a widespread injection driven HIV epidemic in the country.

Below is a brief roundup of the affair’s coverage and only a tiny fraction of the outrage this move has caused.

BBC: Science chief backs cannabis view

The Guardian: Drugs: The 40-year failure

The Independent: Playing the man and not the ball

The Times: Using a sledgehammer

The Telegraph: Cannabis confusion is Labour's fault, not Professor Nutt's

The Mirror: Alan Johnson shouldn't write off Government experts like Professor David Nutt

The Observer: Prejudice and political weakness have rejected scientific facts

Dismal Results for Drug Courts

2009-10-30T15:03:00.005Z

Ireland may ditch drug courts due to "disappointing" figures from the Dublin Drug Treatment Court Programme's first nine years. While some international agencies showed enthusiasm for the scheme, the numbers in Ireland were less encouraging. RTE reported that an "average of only three people had graduated from the treatment programme each year."

That is in addition to extremely poor admission rates. The story says, "The Comptroller and Auditor General, John Buckley, said there had been a low participation by addicts in the programme. He said that between 2002 and 2008 only 22 offenders a year had been admitted to the scheme - a fifth of what had been expected and 17% of them had completed the programme, to the satisfaction of the court."

All this could jeopardise the programme in the very near future. The Irish Examiner reported, "The Dáil Public Accounts Committee (PAC) heard that the future of the Drug Treatment Court in Dublin is in serious doubt."

AIDS experts say Russia needs new HIV strategy

2009-10-29T12:19:00.002Z

The Associated Press reported on a stituation, IHRA, Eurasian Harm Reduction Network (EHRN) and the International AIDS Society, sounded the alarms on recently.

From the AP:

MOSCOW — AIDS experts urged Russian officials on Wednesday to scrap their abstinence-based strategy for curbing the spread of HIV, saying the country's fast-growing epidemic could be entering a dangerous new phase.

AIDS specialists meeting here urged Russia to adopt successful strategies like needle-exchange programs and heroin substitutes such as methadone for drug addicts.

The number of HIV infections in Russia has doubled in the past eight years and there is evidence that in this region the virus is increasingly being spread by heterosexual sex.

The rapid growth of the epidemic in Russia is in contrast to sub-Saharan Africa and South and Southeast Asia, where prevalence of the virus fell during the same eight-year period, according to UNAIDS, the United Nations AIDS agency.

Russia's chief public health officer, Gennady Onishchenko, told a regional AIDS conference Wednesday that Russia is "emphatically against" the use of drug replacement therapy. Meanwhile, he criticized programs that exchange clean needles for used ones, saying such programs may promote illicit drug sales and HIV transmission.

Click here for the full story.

Unbearable Pain

2009-10-29T10:47:00.008Z

Human Rights Watch, October 28:

India’s Obligation to Ensure Palliative Care

(New Delhi) - Hundreds of thousands of patients in India unnecessarily experience excruciating pain, Human Rights Watch said in a report today. Restrictive drug regulations, lack of training for health care workers, and poorly integrated care result in needless suffering for patients because they cannot get inexpensive and effective pain medications.

The 102-page report, "Unbearable Pain: India's Obligation to Ensure Palliative Care ," found that many major cancer hospitals in India do not provide patients with morphine, despite the fact that more than 70 percent of their patients are incurable and likely to require pain treatment and palliative care. Health centers offering services to people living with HIV similarly do not have morphine or doctors trained to prescribe it.

"India's health care system abandons so many patients to severe pain," said Diederik Lohman, senior health and human rights researcher at Human Rights Watch. "They are left to suffer; many told us that their pain was so bad they would prefer to die."

Severe pain is a common symptom among cancer patients, particularly during the last stages of the disease. It is estimated that more than 1 million advanced cancer patients in India experience severe pain in any given year. In addition, many other patients, including those with HIV, TB, or other infections or illness, may face acute or chronic severe pain.

The report identified three key obstacles to improving the availability of pain treatment and palliative care:

Restrictive drug regulations. Many Indian states have excessively strict narcotics regulations that make it very difficult for hospitals and pharmacies to get morphine. In 1998, the central government recommended that states adopt modified regulations, but more than half of India's states have not done so.

The failure to train doctors. Most medical students and young doctors receive no training on pain treatment and palliative care because the government does not include such instruction in relevant curricula. As a result, most doctors in India simply do not know how to assess or treat severe pain.

Poor integration of palliative care into health services. National cancer and AIDS control programs do not contain meaningful palliative care components, thus depriving such care of public funds and relegating it to second-tier status.

"India is one of the world's largest legal producers of opium, the raw material for morphine," Lohman said. "But almost all of it is exported while hundreds of thousands - if not millions - of Indians suffer needlessly."

The report focuses specifically on the availability of pain treatment for cancer patients. It says that, based on official morphine consumption reports, fewer than 4 percent of patients with advanced cancer have access to appropriate pain treatment. The report also says that increased government funding for cancer has not emphasized palliative care.

"The Indian government deserves credit for investing in regional cancer centers and increasing funds for cancer control," Lohman said. "But without specific efforts to ensure that all cancer hospitals can treat pain and offer palliative care, these funds will do little to relieve the suffering for patients with advanced, incurable cancer."

The report is the first by an international human rights organization to examine access to pain relief medicines from a rights perspective. Human Rights Watch believes that governments have an obligation to ensure that essential medicines, including morphine, are available to patients and that health care workers receive adequate training in their use. The report says that the failure by the Indian government to fulfill this obligation violates the right to health.

Human Rights Watch further argues that the government's failure to ensure that cancer hospitals offer pain treatment may violate the prohibition against torture and cruel, inhuman and degrading treatment because of the widespread nature and severity of the suffering it causes. Human Rights Watch says that much of this suffering could be prevented with relatively basic and inexpensive steps.

Waiting for a Legal Shot: Heroin Maintenance in Denmark

2009-10-22T12:00:00.003+01:00

Check out this video by the Hungarian Civil Liberties Union and the Danish Street Lawyers Project about the introduction of a heroin maintenance program to Denmark.

British man facing execution in China: Amnesty issues urgent appeal

2009-10-22T10:57:00.002+01:00

Amnesty International, October 20: Amnesty International today issued an urgent appeal on behalf of a British man who could be executed in China within days. Akmal Shaikh, a 53-year-old father of five from north London who is believed to be mentally ill, was sentenced to death for drug-smuggling on 29 October. He has now lost his appeal and China provides no clemency procedures for condemned prisoners after they have exhausted their appeals through the courts.

Amnesty is asking people to go to www.amnesty.org.uk/deathpenalty and write urgently to the Chinese authorities, calling on the Supreme People's Court not to execute Akmal Shaikh. They are also urging the authorities to ensure that Akmal Shaikh has access to his family and any medical attention he may require, including psychiatric evaluation.

Akmal Shaikh's family and lawyer have argued that he has suffered for many years with mental instability and is likely to have a bipolar disorder. Despite these claims, the Chinese authorities have refused to allow Akmal Shaikh to be examined by a doctor. Forensic psychologist Dr Peter Shaapveld, who travelled to China specifically to meet Shaikh, was not allowed to meet him. After investigating through family members and other channels, however, he concluded that "the evidence clearly points to the fact that Mr. Shaikh was and/or is suffering from a severe mental disorder."

According to Article 18 of China's Criminal Law, a mental patient who commits a crime, and has not completely lost the ability to recognise or control his own conduct at the time, still has criminal responsibility but may be given a lighter punishment.

Amnesty International UK Campaigns Director Tim Hancock said:

'Akmal Shaikh should not be executed. There's evidence that he may have a serious mental disorder, which could warrant a less extreme sentence under Chinese law. The Chinese authorities should allow a psychiatric evaluation immediately.

'China's Supreme People's Court has it in their power to stop this execution. We're calling on people to write to them immediately, urging them to intervene.

'The death penalty is always wrong, the ultimate cruel and inhuman punishment. But in countries like China, where the prisoner is highly unlikely to have received a fair trial, its use is even more deplorable.'

No one who is sentenced to death in China receives a fair trial in accordance with international human rights standards. Confessions are accepted even when prisoners tell the court that they were extracted under torture; other prisoners have had to prove themselves innocent, rather than be proven guilty. Many people have limited access to legal counsel when they are put on trial.

Reprieve's Executive Director Clare Algar said:
'Sadly, our investigations show that Akmal Shaikh is on death row because he is mentally ill. Since the case was 'tweeted' by Stephen Fry, yet more witnesses have contacted Reprieve to offer testimony confirming Akmal's bizarre behaviour when he lived in London. Thankfully there is a mental illness defence in China; we hope that Amnesty's Urgent Action will encourage the Supreme People's Court to consider it and spare Akmal's life.'

The death penalty is applicable to approximately 68 offences in China, including non-violent ones. China executes more people each year than any other country and while official statistics remain secret, Amnesty's figures show that China executed at least 1,718 people in 2008, nearly three-quarters (72%) of the world's executions. At least 7,003 people were sentenced to death in China last year. These figures represent a minimum - the real figures are undoubtedly much higher. Amnesty is urging China to introduce a legal procedure for clemency and to eliminate the death penalty for all non-violent crimes, with a view to establishing a moratorium on the death penalty.

In January 2007, China restored the Supreme People's Court (SPC) review for all death sentences. All death sentences must now be reviewed by the SPC, which has the power to approve, revise or remand death sentences. Chinese authorities have reported a drop in executions since the SPC resumed this review. Nevertheless, the application of the death penalty remains shrouded in secrecy in China. Without access to such information it is impossible to make a full and informed analysis of death penalty developments in China, or to say if there has been a reduction in its use.

Akmal Shaikh was detained at the airport in Urumqi, capital of China's Xinjiang region, on 12 September 2007, when he arrived on a flight from Tajikistan. He was accused of carrying four kilogrammes of heroin in his luggage. According to Hong Kong and international media, Shaikh had been tricked by a criminal gang in Poland, where he had been living. Gang members had promised to introduce him to people in the music business, who would assist him with his music career, and arranged for him to travel to Kyrgyzstan and then to China; they asked him carry the luggage that contained the heroin. Believing that he was going to be able to launch a career as a pop star, he boarded a plane for China, carrying the piece of luggage.