Media/News > Latest News > 16.03.04

New Report Finds UN Policies on Illicit Drugs Fuel Global HIV Infections Imprisonment, Institutionalization Accelerating Epidemics in Asia and Former Soviet Union

Press release from the Open Society Institute 16.03.04

UN policy on illicit drugs and wholesale criminalization and imprisonment of drug users at the national level are fueling HIV epidemics across Asia and the former Soviet Union, according to a report released today.

The study, Illicit Drug Policies and the Global HIV Epidemic: Effects of UN and National Government Approaches , was commissioned by the UN Millennium Project and published by the Open Society Institute. It was released at the 47th session of the UN's Commission on Narcotic Drugs (CND), one of the UN entities the report says should play a leading role in healthy reform of international drug policy.

"While much is said about how injection drug use spreads HIV, little attention is paid to the role of drug policy in accelerating HIV epidemics," said Kasia Malinowska-Sempruch, director of the Open Society Institute's International Harm Reduction Development program and one of the report's authors. "Governments from Thailand to China to Russia look to the United Nations to justify jailing thousands of drug users, or to excuse their own failures to offer public health services proven to save lives."

The report calls for a new UN drug convention to explicitly acknowledge that harm reduction measures to reduce HIV without requiring abstinence from injection drug users (IDUs) are permissible under international law. It also urges an end to forced drug treatment and indiscriminate imprisonment that can accelerate rates of global HIV infection without effectively addressing problems related to illicit drug use.

Contradictory UN Policy

Numerous studies have documented the effectiveness of harm reduction measures such as distribution of sterile injection equipment and methadone treatment in reducing HIV transmission and other social costs of drug use. Yet UN drug control and health promotion entities remain divided on harm reduction.

"The UN claims to have reached consensus on HIV prevention, but these declarations do not carry the force of law," said Daniel Wolfe of Columbia University, a co-author. "The measures with real teeth are the UN drug conventions, which are routinely used to excuse wholesale imprisonment, forced labor camps, and other efforts that spread HIV infection without demonstrably reducing drug use."

Two of the three UN drug conventions predate AIDS entirely, and the third was enacted before there was widespread understanding about how injection drug use can fuel the epidemic.

Among the inconsistencies detailed by the report:

•  The World Health Organization (WHO) and the Joint United Nations Programme on AIDS (UNAIDS) say the UN system is unified in support of harm reduction. The United Nations Office on Drugs and Crime, by contrast, has no official position on harm reduction, and the International Narcotics Control Board frequently describes harm reduction as contributory to drug use, illegal, and carrying negative national and international consequences.

•  WHO and UNAIDS claim that they support substitution treatment for opiate addicts. Methadone, however, among the best studied and cheapest of substitution treatments, remains classified by the CND as one of the most dangerous and strictly controlled drugs, effectively obstructing its use as an HIV and drug treatment tool in many countries.

•  Neither WHO nor UNAIDS has worked with bilateral donors or recipient governments to bring a single harm reduction program to national scale in Asia or the former Soviet Union.

National Policies: Incarceration and Institutionalization as Engines of Infection

The report also details consistent patterns, including "social evils" campaigns and overcriminalization of drug users, in countries with established injection-driven epidemics ( >50,000 registered cases, a majority of which are IDUs). Drug users make up the majority of HIV cases in many Central and Southeast Asian countries, and five countries—Malaysia, China, Russia, Ukraine, and Vietnam, which together account for 20 percent of the world's population—face major injection driven epidemics.

Those suspected of drug use in these countries face consistent human rights violations and state-sanctioned measures that increase the risk of HIV. Current policies emphasizing institutionalization and imprisonment accelerate the epidemic, forcing infected and uninfected users together in situations where sex and drug use continue but means of HIV prevention are unavailable.

Calls for Reform at National and International Levels

In addition to calling for a UN drug convention explicitly acknowledging the effectiveness of harm reduction measures, the report also details a number of national and international policy reforms. These include the reclassification of methadone into a less restrictive controlled substance category, and national repeal of legislation or practices that stigmatize drug users through registration or forced imprisonment/institutionalization for possession of small amounts of illicit drugs. According to the study, reforms should begin at the CND. "Nations now seeking guidance from the UN instead find obsolete and contradictory policies," said Malinowska-Sempruch. "Drug conventions created before the AIDS epidemic must not dictate the international response to one of the most pressing health care crises of our times."

http://www.soros.org/initiatives/ihrd/news/drugpolicy_20040316