Towards a gender-sensitive approach to drug demand reduction: a process within the United Nations system

Sections

ABSTRACT
Introduction
United Nations system-wide collaboration in assessing the situation regarding women and drug abuse
Gender analysis of drug abuse
Paving the way for the adoption of the Platform for Action
Resolution 3 (XXXVIII)
Towards a United Nations System-Wide Action Plan on gender aspects of drug abuse control

Details

Author: L-N. HSU , J. du GUERNY
Pages: 1 to 14
Creation Date: 1995/01/01

Towards a gender-sensitive approach to drug demand reduction: a process within the United Nations system

L-N. HSU * Focal Point on Women, United Nations International Drug Control Programme, Vienna
J. du GUERNY Chief, Population Programme Service, Women and Population Division, Food and Agriculture Organization of the United Nations (FA O), Focal Point on, AIDS, FA O, and Chairman of the Interagency 4dvisory Group on AIDS (IAAG)), United Nations **

ABSTRACT

Women are linked to illicit drug-related activities, whether they be cultivation, production, trafficking, peddling or consumption. The real extent of the impact of these activities on women, however, has only gradually been gaining the attention of policy makers dealing with matters related to drug abuse and illicit trafficking. This increase in awareness is the result of successful collaboration between organizations of the United Nations system in conducting gender analysis and research into the relationship between drug abuse and related activities and women. The present article documents the process of that collaboration, which led to the recognition of the issue at the Fourth World Conference on Women: Action for Equality, Development and Peace, held at Beijing from 4 to 15 September 1995. Since the World Conference, a United Nations System-Wide Plan of Action was developed in 1996 on "Women and Drug Abuse: a Gender Perspective".

Introduction

The social and economic impact of illicit drugs on people from different geographic, social and cultural groups is increasing. The short-term gains from the illicit manufacturing, trafficking and consumption of drugs, however, cannot compensate for the long-term costs to society in terms of social and economic development.

The views expressed in this article are those of the author and do not necessarily reflect those of the United Nations Secretariat.

*Dr. Lee-Nah Hsu began this work when she was a scientist at the World Health Organization Programme on Substance Abuse, Geneva, Switzerland and a Faculty Associate at the Johns Hopkins University School of Public Health and Hygiene, Department of international Health, Baltimore, Maryland.

**Mr. Jacques du Guerny was a Senior Social Affairs Officer, Division for the Advancement of Women, United Nations Office at Vienna (UNOV) and Focal Point for UNOV on AIDS, Vienna, Austria.

A misconception prevails that problems related to drugs refer mostly to men. Such a gender bias reinforces conventional strategies for dealing with issues related to illicit drugs in the area of supply control, law enforcement as well as demand reduction. For example, individual medical treatment tends to be focused on detoxification and often treatment and rehabilitation efforts in general are targeted at men [ 1] . Although women may not always have high visibility in drug-related activities, they are usually involved in trafficking and abuse either by themselves or through their male associates. Yet social attitudes have often led to the concealment of problems related to women's involvement.

Previously, international data on women and drug abuse had been lacking except concerning the effects of drug abuse on the foetus during pregnancy. In the process of gathering data, it was found that, either as a rule or practice, many in-patient drug-abuse treatment facilities do not admit women, particularly if they are pregnant or human immunodeficiency virus (HIV)-positive. The reasons given for such restrictive admission policies range from lack of sex-segregated accommodation and lack of expertise in dealing with pregnant drug abusers to fear of transmission of HIV to other patients and to staff. Consequently, most health facility statistics underreport female drug abusers. Since such statistics are one of the main sources for official annual reports on drug abuse to the United Nations, the data on women have remained scanty.

The improvement of the status of women is an issue that has been receiving increasing attention not only internationally, but also within the United Nations system. As the global movement in improving the status of women accelerated with the approach of the Fourth World Conference on Women: Action for Equality, Development and Peace, held at Beijing from 4 to 15 September 1995, each United Nations entity began a critical examination of the issue within the context of its mandates.

The issue of the situation of women in relation to drug abuse was first brought to the attention of the Commission on the Status of Women at its thirty-eighth session, held in March 1994, in the form of a background paper [ 2] .

In March 1995, at its thirty-eighth session, the Commission on Narcotic Drugs considered the issue of women and drug abuse under an agenda item on the reduction of illicit demand for drugs. It then adopted resolution 3 (XXXVIIl) on women and drug abuse [ 3] . Later, in the same year, the Fourth World Conference on Women adopted the Platform for Action, which specified actions to be taken in relation to women and drug abuse [ 4] .

These events are not a coincidence but the result of a continuous process of collaborative effort within the United Nations system. The purpose of the present article is to document this process because it shows the positive role that coordination and collaboration within the United Nations system can play in promoting awareness in the international community and consensus among Member States.

This successful process was made possible because the use of gender analysis revealed a hitherto concealed issue in drug abuse control and brought together areas of expertise in the United Nations system that led to a greater understanding and recognition of the importance of the gender dimension in drug abuse control.

United Nations system-wide collaboration in assessing the situation regarding women and drug abuse

Three United Nations bodies shared an interest in examining problems related to drug abuse and women in their preparations for the Fourth World Conference on Women. First, the United Nations International Drug Control Programme (UNDCP), which was established at the request of the General Assembly in its resolution 45/179 of 21 December 1990 as the main focus for concerted international action for drug control.

The second body was the Division for the Advancement of Women of the Secretariat of the United Nations, which took up the issue of gender analysis of women and the human immunodeficiency virus/acquired immunodeficiency virus (HIV/AIDS) in 1990 [ 5] . In an article prepared by the second author and a colleague discussing the relationship between gender and HIV infection, it was hypothesized that there might be a linkage between gender and drug abuse.

The third body was the World Health Organization (WHO). In September 1991, WHO established the Programme on Substance Abuse, whose task was to examine health problems among people who were abusing drugs and other psychotropic substances.

The Administrative Committee on Coordination (ACC), comprising the executive heads of all the programmes, organizations and specialized agencies of the United Nations system under the chairmanship of the Secretary-General, currently holds two sessions a year to discuss matters of common interest. At the Ad Hoc Inter-agency Meeting on Coordination in Matters of International Drug Abuse Control, held in September 1992, these three United Nations bodies decided to work together in developing a cohesive United Nations' system-wide position paper on women and drug abuse. Preparations on the scope, outline and methods for such a paper were begun by the two authors and were then discussed and agreed to at the Inter-agency Meeting on Coordination in Matters of International Drug Abuse Control held at Vienna in April 1993.

UNDCP, as a result of this concern, provided funds for a global project to assess the situation regarding women and drug abuse. The project, which was implemented from 1992 to 1993 by WHO in collaboration with the Division for the Advancement of Women of the Secretariat of the United Nations, represented the first United Nations system-wide attempt to assess the impact of drug abuse on women throughout the world. It used gender analysis and, where appropriate, a rapid assessment methodology that combined the collection and analysis of both quantitative and qualitative data. Assessments were conducted in 27 countries * covering different geographic and cultural environments [ 6] , [ 7] .

One of the objectives of the assessment was to answer the question: whether there is a problem of drug abuse among women. By gathering results from epidemiologic surveys that covered mainly high-school and university students, health service statistics on drug abuse, and police and prison records of drug-abuse-related offences, arrests and imprisonment, quantifiable data could be collected and analysed. In addition, where gaps existed, and in order to gather qualitative data, key-informant interviews, focus-group discussions and in-depth case-studies were conducted among communities, families and women who were either drug abusers themselves or who were affected ** by a drug-abusing family member.

To supplement the country studies, an extensive review of literature was conducted on gender issues in their socio-cultural context, taking into account the health implications for different age groups according to type of substance used, and programme and policy responses to drug abuse. Furthermore, a consultation meeting entitled "Women and Drug Abuse" was held jointly by the Division for the Advancement of Women of the United Nations Secretariat, UNDCP and WHO at Geneva in August 1993 in which international experts participated [ 1] . The objective of the meeting was to gather state-of-the-art knowledge on the effects of abuse of psychoactive substances on women from a health, sociocultural and policy perspective.

The authors then synthesized all the materials thus gathered and drafted a position paper on women and drug abuse [ 2] , which was reviewed at the Inter-agency Meeting on Coordination in Matters of International Drug Abuse Control held at Paris in September 1993. Many bodies and specialized agencies of the United Nations provided contributions based on their own mandates and expertise. Written contributions were included from the United Nations Development Programme, United Nations Development Fund for Women, United Nations Interregional Crime and Justice Research Institute, International Labour Organisation, Food and Agriculture Organization of the United Nations, United Nations Educational, Scientific and Cultural Organization, World Bank, International Fund for Agricultural Development and United Nations Industrial Development Organization.

*Bahamas, Bolivia, Brazil, Cameroon, China, Czech Republic, Egypt, El Salvador, Estonia, Greece, Guatemala, Honduras, Hungary, India, Japan, Kazakstan, Kenya, Lebanon, Mexico, Nigeria, Philippines, Poland, Slovakia, Sri Lanka, Turkmenistan, United Republic of Tanzania and Zimbabwe.

** Women who are affected by family members who abuse drugs have to bear the consequences of that abuse or HIV-infection. They are distinct from women who are themselves drug abusers or HIV- infected. This concept is adopted from a statement made by Jacques du Guerny at the International NGO Consultation Meeting on Women and AIDS, held by the Global Programme on AIDS, WHO at Geneva, Switzerland, in November 1989.

The position paper was then presented at a seminar on urban women organized by the Division for the Advancement of Women, * Secretariat of the United Nations, which was held at the International Research and Training Institute for the Advancement of Women, Santo Domingo, Dominican Republic, in November 1993. The findings of the seminar, which had taken into consideration the background paper, were included in a report of the Secretary-General (E/CN.6/1994/3) and considered by the Commission on the Status of Women, at its thirty-eighth session, under the priority theme of development: women in urban areas: population, nutrition and health factors for women in development, including migration, drug consumption and acquired immunodeficiency syndrome.

Gender analysis of drug abuse

In the course of the collaborative work, authors analysed drug abuse from a gender perspective.

Patterns of drug abuse

It was found that the patterns of drug abuse among women in developed countries differ from those in developing countries. In the developed countries, women abuse tranquillizers, sedative hypnotics, cocaine, particularly crack, heroin and cannabis. Among men, the abuse of cocaine and heroin is more prevalent than that of tranquillizers and sedative hypnotics. In the developing countries, women tend to abuse alcohol, opium or cannabis more than tranquillizers or sedative hypnotics. This difference may be linked to the availability of certain drugs. The abuse of heroin and cocaine by both men and women is an emerging trend in developing countries in addition to the abuse of opium and cannabis. It is common in developing countries for men and women to purchase drugs from street markets for self-treatment. Alcohol and tobacco are often mixed with other drugs when consumed by both men and women [ 6] , [ 7] .

In a survey of drug abuse among women in rural and urban areas, it was found that the average age of female drug abusers in rural areas tended to be higher than that of female drug abusers in urban areas. Even the starkness of this age differential, however, is beginning to blur as more recent data become available from both developing and developed countries that show a growing trend in rural communities of drug abuse among female adolescents. Nevertheless, either because of the difference in findings or as a reflection of reality, there are more female drug abusers in urban areas than in rural ones [ 6] , [ 7] . In view of the magnitude of rural poverty, any diversion of very limited resources to drugs could have a negative impact on food security.

*In autumn 1993, the Division for the Advancement of Women was transferred from the United Nations Office at Vienna to United Nations Headquarters to become part of the Department for Policy Coordination and Sustainable Development.

The patterns of drug abuse among different age groups of females also differ. Surveys conducted in high schools in both developed and developing countries showed that the prevalence of experimentation in drug use among teenage females and males was similar. The drugs of choice included glue, organic inhalants and cannabis and their use was often associated with cigarette smoking and beer drinking.

Drug abuse among adult women is more often associated with analgesics, tranquillizers, sedative hypnotics, cocaine, marijuana, heroin and alcohol, although the pattern of use differs between developed and developing countries. Some adult female drug abusers engage in sex work in exchange for drugs [ 1] .

Women in the older age groups (over 60 years of age) from both developing and developed countries were also found among drug abusers. In the developed countries, drug misuse by elderly women could often be traced back to initiation through a medical prescription. In developing countries, many elderly women resorted to opium, ganjaor home brews for either medical reasons or social reasons. Some examples are shown in table I below.

Table 1. Some findings from country assessments of drug abuse among women a

Africa

Drug abuse among adolescents in rural areas

According to rural health workers, the increasing abuse of cannabis among adolescent girls in some countries was a major health problem.

Caribbean

Women engaged in drug trafficking

Women were involved in cocaine and heroin smuggling. Many of them also abused drugs and engaged in sex work,

Central Asia

Effect of drug abuse on non-drug-using family members

Passive opium smoking was observed among the families of opium abusers. For instance, opium withdrawal symptoms would appear in the wife and children of an opium smoker in his absence and cease when he returned to the house and resumed his habit

North America

Drug mouse among elderly women

Among persons over 60 years of age, the number who were receiving sedative hypnotic drugs from physicians was 2.5 times higher for women than it was for men. In addition, women continued to use these drugs longer. continued

South-East Asia

Pregnancy and drug abuse

On account of poverty, tradition and the lack of local health-care facilities among rural hill tribes, women wre using opium Io alleviate physical pains, including abdominal pains during pregnancy.

Source: Hsu, L-N, "Programme on substance abuse: women and substance abuse: 1993 country assessment report" (World Health Organization, Geneva, 1993) (WHOIPSA/93.13).

a"The examples are drawn from assessments of 27 countries to illustrate the diversity of problems among women and are not meant to be representative of any particular region. The countries are listed on page 4 (footnote 1).

Patterns of behaviour

The authors assessed the problem for females and for males in terms of their relationship to each other and their socially assigned roles. The misconception that drug abuse is mainly a male problem was thus dispelled. It appears that the number of people affected by illicit drugs (especially among women) is much greater than the number of actual drug abusers. Because of the socially assigned care-giving role of women, there are large hidden numbers of women who are drawn into carrying out the additional burdens of ensuring household food security and the economic survival of families abandoned by their male drug-abusing family members [ 8] .

It was found that, because of their caring role and their interaction with drug abusers, women are a potentially powerful resource in drug demand reduction [ 9] . As for females affected by illicit drugs, they can be categorized into two groups:

  1. Females who abuse drugs;

  2. Female non-drug-users with families or male sexual partners who abuse drugs.

A comparison between these two groups of women from similar environments revealed that many of those women who resisted drug use tended to have a greater sense of responsibility for the care of their children and families, and were convinced that drug use was not a solution to their current predicament. Some of these women were also supporting their male partners who were drug dependent. A summary of gender analysis and drug abuse is provided in table 2 below.

In addition to the difficulty that women experience in obtaining access to treatment services -even in countries where there are no such barriers -many women still will not seek treatment. Some of the reasons given by the women who were interviewed were as follows:

  1. In the prevailing sociocultural environment, female drug abusers, especially women of reproductive age, are stigmatized. This cultural restriction is more prevalent against women of "good social standing". It is therefore considered shameful for "good" women to admit to having a drug abuse problem;

  2. When a female drug abuser realizes that she needs treatment, other gender-role-imposed barriers prevent her from seeking help. These barriers included the lack of child-care facilities and the lack of an alternative to the woman's care- giver role within her household. A period of in-patient admission is usually necessary for thorough detoxification, treatment and rehabilitation, which is both financially and practically unfeasible for some women.

Table 2. Gender analysis of drug abuse

Female drug abuser (lower social status than male drug abusers)

Male drug abuser (higher social status than female drug abusers)

Female non-drug user affected by drug abusers (lower social status than male drug abusers)

Because society is less
Because society is more tolerant
 
tolerant of women who use
of men who use drugs and
 
drugs and alcohol, a female
alcohol, a male drug abuser:
 
drug abuser:
   
Feels guilty and ashamed
Might feel ashamed
Tolerates drug-abusing family
   
members for emotional, social,
   
cultural and economic reasons.
   
Feels guilty, ashamed and
   
frustrated in trying to care for
   
drug abusers
Covers up heir drug- abusing
Can publicly use drugs with less
Is subject to domestic violence,
behaviour
risk of social disapproval
often drug-related
Is afraid of losing her
Assumes little responsibility for
Fears for the safety of children
children
child care, and sometimes sells
or may be blind to, or unable to
 
his own daughter(s) or sister(s)
prevent child abuse
 
into prostitution to support his
 
 
drug habit
 
Feels responsible for the
Assumes no responsibility for
May be pressured into sex trade
effects of drug abuse on the
foetal defects related to parental
to support partner's drug use
foetus
drug and alcohol use a
owing to lack of control of
   
household resources diverted to
   
drug purchase
Is at higher risk than men of
Is at lower risk than women are
Is exposed to the risk of STD,
contracting STD, including
of contracting STD, including
including HIV
HIV
HIV
 

Source: Based on J. du Guerney, L. N. Hsu and F. Sjoberg, "Gender analysis of substance abuse in a sociocultural context", in.A Collaborative Project with WHO/UNDCP and United Nations Division for the Advancement of Women: Women and Substance Abuse: a Gender Analysis and Review of Health and Policy Implications

Note: STD: sexually transmitted disease.

a Although it is well established that drug abuse by the pregnant mother can have an impact on the foetus, the impact on the foetus of drug abuse by the father has only recently begun to be investigated.

Another critical problem is drug abuse during pregnancy because of the increased risk for the mother and the foetus, the negative influence on the development of the future newborn baby and the increased socioeconomic cost to society if the problem is not adequately dealt with.

Yet another problem is the risk of exposure to HIV infection when injecting paraphernalia is shared or contaminated needles are used.

Female drug injectors are found to have a higher incidence of HIV infection compared with male drug injectors. This phenomenon is partly due to the synergy between the lower status of women and their physiology. Females usually defer to males when sharing food. This behavioural pattern persists among drug injectors. Physiologically, females tend to have smaller and less prominent veins than males do and a different distribution of fatty tissue. The result is that women have to search longer for injectable veins and the pace at which they can inject drugs is slower. A study of street drug injectors revealed that when both men and women are present in a group sharing drug-injecting equipment, the women usually receive the equipment only after the men have finished their rounds. Because women use the equipment and drugs last, the likelihood is greater for them than it is for men that the paraphernalia and drugs will be contaminated, which means that women are exposed to a higher risk of HIV infection.

Non-drug-using female sexual partners have been known to become infected with HIV through sexual contacts with their male drug-abusing partners. The risk of contracting HIV through sexual transmission is five times higher for females than it is for males among discordant HIV-status couples [ 10] . Discordant HIV-status means that while one sexual partner is HIV-positive, the other is not. The study provided solid evidence of the fact that, other factors being equal, females are more susceptible to HIV and other sexually transmitted diseases than men are.

Female non-drug users, be they grandmothers, mothers, sisters, daughters, wives or sexual partners, are more affected by their family members who abuse drugs than male non-drug users are. 'Be traditional caring role assigned to women in a family places increased burdens on them in caring for drug-abusing family members. There is an opportunity cost to society when women switch from carrying out productive activities to caring tasks. These phenomena affect rural women who are the traditional producers of food and urban women who are gainfully employed outside the household.

Paving the way for the adoption of the Platform for Action

The response of the United Nations system to issues such as women and drug abuse is a reflection of the awareness, policies and readiness of its Member States to take action. The ability of the United Nations to take action on a particular issue depends therefore on the priority given to the issue by the Member States and on the resources those Member States are willing to provide.

Because women and drug abuse is a cross-sectoral issue, cutting across organizational structures within the United Nations system, international action presents a special challenge. Two legislative bodies have considered the issue: the Commission on the Status of Women and the Commission on Narcotic Drugs. Although WHO participated in the collaborative assessment of the situation related to women and drugs, the issue has not been considered by the World Health Assembly.

Commission on Narcotic Drugs

UNDCP, which inter alia acts as the secretariat for the Commission on Narcotic Drugs designated "Women, Drug Abuse and Drug Control" as the theme for the observance of the International Day against Drug Abuse and Illicit Trafficking in 1994, thus drawing attention to the problems of women in relation to drug abuse [ 12] . Subsequently, in July 1994, the Office of the Executive Director of UNDCP appointed the first author as the Focal Point on Women in UNDCP to deal with all technical and policy aspects of drug issues from a gender perspective.

In January 1995, at the monthly staff seminar of UNDCP the Focal Point on Women made a presentation at which she analysed the gender dimension in drug control and presented the cost-effective approaches adopted by projects that had taken into account the gender dimension of drug-related issues. On account of the interest generated, a working group on gender was formed in February 1995, composed of a representative of each organizational section of UNDCP, to begin examining ways in which to integrate gender considerations into drug control work.

At its thirty-eighth session held in March 1995, the Commission on Narcotic Drugs discussed the issue of women and drug abuse and subsequently adopted resolution 3 (XXXVIII) [ 3] , which had been tabled by the Italian Government and co-sponsored by 36 Member States as follows: Austria, China, Cte d'lvoire, Denmark, Egypt, Finland, France, Gabon, Germany, Ghana, Greece, Guinea, Hungary, India, Indonesia, Italy, Jordan, Lebanon, Madagascar, Morocco, Nicaragua, Norway, Pakistan, Peru, the Philippines, Poland, Romania, South Africa, Sri Lanka, Sweden, Switzerland, Syrian Arab Republic, Thailand, Tunisia, Turkey and United States of America. The adopted resolution is reproduced below.

Resolution 3 (XXXVIII)

Resolution on Women and drug abuse

Commission on Narcotic Drugs,

Notingthat a collaborative effort of the United Nations system has uncovered the previously unrecognized dimension of female drug abuse problems in many parts of the world as well as the disproportional socio-economic burdens on women who bear the consequences of drug abuse among their family members,

Deeply concerned by the growing problems in many countries involving illicit drug abuse, drug trafficking and human immunodeficiency virus (HIV) infection related to drug abuse among women and children in both developed and developing countries, in both rural and urban settings, affecting all socioeconomic levels of those countries,

Awareof the Fourth World Conference on Women: Action for Equality, Development and Peace, to be held at Beijing from 4 to 15 September 1995 and its draft Platform for Action, calling attention to strengthening prevention, treatment and social reintegration services for women affected by drug abuse,

Noting withappreciation the contribution resulting from the collaborative effort of the United Nations system in identifying the nature and extent of drug abuse and the problems that it poses for women, which cut across geographical and sociocultural distinctions and affect women directly as drug abusers in their roles within the family and the community and as workers in the field of drug abuse control,

Notingthe particularly dangerous effects of dependence-producing substances during pregnancy, as well as the harmful behavioural and social consequences of drug abuse for the family, and the need for States to include accordingly in their national policies and programmes drug abuse prevention programmes that specifically concern women,

  1. Urges States to recognize, assess and take into account in their national policies and programmes the problems that drug abuse poses for women;

  2. Also urges States, in collaboration with non-governmental organizations, to develop and test activities to respond in an innovative way to the problems that drug abuse poses for women;

  3. Requests the Secretary-General to transmit the present resolution to all Governments for consideration and implementation.

Commission on the Status of Women

The Commission on the Status of Women focuses on issues related to the advancement of women. The national delegations to the Commission often include the head of the national machinery for women, which in practice means the ministries or commissions designated to deal with such issues within a country. These delegates are particularly concerned with the rights, welfare and socio- economic development of women as well as discrimination against them.

The document that served in recent years (1985-1995) as the blueprint for actions to improve the status of women: the Nairobi Forward-looking Strategies for the Advancement of Women [ 11] did not discuss the issue of drug abuse in its 372 paragraphs.

The issue of drug abuse was first brought to the attention of the Commission at its thirty-eighth session, held in March 1994, in the form of a background paper [ 2] .

In the "Second review and appraisal of the implementation of the Nairobi Forward-looking Strategies for the Advancement of Women: Report of the Secretary-General"(E/CN.6/1995/3/Add.3), which was considered by the Commission at its thirty-ninth session, in 1995, the issue of substance abuse was included in the section on inequality in access to health and related services. Emphasis was placed on tobacco and alcohol abuse. Only one sentence dealt with drug abuse as follows: "Illicit drug-abuse problems among females have been underestimated, as statistics in many countries are not gender-disaggregated" (para. 78).

Fourth World Conference on Women

At the regional preparatory conferences held during 1994 and 1995 for the Fourth World Conference on Women, efforts were made to draw attention to the plight of women affected by drug abuse. A special event on women and substance abuse was held on 7 September 1995, during the Fourth World Conference on Women. The event had been jointly organized by UNDCP, United Nations Interregional Crime and Justice Research Institute, NGO Committee on the Status of Women and NGO Committee on Narcotic Drugs. About 100 men and women from Africa, Asia, Europe, Latin America and the Caribbean, Middle East, North America and the Pacific Islands participated in the event. Its purpose was to bring together, in one forum, diverse representatives of government non-governmental organizations of the United Nations and academic institutions.

Eventually, in the Platform for Action adopted at the Fourth World Conference on Women, several paragraphs [ 4] were included on women and drug abuse, as follows:

  1. Strategic objective C.1. Increase women's access throughout the life cycle to appropriate, affordable and quality health care, information and related services

    Paragraph 106(v). Provide improved access to appropriate treatment and rehabilitation services for women substance abusers and their families

  2. Strategic objective C.2. Strengthen preventive programmes that promote women's health

    Paragraph 107(k). Develop and undertake media campaigns and information and educational programmes that inform women and girls of the health and related risks of substance abuse and addiction and pursue strategies and programmes that discourage substance abuse and addiction and promote rehabilitation and recovery

  3. Strategic objective C.3. Undertake gender-sensitive initiatives that address sexually transmitted diseases, HIV/AIDS, and sexual and reproductive health issues

    Paragraph 108(n). Support programmes which acknowledge that the higher risk among women of contracting HIV is linked to high-risk behaviour, including intravenous substance use and substance-influenced unprotected and irresponsible sexual behaviour, and take appropriate preventive measures

  4. Strategic objective C.4. Promote research and disseminate information on women's health

    Paragraph 109(g). Support health service systems and operations research to strengthen access and improve the quality of service delivery, to ensure appropriate support for women as health-care providers and to examine patterns with respect to the provision of health services to women and use of such services by women

Thus, for the first time in efforts to improve the status of women, drug-abuse-related issues were finally established as a strategic objective on which action should be taken by all concerned at the intergovernmental and non-governmental level. It should be noted, however, that the issue is seen from the perspective of improving the status of women and not yet form a gender one.

Towards a United Nations System-Wide Action Plan on gender aspects of drug abuse control

At its meeting held at Geneva from 31 July to 2 August 1995, the ACC Subcommittee on Drug Control decided to include women and drug abuse as one of the themes as part of the revision of the United Nations System-Wide Action Plan on Drug Abuse Control to be included in the United Nations medium-term plan for 1996-2001. The organizations participating in this initiative are: Division for the Advancement of Women of the Secretariat of the United Nations, United Nations focal point on tobacco (United Nations Conference on Trade and Development), UNDCP, United Nations Interregional Crime and Justice Research Institute, joint United Nations Programme on HIV/AIDS, UNESCO and WHO.

The Action Plan follows the findings and recommendations of the United Nations System position paper on women and drug abuse [ 2] . The Action Plan aims at improving services for female drug abusers, strengthening family and community support networks to facilitate the social reintegration of women drug abusers and promoting gender-sensitive treatment services, and information and education facilities. The success of the Action Plan is dependent on ensuring that gender-disaggregated data are routinely collected in order to document the extent of and trends in drug abuse and the consequences for men and women. In addition, the promotion of women to decision-making positions for demand reduction is necessary to ensure that policy decisions are made in a gender-sensitive way. The key in the Action Plan is that women and men should work together in partnership with families and the community through strengthened collaboration between governmental and non-governmental organizations.

UNDCP is in a unique position, as the international coordinator on drug-related matters, to facilitate the implementation of the Action Plan. By paying special attention to women as a resource for development and for illicit drug demand reduction, more effective development programmes can be designed and implemented in the future.

The United Nations system has succeeded in making the issue of women and drug abuse visible by gender analysis. Member States have endorsed many of the results. However, an area in which work is still needed, particularly at the operational level, is the transition from women-only issues to true gender activities, a change that includes considering the socially determined roles of men and women from a holistic perspective.

References

01

J. du Guerny, L-N. Hsu and E. Sjberg, "Gender analysis of substance abuse in a sociocultural context", in .A Collaborative Project with WHO/UNDCP and United Nations Division for the Advancement of Women: Women and Substance Abuse: a Gender, Analysis and Review of Health and Policy Implications (Geneva, World Health Organization, 1993) (WHO/PSA/93.12), pp. 3-9.

02

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03

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04

Report of the Fourth World Conference on Women: Action for Equality, Development and Peace, Beijing, 4-15 September 1995 (A/CONF. 177/20), annex II, chap. III, paras. 106(v), 107(k), 108(n) and 109(g).

05

J. du Guerny and E. Sjberg, "Inter-relationship between gender relations and the HIV/AIDS epidemic: some possible considerations for policies and programmes" ,,AIDS Journal,vol. 7, No. 8 (1993), pp. 1027-1037.

06

L-N. Hsu, Women and Substance Abuse: 1992 Interim Report (Geneva, World Health Organization, 1992) (WHO/PSA/92.9).

07

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08

du Guerny, Hsu and Sjberg, "Gender analysis...", p. 3.

09

L-N. Hsu, "Drug use and the family", World Health Magazine, vol. 46, No. 6 (November-December 1993).

10

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11

Report of the World Conference to Review and, Appraise the Achievements of the United Nations Decade for Women: Equality, Development and Peace, Nairobi, 15-26 July 1985 (United Nations publication, Sales No. E.85.IV.10), chap. I, sect. A.

12

United Nations International Drug Control Programme, "Women, drug abuse and drug control", pamphlet (June 1994).