UN Special Rapporteur on Right to Health discusses harm reduction in Thailand

Bangkok (Thailand), 25 April 2012
- In Thailand, over one million people were reported to have used illicit drugs in 2010. Drug use, particularly use of methamphetamines, is on the increase in the country. This impacts the health and wellbeing of individuals, families and communities. On Monday, 23 April, over 60 representatives from the Royal Thai Government, the community of people who use drugs, international organisations, academia and the United Nations agencies joined a national seminar hosted by the Ministry of Justice and the United Nations Country Team to discuss current government policy on drug use and alternative approaches to compulsory detention of people who use drugs.

The meeting was one of a series which being organized by the United Nations in Thailand to ensure that important public issues are given a discussion forum at national level.

"Drug use is a complex global challenge that intersects across health, justice and law enforcement sectors" said Dr Maureen Birmingham, UN Resident Coordinator a.i. in her welcome remarks. She added that "a wide range of approaches have been tried, the world over, and that some of these approaches have been met with more success than others and this affords countries an opportunity to reflect on what has worked elsewhere, and learn from it."

"The current policies and approaches to drug treatment in Thailand need to be reviewed and greater focus needs to be given to voluntary, community based approaches", said His Excellency, Mr Pracha Promnok, the Minister of Justice during his opening remarks.

"Detention of people who use drugs in compulsory centres for rehabilitation, without individual informed consent is not only a violation of the right to health, but also illegal in international law" remarked Mr Anand Grover, UN Special Rapporteur on the Right to Health in his key note speech and presentation. Mr. Grover made reference to countries in the region that have adopted a harm reduction approach to drug use. He then noted that harm reduction services, such as opioid substitution treatment with Methadone, have enabled opioid dependent people to start living normal lives (holding down jobs, engaging in stable family relationships) following years of struggle with drug dependence.

Whether harm reduction is a duty, right or a choice was further debated during an interactive panel discussion with representatives from the Ministry of Justice, the Office of the Narcotics Control Board, the Thai Drug Users Network and Klongteuy Community/ Duangprateep Foundation.

Like other panelists, Mr. Sakda Puekchai, Chair of the Thai Drug Users Network (TDN), expressed the view that the main challenge in Thailand currently is that the "law on the books" and "law on the streets" make no distinction between drug use and drug dependence. As long as the general public and authorities continue to view drug use as a criminal offence, rather than a health issue, he said, access to voluntary health care and drug treatment by people who need such services would be hampered. He disagreed with referral of people who use drugs to compulsory centres because such an approach solved neither the root causes nor the consequences of drug use.

Finally, the participants discussed and deliberated on policy recommendations for submission and consideration by the top level government. These recommendations ranged from the need to educate the general public about the difference between drug use and drug dependence and to the need to harness a more symphathetic attitude among the general public and authorities towards people who use drugs. There was discussion about the need to develop operational guidelines for police on health and human-rights-oriented approaches when in contact with people who use drugs. There was a call for increased collaboration between the law enforcement and public health sectors to explore and implement alternative approaches to compulsory treatment. Finally - among the key recommendations - was the need to reduce the current length of pre-detention of people who use drugs waiting for their case to be reviewed by the Rehabilitation Act Committee.