Eight ASEAN Member States and China debate making voluntary, community-based treatment a priority for people who use drugs

Kuala Lumpur (Malaysia), 4 October 2012
- Countries in East and Southeast Asia currently detain over 238,000 people who have used drugs (or are suspected of drug use) in over 1,000 compulsory centres (CCDUs).

These centres represent an institutional and punitive approach to drug use and drug dependence. Relapse rates are high raising concerns over the cost effectiveness of the centres. The centres often lack HIV prevention, treatment and care services and, in many cases, primary health care is limited. There have also been allegations of human rights violations such as forced labour.

In order to address these issues through an intergovernmental dialogue, eight ASEAN countries (Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand and Viet Nam) and China gathered in Malaysia during 1-3 October to discuss the way forward.

This meeting was the second such Regional Consultation on CCDUs. It was jointly organized by UNODC, ESCAP and UNAIDS with support from the Australian National Council on Drugs and AusAID. The Malaysian National Anti-Drugs Agency (NADA) was co-host.

In opening the meeting, Malaysian Deputy Minister of Home Affairs, Hon. Dato' Lee Chee Leong said: "We must take measures to ensure that the treatment for drug-related problems is always available and easy to access by all citizens regardless of gender, religion and age. We also must create public awareness that these services are available."

The Consultation reviewed progress made in each participating country and the Secretariat on the implementation of the recommendations detailed in the Report of the first Regional Consultation held in Bangkok in 2010.

Concerned about the CCDUs, 12 UN agencies issued a Joint Statement in March this year. The Joint Statement highlighted the UN's concerns over the CCDUs. It called on states which operate such centres to close them and offered technical assistance in this regard.

As an alternative to CCDUs, the UN advocates for states to make available voluntary and rights-based health, social and legal services at the community level, including evidence-based drug dependence treatment as well as HIV and TB prevention, treatment, care and support.

Against this background, at this second meeting, delegates shared good practices and positive steps taken by governments towards community-based treatment in the region.

The highlight of the meeting was a visit to the NADA Cure & Care 1Malaysia clinic in Sungai Besi, in the heart of Kuala Lumpur. There the delegates had an opportunity to view the Malaysian model which is in line with the UN approach, up close and to pose questions to staff and clients.

According to Mr. Gary Lewis, UNODC Regional Representative, Malaysia is setting the pace in the region for evidence-based treatment. "Visionary leadership shown by the Malaysian Government has led to an increasing number of compulsory centres have been transformed into Cure and Care 1Malaysia Clinics."

Following the visit to the centre, the consultation examined the challenges and opportunities that the region faces in transitioning to voluntary and community-based drug dependence treatment services.

"Countries, including Malaysia, Viet Nam, Cambodia and Myanmar, are moving away from compulsory detention for people who use drugs and investing in evidence-informed, community-based treatment approaches. Such efforts promote and protect human rights and produce higher quality public health outcomes, including for HIV," said Mr. Steven Kraus, Director of UNAIDS Regional Support Team for Asia and the Pacific.

One delegate observed that "transforming CCDUs into community based treatment services requires a 'step by step' approach. And this takes time". Others pointed to the need to "resolve concerns over public safety". For the voluntary, community-based treatment approach to succeed it would need the support of "community leaders and local authorities in collaboration with law enforcement officers".

During the consultation, small working groups deliberated over the challenges and opportunities within existing national laws and policies to make the transition.

At the end of the deliberations the Consultation adopted a meeting report including a set of recommendations for country-level action. Among them is a recommendation that countries should consider reviewing those laws, policies and practices that hinder access to voluntary end effective drug dependence treatment and to reallocate human and financial resources from CCDUs to voluntary community-based treatment.

Reflecting on the overall results of the gathering, including the final outcome statement, Mr. Lewis said: "These three days here in Kuala Lumpur have allowed us to sample what can be done if there is sufficient political courage to work with what the evidence says will deliver results. And we are delighted at the outcome statement which is a strong demonstration of interest by the countries of the region to move - albeit at different speeds - towards the goal of voluntary, community-based treatment. This represents a major step forward."

Three countries registered their interest to host a third meeting - and subsequent ones - in pursuit of the same goal.