Delivered by Mariangela Simao, Director, Community Support Department, UNAIDS
26 September 2017
I have the pleasure to address you today on behalf of the Strategic Advisory Group to the United Nations on HIV and Drug Use, or the "SAG" as it is more commonly known. The SAG was established in 2014, and is comprised of representatives from UN agencies, donor governments, networks of people who use drugs, and civil society networks from around the world, all with a specific interest and focus on ensuring a scaled up and sustainable harm reduction response that is effective in preventing HIV transmission among people who inject drugs, implemented within a supportive and enabling legal and policy environment, and firmly rooted in human rights principles.
The SAG would like to take this opportunity to welcome the UNGASS Outcome Document as a forward-looking and progressive " blueprint for action", that reiterates the commitment to end, "by 2030, the epidemics of AIDS and tuberculosis, as well as to combating viral hepatitis and other communicable diseases…among people who use drugs, including people who inject drugs" (Pp 24). This commitment is reinforced by the call on member states to introduce measures towards "minimising the adverse health and social consequences of drug use" including critical harm reduction interventions (Op 1(o)) and overdose prevention in the form of naloxone (Op 1(m)). Member states are further encouraged to make these interventions available in prisons and other custodial settings.
The SAG notes with grave concern that HIV transmission amongst people who inject drugs has continued to increase. The 2011 Political Declaration on HIV and AIDS committed to reducing transmission of HIV among people who inject drugs by 50 percent by 2015. Yet, UNAIDS estimates that the number of new cases among this population has risen by 33% during a period when governments committed to cut transmission in half. The commitment to end AIDS by 2030 and to reduce the number of new infections among PWUD by 90% will only be achieved through a fully funded, scaled up and sustainable global harm reduction response that ensures universal access to the critical interventions set out in the UNGASS Outcome Document.
However, the coverage of proven harm reduction services remains woefully low. Harm Reduction International's 2016 report on Global State of Harm Reduction shows that among countries reporting injecting drug use only 56% (90 out of 158) have NSP and 51% OST (80 out of 158) with almost no progress since 2014.
Secondly, funding for harm reduction continues to be severely limited. In March, at the 60 th Session, the CND adopted Resolution 60/8 that urges member states and other donors to continue to provide funding for the "global HIV/AIDS response, including to the Joint United Nations Programme on HIV/AIDS, and to strive to ensure that such funding contributes to addressing the growing HIV/AIDS epidemic among people who inject drugs, and HIV/AIDS in prison settings". The SAG welcomes this resolution and the political will to ensure adequate funding for the AIDS response for people who inject drugs. As UNAIDS stated in 2015, "public health programmes can be fully funded for a fraction of the current investments in the criminal justice system related to drug offenses and they will produce significantly higher health and social benefits".
Finally, the evidence that new HIV infections fall dramatically when people who inject drugs have unhampered access to harm reduction services is now indisputable. Ensuring alternatives to criminalisation and incarceration facilitates access to such services, resulting in improved health outcomes for people who use drugs). The UNGASS Outcome Document, as well as the UN drug control conventions, encourage member states to adopt alternatives to conviction and punishment in cases of an appropriate nature (Pp 4 (j)).
The current period of UNGASS follow-up, alongside the preparations of the 2019 high-level meeting, provide the global community with an opportunity to act on the important commitments made at the UN General Assembly, as well as here at the CND. In tandem, the Sustainable Development Goals encourage a people-centred approach that reinforces the need ensure that the health and social needs of people who use drugs are met. Target 3.3 pledges to end AIDS and combat hepatitis, but we will only achieve this - as well as Target 3.5 to strengthen drug treatment - if we treat drug use as a health issue that prioritises human rights and dignity."
The SAG remains committed to bringing attention to these concerning issues and will continue to provide strategic advice and guidance to the UN to ensure that people who use drugs are not left behind.
Thank you for your attention.