4 DECEMBER 2023 - Hybrid – The World AIDS Day event “Let communities lead” took place on the margins of the 2023 Commission on Narcotic Drugs (CND) Thematic Discussions on the Implementation of All International Drug Policy Commitments. It was hosted and organized by the HIV/AIDS Section and the International Network of People who Use Drugs (INPUD), together with the Group of Friends of HIV Prevention Among People Who Use Drugs and People Living in Prison Settings (currently chaired by the Permanent Mission of Belgium).
The event – moderated by Judy Chang, Executive Director, INPUD, – aimed at putting the focus on leadership from the community of people who use drugs (PWUD). It gathered speakers and panelists from the lead UN agencies on HIV and drugs, as well as community advocates and activists.
To open the event, a statement from Ms. Ghada Waly (Executive Director, UNDOC) was delivered by Jean-Luc Lemahieu, Director, Division for Policy Analysis and Public Affairs, UNODC, reaffirming the central role communities play towards ending AIDS by 2030. Community-led responses need to be adequately resourced, supported and integrated into national responses, and PWUD as well as people in prisons, including women and young people, should be meaningfully involved at all stages of decision making, but also designing, implementing and monitoring programs and policies. H.E. Ambassador Caroline Vermeulen (Permanent Representative of Belgium to the United Nations in Vienna), echoed this message as Chair of the Group of Friends for 2023, reasserting the pivotal impact communities have in shaping the HIV response, as well as global health at large.
Emily Christie, Senior Advisor, Human Rights and Law, UNAIDS, delivered a statement on behalf of Christine Stegling, Deputy Executive Director, Policy, Advocacy and Knowledge Branch, UNAIDS, and set forth that in 2022, HIV prevalence amongst people who inject drugs was seven times higher than the rest of the adult population. She stressed the need for community-led responses, which UNAIDS defines as actions and strategies that seek to improve the health and human rights of their constituencies and that are specifically informed and implemented by and for communities themselves and the organizations, groups and networks that represent them. Dr. Zuki Zingela, 2nd Vice-President of the International Narcotics Control Board then shared key legal concepts enshrined in the three international drug conventions that can also be used in guiding interventions to address the problem, such as the principle of proportionality and the importance to ensure and not unduly restrict the availability of drugs considered indispensable for medical and scientific purposes. She emphasized that the availability of methadone and buprenorphine for the treatment of opioid dependence is critical in the efforts to reduce HIV transmission among people who inject drugs.
Ms. Chang proceeded to the first of two panel discussions, asking 3 panel members to share some contextual and personal challenges as a community leader. Dr. Annie Madden, INPUD, shared how at times, enormous personal risks can be involved just to be at the table and to speak out for the rights of people who use drugs. Mr. Francis Joseph from the Asian Network of People who Use Drugs added that people who use drugs often face intense societal stigma that leads to discrimination in various aspects of their lives, including employment and healthcare, which hinders their ability to effectively address their needs. Internalized stigma also leads to a lack of self-esteem and self-efficacy, which is a significant challenge for many in this population. Ms. Olga Belyaeva from the Eurasian Network of People who Use Drugs raised concerns about opioid agonist treatment not being provided in Ukrainian prisons.
Ms. Chang turned to the second panel and asked them about some of the key issues that they were responding to in their region or country and what early successes they had seen. While Aniedi Akpan from the African Network of People who Use Drugs proudly shared how Nigeria is now looking at implementing the community provision of naloxone, Mr. Ernesto Cortes from the Latin American Network of People who Use Drugs stressed how the war on drugs has fuelled violence and inequality in Latin America. Angela McBride, the South African Network of People who Use Drugs, drew attention to the importance of addressing needs and challenges through a country-context lens.
When asked about community-led organizations needs, all panellists agreed on the urgent necessity for adequate funding, recognizing their crucial role not just in the provision of harm reduction services but also in effectively advocating on the policies that affect them. Criminalization has also been pointed out as being the main barrier for community leadership, as it prevents the involvement of people who use drugs in many countries.
Communities, thanks to their knowledge and expertise, are irreplaceable within the global HIV/AIDS response and need to be effectively supported both politically and financially. Measures need to be taken to ensure that they have a seat at the table, as well as addressing stigma and criminalization.