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Notes on the convened on Human Rights of Drus Users in the Age of HIV/AIDS

Geneva - April 1, 2004

Let me thank the Open Society Institute, Human Rights Watch and the Transnational Radical Party for having convened this event, which to my knowledge is the first of this type that has been organized at the Commissiono on Human Rights, and in particular let me thank the Brazilian Government and the Brazilian delegation to the UN for having decided to host a briefing that addresses the issue drugs in a human rights forum. As you all know, the United Nations is the guarantor of the three conventions that the international community had adopted to control the presence of licit and illicit drugs in the world; therefore, it is of particular importance to bring the debate on the effectiveness of those policies also to the UN involving its specialized agencies, member states as well as those non-governmental organizations that try, with their contributions, to assist the United Nations in discharging its mandate. I hope that what we are discussing today will bring some new arguments and proposals to try and make the drug control system work better. I believe that, after three decades of efforts that have failed to curb the production, consumption and trafficking of narcotic drugs, the international community and the United Nations, should initiate a process of assessment of the world situation with a view of finding more effective ways to govern the phenomenon. For more than 30 years, we have seen a turn of the prohibitionist screw, that, rather than diminishing the harm produced by drugs, or strengthening the system of controls that were devised in the first Convention of 1961, has increased the presence of drugs in the world. It is not for me to discuss if drugs are bad or good, if they really “narcotize” or can also provide medical remedies to several diseases. What I would like to focus my attention on, are the policies and, most of all, laws, that have been adopted over the years, to try and control the phenomenon. Since 1912, with the adoption of the convention to ban opium, the international community has adopted the philosophy of prohibition as the guiding principle to "control" drugs. In 90 years of "just say no" policies, all the substances that were outlawed by the international conventions and their chemical derivatives have invaded the world. Both plants and refined narcotics have reached the remotest corner of the globe, nourishing a culture of criminality that has enriched the narco-mafias of the world, reduced to poverty entire regions, criminalized drug users and, more recently, provided an incredible source of financing for terrorist networks. Prohibition has not been able to produce the desired results. This failure is documented by the UN itself every time it publishes the trends in consumption, the estimates on production or launch an alarm on a new drugs that have invaded the market. The Vienna Office on Drugs and Crimes provides the member states with unquestionable figures concerning the increase of the presence of drugs, and their repercussion on society. Unfortunately, when it convenes the meetings of the Commission on Narcotic Drugs, the Vienna Office does not complement those figures with a comprehensive analysis of the data produced and also a list of possible suggestions on how to make the system work better. A recent UNOCP study on Afghanistan, demonstrated how that country has gone back to produce more than 70% of the opium necessary to refine the heroin consumed all over Europe. As a remedy to that, at the end of the 47th session of the Commission on Narcotics, the Director of the UN Vienna Office Mr. Costa announced that soon eradication projects will again be launched in Afghanistan to destroy those illicit cultivations. Those same programs were carried out during the Taliban regime, when the fanatic Islamists were involved in the production, contrarily to what publicized in 2001; they did not work then, they will not work today. Those millions of dollars should be invested in making Afghanistan progress towards the 21st Century establishing a minimum of democratic infrastructures and in trying to find other ways, through the creation of a sustainable market economy to substitute illicit revenues with licit ones through the exploitation of that crop. We al know that opium can be used to produce medicines, and we also know that many of those medicines, as the International Narcotics Control Board stated clear in its 2004 report, are not available to poor societies; if Afghanistan were allowed to produce licit opium in bigger quantities a possible solution to two urgent and dramatic problems could be found in a reasonable time. This can only occur with the full involvement of the international community under the auspices of the United Nations itself. In September 2003, the UN launched an alarm on metamphetamines without reserving an expression of concern on how, for instance, the Thai Government dealt with the the problem last year - when some three thousand people were summarily killed in the violence that erupted in a series of anti-drug raids. As documented last year by the NGO Hands Off Cain, countries such as Burma, Laos, China and Vietnam are praised for their progress in the fight against narcotics, without taking into account the fact that drug users can also be sentenced to death. One of the main focuses of today's meeting is "drug users". I believe that the choice to address such an issue in a context where human rights are discussed - even if one could question the effectiveness of the deliberations of a body such as the Commission on human rights – was an appropriate choice. I am convinced that those who take drugs - those who decide to ingest a substance, willingly, unwillingly, desperately, happily - should not be treated as criminals; they should not be sentenced to prison, they should not be forced to live at the margins of society. Their actions do not have a direct impact on another person. For these reason I believe that we should oppose policies, and also laws, that want to establish a criminal responsibility where there is no victim! Some countries, mainly in Europe, with a couple of American exception such as Brazil and Canada, continue to modify their legislation to facilitate the treatment and rehabilitation of drug users and addicts. The last five years, for instance, have seen a 34% increase in the availability of substitution treatment in the EU and Norway. Some 400,000 people now receive substitution treatment in the 16 countries. Over 60% (around 250,000) of these treatment places are found in Spain, France and Italy. The biggest rise in treatment has been in countries with low initial provision such as Greece, Ireland, Portugal, Finland and Norway. Methadone is by far the most common treatment substance, but buprenorphine is increasingly used. Prescription of heroin is practised in the UK, is under scientific trials in Germany and the Netherlands and is in its preliminary stages in Spain. This shift in focus is also true on prevention and reduction of health-related harms associated with drug dependence, which is starting to become an integral part of the response to drugs across Europe. Syringe exchange to prevent the spread of infectious disease through injecting drug use is now becoming to be well established and widely available in the EU and Norway, although coverage is limited in Greece and Sweden. Only in Spain are syringe exchange services implemented systematically in prisons. According to a recent study issued by the European Monitoring Center on Drugs and Drug Addiction, since the mid-1990s, the evidence-base of medical and educational measures to prevent drug-related deaths has grown considerably and the reduction of the number of deaths is increasingly considered as an achievable goal. A cut in drug-related deaths is identified as a priority in the new national drug strategies of Germany, Greece, Ireland, Luxembourg, Portugal, Finland and the UK. There are supervised drug-consumption rooms in Germany, Spain and the Netherlands. Another important new development Europe-wide is the provision of medical care to drug users through low-threshold services, targeting those that are homeless or leading otherwise unstable lives. At the very beginning, those policies were imagined and implemented to reduce the harms produced by narcotics; after over half a decade of encouraging results, I believe that similar changes should be devised to reduce the harms created by prohibition. I will not elaborate here on the specifics of harm reduction, there are more qualified people in this room to do that. What interests me more is the evident contradiction that sees a growing number of countries that have opted to "interpret" drug policies not strictly as anti-drug policies, but rather as a anti-harm policies. A contradiction that once again the International Narcotics Control Board stigmatized in its 2004 Report stating for instance that the Swiss projects of needle exchange are against the UN Convention. This contradiction should become evident, should be brought to the attention of Drug-related UN bodies in order launch a comprehensive revision of drug policies all over the world to finally make them work. If, in dozens of countries, we have seen a drastic improvement in the treatment of people with addiction through harm reduction measures, if we have seen a limitation of the spread of HIV/AIDS through the distribution of sterile syringes, if in hundreds of cities we have seen also a decrease in the criminal activities that have always characterized drug users, if in thousands of cases methadone has been able diminished deaths by overdoses, I believe that we, and most of all those that are in charge of promoting policies and measures to control drugs, should face this new context with a different type of reaction taking into account the progress made by those administrations. Those successful project need to be presented to other States in order to duplicate them in poorer countries in order to assist them to cope with the phenomenon. I am sure that if harm reduction works in Europe and North America or Australia, it can also work in Central and South East Asia or in Africa. Let us have a look for a moment at the European situation. It is commonly believed that European countries, unlike the United States tend to have a more tolerant approach to issues, unfortunately, despite some major shifts, like the one that I presented before, the mainstream remains prohibition. And also for this reason, in Europe, as in the rest of the world, the situation remains of particular concern. The figures produced each year by the European Monitoring Center are similar to those elaborated by the UN and document a situation that shows no improvement vis-à-vist the decrease of the presence of drugs worldwide. The Center's 2003 report states that despite “some grounds for cautious optimism” about the drug situation in Europe, “new problems are emerging in some areas”, and that “there are no data to suggest a significant fall in drug use.” According to the indicators of the Centre overall, the drug-use trend “remains upwards and new problems are emerging, such as growing cocaine use in some big cities.’ Europe remains the world’s biggest market for cannabis resin (hashish), accounting for some three-quarters of global seizures. Herbal cannabis (marijuana) grown in the EU is also increasingly available. The average potency of cannabis in the EU has risen and this raises also public health concerns. Eu countries and Norway remain also a key area for the production and use of amphetamines and ecstasy. After cannabis, these are the second most commonly used illicit drugs, with lifetime adult consumption ranging from 0.5–5%. Contrarily to what some European politicians are saying, the Center honestly points out that “deaths where ecstasy is mentioned, though widely highlighted in the media, remain relatively rare, although these are increasing.” Almost all European countries express new concerns about rising cocaine use. Surveys suggest it is rising in the UK and, to a lesser extent, in Denmark, Germany, Spain and the Netherlands. Data from 2000–2002 show that lifetime experience ranges from 1–9% of those aged 15 to 34. Other researches conducted by the Centre between 2000 and 2002 estimate that, at least one in five (20%) adult Europeans have used cannabis at least once in their lifetime. Figures for young people between 15 and 34 years are generally even higher, ranging to up to 44% – Spain (35%), France (40%), the UK (42%) and Denmark (44%). Estimates of recent (previous year) use among this age group range in most countries from 5–20%. At the higher end of the scale are Spain (17%), Ireland (17%), the UK (19%) and France (20%), while at the lower end are Sweden (1%), Finland (5%), Portugal (6%) and Norway (8%). Over the years, the lack of an effective health responses have created an inextricable link between drugs and HIV/AIDS. The European Monitorning Center says that HIV prevalence among injecting drug users (IDUs) varies considerably all over the Union “from around 1% in the UK to over 30% in Spain”, and that in a number of countries, “local rates of over 25% are found in a variety of settings”. These mostly reflect “established epidemics rather than new infections, but some rises have been reported. Prevention remains critically important to protect the sexual and injecting partners of infected IDUs.” The Center also states that “although national HIV prevalence data remain mostly stable, they can mask considerable variations locally and among certain groups. HIV increases among IDUs have been reported in the last few years from some regions or cities in Spain, Ireland, Italy, the Netherlands, Austria, Portugal, Finland and the UK.” The Center also notes that the long-term costs of hepatitis C infection, both in terms of health-care spending and personal suffering, are likely to be considerable. Prevalence rates among current and former injectors are extremely high in all countries, at 40–90%. High infection rates among young injectors suggest that many are still contracting the hepatitis C virus rapidly after short periods of injecting, stressing the need for early interventions. In the last decade, between 7 000 and 9 000 drug-related deaths were reported every year in the EU and Norway and the trend is upwards, with most affected in their 20s and 30s - a figure which is in contradiction with that of the UN. In almost all countries, opiates are present in most cases of death (over 80%), often combined with other substances such as alcohol, benzodiazepines or cocaine. Harm reduction, as well as depenalization, or, as more radically, the legal control of narcotics, are not intended to tolerate or to promote drug use, as we hear at times, nor are they an operation of a pro-drugs lobby that wants to undermine the UN Conventions profiting form legalization - as Mr. Costa repeated last weekend in an interview with Radio Radicale in Rome. All these common-sense measures, that today are the alternative to the current prohibitionist regime, are proposals to govern the problem. And the word govern should be kept in mind if one really wants to “combat” a phenomenon. No one of those involved as practitioners of harm reduction or as advocates of drug policy reform wants the death of their fellow human beings, what I believe we all want is to control the problem in a more effective way helping people live a better life. To all of you that deal with human rights, it should be clear that the current drug policy regime poses human rights problems, as it criminalizes non violent offences and militarizes the policy and uses the army to patrol entire regions; it poses environmental problems as it fumigates entire regions; it poses development problems as it outlaws traditional crops in many regions of the world where they could represent a means of sustainable development - I invite you to read the written statement submitted by the Transnational Radical Party to this Commission – it poses economic problems as it diverts substantive resources that could be used to create a peaceful and democratic environment to the fight against drugs, which is a war against all those that are involved in the chain of drugs and not only traffickers. I am sure that if we could find a way to document the costs of prohibition we could make our cases even clearer. I was recently told by a professor at the Rome University that the phenomenon is so huge that we might discover it goes beyond the 8% of world trade, as estimated by the UN in the 1997 World Drug Report. Professor Carla Rossi also told me that such a task is almost impossible, not only because we will have to deal with figures on an illegal subject, that is difficult to fully document, but also because we will have to deal with estimates, and the UN itself says, that almost 90% of the data they process is outdated or not 100% reliable. Many are the sectors that suffer the impact of prohibition: administration of justice, the prison system, police forces, the army, the psycho-phisical health of drug users and their families, law enforcement in general, prevention campaigns, international cooperation, supply and demand reduction programs, alternative development project, money laundering, the financing of the Mafia and terrorist networks ect, etc. If we were able to overcome many of these problems, I am sure that such a study could in fact provide an appreciation of the real impact of prohibition on our societies where drugs are used or produced. This may be an impossible task for independent researchers, but not an impossible one for the UN system. If the UN is really serious about its mandate, if it is really after an effective, also cost-effective, system of drug control the UN should make such an evaluation become a top priority. In conclusion, I believe that progressive and liberal governments, like our host today, should reach out to other countries that have taken similar decisions to create a group of like-minded states interested in advancing drug policies. Our experience within the UN tells us that if a small group of countries decide to get together to address a international problem in a pragmatic way, whether it is land mines or the international criminal court, utopian ideas could become reality. Just like at the beginning of the process that triggered the advancement of international humanitarian law, we will need to mobilize some countries like Brazil, Switzerland, Canada, Spain, the Netherlands and others, to make them become the nucleus of a new coalition to address drug policies in multilateral fora in a more pragmatic way. Human rights advocates should facilitate the creation of such a group and the initiation of such a process engaging those governments at home and abroad emphasizing all the human rights aspects of the drug question. If, in the next few years, we will be able to launch a world movement to put an end to prohibition. I am sure that it will generate the same important outcome, also in symbolic terms, as the one that was able to put and end to impunity with the adoption of the statute of the International Criminal Court six years ago. In 1998, on the eve of the Special Session of the General Assembly on drugs, together with Aryeh and scores of opinion leaders and decision-makers, we signed a letter addressing the UN secretary-general point out that “persisting in our current policies will only result in more drug abuse, more empowerment of drug markets and criminals, and more disease and suffering.” The UN and other organization have documented that increase and were supposed to take it into consideration last year at the “ministerial segment” in Vienna, they did not. In that letter we also warned that “too often those who call for open debate, rigorous analysis of current policies, and serious consideration of alternatives are accused of 'surrendering.' But the true surrender is when fear and inertia combine to shut off debate, suppress critical analysis, and dismiss all alternatives to current policies.” We urged the UN Secretary-General “to initiate a truly open and honest dialogue regarding the future of global drug control policies - one in which fear, prejudice and punitive prohibitions yield to common sense, science, public health and human rights.” Not only such a debate was never initiated, but for years the UN Vienna Agency was engaged in the prohibition of alternative views to emerge. We all know that eventually the situation worsened. Last year, with some 250 parliamentarians and thousands of citizens, I endorsed another appeal to the UN launched by the International Anti-prohibitionist League and my Transnational Radical Party which called on the Secretary-General and the Member States of the UN “to take action in order to make the fight against organized crime and drugs trafficking more effective, establishing a system for the legal control and regulation of the production, sale and consumption of substances which are currently illegal” and to “initiate a process of revision of the UN Conventions, in order to reform or amend the 1961 and 1971 Conventions, with the aim of re-classifying substances and providing for other uses of drugs than only for medical and scientific purposes to be legal, and to repeal the 1988 Convention. I know that my friends of the TRP have copies of that petition here today. I invite you to sign it and circulate it. I hope that, thanks also to today event, we will be able to resuscitate that movement and to devote some efforts to relaunch those ideas and documents keeping in mind 2008 as the date for the final evaluation that the UN will have to carry out of its failing drug policies.

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