The people who have the least health care services also have the least chance to make noise about it. MeetUpMondays is super idea. I want to help make serious effort to bring together mobile phone only people to participate too.

With the UNAIDS (PCB) Board Meeting this week in Geneva, and Criminalisation on the agenda, there will be a few chats happening at this weeks MeetUpMondays. This excellent blog, by Mat Southwell from INPUD and a UNAIDS PCB NGO Delegate, puts in all in focus.
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"On World AIDS Day people who used drugs demonstrated outside Russian Embassies around the world to highlight the failure of Russian drug policy. In particular the demonstrations focussed on the growth of home baked drugs like Krokodil that have concerning but untested risk profiles. Krokodil is symptomatic of Russian drug policy where failed policy and a highly corrupt and criminalised legal environment drives up harms while denying the human rights to the drug using community. The scrabble to buy or produce affordable and accessible drugs highlights the limitations of a demand reduction approach; rather than reducing drug use it drives people who use drugs to riskier drugs and forms of drug taking.

However, Russia is far from the only country that hampers its HIV response by ensuring that the context for the drug using community is criminal one; to one degree or another, criminalisation is the reality for people who use drugs in every country in the world, even if the intensity and scale of the criminalisation varies substantially from one country to another. As such when the PCB NGO Delegation decided to focus its 2011 NGO Report on HIV and the Legal Environment, INPUD saw this as a chance to join with other NGO partners in highlighting the impact of punitive laws and the criminalisation of key populations. In particular INPUD funded two focus groups in two very different contexts where criminalisation bites most deeply - Eurasia and Afghanistan.

In Eurasia, Irina Teplinskaya from the Eurasian Network of People who Use Drugs (ENPUD) had been working as a consultant for the Eurasian Harm Reduction Network (EHRN) to deliver a regional consultation process with people who use drugs in Eastern Europe and Central Asia. This consultation was directed at the Eurasian Regional Consultation for the Global Commission and the Law. The resulting report called 'xxx' identifies . Rather than start afresh, INPUD engaged Irina to run a virtual focus group with participants from the original consultation group.

In Kabul Afghanistan Raheem Rajeay from the Afghan Drug User Group including both people in MdM Methadone Clinic in Kabul and current drug users attending the MdM drop ins. The focus group in Afghanistan highlighted the consequences of living in a highly volatile environment within which old style couternarcotic police and brutal detox centres dominate while drug user rights are routinely abused. However, since the focus group was run in Afghanistan, the situation has deteriorated further; police have cracked down severely on very marginalised drug users living under bridges in very cold weather and vulnerable situation. Police attempts to drive drug users from under the bridges 'to protect them from the cold' first resulted in one drug user being shot in the leg for challenging a police officer who stole money from him. Subsequently significant numbers of drug users have been rounded up and placed in a 'shelter' which is a poorly disguised and barbaric forced detox centre with no medical treatment for drug users using very high doses of pure illicit heroin.

Within the context of the NGO Report, INPUD will hold its first Side Meeting at a major UN event during the forthcoming board of the UN Joint Programme on HIV/AIDS. The two focus group leaders will be the stars of the show highlighting two of the most extreme and dangerous environments for people who use drugs. Against this backdrop, Jorge Roque INPUD's new Director will present the experience from Portugal where the removal of criminal and administrative laws from people who use drugs has led to significant progress with HIV prevention, a doubling of treatment access, and the easing of pressure from people who use drugs.

The European Union audit of the last ten years of prohibition highlighted that hardline drug policy approaches are ineffective in their desired aim of reducing drug use but are extremely successful in driving up harm and sabotaging HIV prevention, treatment, care and support. Against this backdrop and the shocking human rights situation for people who use drugs in countries like Russia and Afghanistan, lead many looking at new drug policy experiments in Portugal, the Czech Republic, Argentina, and a number of other European and Latin American countries as a clear indication of just how far the situation can be improved even within the current UN drug control regulations.

The NGO Report and the INPUD Side Meeting will act as a chance to raise issues that many members states struggle to engage with given that it conflicts with their current drug policy approaches. However, there is growing recognition that the legal environment does impede HIV prevention, treatment, care and support. This is particularly sad in the case of people who inject drugs, as HIV prevention strategies are so well tested and known to be highly effective. Sadly both the Russian and Afghan Governments resist the mainstreaming of harm reduction in general and particularly seem resistent to allowing opioid subsitution therapy (OST) to deployed or extended in their countries leading INPUD to question what motivates such a disregard for the human rights of people who use, and particularly inject, drugs. However, in corrupt political and criminal justice environments the profits of the illegal drug trade inevitably override the needs of the most marginalised as greed and cruel disregard dominate."
Mat Southwell
NGO Delegate Europe and INPUD