Delivered by Wangari Kimenia (Médecins du Monde)
Ladies and Gentlemen. I speak on behalf of Médecins du Monde, an independent medical NGO providing healthcare in more than 40 countries around the world. I also speak on behalf of the International AIDS Society, the world's largest association of HIV professionals, working on all fronts of the global AIDS response; the World Hepatitis Alliance, a global patient-led organization dedicated to the elimination of hepatitis; and the hepCoalition, a global coalition of hepatitis C activists.
We have closely followed preparations for this CND and, in particular, negotiations on Resolution L4, submitted by Norway, on promoting measures to prevent and treat viral hepatitis C among people who use drugs. We welcome this resolution and its impact on reinforcing the response to hepatitis in the drug policy agenda. We believe this will push countries towards achieving viral hepatitis elimination goals set by the WHO in 2016, as well as Sustainable Development Goals 3.3, 3.4 and 3.5.
We welcome the emphasis this Resolution places on the important role of civil society, in particular networks of people who use drugs, in all aspects of preventing, diagnosing and treating viral hepatitis. However, we are concerned by neglect of the WHO target of providing 300 sterile needles and syringes per person who injects drugs per year by 2030, and by failure to address the structural and policy barriers fuelling the hepatitis C epidemic.
Despite strong scientific evidence and WHO recommendations, comprehensive harm reduction services remain inaccessible for most people who use drugs. Where services exist, people who use drugs face difficulties accessing hepatitis C prevention and treatment due to: poor access to health services; exclusion through non-evidence-informed treatment eligibility criteria; threats of violence and abuse by law enforcement officers and healthcare workers when disclosing their status as drug users; and universal stigmatization. And so, hepatitis C still spreads among people who use drugs and attention to specific needs, for example, of women who use drugs, are often overlooked.
This lack of access to care for people who use drugs is deeply rooted in and driven by laws and policies that criminalize drug use, possession and people who use drugs themselves. Punitive drug law enforcement, with harsh sentences for minor offences, is a direct barrier to harm reduction service delivery and uptake. This often leads to treatment interruption and heightened risk of hepatitis infection. It also fuels stereotypes and negative assumptions about people who use drugs, reinforcing stigma and discrimination.
While laws and policies that prohibit drugs are portrayed as necessary for public health and safety, evidence is that they have led to human rights violations, including violence, disease and discrimination. With growing recognition of the need for evidence-based drug policy reform, several world leaders, public health experts and UN agencies recommend decriminalization of minor, non-violent drug offences and health-oriented alternatives to criminal sanctions.
Following the 2nd World Hepatitis Summit in 2017, more than 60 organizations issued a call to world political leaders.
We reiterate that call here. We ask that governments ensure:
- Greater attention to the diverse needs of people who use drugs, including women
- The removal of barriers to uptake of prevention services by people who use drugs
- The reform of laws and law enforcement procedures in respect of the dignity and needs of people who use drugs
- The decriminalization of minor, non-violent drug offences
- The end of all forms of discrimination against people who use drugs.
I thank you for your attention.
Read the statement on Médecins du Monde's website (in French).