Wednesday, 14 April, 2021 - I am honoured to join you at the plenary of the 64th session of the Commission on Narcotic Drugs. My statement today is the result of the virtual pre-CND multi-stakeholders consultation organized by UNODC HIV Section in close collaboration with the IAS - International AIDS Society, World Health Organization, UNAIDS and INPUD.
For people who use drugs, COVID-19 has added to an already difficult situation marked by widespread violations of human rights, criminalization, disproportionate use of force by law enforcement, violence, stigma, discrimination, high prevalence of HIV and viral hepatitis and high rates of overdose.
We have known for many years the solution to these problems: fully implement harm reduction and protect and promote the human rights of people who use drugs.
The evidence gathered since the beginning of the pandemic shows that:
- People who use drugs are particularly at risk of COVID-19 and severe disease due to underlying health issues, stigma, social marginalization, criminalization and greater economic and social burdens.
- In many contexts, COVID-19 prevention measures resulted in the closure or restriction of harm reduction services as they were erroneously not considered essential services.
- Human rights violations and discrimination can be unintended consequences of COVID-19 mitigation measures.
- The pandemic exacerbated existing disparities and inequities faced by women who use drugs, especially in relation to gender-based violence and poverty, and increased their risk of acquiring HIV and hepatitis C virus (HCV).
- Representatives of the community of people who use drugs were not included in the design of COVID-19-related policies.
Despite these many challenges, there are some promising responses reported since the beginning of the pandemic:
- Community-led organizations proved creative and resilient, finding solutions to protect people who use drugs.
- The response to COVID-19 revealed how vital harm reduction services are for people who use drugs. These services provide not only life-saving commodities and care, but also equally essential human and social connections.
- In over 50 countries, harm reduction services were quick to innovate and adapt to more flexible models of service delivery, such as simplified prescribing requirements, take-home opioid agonist therapy, access to naloxone and integrated mobile COVID-19 and harm reduction services.
How can we move forward and “build back better”?
I would like to share with you the recommendations resulting from our consultation:
- Harm reduction services are essential public health interventions and pivotal in reaching key populations and must be maintained and scaled up.
- COVID-19 adaptations in the delivery of harm reduction, particularly the expansion of take-home opioid agonist therapy and community-based, peer-supported treatment for HIV and HCV, are proven to increase the acceptability and uptake of services. They should remain in place.
- Greater involvement of the community of people who use drugs in planning the COVID-19 response is crucial to increase acceptability, access and retention in services. Adequate resources must be allocated to support peer-led interventions.
- Harm reduction services are a trusted source of information on COVID 19 prevention, as well as vaccination, and should be properly prepared and equipped to provide vaccination to their clients.
- Prisons should be part of local and national COVID-19 prevention and vaccination plans. Protecting the human rights of people who use drugs and reducing stigma, discrimination and inequalities are key to optimizing public health outcomes during the pandemic and beyond.
Let us ensure that the learnings from the hardships of COVID-19 are not forgotten and, indeed, contribute to stronger human rights and improved health for all.
Participants in the virtual pre-CND multi-stakeholders consultation were: Joseph Amon, PhD, MSPH, Dornsife School of Public Health, Drexel University; Ruth Birgin, WHRIN; Judy Chang, Executive Director, INPUD; Collen Daniels, Deputy Director, HRI; Jason Grebely, The Kirby Institute INHSU, UNSW, Australia; Adeeba Kamarulzaman, MBBS, FRACP, FAMM,FASc, HonLLD Monash, DPMP, Professor of Infectious Diseases, Faculty of Medicine, University Malaya, President, International AIDS Society; Prawchan K.C., Senior Program Manager, SPARSHA Nepal; Tetiana Kiriazova, Senior research scientist, Ukrainian Institute of Public Health Policy, Ukraine; Lisa Maher, AM FAHMS FASSA, The Kirby Institute, Faculty of Medicine, UNSW Sydney; Svitlana Moroz, Eurasian Women’s Network on AIDS; David Otiashvili, Director, Addiction Research Center ‘Alternative Georgia’, Associate professor of Healthcare, Ilia State University, Georgia; Andrew Scheibe, MBChB, Dip HIV Man, MPH, South Africa; Mat Southwell, Stimulants Expert Working Group; Doan Thanh Tung, Executive Director, Lighthouse Social Enterprise and Lighthouse Clinic, Viet Nam; and Tanyaporn Wansom, Director of Research and Advocacy, Dreamlopments, Thailand.
The Commission of Narcotic Drugs is the central policy-making body for the UN drug control system. The 64th session took place from 12-16 April 2021.