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Remarks from IAS President Adeeba Kamarulzaman at the 65th session of the Commission on Narcotic Drugs

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Thursday, 17 March 2022 – I am honoured to join you at the plenary of the 65th session of the Commission on Narcotic Drugs.

My statement reflects a consultation among scientists and community leaders on the impact of inequalities on HIV and viral hepatitis prevention, treatment, care and support among people who use drugs.

We have seen major progress in addressing the AIDS epidemic. But despite new diagnostics, prevention tools and treatment, this progress remains fragile and inadequate among people who use drugs. Social, economic, racial, legal and gender inequalities and the infringement of human rights are hindering the HIV response.

The COVID-19 pandemic, and the armed conflict in Ukraine, have shone a harsh light on structural inequalities that block access to services for vulnerable, criminalized and marginalized populations. This is especially true for people who use drugs. Our consultation heard from the Executive Director of the Alliance for Public Health in Ukraine that the harm reduction and HIV programmes – considered among the best globally – are now under threat.

When countries fail to designate harm reduction as an essential service – whether in emergency situations or under normal conditions – that is a structural choice to treat one group of people as less deserving of health and human rights than others.

Because of criminalization, stigmatization and underfunding, people who use drugs are disproportionately affected by HIV and viral hepatitis. Access to tailored services is even harder for women, young people, sex workers, refugees, indigenous people and people of colour.

This is not just a violation of human rights, but poor health policy. If we want to end these epidemics, we must scale up access to harm reduction services so that they can be easily, voluntarily and confidentially accessed by all people who use drugs.

That is why the Global AIDS Strategy 2021-2026 calls for ending inequalities to end AIDS and underlines the importance of the active involvement of all stakeholders: policymakers, the community, law enforcement, the criminal justice system, healthcare providers and non-governmental organizations.

Programmes will only be effective if we have disaggregated data to understand the full extent and variety of drug use, including stimulants and new psychoactive substances as well as opioids. More research will support strategic harm reduction programming.

Creating an enabling legal environment, by removing laws that criminalize drug use or possession for personal use, is a crucial step to reduce the spread of HIV and other harms among people who use drugs. I urge the Member States to fulfil the commitments made under the 2021 United Nations Political Declaration on HIV/AIDS, which sets strict targets to reduce restrictive legal and policy frameworks, lessen gender-based inequalities, and decrease stigma and discrimination.

Community-led organizations are critical to the HIV response among people who use drugs. Governments must act now and invest to meet the targets for community-led organizations to deliver 30% of testing and treatment, 80% of HIV prevention, and 60% of programmes to support the achievement of societal enablers. Community participation in policymaking – should be funded and actively supported.

Recognizing the equal worth and dignity of every person is an ethical imperative and an obligation arising from international human rights instruments. Ending stigma and discrimination; reforming punitive laws; investing in community-led responses, research; and funding – these are the path to equitable access to services for people who use drugs, and to a healthier world for us all.

The Commission of Narcotic Drugs is the central policy-making body for the UN drug control system. The 65th session took place from 14-18 March 2022.

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