The World Hepatitis Alliance launched an open letter calling for immediate action to vastly improve access to life-saving drugs for viral hepatitis. Signed by over 120 organisations from 55 countries, the letter highlights that more people die each year from hepatitis B and C than from HIV/AIDS, TB or malaria and that “the single most important reason for this is that they do not have access to life-saving drugs for hepatitis B and hepatitis C“.

The open letter has been signed on behalf of the 400 million people worldwide living with hepatitis B and C and makes specific requests to governments and pharmaceutical companies.

Signatures were collected from delegates during the inaugural World Hepatitis Summit, a joint World Health Organization and World Hepatitis Alliance event that took place 2-4 September 2015 in Glasgow, UK. The letter has been sent to all pharmaceutical and diagnostics companies working in the field of hepatitis and the World Hepatitis Alliance will encourage its 220 member organisations to use the letter to lobby their national governments.

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The global hepatitis community unites to demand access to life-saving hepatitis treatment

Germany plans to set up a state cannabis agency to regulate the drug's cultivation and distribution to treat seriously-ill patients, according to a draft bill.

More pain sufferers would be given regulated access to the drug on prescription and paid for by their health insurance under measures outlined in a draft bill from the ministry of health and seen by German newspaper Welt am Sonntag. However, patients would still be prohibited from growing the drug themselves.

So far almost 400 pain sufferers in Germany have been legally authorised to obtain cannabis at their own expense, almost exclusively those suffering from terminal cancer, with the demand met through imports from the Netherlands, the newspaper reported.

Thumbnail: Sonya Yruel/Drug Policy Alliance

Germany could create state cannabis agency for treating seriously-ill patients

Drug users will be able to use supervised injecting rooms in Dublin next year, followed shortly afterwards by Cork, Galway and Limerick, according to the Minister in charge of the National Drugs Strategy.

Aodhán Ó Ríordáin, who is set to announce the radical move in a speech to the London School of Economics on Monday, told The Irish Times that medically supervised injection rooms “will happen next year”.

In his address he will also outline plans to decriminalise the possession of small amounts of drugs, including heroin, cocaine and cannabis, for personal use, as part of a “radical cultural shift” in the approach to drug addiction.

Ireland: Injection rooms for people who use drugs to open next year, says Minister 

A reverend from Kenya, a doctor from Senegal, a psychiatrist from Tanzania, and a pharmacist from Malawi sip a cup of coca tea and munch on coca leaf cookies. This was the scene at the recent South–South Drug Policy Exchange in Bogota, a gathering of African and Latin American officials and civil society representatives to discuss the pressing issue of drug policy reform.

At the center of the war on drugs, Latin America is leading a growing international movement toward alternative drug policies based on promoting health, human rights, and proportional punishment. With a wealth of experience and innovation in the realm of drug policy reform, the region is well positioned to advise other Global South nations struggling with similar issues.

The South–South Drug Policy Exchange, part of a series of Africa–Latin America discussions organized by the Centro de Estudios de Derecho, Justicia y Sociedad (Dejusticia), aimed to blaze a new path forward for the movement. Participants surveyed the results of alternative drug policies and visited a small shop that legally sells coca-based products through an economic project created by a local indigenous community.

All too familiar with the war on drugs, Latin America offers advice to Africa

With the year 2016 fast approaching, players in the drug sector including non-governmental organizations, stakeholders, civil society organizations, governmental organizations, and public health workers are holding series of meetings to ensure that no stone is left unturned in working to meet the United Nation’s General Assembly’s Special Session (UNGASS) 2016 view on drug policy formation.

It is in this vein that the West Africa Civil Society Institute (WACSI) in partnership with the Open Society Initiative for West Africa (OSIWA), have organized a 2-day multi-sectoral meeting on drug policy reform to brainstorm on how best West African countries can seize the opportunity offered by the UNGASS World Drug Problem to evaluate and adjust existing drug policies to ensure that they respond to national and region realities.

The 2-day meeting was dubbed: The Road to UNGASS 2016, and was started on Tuesday October 27, and expected to end on Wednesday October 28.

In an address, the Executive Director of WACSI, Nana Asantewa Afadzinu, the meeting was a crucial one which aims at assessing current drug policies and the impact of the international conventions on national drug policies; while interrogating the measures put in place at the national levels to deal with drug trafficking, production and consumption.

She said the two-day meeting will also identify and highlight best practices in tackling drugs, security and organised crime at country levels, and to foster collaboration among key government and civil society in the fight against drug trafficking in the West Africa sub-region.

Nana Afadzinu quoted a famous quote by Kofi Annan on drug policy, and she lamented on the rate at which bad drug policy is having a toll on the socio-economic development on West African countries.

“We are not unaware of the socio-economic problems that drug causes. But how are we dealing with the drug issues in terms of policies and the treatment meted out to people who are caught using drugs. Are they treated like the traffickers who are making the money?” Nana lamented.

She advocated that the current drug policy in which drug users are criminalized must be checked and rather, drug abuse must be considered as a public health concern.

The WACSI Executive Director said government must channel resources in providing health centres and rehabilitation places to cater for drug users, as a better option over the resources used in building more prisons to house drug users.

The prisons, she said, does not transform the drug abusers but rather make their condition worse when they come out, and added that over avenues like the prayer camp offer no help in transforming drug users.

Key stakeholders in West Africa meet to discuss drug policy reform

The launch of a new Senegalese drug harm reduction network has solidified the traditionally conservative country’s reputation as a regional leader amid fears that increased exposure to drug trafficking routes could see a rise in national drug use.

The new National Network of Civil Society Drug Organisations (Réseau national des intervenants de la société civile sur les drogues) has been formed by non-governmental organisations hoping to promote cooperation in order to better support people who use drugs problematically.

Civil society groups met 4 October to strategize how the network could identify relevant groups working on issues as diverse as gender-based violence, HIV/AIDS & TB prevention and drug education reports Senegalese newspaper Le Soleil. The network hopes to encourage mutual dialogue and the establishment of common positions on drug issues between these groups.

The Executive Secretary of the National Council to Fight AIDs who presided over the meeting, and with whose organisation the new network will be working closely, told Le Soleil that “we can no longer obscure the issue content with saying that Senegal is merely a transit country for drugs, because our country is also a place of drug consumption”.

Senegal has a relatively low rate of HIV infection in the general population (0.7%) reports the West African Commission on Drugs (WACD), the rate among people who inject drugs is significantly higher (10.2%) and Hepatitis C prevalence is as high as 23 percent among this demographic according the United Nations Office on Drugs and Crime.

Effective action by the Senegalese government such as including drug users as a target group in their 2011-2015 National AIDS programme and the establishment of a community-based needle exchange programmes in 2013 has made Senegal a regional bright spot; the only country where such provision exists report Harm Reduction International (HRI).

These programmes allow educational outreach on safer drug injection practices as well as the distribution of sterile equipment.

UNODC reports that since the 1990s the West African region has become a key trafficking route for heroin, cocaine and amphetamine-type stimulants. Senegal’s increasing consumer purchasing power combined with already established availability of drugs entering through its extensive coastline makes the country vulnerable to an increase in problem drug use.

New harm reduction network launched in Senegal faces uphill battle

Under investigation was what sort of harm-reduction interventions can be developed with a view to reducing the risk of a GHB-related (Gamma-hydroxybutyrate) overdose and the associated health damage. The study’s conclusion is that the harm reduction measures to be developed are strongly dependent on the subgroup based on the GHB experience, their information needs and their level of knowledge on the topic of overdosing.

Within this study, three distinct groups were identified:

1. People with modest GHB experience
(lifetime use: 1 – 50 times)

are the ones most eager to avoid passing out. This group is interested in hearing stories of other people who use, harm-reduction tips and the long-term effects of GHB.

 befitting this often higher educated audience are informative online / offline articles about sex, drugs and health where experiential stories are supplemented with expert knowledge. This group often cites sexual arousal as a motivation for using GHB. Other possibilities include: strengthening bonds within peer groups, such as appointing someone to keep track of time and dosages, and developing a GHB helpline where people can seek advice anonymously.

2. People with considerable GHB experience
(lifetime use: 50 to 200 times)

say they pass out occasionally due to their frequency of use. They are interested in tools that facilitate safer use. Under the influence you lose your inhibitions, your vision and sense of time.

 is to distribute syringes with which the dosage can be measured more precisely in millilitres. The use of a timer can also be encouraged. These tools can be integrated with a 'G-app': an application on smartphones with information about GHB and passing out. An added value of an app can be a monitoring function that makes your substance use within the time period visible. With the help of self-control tips, periods of non-use can subsequently be strengthened.

Overdose prevention among hard-to-reach people who use GHB at home

Outreach workers armed with sterile needles, condoms, and screw caps patrol the narrow river that marks Malaysia's northern border with Thailand, looking for men from both countries who gather there to take drugs.

Even though punishments for drug use in the Southeast Asian nation are severe, none of the users they meet are likely to be arrested. The police know what's going on but stay away.

The workers are the front line in Malaysia's 10-year-old harm reduction programme that has helped curb a disturbing rise in HIV infections among injecting drug users. Cooperation between health officials, civil society groups, and the police has also eased widespread scepticism about needle exchanges and the provision of methadone treatment for people addicted to drugs.

"We needed this programme, and we needed it to be quick," said Dr Ilias Adam Yee, executive director of the Malaysian AIDS Council. "The epidemic was blowing up."

In Kelantan, the site of the Golok River, the HIV infection rate was running at four times the national average before harm reduction was introduced.

"The reality is that we cannot stop them from getting involved in drugs, so we make sure when they do, they can use a clean syringe and have safe sex," explained Dr Ahmad Razin Ahmad Mahir from the Ministry of Health in Kelantan.

"That is the crux of the programme. Our interest is to control HIV, and we have managed to do that."

Yet, despite growing evidence that the programme reduces the risk of HIV and helps wean users off hard drugs, global funding for such initiatives - already only seven percent of the $2.3bn UNAIDS estimates is needed in 2015 - is under threat as donor priorities shift.

Malaysia: Halting HIV and drug use with compassion

Civil society organisations (CSOs) in West Africa have been urged to effectively strategise and work together and with their respective governments to influence better policies aimed at addressing the drug problem in the region.

Members of the West Africa Drug Policy Network (WADPN) were invited to influence their governments to take a common position to counter the ‘war on drugs’, which is considered to be a failed approach to address the drug problem in the region.

“We have a huge task ahead. As we target UNGASS to get more of our governments to support our agenda and make political commitments at the global level but also come home to domesticate and implement them, we must bear in mind the fact that it will take more than the ordinary to get us what we want and we must be prepared”, said Nana Afadzinu, Executive Director of the West Africa Civil Society Institute (WACSI).

She made this call as national focal points of WADPN convened in Dakar, Senegal from October 13 to 16 to deepen their understanding of the drug problem in the region and brainstorm on a common position towards UNGASS 2016.

This convening created a forum for the capacity of participating organisations to be enhanced on emerging issues related to drug policy, drug prevention and treatment, harm reduction, security and governance and effective advocacy.

CSOs in West Africa promote harm reduction strategies 

A recent ruling in Australia could result in naloxone, the life-saving drug that reverses opioid overdoses, being available without prescription from February 2016.

The interim ruling, made by the Therapeutic Goods Administration (TGA), moves naloxone from Schedule 4 to Schedule 3, removing physical and legal barriers for those most in need of access to the life-saving medication, while also making it possible for families and friends of drug users to obtain naloxone to keep on hand. One of the reasons provided for the decision is the following:

"Benefits of rescheduling naloxone for reversal of opioid overdose to Schedule 3 include that products would be supplied labelled with full and clear instructions for use, understandable by consumers. People who need naloxone would be able to obtain it more easily, which is likely to decrease the proportion of (deliberate or accidental, usually illicitly obtained) opioid overdoses that result in death. Increased accessibility would also potentially reduce morbidity due to opioid overdose, such as hypoxic brain damage."

As it currently stands, those who seek access to naloxone need to visit a doctor and admit to using opioids in order to receive a prescription.

When it comes to opioids, heroin has historically been the most misused in Australia, though there has been concern about an uptick in the rate of overdoses related to prescription painkillers in recent years.

In 2011 the National Drug and Alcohol Research Centre (NDARC) reported 683 opioid-related deaths and the rate of fatal opioid overdose in Australia to be 30.5 deaths per million, highlighting the need for unrestricted access to naloxone. In 2012, the amount of drug overdose deaths outnumbered the amount of deaths from road accidents (1,427 and 1,338 respectively). Opioids are estimated to account for around 650 overdose deaths on an annual basis.

Naloxone to be made available over the counter in Australia

On October 24, 2015 in the case of Beka Tsikarishvili v. Parliament (application 592) the Constitutional Court of Georgia declared as unconstitutional the imprisonment for purchase and keeping of marijuana for personal use. The court ruled that imposing such punishment is mainly a torture, cruel, inhuman, or degrading treatment.

The Constitutional Court made a big and progressive step for changing the repressive drug policy of Georgia and took a heavy burden out of the society, which in general one more time highlighted Georgia’s rank in democratic index in the region and at an international level.

According to the official website of the Constitutional Court where the information published on 24 October 2015 the court notes that purchase and keeping of 70 grams of marijuana for which the applicant is charged cannot be indicative towards the purposes of sale or its real intent, and imposing the imprisonment amounts to torture,

cruel, inhuman, or degrading treatment confronting the Article 17 of the Constitution. Article 17 § 2 of Georgian Constitution provide: “No one shall be subjected to torture, cruel, inhuman, or degrading treatment or punishment”.

The Court further notes that current legislation considers 50-500 grams of marijuana as a large amount. The Court considers that keeping 70 grams of dry marijuana do not represent such an amount which might indicate to the intention of sale of drug. The court noted that legislature have an obligation to form such provisions which will enable a judge to find the fact if there is an intention of sale during purchase or keeping of marijuana or probability of such an intention and finally impose the imprisonment only in the case of established intention of sale.

Georgia: Imprisonment for purchase and possession of marijuana is unconstitutional 

Russia is home to 69% of all people living with HIV in Eastern Europe and Central Asia, and its HIV epidemic is concentrated among people who inject drugs. In Moscow alone there were more than 30,000 people who use drugs registered with the drug treatment specialists in public clinics in 2013, and the total number of people who use drugs in the city is likely to be higher.

In addition to being at highest risk of HIV in Russia, people who inject drugs are among the most marginalized and stigmatized populations in the country. Criminalization of drug use, quota-based law enforcement and low availability of opioid substitution therapy are major barriers to harm reduction.

Activists in Moscow allege that people who use drugs are frequently denied their rights. An initiative by the Andrey Rylkov Foundation (ARF), a non-governmental organization working in Moscow since 2009, is providing legal support to people who use drugs and seeking justice through the legal system. In late 2013, the Foundation’s Harm Reduction – Moscow Project with support of the Canadian AIDS Legal Network launched a ‘street lawyer’ initiative, which links those who need legal aid with a social workers and a legal advisers. Services include rights counselling, mediation, filing of official requests or complaints to medical practitioners or government offices, and resolution of cases through the justice system. In addition to legal support, the project gives clients moral support and boosts confidence in their ability to access legal recourse. The Foundation also provides expert witness testimony in court and advocates for changes to Russia’s drug policy.

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