Reports from Kenya suggest violence against women who use drugs rose during the COVID-19 lockdown, fuelled by tensions as incomes disappeared and couples found themselves in close confinement with one another.

Both men and women who use drugs are also being unfairly blamed and beaten for petty crimes, often without evidence, which are on the increase due to a lack of wages.

But Kenyan partners from the Partnership to Inform, Transpire and Connect the HIV response (PITCH) are finding ways to address the situation. To link women to various forms of support they have formed a response team with police and a referral system with legal and medical services. Peer workers are also receiving training in counselling, mediation and conflict resolution, while advocacy is underway to ensure the lockdown experiences of women who use drugs are being heard and understood.

“Gender-based violence has escalated during lockdown, it has taken a turn for the worse,” says John Kimani, director of the Kenya Network of People using Drugs (KeNPUD). “Before, these cases [of violence] were there but there were not as many and they were not as extreme.

“We are seeing an increase in women becoming homeless as a result of this. Fewer women are also accessing healthcare, particularly antenatal care, for fear of emotional or verbal abuse.”

In Nairobi it is common for women who use drugs to engage in sex work to support themselves, their partner and their children. But Bernice Apondi, Policy Manager at VOCAL Kenya, says lockdown made sex work impossible as bars and lodges where many women find business shut down and curfews meant people were no longer allowed on the street.

First responders: The peers providing psychological first aid for women who use drugs in Kenya

The new Security Union strategy would “fight” against drugs together with child abuse and arms trafficking. This is a bad approach.

The European Commission has published its new EU drug strategy (now called the Drugs Agenda), which is part of a wider Security Union strategy entitled “Delivering on a Security Union: initiatives to fight child sexual abuse, drugs and illegal firearms.” While I celebrated the previous Action Plan as the most progressive ever, I think this document has come as a disappointment for civil society organisations that have been advocating for a sensible, balanced approach in drug policies.

Here are 4 reasons why (this article is not a comprehensive review and it does not reflect the official position of the Civil Society Forum on Drugs or other organisations but only my personal views).

The European Union should not fight drugs but reduce harms

While Latin American countries face deteriorating conditions in prisons and the ongoing impact of COVID-19 on incarcerated people, one group in conditions of vulnerability continues to be rendered invisible: trans women deprived of liberty. Although countries have the responsibility to protect the physical and mental health and well-being of all people in their custody, in particular those who come from more vulnerable situations, the majority of governments in the region have not implemented specific measures to protect LGBTI+ people behind bars. The impact of the COVID-19 pandemic on trans women deprived of liberty has been disproportionate in comparison with other groups, particularly because of the diverse intersectionalities affecting their lives.

In light of this worrisome situation, civil society organizations led by and/or that work with trans people deprived of liberty have developed various initiatives to ensure the full exercise of this group’s dignity and protection of their human rights. In this context, these organizations convened a workshop entitled Trans Women Behind Bars: Strategies for Resistance in the Context of the COVID-19 Pandemic, with the aim of sharing experiences and resistance strategies, along with good practices and challenges that are being faced by civil society groups.

In addition, trans women fit the criteria established by the United Nations High Commissioner to be eligible for alternatives to incarceration in the context of COVID-19, since they are people who 1) face a greater health risk if they were to contract the disease; 2) experience inhuman and unsafe prison conditions and situations of violence; and 3) have been criminalized, resulting in their excessive incarceration. However, the measures announced by various countries in the region to reduce the number of people behind bars have not taken into account trans people’s specific needs.

During the workshop, trans women who have been in prison advocated for alternatives to incarceration and underscored the need to incorporate intersectional perspectives and a differentiated approach that would protect the rights of LGTBI+ people. These recommendations include:

Take immediate action to release trans women who have greater health risks and who find themselves in inhuman and unsafe prison conditions. Their release could be implemented via alternatives to incarceration, pardons, sentence reductions, or other means, in accordance with the legal and judicial system in a given country.

Ensure that LGTBI+ persons deprived of liberty have access to information on the COVID-19 situation.

Establish a Penitentiary Monitoring Program on COVID-19 with a gender and sexual diversity perspective in order to identify the differentiated effects on groups in situations of vulnerability.

Provide all of the inputs needed to prevent, control, and safeguard the health of LGTBI+ persons deprived of liberty in the face of the COVID-19 pandemic.

Guarantee that trans women have adequate access to comprehensive health care and counseling suited to their needs and specificities, particularly in light of possible COVID-19 contagion. For women who opt for it, the continuity of hormone treatments and reassignment surgery should be ensured.

Promote constant awareness-raising and training on sexual orientation, gender identity, and gender expression for prison workers, and other actors and officials in the judicial system. These trainings should be coordinated with specialized civil society organizations that have experience in these matters and should include the active participation of trans women.

Support reentry for trans women who leave prison by ensuring, at the very least, tests to detect COVID-19, proper medical services, a safe form of transportation home or to a halfway house, and the immediate provision of official identification documents.

Implement programs and partnerships between the state and civil society organizations—including the private sector when appropriate—to ensure access to work, personal development, health, housing, and education to people who have been deprived of liberty.

Promote the participation of trans women who have been deprived of liberty in spaces for planning and implementing public policies aimed specifically at promoting the human rights of the trans population.

Trans women behind bars: Strategies for resistance in the midst of the COVID-19 pandemic

Merri Utami was sentenced to death after airport authorities found drugs in her handbag.

On 29 July 2016, Merri waited to be led before a firing squad. She listened to the execution of four other people before her execution was halted at the last moment. Four years later, Merri remains in prison and her petition for clemency has gone unanswered by Indonesian President Joko Widodo

The death penalty for drug offences is unjust, ineffective, and a violation of international human rights law. It must be abolished.

Sign the petition and demand clemency for Merri.

Indonesia: A death sentence for a drug offence

Anton Basenko is worried. He fears all the hard-won progress made in fighting the AIDS epidemic is on a collision course with the urgent needs of the coronavirus pandemic.

"For people with HIV, it's double, triple the crisis since the start of the lockdown," says the Ukrainian AIDS advocate. "I have a bad feeling that organizations and governments are so concentrated on COVID that they are completely forgetting about HIV. For marginalized people, it's a question of life and death."

Basenko is no stranger to health crises. After years of injection drug use, he contracted HIV (which he now lives with) and hepatitis C (which he's now cured). He started opioid substitution therapy in 2004.

Today, he works for the Alliance for Public Health in Ukraine as a coordinator for harm reduction programs that help IV drug users get clean needles or safer alternative drugs like methadone.

On July 10, he led a session at the 23rd (virtual) International AIDS Conference on the impact of COVID-19 on AIDS.

Suddenly, he and other AIDS advocates, researchers, doctors and patients have a 40-year-old epidemic 

 a brand new pandemic to worry about. "The concern is that AIDS is already being set back by COVID-19," says Dr. Monica Gandhi, director of the University of California San Francisco Center for AIDS Research.

What happens when a pandemic and an epidemic collide

There is genuine hope that by sharing her story as a woman who grows opium, Nang Kham could help encourage other women farmers to speak out, and encourage the wider community to realise the collective benefits of gender equality.

Nang Kham (a pseudonym) is 32 years old and lives with her husband and two children in a mountainous village in southern Shan State, Myanmar. Like many women around the world, she bears a disproportionate share of household work. She is also one of the tens of thousands of women who cultivate opium as a means of survival in Myanmar. She lives in a high-altitude area, where opium fields stretch out as far as the eye can see.

Cultivation for household needs such as traditional medicines has been common in Nang Kham's village for some time, but larger scale cultivation is a relatively new phenomenon. The violence and insecurity that followed the conflict in the late 1990s forced Nang Kham and her fellow villagers to flee.1 When they returned years later they discovered that all their crops and domesticated animals had disappeared. The only viable cash crop at the time was opium. It grows relatively quickly, is low in volume and high in value and traders come to the village so there is no need to travel to the nearby market. And as the roads are in bad shape, and conflict sporadically flares up, opium was and is a life saver cash crop.

Nang Kham earns more than 70 percent of her annual household income with one season of opium cultivation and harvesting per year. Most of this income is spent on food, healthcare, and education. She also grows a small amount of food for household consumption, as well as tea and coffee to be sold to local cooperatives.

A day in a life of a woman opium poppy farmer in Myanmar

The Netherlands has been a global leader for ensuring the health and human rights of people who use drugs and has contributed significant funding over the past decade for harm reduction and drug policy reform. Within this frame, recent funding decisions signify a withdrawal from this critical agenda.

This letter, signed by 330 civil society and community networks from across the globe, calls on the Dutch government to recommit to their brave and long-standing political and financial support for harm reduction and drug policy advocacy and to continue to build on their significant investment in this issue.

Dear Minister Kaag, Minister of Foreign Trade and Development Cooperation,

CHANGE IN DUTCH FUNDING PRIORITIES WILL SIGNIFICANTLY DISRUPT GLOBAL HIV AND HEPATITIS RESPONSE FOR PEOPLE WHO USE DRUGS

The Netherlands is a global leader for health, human rights and development. Within this frame, the Netherlands has steadfastly aimed to shift the focus of drug policies away from counterproductive and damaging punitive measures, towards ensuring the primacy of human rights, health and development commitments for people who use drugs. In particular, since the inception of harm reduction as a response to drugs in the late 1970s, the longstanding and continuous leadership of the Netherlands in championing this approach has been unparalleled. The Dutch global leadership in the harm reduction movement throughout the past two decades has saved thousands of lives and positively influenced countries towards adopting health, human rights-based and evidence-based approaches to drug use.

Just two years ago, at the 2018 AIDS Conference, hosted by the Netherlands in Amsterdam, there was a special focus on Eastern Europe and Central Asia (EECA), where HIV is predominantly driven by unsafe injecting drug use. The Dutch government used the opportunity to re-iterate its commitment to harm reduction and to addressing the HIV epidemic in EECA. Consistent with this commitment, the current policy ‘strengthening civil society’ and in the Ministry’s SRHR Theory of Change, prioritises people who use drugs and mentions harm reduction explicitly.

In sharp contrast to this, the latest round of funding decisions under the SRHR Partnership Fund represents a drastic shift away from these long-standing and critical priorities. None of the selected partnerships include comprehensive, consistent and high-quality harm reduction service delivery or advocacy for drug policy reform. Moreover, the selected programmes that include HIV as a topic do not substantially include regions such as EECA, the Middle East and South-East Asia – where HIV incidence among people who use drugs is still rising.

There are an estimated 15.6 million people around the world who inject drugs. Just 1% of them live in countries with high coverage of harm reduction services. People who inject drugs are 22 times more at risk of HIV compared with the general population. The 2018 research report ‘the Lost Decade’ demonstrated there had been a 24% decrease in harm reduction funding from international donors between 2007 and 2016; amounting to a shocking 87% shortfall in funding for harm reduction in low- and middle-income countries. In this context, the Dutch have stood out for its ongoing and outstanding commitment to funding harm reduction in low- and middle-income countries. Until now.

The ramifications of the current Dutch funding decision are wide and far-reaching. This letter makes an urgent appeal to the Dutch government, to continue funding life-saving, rights-affirming interventions and drug policy reform work.

The undersigned call on the Dutch Minister of Foreign Trade and Development Cooperation to validate a strong Dutch tradition of promoting a human rights and public health approach. And with that we urge the Netherlands to recommit the brave and long-standing political and financial support for the health and rights of people who use drugs.

330+ NGOs warn changes in Dutch funding priorities will disrupt global HIV and hepatitis response for people who use drugs

B.C.’s top doctor fought back tears Thursday as she responded to a record number of overdose fatalities in the province last month.

The B.C. Coroners Service reported 175 suspected overdose fatalities in June, the province’s highest-ever monthly death toll. COVID-19 is linked to 189 deaths in total in the province.

“We need to put as much time and effort and kindness and compassion into caring for people who use drugs as we have been successful in doing in responding to the COVID-19 crisis,” said provincial health officer Dr. Bonnie Henry.

Henry urged the federal government to end criminal penalties for people found in possession of small quantities of drugs, and renewed her call for access to “clean” drugs for people with addictions.

“I am calling again on the federal government to take this to heart, to take the advice of the chiefs of police who know that this is an important step … and there’s no more important time for us to do this than now,” said Henry

Amid record overdose deaths, B.C.’s top doctor calls for decriminalization

Brian, Dave, and Russell continue their conversation about neoliberals in psychedelia, including companies using the coronavirus pandemic to promote psychedelics for mental health. They also deconstruct non-profit vs. for-profit rhetoric and propose more pragmatic frameworks for examining the implications (and material realities) of psychedelic corporations and their operating structures, such as cooperative vs. non-cooperative.

Plus Three goes deep into the world of drugs, from local decriminalization and emerging psychedelic corporations to leftist politics and mass incarceration. Each week the team and guests attempt to make sense of the complex connections between drugs, science, capitalism, policy, and culture.

Podcast: Psychedelic Capitalists Part 2: Pandemic Profiteers and Non-Cooperative Actors

The global movement of people who use drugs has achieved exponential growth over the last four decades. Throughout the world drug user led advocacy has become a global phenomenon pushing to protect and defend the health and human rights of the drug using community and other people facing marginalisation in society.

In collaboration with the Rights Reporter Foundations (Drugreporter), we are very excited to share "Taking Back What's Ours!", a new documentary film series which captures the history and genesis of the global movement of people who use drugs. In this series you will meet activists undertaking critical work in their communities, and learn how they navigate this work within the context of criminalisation, stigmatisation and oppression.

The series is part of HIV2020 Online, running from July through October 2020. Starting on Monday, 6th of July 2020 we will be releasing one episode per week. The film has a total of 10 chapters and will cover countries in all regions of the world. You can join the conversation over social media by sharing the film each week with the hashtags #TakingBackWhatsOurs, #ReclaimTheResponse and #HIV2020.

In the second episode we explore the history of the movement in Canada, starting in the early 1990s with the formation of the Vancouver Area Network of Drug Users (VANDU) in response to the HIV crisis. The work of VANDU, the Toronto Drug Users Union, the Canadian Association of People who Use Drugs, and other drug user activist groups have contributed significant changes in how people who use drugs are treated and access harm reduction in Canada.

Taking back what's ours! – Episode 2: Canada

Why do we need advocacy for decriminalisation and harm reduction in Eurasia for effective HIV response?

Why are we speaking about harm reduction advocacy in HIV response? Why bother yourself with the issue of drug policy and decriminalisation of drug use and possession?

A simple response is – even the best medicine cannot cure while it is placed in the box in hospital storage. Harm reduction – is the best vehicle connecting people using drugs to testing, treatment and health care. It is the best comprehensive way to provide access to medical help and social support for people using drugs.

I was growing up in University campus area in Kyiv, Ukraine. In 1991, when I reached 15, soviet social systems crashed and violent primitive accumulation of capital (sorry for Marxism) started. University campus became the best scene for open drug trade, accompanied by gangsters’ shootings, corrupted police from the highest level to local cops, easy access to thrown away drugs around. The most surprising story for our peers was not about starting using homemade opiates (sadly, it was quite common), but to quit “the system”. Now I don’t know how many from my class survived alcohol poisoning, drug overdoses or violence.

Since 1996, HIV infection has been spreading lightning-fast among people using drugs in post-soviet countries. At the beginning of 2000s, up to 90% of all HIV-positive cases were among injecting drug users. Available ART treatment appeared in Ukraine only in 2004. My neighbours and friends had all chances to be infected through needles but had no chances for prevention, testing or treatment.

Why are we speaking about harm reduction advocacy in HIV response?

BOGOTA — Colombia is advancing towards meeting a court's requirements that will allow it to renew aerial herbicide spraying of coca crops, the chief ingredient of cocaine, the minister of defense said Monday.

The Andean country, considered one of the world's foremost cocaine producers, finished 2019 with 154,000 hectares (380,542 acres) of coca crops and a potential cocaine output of 1,137 tonnes a year, according to the United Nations Office on Drugs and Crime.

Though coca crop size fell 9% in 2019 to the lowest level in six years, the capacity to produce cocaine rose 1.5% due to increased productivity. Colombia faces permanent pressure from the United States, the main destination for cocaine, to reduce crops.

The government of President Ivan Duque is looking to meet various health and environmental requirements demanded by Colombia's Constitutional Court to re-start aerial spraying with the herbicide glyphosate.

Colombia suspended spraying campaigns in 2015 following a recommendation by the World Health Organization, which warned glyphosate could potentially be cancerous and harmful for health and the environment.

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