COVID-19 is a serious disease, ranging from no symptoms or mild ones to respiratory failure and death. There is no vaccine to prevent COVID-19. There is no known cure or anti-viral treatment at this time. Those most at risk, according to WHO, include those over 60 years of age and those with cardiovascular disease, diabetes, chronic respiratory disease, and cancer. WHO further states that the risk of severe disease increases with age starting from around 40 years. The US Centers for Disease Control and Prevention (CDC) identifies additional categories at risk, including individuals with blood disorders, chronic kidney or liver disease, compromised immune system, endocrine disorders, including diabetes, metabolic disorders, heart and lung disease, neurological and neurologic and neurodevelopmental conditions, and current or recent pregnancy. That means that a large proportion of people are at risk, especially in middle- and upper-income countries which have aging populations.

This summary presents a picture of extraordinary numbers already affected and at risk and unprecedented response. However, one area where there has been too limited of a response to date is action to prevent transmission in detention centers, including jails, prisons, and immigration detention facilities. All of these institutions are closed environments, much like the cruise ships that were the site of early concentrated outbreaks of COVID-19. Detention facilities are particularly of concern because of crowding, the proportion of vulnerable people detained, and often limited medical care resources. People in detention facilities cannot achieve the physical distancing needed to effectively prevent the spread of COVID-19. Showers, toilets, and sinks are shared. Food preparation and food service is communal. Staff arrive and leave, providing a link between the community and the detention center, often—because of limited testing and asymptomatic infection—without adequate screening. Yet, more than three months since COVID-19 emerged, the US CDC lists guidance for schools, childcare centers, colleges, workplaces, faith-based organizations, community events, homeless shelters, healthcare professionals and retirement communities but not for jails, prisons, or immigration detention centers.

Police, first responders, and correctional officers are also at risk as they are less able to practice physical distancing in their official duties. Unsurprisingly, we are starting to see this population affected and their colleagues who are exposed to them, ordered into quarantine. For example, in Kirkland, Washington, 27 firefighters and two police officers were in quarantine along with four King County, Washington, paramedics. In San Jose, California 77 firefighters were in quarantine.More than 140 firefighters were quarantined in Washington DC. Six New Jersey police officers tested positive for COVID-19 and another 20 officers were under self-quarantine, as of March 19.

If police, first responders, and corrections officers are significantly affected by COVID-19, whether through being infected, exposed by detainees, their fellow officers, or in the community, large numbers will be unavailable to work due to self-quarantine or isolation, at the same time that large numbers of detainees who are potentially exposed will need to be put into individual isolation or transferred to advanced medical care, putting tremendous stress on detention facilities.

States have an obligation to ensure medical care for prisoners at least equivalent to that available to the general population. According to the United Nations Committee on Economic, Social and Cultural Rights, “States are under the obligation to respect the right to health by, inter alia, refraining from denying or limiting equal access for all persons, including prisoners or detainees, minorities, asylum seekers and illegal immigrants, to preventive, curative and palliative health services.”The UN Human Rights Committee has also interpreted the International Covenant on Civil and Political Rights as requiring that governments provide “adequate medical care during detention” and the Committee Against Torture has found that failure to provide adequate medical care can violate the Convention Against Torture’s prohibition of cruel, inhuman or degrading treatment. The United Nations Standard Minimum Rules for the Treatment of Prisoners (known as the Nelson Mandela Rules) provide further protections.

To address the risk in detention settings, detention centers must first and foremost have plans in place to prevent or limit the outbreak of COVID-19, to protect the health of all detainees, and to treat the disease should any detainee acquire it. Beyond this, to achieve physical distancing and protect individuals at high risk, detention centers should release individuals in detention who are arbitrarily detained as well as asylum seekers, those in pre-trial detention, and migrant children. Detention centers should also consider reducing their populations through appropriate supervised or early release of detainees whose release may be soon or who are in pre-trial detention for non-violent and lesser offenses or whose continued detention is in an equivalent manner unnecessary or unjustified. Finally, individuals who are considered at high risk for severe disease or death should be released or put into alternative forms of custody if facilities cannot ensure their protection or care.

These are not impossible steps and some national and local governments are beginning to take action. In Spain, immigration authorities began releasing people held in immigration detention centers on March 18. In Belgium, federal authorities released an estimated 300 migrants from detention on March 19 because detention conditions did not allow for safe physical distancing. The UK government released 300 people from detention centers following legal action which argued that the government had failed to protect immigration detainees and failed to identify which detainees were at particular risk of serious harm or death if they do contract the virus due to their age or underlying health conditions. In the United States, in Alabama, prison officials announced that they are halting intake of inmates from the state’s county jails for the next month. In Chicago, Illinois, the Cook County Jail released several detainees deemed “highly vulnerable to” COVID-19. In Maine, the court system vacated all outstanding warrants (numbering over 12,000) for unpaid court fines and fees and for failure to appear for hearings, to reduce jailing.

However, like everything related to this pandemic, more needs to be done faster. And in lower-income countries which have yet to see a large number of cases, now is the time to act. While these countries may have relatively fewer people incarcerated per capita than middle- and upper-income countries, conditions are often worse, with severe overcrowding, lack of medical facilities, and a high proportion of detainees who are in pre-trial detention and who fall in high-risk categories for severe COVID-19 disease or death. Releasing detainees is a critical part of the COVID-19 response and is both good public health and human rights policy.

COVID-19 and detention: Respecting human rights

Quarantine in Belarus is still not officially declared. There is no practice of take-home prescriptions of OST drugs established in the country. During the last two days we have been working closely with the Ministry of Health in Belarus about the changes to existing clinical protocol of OST administration, which aims to improve access to the .

On February 5, we filed a request to the first deputy Minister of Health about the need to adopt new regulations and clinical protocol for buprenorphine supply and administration. Now we have about 700 OST programme clients. The programme started in 2013 from 1048 patients, however, since 2015 the programme has been state-funded and the number of clients decreases every year.

The key problems we are currently facing: long waiting lines at the OST sites; in some cases methadone is not transported to the local hospitals. There are no take-home OST prescriptions, the risk of losing one’s driving license and parental rights for being an OST patient is relatively high.

Georgia: GeNPUD, members of the “Phoenix 2009” network, “Rubiconi”, and “New Vector” NGOs

On March 18th, all patients received OST drugs on-site, the first time everyone received drugs for 5 days. There has been no regular practice of at-home drug administration before.

Activists have been negotiating with the Centre of Mental Health and Drug Use Prevention, which is in charge of all OST programme management in the country. Thanks to active cooperation of the PUD (people who use drugs) community and experts, people received their medication for home use.

Moldova: Members of the “Together” community in Chisinau and “Pulse” initiative from Balti

In the cities of Chisinau, Balti, Falesti and Ungheni all OST patients receive one week supply of methadone for home use. In Chisinau patients also receive buprenorphine for 5 and more days of home use. OST sites work two times a week in Chisinau - starting March 23 - and in Balti since March 27. Patients are divided into two groups to minimize overcrowding at OST facilities. The PUD community continues close cooperation with medical staff.

Shortage of the Methadone supply: quarantine has revealed the problem of medication supply shortage. Currently there is only enough medication in stock till the end of April. Tender has been conducted and the Italian company, because of the coronavirus epidemic can not ship the medication. After the community’s active involvement, the situation has been solved by signing the emergency contract with the Ukrainian producer company. The local provider Sanfarm-Prim and the Ukrainian company still had to prepare necessary documentation to the medication shipping, which could have taken additional one and a half months. However, the working group has been created from the national OST programme representatives, Ministry of health officials, UN Office on Drugs and Crime experts. The necessary documents will be finalized during the next few days and OST medication will be shipped by plane from Ukraine to Moldova early in April.

Kyrgyzstan: Kyrgyzstan Association of Harm Reduction (АССВ)

Kyrgyzstan has established a curfew and transportation is limited between the cities. Currently there are around 1000 OST patients, including 300 incarcerated people. The National Narcological Centre adopted a decree allowing all OST patients to receive their medication during any further coronavirus limitations, including a state of emergency.

Since March 25, all OST programme clients received methadone for home use for 5 days, sites are open once a week. However, EHRA continues to receive applications from patients, who are not allowed to travel to another town to get their medication, and/or do not have a place to store it due to homelessness.

COVID-19 curfews, supply shortages and take-home prescriptions: How OST is being administered in the EECA region

The unsanitary, overcrowded prisons and juvenile detention centers in most Latin American and Caribbean countries offer prime conditions for outbreaks of COVID-19 that could severely affect the health of detainees and of the population at large, Human Rights Watch said today.

In March 2020, inmates in detention facilities in several Latin American countries rose up to protest a lack of protective measures against COVID-19 and efforts to lock them down. Hundreds escaped, dozens of people were injured, and at least 40 people died in connection with the protests in Colombia, Venezuela, Argentina, Peru, and Brazil.

“An outbreak of coronavirus in Latin America’s prisons would be an enormous public health problem that would affect not just the detainees but also the rest of the population,” said José Miguel Vivanco, Americas director at Human Rights Watch. “There is still time, but the authorities need to act immediately to avoid an entirely foreseeable health disaster.”

Latin America: Cut prison crowding to fight COVID-19

The authorities have granted more than 5,500 prisoners early release to help prevent a possible surge in coronavirus infections in Indonesia’s overcrowded prisons.

Human Rights Minister Yasonna Laoly said on Wednesday during a virtual meeting with the House of Representatives Commission III overseeing legal affairs that he had raised the number of prisoners that were planned to be released to 50,000 people from 30,000. "As of today, at 11 a.m. according to our SDP [Correctional Database System], we have released 5,556 prisoners," he said.

"As of today, at 11 a.m. according to our SDP [Correctional Database System], we have released 5,556 prisoners," he said.

According to Yasonna, the ministry has two legal bases for the release, namely Human Rights Ministerial Regulation No. 10/2020 on terms and conditions of assimilation and integration for prisoners and juvenile inmates to prevent the spread of COVID-19, as well as Human Rights Ministerial Decree No. 19/2020 on the release of prisoners and juvenile inmates through assimilation and integration to prevent the spread of COVID-19.

COVID-19: Indonesia releases more than 5,500 inmates, plans to free 50,000

This grim image has become all too familiar in the Philippines's poorer neighbourhoods: the body of a barefoot, shirtless man, slumped against a wall with blood dripping from bullet wounds, the latest victim of President Rodrigo Duterte's unrelenting anti-illegal drugs campaign that has killed thousands.

On the morning of Sunday, March 23, police and anti-narcotics enforcers from the central island of Cebu carried out an operation against a "high-value individual".

The "buy-bust" mission resulted in an "armed confrontation" and the killing of the suspect, Buen Chiong, according to a Cebu provincial police report obtained by Al Jazeera. Police added that Chiong was on their "provincial-level watchlist".

The Cebu radio station, DYSS, quoted authorities as saying that the suspect was linked to "drug trading and burglary" in his community. Al Jazeera also learned that a calibre .45 pistol was recovered from the scene of the shooting - a detail missing in the police report, which initially misspelt the dead man's name as Buena.

Chiong's death was filed under Control Number 20002-032020-0502.

The Philippines' Duterte presses on with 'drug war' despite coronavirus lockdown

The Road to Kyoto is a podcast series from the GI-TOC with some of the leading experts who study and track organized crime and related issues, in the context of the upcoming United Nations Crime Congress.

The Congress usually takes place every 5 years, and the next one was due to be held in Kyoto, Japan, in April 2020. It has now been postponed to an undetermined future date to the COVID-19 outbreak.

This podcast looks into some of the key issues that will be discussed and debated at the Congress, such as cybercrime, drugs policy, human rights, and the role of civil society in preventing and countering organized crime.

The United Nations Crime Congress, which usually meets every five years, is a key opportunity for the international community to make progress on countering organized crime and the damage it does around the world.

The Congress, as an international non-decision-making conference, is easy to characterize as detached from the realities on the ground. Nevertheless, its influence over crime policy is significant, as is the opportunity it affords to galvanize international action, and to exchange experiences and new ideas. The agreements reached during past UN Crime Congresses do in fact shape the policy direction of the UN on organized crime. At the same time, however, other issues can overshadow those prioritized at the Congress, and follow-up has arguably been too narrowly focused.

This series seeks to shed light on these issues and how to make progress on them through the Congress, particularly in light of the new challenges posed by the COVID-19 outbreak.

On March 2020, the Global Initiative Against Transnational Organized Crime kindly invited Jamie Bridge and Gloria Lai, from the International Drug Policy Consortium, to discuss the evolution of the Crime Congress' approach to drug policy matters. The episode is available here.

Podcast: Road to Kyoto - Drugs and criminal justice

University lectures, business meetings and friendships are increasingly being uploaded to the video conferencing platform Zoom amid lockdowns in response to the coronavirus pandemic. Chemsex sessions are no different. Although Zoom and other webcamming services were widely used prior to the outbreak, they are increasingly important at a time of social distancing. And this has a renewed public health potential.

“Chemsex,” a term mostly used in Europe—”party ‘n’ play” is more popular in North America—describes the sexualized use of drugs, particularly methamphetamine, GHB/GBL and mephedrone, among men who have sex with men and transgender women.

Zoom and other video chatting services seem to have been a part of chemsex since the early 2010s, when crystal methamphetamine use among queer men was re-booted in some places in Western Europe and the United States. “Webcamming and porn are both integral parts of chemsex,” London-based chemsex expert David Stuart told 

. “It’s extremely rare to find anybody who doesn’t engage with online sexual content/activity as part of the (usually extended) chemsex experience.”

But since COVID-19 came to the United Kingdom, “lots and lots of people have stopped hooking up casually/stopped chemsex,” Stuart said. “I can also tell you that lots and lots of people continue to do so.”

“If you are horny and high, you don’t think about minimizing consequences because one of the effects of the drugs is feeling invincible,” London-based chemsex harm reductionist Ignacio Labayen De Inza told 

But he’s identified two barriers that will push people online: “the fear of infection” and “the fear of police.”

The threat of catching the virus seems to be slowing down in-person meet-ups. One London social service provider reported in a chemsex email group that he’s observed most men on Grindr seemingly “complying with social distancing.” Overall, there seems to be “a steady incline in persons active” online, he suggested. A provider in Italy has observed similar trends.

Bold police-enforced lockdowns imposed by jurisdictions in Spain, a country that has now seen more deaths than China, have led some 

 to worry about being punished for leaving their residence for chemsex parties. Some queer men in Madrid “wanted to meet in real but they thought the police was watching,” said Labayen De Inza, summarizing what he’s heard through his outreach efforts on Grindr

These men have good reason to be nervous: On March 20, Barcelona law enforcement charged eight men with “crimes against public health” for gathering in an apartment for a chemsex party.

Zoom and other platforms are seemingly being re-tooled to meet new constraints posed by the pandemic. “People will go to webcam if they don’t have a choice” to meet in person, Labayen De Inza said.

Chemsexeurs are often seeking not just sexual drug experiences online, but intimacy and connection. Being stuck in an apartment as a result of “shelter in place” policies can be an isolating experience, and some have found community through chemsex. “Two of the most powerful reasons why people get involved in chemsex are loneliness and boredom,” Labayen De Inza wrote in a coronavirus-chemsex harm reduction handout he shared with

In Spain, “many” chemsexeurs are using webcamming platforms “to maintain the feeling of doing a group use,” Javier Curto Ramos of Madrid’s Apoyo Positivo, a nongovernmental organization providing chemsex services, told 

Chemsexeurs online seem to agree. “Quarantine seems an appropriate time to find friends to masturbate on cam with us,” wrote one Reddit user on “PnPPlayground” a subreddit group dedicated to party ‘n’ play, on March 19.

Going online and using meth with others might just be another way to pass the time. “First time spun in over 3 months. Decided to use again since I couldn’t stand the boredom of being quarantined,” wrote a different PnPPlayground member on March 21. “God, meth is the best!”

Video chat platforms can help prevent coronavirus infection, and could potentially reduce the harm of social isolation for men who have relied on chemsex for connection. There are obvious reductions in risks to sexual health compared with in-person meet-ups. The platforms have been a “harm reduction staple in regard to sexual health,” said Stuart, noting that they are “especially so” now. “[A]ll the chemsex charities” Stuart knows provide some sort of phone-based support service for chemsexeurs.

But they are no silver bullet, and Stuart cautions against confusing webcamming’s potential for infectious disease prevention with drug-user harm reduction. Using drugs alone is generally riskier than using in groups. “Although there is a lot of good community minded people out there, there is also a lot of chaos and misinformation,” said Stuart. “Imagine a frightened, psychotic person naked and tweaking on meth, worried about if he has taken too much G; if he reached out to general untrained public, whether they are regular chemsexeurs themselves or not, he’d be barraged with an onslaught of conflicting and potentially dangerous information.”

Telecommunication services have been used to prevent fatal overdoses, though. The US hotline Never Use Alone provides people who use drugs the opportunity to call a trained phone operator who will ask for their location, allergies and medical conditions, and will then stay on the line with them for the duration of their drug use, contacting emergency services if the caller becomes unresponsive.

“Online chemsex platforms have pros and cons,” concluded Stuart. “They have harm reduction potential. They have harm reduction qualities. But it’s very nuanced.”

What Zoom can mean for quarantined chemsex participants

Tenu Avafia, Boyan Konstantinov, Kene Esom, Judit Rius Sanjuan, and Rebecca Schleifer

The rapid spread of the COVID-19 pandemic around the world has and will continue to have an incredibly disruptive impact on many lives. As of 24 March 2020, at least 334,981 people have been infected and 14,652 have died across 174 countries. Beyond these already tragic and growing consequences, COVID-19 will also have a major impact on the 2030 Agenda for Sustainable Development and the pledge to leave no one behind. The decisions made by governments, the international community, the private sector, civil society, and individuals will shape the trajectory of the epidemic and its impact on billions of people worldwide.

There are several lessons to be learned by governments and international organizations from the response to the HIV and TB epidemics that could be crucial to the success of the response to COVID-19. These include ensuring that human rights principles are entrenched in the COVID-19 response, relying on the best available evidence to inform decision making, and the fostering of global collaboration to fuel innovation and equitable access while ensuing the allocation of adequate financial and other resources needed to mount an effective response. A rights-based response to COVID-19 contains many important aspects, among them, the right to health, equality and non-discrimination, freedom of peaceful assembly, association and movement, an adequate standard of living, as well as the right to benefit from scientific progress. This viewpoint focuses on the right to health as underpinned by principle of transparency.

The Right to Health and its applicability to COVID-19


The right to the highest attainable standard of physical and mental health was first articulated in the Constitution of the World Health Organization. It is enshrined in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Elimination of All Forms of Discrimination against Women, the International Convention on Protection of the Rights of All Migrant Workers and Members of Their Families, the International Convention on the Elimination of Racial Discrimination, and the Convention on the Rights of the Child, among other international and regional treaties as well as in at least 115 national constitutions. This right is qualified by Member States’ commitment to its progressive realization in accordance with available resources. In the case of a rapidly spreading epidemic such as COVID-19, it is critical first, that UN Member States take all reasonable steps possible to protect, promote, and fulfil their obligations pertaining to the right to health under international and national law, including that international funding and support is channelled to countries with the most fragile health systems and vulnerable populations who could be hardest hit. While the right to health is underpinned by the principle of equity, effective responses to HIV and TB have also demonstrated the importance of focusing on vulnerable or most at-risk populations. In the case of COVID-19, the evidence indicates that higher-risk categories or vulnerable groups must be prioritized if the spread of the epidemic is to be mitigated. It is also critical to ensure the continued access to treatment for people living with HIV, NCDs, and other chronic conditions.

Physical distancing and other behavioral practices are currently the most effective public health measure to reduce the risk of transmitting COVID-19. Prisoners and those in closed settings such as detention centres and refugee camps are at heightened risk of contracting communicable diseases. Many prisons and closed settings are overcrowded, thus heightening the risk of acquiring COVID-19. Refugees, internally displaced people, migrants, mobile populations, and those living in informal, crowded settlements are also at much greater risk than the general population. The recent cases of disease among both detainees and guards, as well as prison riots and breakouts in a growing number of countries including Brazil, Colombia and Italy highlight the plight facing of those in closed settings. Some governments are taking steps to suspend all prison visits in a bid to curb the spread of the epidemic. Others are taking more public health-oriented steps. Iran, one of the countries hardest hit by COVID-19, is reported to have temporarily released as many as 85,000 prisoners in a bid to contain the spread of the pandemic. Corrections authorities in Ireland were said to be considering the temporary release of non-violent offenders incarcerated for minor offences. In some parts of the United States, law enforcement officials have taken to incarcerating only those accused of violent crimes as a public health measure.

According to the latest available evidence from WHO, up to 80% of people who acquire COVID-19 either remain asymptomatic or display mild symptoms, while still able to transmit the disease and infect others. The global response is therefore heavily reliant on trust, solidarity, and broad community engagement to ensure that the most vulnerable are protected. Undocumented migrants, asylum seekers who fear arrest, detention, or confinement are unlikely to seek health services unless they can do so without fear of reprisal. As with the AIDS and TB responses, safeguarding two core components of the right to health confidentiality and privacy, of individuals infected or most at risk will be critical to an effective response. Epidemics emerge along the fissures of our society, reflecting not only the biology of the infectious agent, but pre-existing structures of marginalization, exclusion, and discrimination. The insidious social pathologies of hate, racism, and xenophobia have the potential to exacerbate or even do more harm during a pandemic than the virus itself. Governments should put measures in place to enable refugees and undocumented migrants to access healthcare without fear of detention or deportation and by putting in place protective and remedial measures for communities more likely to face such attacks and discrimination.

The gender dimensions of COVID-19 also require responses by governments, the international community, civil society, and the private sector. A combination of pre-existing biological and socio-cultural factors leave women and girls more impacted by certain elements of outbreaks such as COVID19. Women frequently are the majority of the healthcare force in many settings. Interactions with emergency responders, and health governance structures also have gender dimensions. National health systems often rely on, but fail to recognize women’s unpaid care work. This situation is exacerbated during infectious disease outbreaks, where responses rarely include adequate support for home-based care providers. It is critical that governments respond to the gender dimensions of outbreak and pandemic responses in the design and implementation of COVID-19 interventions.

The underlying importance of transparency as a bedrock to effective COVID-19 responses


Transparency underpins many fundamental rights and freedoms necessary to a more effective COVID-19 response. These include the rights to information, participation, privacy, self-determination, dignity, health, to benefit from scientific progress, freedom of association and freedom from discrimination. Providing complete, transparent information was cited by the South Korean Minister of Foreign Affairs as a critical element to gaining and maintaining the public’s trust. This, together with public health measures such as some of the highest levels of testing by any country clearly aided the Government’s ability to reduce new infections from 900 a day in late February 2020 to as few as 75 a day by mid-March 2020. Ensuring that the public has access to clear, accurate, information and real time data on public health measures, such as the availability of testing and healthcare facilities, the actual number of tests being undertaken, as well the incidence of illness, mortality, and recovery are not just central to maintaining public trust and community adherence to medical guidance, but also to shaping an evidence-informed pandemic response.

In addition to providing information quickly and in a transparent manner to all segments of the population, taking into account linguistic, geographic and literacy barriers, the ability of governments, the international community, and the private sector to counter misinformation being disseminated through social media and other information and news outlets will be crucial. The AIDS and TB responses also contain lessons of how communities of people living with and affected by a disease or condition can play a pivotal role in COVID-19: misinformation can easily fuel stigma and discrimination, and aggravate the crisis, thus driving certain vulnerable groups away from seeking needed health services or to ignore sound medical advice. As COVID-19 is a relatively new strain of coronavirus, much remains unknown about its epidemiological characteristics. It is important for governments and the scientific community to be transparent about what is uncertain or unknown about the pandemic.

Transparency is as relevant to the right to health as it is to the right to benefit from scientific progress, as embodied in Articles 12 and 15 of the International Covenant on Economic Social and Cultural Rights. Transparency has increasingly been regarded as a critical enabler of both the innovation of and access to health technology (diagnostics, medicines, personal preventive equipment and related technologies). For example, the Helsinki Declaration on ethical principles for medical research involving human subjects underscores the importance of undertaking medical research only with the informed consent of research subjects. The International Ethical Guidelines for Epidemiological Studies also recommend that epidemiological study results be made publicly available, and that unnecessary obstacles to research be removed. The sharing of accurate data and other information relevant to the availability, as well as the research and development (R&D) of diagnostics, vaccines, and medicines needed to prevent and treat COVID-19 is essential. The lessons learned from the Ebola outbreaks led WHO to develop guidance on managing a range of scenarios that present in infectious disease outbreaks. The guidance recommends information sharing (including rapid data), participation in international cooperation, and communicating with global stakeholders and other governments, as well as ensuring that human rights and ethical standards are observed during the emergency response to infectious diseases.

There is a plethora of COVID-19 related clinical trials under way. These include trials for potential new treatments and vaccines, as well as trials involving the potential repurposing of a range of existing treatments for HIV, viral hepatitis, malaria, and other diseases, to assess the efficacy and safety for use in preventing or treating COVID-19 and related viruses. There have been a few encouraging signs of research and academic institutions moving towards greater transparency as efforts to develop effective therapies to prevent and treat COVID-19 intensify. In response to a request by scientists, at least 30 major publishers agreed to make publicly available, and reusable, all COVID-19 and coronavirus related publications and supporting data. This is an important and laudable step, but opportunities exist for more widespread and deeper collaboration. Governments, private and public sector researchers and biomedical companies, and philanthropic funders should hasten to make publicly available, non-traceable information and data on all ongoing, completed, and discontinued clinical trials, regardless of the results. Funders of COVID-19-related research as well as the recipients of such research funding should adopt provisions to facilitate and encourage the open-source sharing of COVID-19-related research through publication in open access, peer-reviewed literature.

Transparency during the innovation value chain can be a critical enabler of both future innovation and access, and there is opportunity for greater action here too. Information on patent and other market exclusivities is often difficult to obtain and verify, and reduces the capacity and speed of innovation, as well as the procurement of health technologies. Efforts by the Medicines Patent Pool to provide information on the patent status and licensing status of essential medicines to treat HIV, TB, viral hepatitis, and other diseases are starting to be expanded to some technologies relevant for COVID-19. Additional technologies should be added. The same could be said of the Industry partnership with the World Intellectual Property Organization. Greater transparency on R&D investments and costs, as well as the access policies and strategies of R&D funders and innovators, including Information on pricing, regulatory and manufacturing strategies, licensing terms and conditions, and technology transfer agreements, could also be an important accelerator for access to COVID-19 related technologies. One of the most important lessons from the AIDS response as noted by several bodies and reports is that world class biomedical innovation without the underlying principles and tools needed to guarantee universal access, and the commitment to deliver access, is a job only half done.

This pandemic is a public health and development challenge, but it is also an opportunity. All stakeholders—governments, international organizations, the private sector, civil society—have a responsibility to ensure we ground our efforts in principles of human rights and transparency. It’s a chance we cannot afford to miss.

A rights-based response to COVID-19: Lessons learned from HIV and TB epidemics

Extraordinary measures are being taken by the UK government to tackle Covid-19 which, by its own admission, would not normally be expected outside of wartime. As the Chancellor of the Exchequer has acknowledged, ‘this is not a time for ideology and orthodoxy’. Emergency measures are rightly being taken to prioritise protecting health and saving lives.

Prisons pose a particular risk in light of a global pandemic. In the UK, prisons are extremely overcrowded and often unhygienic, and there is concern that Covid-19 may ‘spread like wildfire’ among prisoners and staff alike. A great number of particularly vulnerable people are detained in UK prisons: prisoners are at greater risk of cardiovascular disease, and there is an ageing prison population. The virus has already been detected in UK prisons and it has been estimated that an outbreak could lead to 800 avoidable deaths. Without action, prisons will become a death trap. Emergency measures are being taken to restrict the risk of the virus spreading, including the suspension of prison visits on 24th March. Limited measures have also been taken to extend access to an early release scheme where individuals are subject to electronic tagging and a curfew. But much more needs to be done, and experts are calling for the considered, managed release of vulnerable and non-violent offenders as a matter of urgency. Other countries have already facilitated this en masse, including Iran and Turkey, while US states are also beginning to release prisoners. The Justice Secretary has indicated that he is looking ‘very carefully’ at whether or not 50 pregnant prisoners could be released, as well as the transfer of some prisoners held on remand to bail hostels. Such calls cannot ignore the fact that prisons in the UK are already at breaking point, in part, due to the huge number of individuals detained there for drug offences. In England and Wales, these make up 15% of the convicted prison population and 18% of those held on remand (a problem made worse when courts are on the verge of closure). In its March 2020 briefing paper, Penal Reform International recommended that ‘individuals convicted for minor or non-violent offenses, especially those sentenced for drug-related offenses or for socio-economic offenses, should be immediately considered for release.’ Many may only have a short time on their sentences remaining, and should not be forced to serve this in prison where it only places themselves and others at risk. In an emergency, policy choices must focus on what is necessary. The safe release of particularly vulnerable individuals — including older prisoners, immuno-compromised individuals, and pregnant women — must of course be considered as a matter of urgency, but wider additional measures need to be taken to ease strain on the prison system as a whole. If the government is looking for the right pressure valve to release, then it must start by looking at individuals detained for non-violent drug and drug related offences, a population whose continued detention has long swelled the UK prison system past breaking point. As the Chancellor has acknowledged, this is not a time for ideology. There is a strong argument that detention of non-violent drug offenders is unnecessary and counterproductive even in normal times. In the midst of the Covid-19 crisis it is unambiguously contributing to serious danger in the prison system. There are other risks. In 2019, 17% of random mandatory drug tests in prisons in England and Wales were positive. Last week, it was reported that almost 1,000 prison officers were in self-isolation, and emergency service provision unfolding in UK prisons includes the cessation of cell searches and drug tests. On 24th March, the Justice Secretary told the House of Commons Justice Committee that 3,500 prison officers (around 10% of the workforce) were now self-isolating. With reduced access to treatment, support and oversight, people who use drugs in prison are left at a heightened risk of harm. In Italy, shortly after an emergency decree suspending prison visits highly similar to that issued in the UK on 24th March, 12 inmates died during riots, mostly as a result of overdoses from drugs taken from the medical room. There are obvious challenges. We need clear policy guidelines to govern release, as well as carefully implemented procedures to ensure safety. This includes actions to minimise the risk of Covid-19 being spread from prisons back into the wider community, as well as ensuring support is available for prisoners to reintegrate them safely — even within a lockdown environment. For individuals with problematic drug use, this includes ensuring they have housing secured in advance, and increasing the availability of treatment provision and harm reduction services in the community. This includes lower threshold access to opioid substitution treatment and naloxone, given that recently released prisoners are at significantly greater risk of overdose. However, without action, UK prisons are a death trap. We know that this is not a time for orthodoxy. There needs to be considered, managed release of individuals from the UK prison system and when doing this, the government must question the necessity of detaining non-violent drug offenders.

Without managed release of prisoners, UK prisons will become a coronavirus death trap

Harm Reduction International, the Canadian HIV/AIDS Legal Network, the Eurasian Harm Reduction Association (EHRA), the International Drug Policy Consortium (IDPC), the International Network of People who use Drugs (INPUD), LBH Masyarakat, Release, and Rights Reporter Foundation welcome the joint statement by the Special Rapporteur and other Special Procedures on the adoption of emergency measures to respond to the COVID-19 pandemic, urging states to “remain steadfast in maintaining a human rights-based approach to regulating this pandemic.”

The COVID-19 emergency poses unprecedented challenges, creating new vulnerabilities and exacerbating existing ones. In this context, people who use drugs have unique needs and face unique risks due to criminalisation, stigma, underlying health issues, social marginalisation and higher economic and social vulnerabilities, including a lack of access to adequate housing and healthcare.

HRI joined leaders in harm reduction to call on the Special Rapporteur on the Right to Health to provide guidance to states on how to promote and protect the right to health of people who use drugs in responding to the COVID-19 pandemic.

Call to action COVID-19 - Special Rapporteur on the Right to Health

The department of correctional services should prioritise the release of elderly detainees, especially those with underlying health conditions, as well as people serving short sentences for non-violent crimes.

This is according to Sonke Gender Justice, commenting on the health and wellbeing of those incarcerated and working within the prisons during Covid-19.

“Once the state deprives a person of their liberty, it is obliged to provide a duty of care,” the group said in a statement.

It cited the Nelson Mandela Rules, which state: “Prisoners should enjoy the same standards of health care that are available in the community, and should have access to necessary health care services free of charge, without discrimination on the grounds of their legal status.”

Social distancing and handwashing are measures that are practically impossible to follow in prison, said Sonke. “Not only are almost all of our prisons overcrowded, many of them also lack sufficient running water and hygiene materials.”

Halting visits to prisoners, which government has announced as a Covid-19 precaution, is an insufficient measure, it said.

Release prisoners in South Africa to meet health mandate: Covid-19 appeal

The New South Wales government has passed emergency legislation providing the Corrections Commissioner with powers to release some of the state’s 14,034 prisoners.

This legislation was introduced in the wake of the global release of prisoners to cope with the COVID-19 pandemic. Most recently, the United States has begun to release thousands of prisoners across four states.

Legislation to release prisoners in NSW was drafted amid the growing number of cases of COVID-19 infections in prison populations, including staff. The overcrowding and poor sanitation and health conditions in prisons make them ripe for the rapid spread of disease.

Long Bay jail in Sydney was locked down this week when two prison staff tested positive for COVID-19 and several inmates displayed symptoms. The higher incidence of chronic health conditions among inmates predisposes them to suffer serious and critical outcomes from the virus.

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