The economical crisis has a huge impact on the public health situation in most of the European countries. Severe budget cuts and austerity measures aimed at NGO’s and low threshold services strongly affect the social and health situation of marginalised and vulnerable groups.

This newsletter is devoted to this urgent issue and presents examples and reports from Correlation partners in South and South East Europe. Greece, for example, is in the middle of a public health disaster. To meet budget-deficit reduction targets set by the European Central Bank, European Commission, and International Monetary Fund (the so-called troika), Greece’s public health budget has been cut by more than 40%. As Greece’s health minister observed, “these aren’t cuts with a scalpel, but with a butchers knife.

The spending was reduced to 6% of GDP, a figure lower than the UK, at 8%, and Germany, at 9%.As a result, HIV infections have jumped by more than 200% since 2010, mainly affecting intravenous drug users, as needle-exchange programme budgets were cut in half.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Policy paper: Who is paying the price for austerity?

The UN Special Rapporteur on Torture has joined the growing list of health experts and human rights bodies urging a move long advocated by the Legal Network: the implementation of prison-based needle and syringe programs (PNSPs). In fact, we were among the invited experts at a meeting convened by the Special Rapporteur last year, to examine how to strengthen the UN's existing Standard Minimum Rules for the treatment of prisoners and people in other places of detention.

Informed by that meeting, the Special Rapporteur's latest report (see "Latest reports") to the UN General Assembly highlights the particular vulnerability to abuse in detention of people living with HIV, people who use drugs, women, sex workers, and LGBT people. It reaffirms that health care in prisons should be equivalent to that in the community, going so far as to state that the new UN rules on prisons should oblige states:

"to ensure that all harm-reduction measures, including ... needle and syringe exchange programmes and evidence-based substance abuse treatment, are available to people who use drugs at all stages of their detention."

The Special Rapporteur also reiterated (from a previous report) concerns about the practice in some settings of withholding methadone or other drug dependence treatment as an interrogation technique.

This latest report represents a significant step forward in the international recognition of the rights of prisoners and people who use drugs. Nevertheless, the Canadian government continues to resist scientifically proven harm reduction services, even working to undermine them at the international level. Such recalcitrance only underscores the necessity of our ongoing court case seeking the implementation of needle and syringe programs in federal prisons, as well as the need for us to keep our engagement internationally as UN member states begin a review of global drug policy over the next two years.

UN Rapporteur on Torture: Provide clean needles in prisons

Criminal justice and public health systems can work together to provide comprehensive HIV prevention and treatment inside and outside correctional facilities. Incarceration presents a window of opportunity for primary prevention, screening, treatment and establishing comprehensive, pro-active transitional linkages for persons approaching release and follow-up.

What is the role of prisons and jails in HIV prevention? 

To coincide with the 17th International Conference on AIDS and STIs in Africa (ICASA), the International AIDS Society, Médecins du Monde (MdM), the International Drug Policy Consortium (IDPC), and the United Nations Office on Drugs and Crime (UNODC) hosted this High Level Panel for around 50 participants including policy makers, journalists and programme managers.

This High Level Panel was the first event of its kind in Africa, warning the participants about the HIV response thoughout the country.

The High Level Panel was expertly chaired by Anso Thom, a leading health journalist from SECTION27 in South Africa – who reminded participants that this was the first event of its kind in Africa, following similarly themed meetings in Asia and elsewhere.

Report from the high-level panel on HIV, drug policy and public health in Africa

This new report aims to assess the various policy responses to new psychoactive substances (so called "legal highs") in five European countries - Hungary, Poland, Portugal, Romania and Serbia - , from the perspective of researchers, service providers, law enforcement officials and activists working with the most affected communities of people who use drugs.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

The not-so-balanced approach: Policy responses to new psychoactive substances

The Affordable Care Act (ACA) represents a remarkable opportunity for criminal justice and drug policy reform advocates to advance efforts to enact policy changes that promote safe and healthy communities, without excessively relying on criminal justice solutions that have become so prevalent under the war on drugs, and which fall so disproportionately on low-income communities and communities of color.

Even with its challenges, the ACA sets the stage for a new health-oriented policy framework to address problems such as substance use and mental health disorders by more appropriately and effectively casting substance use and mental health disorders as matters of public health and not of criminal justice.

To assist advocates in navigating this new terrain, 

Healthcare Not Handcuffs: Putting the Affordable Care Act to Work for Criminal Justice and Drug Law Reform

 outlines some of the major provisions of the ACA immediately relevant to criminal justice and drug policy reform and explores specific applications of those provisions, including program and policy examples and suggested action steps.

Healthcare, not handcuffs: Putting the Affordable Care Act to work for criminal justice and drug policy reform

The report shows clearly that the stigma and discrimination underpinning repressive drug policy is part of a wider project of social spoiling or stigmatization directed at the marginalization and demonization of other communities including LGBTQ people and sex workers.

The report concludes by calling for sex workers, people who use drugs, and other similarly marginalized communities to engage in “parallel battles for autonomy and empowerment in the face of crosscutting social exclusion, control, stigmatisation, and an undermining of agency and self-determination, battles against the same modes of silencing, pathologisation, and disempowerment.”

The harms of drug use: Criminalisation, misinformation and stigma

This is the first issue of Drugs – Policies and Practices. Healthy Options Project Skopje (HOPS) put together this magazine quite quickly, but we went a long way until it materialized. The authors of the articles are people who have been working on drug related issues for a long time and are very well informed about both the situation in Macedonia, and about global trends and currencies. Their knowledge is supported by their long-term experience and hands-on work and contacts with people who use drugs, and also by their participation in initiatives related to the creation of a more humane drug policy and treatment for drug dependent persons. Of course, this magazine presents the experiences, opinions and needs of people who use drugs, also.

This magazine aims to serve as an incentive to widen the debate and produce more responsible actions towards the implementation of policies and practices for a humane treatment of people who use drugs, and at the same time will serve as a source of knowledge and information regarding drug related topics.

HOPS Magazine - Treating drug dependencies

Drug trafficking is not a new phenomenon in the Argentinian city of Rosario. Since the 1990s, and largely under the public radar, the distribution of illicit drugs in the poor, peripheral neighbourhoods of the city has been managed by family-run gangs and small-time dealers; poverty and social marginalisation have facilitated the trade; young gang members, known as

, have fought over territory; local demand for illegal drugs has provided the engine; illicit profits have been laundered in collaboration with local lawyers and financial advisors; and corruption among the police and local officials has ensured that the main traffickers, while their identities are widely known, can operate with few concerns other than threats from rivals. This last element appears to explain why, until the issue was forced into the public domain, there had been a conspicuous lack of political concern with drug trafficking in the city.

The change came on New Year’s Day 2012. That day, three community activists were shot and killed in the Villa Moreno neighbourhood by gang members who mistook them for rivals. The killings were not unique, but the victims were: unlike the usual casualties, the activists had a movement behind them. Their deaths led to local demonstrations and calls for action. The press and local officials were suddenly impelled to pay attention to drug trafficking and related violence. Since then, a spate of official investigations has deepened public understanding of the nature of the drug trade in the city. They have also provided further evidence of the complicity of the security forces and the negligence of the state that have long been known to facilitate trafficking.

Maintain the focus on the leadership of the most powerful and violent gangs, including following the money trail, and reverse the trend where simply increasing the number of security forces in violent areas is considered a sufficient policy response.

Re-focus the judiciary away from a two-tiered approach: recognize underage gang members as a vulnerable population, and that confronting the culture of violence will require special initiatives.

Root out corruption in the local and provincial security forces, recognise the way the state's approach facilitates this complicity, and produce more reliable statistics to better inform policymakers.

Eyes wide shut: Corruption and drug-related violence in Rosario

India has a long history of opium and cannabis use, especially for medicinal, religious and recreational reasons. State regulation and community tolerance ceased after the enactment of the Narcotic Drugs and Psychotropic Substances Act (NDPS) in 1985, which created a restrictive regime around drugs. Clampdown on cannabis and opium in the late 1980‟s purportedly triggered more dangerous use – chasing and injecting heroin and other opioids.

The NDPS Act, 1985 is one of the harshest laws in the country. It prohibits cultivation, production, possession, sale, purchase, trade, use and consumption of narcotic drugs and psychotropic substances except for medical and scientific purposes under license. The Act has been amended twice; in 1989 and 2001. The first amendments in 1989 leaned towards greater stringency by introducing mandatory minimum sentences of 10 years, restrictions on bail and mandatory capital punishment for repeat offenders. Following the amendments, persons caught with small amounts of drugs faced long prison sentences, without the possibility of release on bail. Courts criticized the harsh and disproportionate sentencing structure, which led to a fresh set of reforms in 2001 to rationalize punishment on the basis of whether the quantity of drugs involved is ‘small’, ‘commercial’ or ‘intermediate’ and provide some leniency towards drug offenders who also use drugs.

The narcotic drugs and psychotropic substances act: Ignoring health, infringing rights

How can we encourage activism for the improvement of the quality of addiction treatment programmes among the most stigmatised group of citizens in Macedonia?

How can institutions be made to accept that people using drugs can be constructive participants in the process of improving the quality of drug addiction treatment programmes? How can drug policies be freed from ideological models of thinking and adapt to current trends and the needs of those concerned the most? According to the literature describing community monitoring and advocacy available on the internet, an impression is formed that disenfranchised communities should have the necessary motivation and capacity to independently mobilise themselves and jointly fight issues of common interest, but it is hard to bring this ideal model into reality in
which, evidently, wider social and political factors should be taken in consideration.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert

Community monitoring and advocacy in highly stigmatising circumstances: Eliminating institutional barriers for the improvement of quality of drug addiction treatment programmes in Macedonia

The European Association for Palliative Care (EAPC), the International Association for Palliative Care (IAHPC), the Worldwide Palliative Care Alliance (WPCA) and the Human Rights Watch (HRW) are working together to advocate for access to palliative care as human right.

Access to palliative care is a legal obligation, as acknowledged by the United Nations conventions, and has been advocated as a human right by international associations, based on the right to the highest attainable standard of physical and mental health.

Publications from IDPC Members