本报告中，国际药品政策联合会（IDPC）根据实证和良 好实践案例提出亚洲关于毒品使用政策的改革建议，即 将刑事定罪和惩罚向公共卫生和减低伤害的方向转变。 报告描述了对毒品使用去罪化的有效途径。报告也探讨 了在亚洲实施的被证实无效的一些方法，如将毒品使用 者拘留在强制中心进行“康复”

本报告旨在为亚洲的政策制定者、立法者、毒品使用者 社群和公民社会组织提供资源。报告的整体目标是提供 让毒品使用者从刑事定罪和惩罚中脱离的步骤指南，使 各国可据此制定毒品政策以达到更好的公共卫生成果。 报告也描述了那些不太有效的毒品政策，如将毒品使用 者拘留在强制拘留中心，强迫尿检、强制登记和其他惩 罚性措施。

随时掌握与药物政策发展相关的最新信息。

解决亚洲地区毒品使用问题的公共卫生方法： 去罪化的原则与实践

The Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Hepatitis C (HCV) – are a major health concern in prisons, evidenced by the fact that prevalence rates tend to be substantially higher among prison populations than in the general population.

Prisons and other places of detention are high-risk environments for the transmission of these diseases. This is related to the over-incarceration of vulnerable and disadvantaged groups who carry a disproportionately high burden of disease and ill-health; the criminalisation of drug users and high levels of injecting drug use; overcrowded and substandard prison conditions; inadequate health care; and the denial of harm reduction services.

Several international, regional and national human rights mechanisms are in place to monitor and inspect prison conditions in order to prevent torture and ill-treatment – including the Subcommittee on the Prevention of Torture (SPT), under the Optional Protocol to the UN Convention against Torture (OPCAT), with National Preventive Mechanisms (NPMs), as well as within the Committee for the Prevention of Torture (CPT) of the Council of Europe, and national bodies in a number of European countries.

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

Improving prison conditions by strengthening the monitoring of HIV, HCV, TB and harm reduction

AYOTZINAPA. TLATLAYA. SAN FERNANDO. These places in Mexico are known for the atrocities committed there—they are perhaps the best known of the country’s open wounds. But there are many others, perhaps less well known, such as Ojinaga, Allende, and Apatzingán. Nine years after the Mexican government first deployed federal armed forces to combat organized crime, civilians continue to suffer: killings, disappearances, and torture are carried out both by cartels and by the federal and state forces who are supposedly fighting them. From December 2006 through the end of 2015, over 150,000 people were intentionally killed in Mexico. Countless thousands have disappeared.

The Open Society Justice Initiative and five independent Mexican human rights organizations have spent four years examining the extent and nature of this crisis. We have concluded that there is a reasonable basis to believe that both state and non-state actors have committed crimes against humanity in Mexico.

Undeniable atrocities: Confronting crimes against humanity in Mexico

The Mainline annual report offers highlights on the activities and projects of the foundation in 2015.

Mainline Annual Report 2015

There has been huge international interest in the new direction that Portugal has taken in its drug policy since 1999. In that year, a new national drug strategy was adopted. This included a new law that decriminalised the possession of all illicit drugs, which came into force in July 2001 (Lei n.° 30/2000, de 29 de novembro 2000). It also included a broader expansion of public health, prevention and treatment services. The Portuguese approach has recently been described as a ‘model of best practices’ by the President of the International Narcotics Control Board (Sipp, 2015).

This chapter will describe these developments and will provide data that enables some assessment of their effects. It draws on research published in previous articles (Hughes & Stevens, 2010, 2012; Hughes & Stevens, 2007) and more recently published data1. These studies themselves drew on secondary analysis of documents and data produced, as well as interviews with key stakeholders in Portugal in 2007 and 2009. It should be stated at the outset that there remains contestation about some of the outcomes from this reform (for an overview of the two most divergent accounts see Hughes & Stevens, 2012). It is also very difficult to identify whether the patterns in drug use and related problems have been caused by the new strategy, especially as little data is available on the situation prior to 2001. It is even more difficult to identify which parts of the strategy may have led to which particular outcomes. The Portuguese strategy must be seen as an integrated package of measures, rather than attributing any changes observed to decriminalisation alone.

Decriminalisation and public health: the Portuguese approach to drug policy

Drug control policies have left an indelible footprint on human development. In many instances, they have fuelled the poverty, marginalization and exclusion of people and communities linked with illicit drug use or illicit drug markets. They have entrenched and exacerbated systemic discrimination against poor and the most marginalized populations and resulted in widespread human rights violations.

Involvement in drugs — whether its cultivation, production, sale or use — has traditionally been treated as a criminal problem, with the solution found through law enforcement. In recent years, there has been growing recognition that this vision is narrow and counterproductive. There has likewise been growing recognition that the connection between drugs and crime is not so straightforward and that drug control efforts focused on criminal law responses have had harmful ‘unintended’ consequences.

UN Secretary-General Ban Ki-moon has also identified illicit drugs and crime as a “severe impediment” to achieving sustainable development, as well as to securing human rights, justice, security and equality for all (UN, 2012). There has also been increased attention to the multidimensional relationship between drug control and development outcomes and to devastating consequences of drug control efforts on public health, security and development. As various UN organizations have observed, these efforts’ harmful collateral consequences include: creating a criminal black market;

fuelling corruption, violence and instability; threatening public health and safety; generating large-scale human rights abuses, including abusive and inhumane punishments; and discrimination and marginalization of poor and the most marginalized populations, including people who use drugs, indigenous peoples, women and youth (UNDP, 2015; UNODC, 2008; OHCHR, 2014; WHO, 2011; UN Women, 2014; UNAIDS, 2014).

UNODC has recognized the “vicious cycle” of drug production, drug trafficking, poverty and instability, as well as the harmful consequences of drug control policies on the health and human rights of people who use drugs and those who live in communities where drugs are cultivated.

Reflections on drug policy and its impact on human development: Innovative approaches 

Asia and the Pacific is home to the second highest number of people living with HIV after sub-Saharan Africa. Our culturally, politically and economically diverse region has an epidemic that is predominantly concentrated among key populations - men who have sex with men, sex workers, transgender people and people who use drugs - but also impacts heavily on women and girls, migrants, young people and adolescents, people in prisons, indigenous peoples, orphans, vulnerable children, and ageing populations.

In 2011, two UN-ESCAP Resolutions called for regional action to achieve universal access to HIV prevention, treatment, care and support. Underlying these are specific calls for political leadership to amend or remove laws, policies and practices that fuel stigma and discrimination; ensure sufficient investment to sustain the response; address all forms of gender-based violence; and promote access to affordable medicines, diagnostics and vaccines. Resolution 67/9 also named key populations of people who use drugs, sex workers, men who have sex with men and transgender people. In 2013, governments in the region again committed to addressing policy and legal barriers for key affected populations, and furthermore to eliminating discrimination on the basis of sexual orientation and gender identity and scaling up efforts to achieve Universal Access.

Ending AIDS in 2030: Do not leave Asia-Pacific behind.

The Middle East and North Africa region is at the centre of many of the burning issues of our globalized and inter-dependent world. When it comes to drug use, infectious diseases and marginalized populations, however, the debate falls short. While the incidence and prevalence rates of drug injection and of related HIV infections remain low compared to other regions of the world, tough drug policies and discrimination against vulnerable populations remain embedded in the social, economic and cultural contexts of the region.

Drug policy and human rights in the Middle East and North Africa: Harm reduction, legal environment and public health

Cultivation of cannabis for medicinal or scientific purposes needs considered management before it is rolled out as a therapeutic good

Since the publication in the Journal last year of a perspective on cannabis that stated: “Australia is behind the times on the medicinal use of cannabis”, there appears to have been a palpable change in community attitudes around cannabis as medicine. This has occurred alongside anecdotal reports from people with intractable illnesses who have had symptomatic benefit with cannabis. Palliative care specialists have acknowledged a potential role for medicinal cannabis in their specialty. Internationally, the scene is also changing. For example, the Netherlands Office of Medicinal Cannabis enables dispensation through pharmacies after purchase from a contracted company, which also exports to other European countries. In the United States, 23 states and Washington, DC, have legalised marijuana in some form, mostly for medicinal purposes, since June 2015.

In Australia, the New South Wales Government Terminal Illness Cannabis Scheme (TICS), established in 2014, enables compassionate access to adults with a terminal illness. Under TICS, a registered medical practitioner involved in a person’s ongoing care must certify that he or she has a terminal illness as defined by the scheme. In 2015, the New South Wales Government-funded trials of cannabis in palliative care and in children with a specific type of epilepsy, and in Victoria, a cannabidiol study for paediatric epilepsy is also in process.

Medicinal cannabis in Australia: the missing links

Recognizing the urgent need for strong, forward-thinking action, and evidence-informed, rights-based, well-resourced, community-led HIV responses, civil society emphatically call for a more progressive vision in the 

2016 Political Declaration on Ending AIDS

. It is toward this goal that we, the undersigned civil society advocates and organizations, engage with the process of the 

 in good faith and with hope for ending the HIV epidemic by 2020. We seek to align the HIV response to the 2030 Agenda, and were encouraged by the initial (zero) draft of the Political Declaration, and to that end commend the co-facilitators (H.E. Jürg Lauber from Switzerland and H.E. Mwaba Patricia Kasese Bota from Zambia) and recognize the efforts made by many member states to secure a bold and progressive vision and set of commitments.

Civil society and communities declaration to end HIV: Human rights must come first

The current survey has been designed to capture the level of satisfaction of civil society at large on the work done by the Civil Society Task Force (CSTF) in the preparatory process of and during the United Nations General Assembly Special Session (UNGASS) and its impact in it. We are also interested in your opinion about the future and the role the CSTF could eventually play in view of 2019, i.e. the final review of the 2009 Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem.

The estimated time to complete the survey is 10 minutes.

Evaluation Survey - Civil Society Task Force for UNGASS 2016

The below text is a response from Keith Scott, medical pratictioner and civil society collegue:

In its three previous declarations on HIV, the General Assembly has repeatedly and unanimously reaffirmed that “the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV epidemic, including in the areas of prevention, treatment, care and support.” The UNAIDS Reference Group on HIV and Human Rights therefore offers a number of human rights-oriented recommendations to Member States for the 2016 Political Declaration, under three broad headings:

§ removing punitive laws, policies and practices, particularly those targeting key populations, and instead creating a more enabling environment through protective laws, policies and practices;
§ accelerating universal access to treatment; and
§ scaling up the human rights programs that are essential to an effective response to HIV.

In the enclosed brief, the UNAIDS Reference Group on HIV and Human Rights explains why each of these areas of human rights concern requires attention, and sets out, in the Annex, specific proposed language for inclusion in the Political Declaration.

This is a key moment in the HIV response. Extraordinary progress has been made in responding to one of the world’s worst public health crises – and the international community has unanimously agreed on “ending AIDS by 2030” as one of the Sustainable Development Goals. But the crisis of both HIV prevention and treatment continue, with millions of new infections each year and less than half of those in need of life-saving antiretroviral medication receiving it. It is simply not possible to achieve “the end of AIDS” without a political and financial commitment to rapidly scaling up the response to meet ambitious HIV prevention and treatment targets, and, to that end, without taking action to protect and promote human rights, particularly the rights of the populations and communities most heavily affected by the epidemic. Efforts to “fast-track” the end of AIDS through the achievement of ambitious HIV prevention targets, or of the “90-90-90” treatment targets, will not succeed without attention to the structural factors continuing to drive new infections or impeding access to medicines.

The human rights approach has brought great success and saved millions of lives. Now is not the time for national governments, donors or the United Nations to back away from the fundamental principles of human rights. We all want to achieve the end of AIDS, but in speaking of an end, we must speak boldly and honestly not only of the successes of the HIV response, but also of the failures—including the ongoing human rights failures—because both successes and failures offer key lessons to galvanize future commitment and action, not only to end AIDS eventually but also to transform and advance global health more broadly, in keeping with the Sustainable Development Goals. Otherwise, we risk falsely declaring “the end of AIDS” while the epidemic becomes another disease of those who are poor and marginalized.

About the UNAIDS Reference Group on HIV & Human Rights
The Reference Group was established in 2002 to advise UNAIDS on all matters relating to HIV and human rights. The membership of the Reference Group brings together people from the HIV and human rights community, including advocates, jurists, ethicists, people living with HIV, people working in the NGO and community sector, people working in the government sector, and academics. The Reference Group speaks with an independent voice. Thus, its views do not necessarily reflect the views of the UNAIDS Secretariat or any of the UNAIDS Cosponsors. The Reference Group advises UNAIDS on how it can strengthen the capacity of governments, civil society and the private sector to protect and promote human rights in relation to HIV, and how it can best operationalize human rights and GIPA (Greater Involvement of People Living with HIV) principles in UNAIDS’ policies and technical support.

Publications

解决亚洲地区毒品使用问题的公共卫生方法：去罪化的原则与实践