Health of people with HIV who use drugs cannot improve without acknowledging their human rights
The a new paper in The Lancet Series on HIV in people who use drugs says a review of evidence shows that there is widespread abuse of human rights in people who use drugs, which increases risk of HIV infection and adversely affects delivery of HIV programmes. The paper is by Dr Ralf Jürgens, Consultant on HIV/AIDS, Health, Policy, and Human Rights, Mille-Isles, Quebec, Canada, and colleagues.
The authors say these abuses can take the form of denial of harm-reduction services, discriminatory access to antiretroviral treatment (ART), abusive law enforcement practices, and coercion in the guise of treatment for drug dependence. Women and young people who use drugs face further, additional abuses. They add that the rights of people with HIV, and who use drugs, or are in prison—or any combination of these— must be respected as for any other person, not only because that is their right, but because it is also essential to improve their health. Rights-based responses to HIV and drug use have had good results where they have been implemented. Examples include providing legal services to people who use drugs in Ukraine or meaningfully involving people who use drugs in development, implementation, and monitoring and evaluation of policies and services. The authors call for other countries to try to replicate these successes.
The authors say: "The right to health requires that all countries have an effective, national, comprehensive harm reduction policy and plan, delivering essential services. High-income countries are expected to provide more than the essential services," adding that "Joining human rights law with public health evidence should help shift global responses to drug control away from the failed emphasis on prohibition to a more rational, health-promotion framework that is both pragmatic and principled."
The authors point out that reform of international drug policy and policy making processes is needed. They refer to the so called 'parallel universes' of United Nations (UN) human rights mechanisms and UN drug control mechanisms, stating that the human rights of people who use drugs do not feature prominently in either. The authors say: "The welcome recognition by UN Special Rapporteurs and the UN High Commissioner for Human Rights of the vulnerability of people who use drugs to a wide range of human rights violations should move debates forward."
They conclude: "In 2009, the UN Office on Drugs and Crime called for global attention to the right to health of people dependent on drugs and urged that law enforcement should shift its focus from people who use drugs to drug traffickers. If UN Resources were directed to building country capacity for action in these areas, the so-called parallel universes might be nudged to intersect around the human rights of people who use drugs."
