The World Needs a Healthier, Rights-based Approach Towards People Who Use Drugs

The world is failing to protect the health and human rights of people who use drugs.

As a result, people who use drugs, especially people who inject drugs, have been isolated and denied the means to protect themselves from HIV, hepatitis C, tuberculosis and other infectious diseases.

Among the estimated 12 million people who inject drugs globally, one in 10 is living with HIV. From 2010 to 2014, there was no decline in the annual number of new HIV infections among people who inject drugs, in contrast to the global trend of declining new HIV infections.

The evidence is overwhelming. The world needs a fresh approach towards people who use drugs that is people-, rights- and health-centered.

In a new report, Do no harm: health, human rights and people who use drugs, UNAIDS presents the evidence for what works to reduce the impact of HIV and other harms associated with drug use. Countries that have shifted their focus away from laws and policies that are harmful to people who use drugs and that have increased investment in harm reduction programs have reduced new HIV infections and improved health outcomes.

For example, investment in needle-syringe distribution and opioid substitution therapy has proved effective at reducing the impact of the AIDS epidemic among people who inject drugs in several countries, including China, the Islamic Republic of Iran and the Republic of Moldova.

China's free voluntary methadone program piloted in the early 2000s now serves more than 180 000 people. People who inject drugs represented less than 8% of people newly diagnosed with HIV in the country in 2013, compared with 43.9% in 2003. In prisons in the Islamic Republic of Iran, health clinics provide integrated services for the treatment and prevention of sexually transmitted infections and for injecting drug use and HIV, and new HIV cases among people who inject drugs fell from a peak of 1897 in 2005 to 684 in 2013. In the Republic of Moldova, the proportion of prisoners living with HIV having access to antiretroviral medicines has increased from 2% in 2005 to 62% in 2013.

Some countries, such as Australia, the Netherlands, Portugal and Switzerland, have de-penalized the possession and use of small quantities of drugs for personal use, encouraging people who inject drugs to access strengthened harm reduction programs.

UNAIDS would like to see a global adoption of a people-centered, public health and human rights based approach to drug use.

The world cannot continue to ignore what works.

In the coming weeks, the United Nations General Assembly will have two opportunities to consider the weight of evidence supporting a change in approach. This week's United Nations General Assembly Special Session on the World Drug Problem provides an opportunity to refocus international drug policies on their original goal--the health and well-being of humankind. A few weeks later, from 8 to 10 June, the General Assembly will meet again for the High-Level Meeting on Ending AIDS, which must translate commitments to leave no one behind in the AIDS response into measurable progress for people who inject drugs.

There is a unique opportunity to begin to treat people who use drugs with dignity and respect, to provide people who use drugs with equal access to health and social services, to greatly reduce the harms of drug use and to take a step towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.