Halving HIV transmission among people who inject drugs – Background note (UNAIDS/PCB (35)/14.27)

29. Criminalization of drug use and possession has been found to lead to an increased risk of illness among people who use drugs. Higher rates of legal repression have been associated with higher HIV prevalence among people who use injecting drugs, without a decrease in prevalence of injecting drug use. This is a likely result of individuals’ adopting riskier injection practices such as sharing of needles and syringes and other injection equipment, hurried injecting, or use of drugs in unsafe places for fear of arrest or punishment.

30. Although the first two preambular paragraphs of the Single Convention on Narcotic Drugs 1961, which is still the international treaty that guides drug control, state that Member States are “Concerned with the health and welfare of mankind” and “that the medical use of narcotic drugs continues to be the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for such purposes”, the third and fourth paragraphs describe drug addiction as a “serious evil” and commits to countering such “evil”. Many countries have focused on countering the “evil” and have developed drug control policies that focus not on the drugs themselves, but on those who use drugs.

31. Policies and legislation based on prohibition, criminalization and punishment have not been found to achieve their aims in reduction of drug use. At a time where a number of countries are implementing strong anti-drugs policies, an estimated 183,000 drug related deaths nevertheless occurred in 2012. ‘ People undertaking ‘High- risk’ drug use were estimated at about 27 million, roughly 0.6 per cent of the world’s adult population, or 1 in every 200 people…

32. Stating that the ‘War on Drugs’ has failed, the Global Commission on Drug Policy emphasizes alternative approaches to drug policies that work including: putting people’s health and safety first; ensuring access to essential medicines and pain control; ending the criminalization and incarceration of people who use drugs; and targeted prevention, harm reduction and treatment strategies for dependent users. As the Commission point out “there is growing support for more flexible interpretations and reform of the international drug control conventions aligned with human rights and harm reduction principles.”

63. The 2016 UNGASS on the World Drug Problem will be an opportunity to incorporate lessons learned in the AIDS response into the analysis of the response to the global drug problem and to ensure ending AIDS is well reflected in any resulting UNGASS goals and targets. This is predicated on a comprehensive and critical review of current international drug conventions based on prohibition and the criminalization of drug use and drug users. In this regard it is notable that the WHO’s 2013 Consolidated Guidelines recommends the review of laws, policies and practices including current criminalization of injecting and other use of drugs, citing the example of Portugal where decriminalization has led to an increase in people accessing treatment, a fall in HIV cases among people who inject drugs, reductions in drug use and less overcrowding within the criminal justice system.