Global Commission Calls for Drug Decriminalization and Expansion of Proven, Cost-Effective Solutions to Reduce HIV/AIDS – Including Sterile Syringe Access, Safer Injection Facilities, and Prescription Heroin Programs
While Some Countries Have Virtually Eliminated Drug-Related HIV Transmissions, Drug War Policies in U.S., Russia, Thailand and China Cause Millions of Needless Infections and AIDS Deaths
Today, the Global Commission on Drug Policy will release a groundbreaking report at a press conference in London followed by a worldwide teleconference. The report condemns the drug war as a failure and recommends immediate, major reforms of the global drug prohibition regime to halt the spread of HIV infection and other drug war harms.
The report is being released in advance of the International AIDS Conference, the world’s largest gathering of HIV/AIDS experts. It will be held in the U. S. for the first time in 22 years this July 22-27, in Washington DC.
The global war on drugs is driving the HIV pandemic among people who use drugs and their sexual partners. Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated. Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic. Today, there are an estimated 33 million people worldwide living with HIV – and injection drug use accounts for one-third of new HIV infections outside of sub-Saharan Africa.
The report describes the remarkable failure of drug law enforcement policies in reducing global drug supply, noting that the worldwide supply of illicit opiates, such as heroin, has increased by more than 380 percent in recent decades. The Commissioners also stress the drug war’s contribution to the growth of organized crime and violence, and urge countries that under-utilize proven addiction treatment and public health measures to immediately scale up evidence-based strategies to reduce HIV infection and protect community health and safety. These measures include sterile syringe distribution, safer injecting facilities, and prescription heroin programs. “Failure to take these steps is criminal,” the Commissioners state.
The report also depicts how the fight against HIV is being won in countries where addiction is treated as a health issue. In Australia and European countries such as Portugal and Switzerland, newly diagnosed HIV infections have been nearly eliminated among people who use drugs, just as vertical transmission of HIV has been eliminated in countries where broad access to prevention of mother-to-child transmission of the virus is available. However, a number of specific countries, including the U.S., China, Russia and Thailand, have ignored scientific evidence and resisted the implementation of evidence-based HIV prevention programs – with devastating consequences. In Russia, for example, approximately one in one hundred adults is now infected with HIV. In the United States, Congress recently re-instated a longstanding ban on the use of federal funds for syringe exchange programs.
This is the second report published by the Global Commission. Its first report, released in June 2011, generated unprecedented media coverage and catalyzed international debate about the urgent need for fundamental reforms of the global drug prohibition regime. The Global Commission is the most distinguished group of high-level leaders to ever call for such far-reaching changes – including alternatives to incarceration, greater emphasis on public health approaches to drug use, decriminalization, and experiments in legal regulation.
The Commission’s recommendations are summarized here. They include:
- Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.
- Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.
- Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.
- Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.
How the drug war fuels the HIV pandemic:
- Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.
- Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.
- Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.
- Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.
- Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.
- Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.