World AIDS Day: Punitive Drug Laws, Policing Practices Impede HIV/AIDS Response

Governments worldwide should take urgent action to reform punitive
drug laws, disproportionate penalties, and harsh and discriminatory law
enforcement practices as part of their efforts to address HIV among
people who use drugs, Human Rights Watch and the International Harm
Reduction Association said today, World AIDS Day. Current policies also
cause needless suffering among people living with HIV/AIDS, the two
groups said in a joint briefing note released today.

"The 'war on drugs' is fueling HIV epidemics among people who use
drugs around the world, and condemning millions of people with terminal
cancer and with HIV/AIDS to needless suffering," said Professor Gerry
Stimson, Executive Director of the International Harm Reduction
Association.

In many countries, drug control efforts block lifesaving HIV
services to people who use drugs, even where they are legal, Human
Rights Watch and the International Harm Reduction Association said.
Overly strict, complex drug laws and regulations block access to cheap,
effective pain medications, like morphine, relegating hundreds of
thousands of people living with HIV/AIDS, and millions with terminal
cancer, to suffer severe pain.

Outside of sub-Saharan Africa, as many as 30 percent of all new HIV
infections occur among people who inject drugs and within sub-Saharan
Africa, injection drug use is increasing. In some countries, in
particular in Central and Eastern Europe and East Asia, injecting drug
use is the primary driver of HIV epidemics.

International health and drug control agencies - including the UN
Office on Drugs and Crime, UNAIDS, UNICEF, the United Nations
Development Program, and the World Health Organization - all endorse
comprehensive harm reduction services as the best ways to address HIV
among people who use drugs, including those in detention. These
services include needle and syringe exchange, medication-assisted
therapy (for example, with methadone), and peer outreach and education
programs. Notwithstanding broad endorsement and overwhelming scientific
evidence that these approaches work, they are out of reach for the vast
majority of people who need them.

In the joint briefing note, Human Rights Watch and the
International Harm Reduction Association also expressed concern that
criminal laws, disproportionate penalties, and law enforcement
practices drive people away from lifesaving HIV services that do exist,
and impede access to pain treatment for tens of millions of people who
need it. Some laws concerning the possession and use of drugs, and the
possession of drug paraphernalia, can keep many people who use drugs
from carrying sterile syringes or other injecting equipment, even where
it is legal to do so, and cause them to avoid drug treatment or harm
reduction services altogether out of fear of arrest and conviction.

Laws creating criminal penalties for incitement to use drugs or
facilitating/encouraging drug use likewise interfere with peer outreach
services. The pressure on police officers to meet arrest quotas as a
measure of success exacerbates police abuse of drug users by
encouraging them to seek out easy targets, like drug users, for arrest.

In some countries, people who are identified as, or suspected to be,
drug users are detained, sometimes for years, in locked facilities for
"drug treatment," regardless of whether they need treatment and without
due process of law. Basic medical services are often unavailable, and
"treatment" often consists of forced, unpaid labor, and in some cases,
physical and psychological abuse. The impact of drug control is often
disproportionately focused on vulnerable groups and marginalized
communities, such as African Americans in the United States.

Human Rights Watch and the International Harm Reduction
Association also expressed concern that laws concerning drugs and
syringe possession, together with associated policing practices
targeting people who use drugs, may increase HIV risk. The
organizations called for greater discussion among governments and
relevant United Nations agencies on these issues.
"Of course these are complex and controversial issues," Rebecca
Schleifer, advocacy director of Human Rights Watch's Health and Human
Rights Division said. "But we must have the courage to discuss them
openly if we are to fully understand what is needed to halt and begin
to reverse drug-related HIV/AIDS."