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The 67th UN CND—upholding human rights in drug policy

2024; Elsevier BV; Volume: 403; Issue: 10439 Linguagem: Inglês

10.1016/s0140-6736(24)00763-3

1474-547X

Ahsan Maqbool Ahmad, Adeeba Kamarulzaman, Michel D. Kazatchkine, Ruth Dreifuss, Helen Clark,

Opioid Use Disorder Treatment

Addressing the harms associated with drug use, illicit transnational drug trade, and the policies tied to them is one of the greatest policy challenges of our time—with intersectionalities to health, economics, and security. Restrictive interpretations by many Member States of the International Drug Control Conventions over the last 60 years have led to mass incarceration, lack of due process and fair trial, disproportionate sentencing, corporal punishment, ineffective compulsory drug treatment centres, extra-judicial killings, and iniquitous death penalty. Where policies are not blatantly violating human rights, they often facilitate future infringements. Worldwide, more than 30 countries and 50 jurisdictions have taken bold actions rooted in science and adopted some form of decriminalisation of drug possession for personal use.1Office of the United Nations High Commissioner for Human RightsAligning drug policies with human rights.https://www.ohchr.org/en/statements/2022/06/aligning-drug-policies-human-rightsDate: 2022Date accessed: May 2, 2024Google Scholar At the 2024 midterm review of the 2019 Ministerial Declaration, during the 67th session of the Commission on Narcotic Drugs (CND), a coalition of more than 60 countries led by Colombia called for the complete reform of the international drug control system. The 67th session also included the adoption of a historical resolution explicitly recognising harm reduction—representing political commitment towards a public health-oriented drug policy.2Joint United Nations Programme on HIV/AIDSUNAIDS welcomes the adoption of a crucial resolution recognizing harm reduction measures at the UN Commission on Narcotic Drugs.https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2024/march/20240322_harm-reductionDate accessed: March 22, 2024Google Scholar Speaking at the CND, the UN High Commissioner for Human Rights, Volker Türk, urged that global drug policy be rooted in human rights and aligned with the Sustainable Development Goals.3Office of the High Commissioner of Human Rights (OHCHR)Human rights challenges in addressing and countering all aspects of the world drug problem.https://www.ohchr.org/en/calls-for-input/2023/call-inputs-ohchrs-report-human-rights-challenges-addressing-and-counteringDate accessed: March 2, 2024Google Scholar The data speak for themselves: securitised approaches to drug policy have only exacerbated the health burden on people who use drugs, violating their human rights.4Beyrer C Kamarulzaman A Isbell M et al.Under threat: the International AIDS Society–Lancet Commission on health and human rights.Lancet. 2024; 403: 1374-1418Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar People who use drugs are disproportionately represented in the criminal justice system. Among people who inject drugs, 42% have faced arrest and 29% have been subjected to incarceration. This relationship substantially contributes to the issue of prison overcrowding, consequently posing a heightened risk of infectious disease transmission in people deprived of liberty and correctional facility staff.5Global Commission on Drug PolicyHIV, hepatitis and drug policy reform.https://www.globalcommissionondrugs.org/wp-content/uploads/2023/11/GCDP_Report2023_forweb.pdfDate accessed: March 19, 2024Google Scholar, 6Degenhardt L Webb P Colledge-Frisby S et al.Epidemiology of injecting drug use, prevalence of injecting-related harm, and exposure to behavioural and environmental risks among people who inject drugs: a systematic review.Lancet Glob Health. 2023; 11: e659-e672Summary Full Text Full Text PDF PubMed Scopus (34) Google Scholar For example, more than 60% of people incarcerated in Malaysian prisons are charged with minor drug offences, and high prevalence rates have been reported for active TB (7%), latent TB (80%), HIV (6–15%), hepatitis C infection (60–70%) and substance use disorders, with limited access to prevention, harm reduction and treatment services.7Bazazi AR Wickersham JA Wegman MP et al.Design and implementation of a factorial randomized controlled trial of methadone maintenance therapy and an evidence-based behavioral intervention for incarcerated people living with HIV and opioid dependence in Malaysia.Contemp Clin Trials. 2017; 59: 1-12Crossref PubMed Scopus (0) Google Scholar Additionally, the use of the death penalty for drug-related offences has reached alarming levels, accounting for roughly 42% of global executions in 2023, with 34 countries retaining the death penalty.8Harm Reduction InternationalThe Death Penalty for Drug Offences: Global Overview.https://hri.global/wp-content/uploads/2024/03/HRI-GO2023-finalfinal-WEB.pdfDate: 2023Date accessed: March 20, 2024Google Scholar However, there have been glimpses of progress. For example, in 2023, Pakistan was the first country in a decade to abolish the death penalty for drug-related offences, and Malaysia abolished the mandatory death penalty devolving full judicial discretion to the courts.8Harm Reduction InternationalThe Death Penalty for Drug Offences: Global Overview.https://hri.global/wp-content/uploads/2024/03/HRI-GO2023-finalfinal-WEB.pdfDate: 2023Date accessed: March 20, 2024Google Scholar Although these wins are substantial, much still needs to be done. With the rising death toll from synthetic drugs, governments need to take life-saving actions, primarily by reassessing policies to uphold human rights. As the global paradigm shifts in favour of an evidence-driven, human rights-based approach to drug policy, this momentum needs to be capitalised on. The Global Commission on Drug Policy, alongside multisector stakeholders across the globe, stands ready to support and guide the way. We declare no competing interests.