Am Johal
VANCOUVER, Canada, Oct 3 2007 (IPS) – For more than two decades, the Vienna-based International Narcotics Control Board (INCB) has tried to discourage nations from developing harm reduction programmes and other HIV/AIDS prevention programmes.
Insite safe injection and health centre in Vancouver, Canada. Credit: Vancouver Coastal Health
Civil society critics have argued that the position of the INCB is built upon a fundamental misunderstanding of drug addiction viewing it purely as a criminal justice issue rather than also a health and human rights issue requiring medical intervention and access to health care.
The idea behind harm reduction is a scientifically verified medical intervention that focuses on dealing with drug addicts where they are at, rather than focusing solely on an abstinence-based approach. The goal is to reduce both the negative impacts to the individual and to the broader community.
For example, needle exchange programmes were initiated in North America and Europe to reduce the spread of infectious diseases by reducing needle sharing by drug addicts.
Soon after, civil society advocates coined the phrase, Dead people don #39t detox.
The International Narcotics Control Board (INCB), according to its own website, is the independent and quasi-judicial monitoring body for the implementation of the United Nations international drug control conventions. It was established in 1968 in accordance with the Single Convention on Narcotic Drugs, 1961. It had predecessors under the former drug control treaties as far back as the time of the League of Nations.
Related IPS Articles
The INCB position regarding harm reduction seems to contradict the position of U.N. agencies like UNAIDS, the World Health Organisation and even certain human rights conventions, according to civil society critics.
In 2002, the INCB asked the Legal Affairs section of the U.N. International Drug Control Programme to review whether harm reduction interventions were in compliance with U.N. drug conventions. The review supported harm reduction measures since they alleviated health and social problems and also argued in support of supervised injection facilities as viable health interventions.
The authors wrote, It would be difficult to assert that, in establishing drug-injection rooms, it is the intent of Parties [states] to actually incite or induce the illicit use of drugs, or even more so, to associate with, aid, abet or facilitate the possession of drugs. On the contrary, it seems clear that in such cases the intervention of governments is to provide healthier conditions for IV drug abusers, thereby reducing their risk of injection with grave transmittable diseases and, at least in some cases, reaching out to them with counseling and other therapeutic options.
Albeit how insufficient this may look from a demand reduction point of view, it would still fall far from the intent of committing an offence as foreseen in the 1988 Convention, they concluded.
In March 2007, the INCB made public statements which were widely covered by Canadian media against Insite, North America #39s only supervised injection located in Vancouver #39s Downtown Eastside neighbourhood.
The site was set up after the mounting problem of HIV/AIDS and overdose deaths led to a public health advisory from Health Canada in 1997. The site opened in 2002 and received a three-year exemption to operate from the federal government. This week, authorities granted another six-month extension, but it is unclear what will happen to the site when that expires on Jun. 30.
At Insite, nurses provide clean syringes and watch out for overdoses. Injection drug users bring their own drugs, and can access referrals to drug detox and rehabilitation services if they choose.
Insite presently has over 800 users a day and has, according to 20 peer-reviewed academic studies, reduced public drug use, reduced dangerous syringe sharing, reduced HIV/AIDS and reduced publicly discarded syringes. Overdose deaths have also decreased in the four-and-a-half years it has been in operation.
The opening ceremonies for the 2010 Olympic Games will take place only a short 10- minute walk from its present location in Vancouver #39s Downtown Eastside neighbourhood, making this issue a political lightning rod.
In March, Zhu Li-Qin, chief of the Convention Evaluation Section of the INCB, criticised the Canadian government for encouraging illicit trafficking by allowing the supervised facility to operate legally.
The INCB has been heavily linked to the United States #39s hardline drug policy, which does not recognise the viability of harm reduction programmes beyond clean needle distribution. The intervention of the INCB in the harm reduction debate in a number of nations has also led to increased criticism from some high-profile civil society organisations.
A report released in February 2007 by the Canadian HIV/AIDS Legal Network and the Open Society Institute #39s Public Health Programme titled Closed to Reason: The International Narcotics Control Board and HIV/AIDS states in the introduction, The United Nations system as a whole is committed to reducing HIV among people who inject drugs, to safeguarding the human rights of people who use drugs, and to increasing accountability and civil society involvement. In this context, the INCB is an anomaly: a closed body, accountable to no one, that focuses on drug control at the expense of public health and that urges national governments to do the same.
The report also stated that the INCB Board attempted to silence Stephen Lewis, the U.N. secretary-general #39s special envoy for HIV/AIDS in Africa, after he spoke favourably about the Canadian data which showed that the facility had reduced HIV risk at the International Conference on the Reduction of Drug Related Harm in 2006.
The day after his speech, according to the report, Lewis received an angry telephone call from the INCB Secretariat and a promise that the Board would write a letter to the Secretary-General to urge that Lewis be censured for support of #39opium dens #39.
The Canadian HIV/AIDS Legal Network #39s then executive director, Joanne Csete, released a statement along with the report in February stating, Nearly one in three HIV infections outside Africa is among people who inject drugs. The International Narcotics Control Board could and should be playing a key role in stopping this injection-driven HIV epidemic but it #39s not.
INCB Board meetings are also closed to the public and no minutes are available. Critics have argued that none of the members of the INCB have expertise in health, international law or human rights.
The current executive director of the HIV/AIDS Legal Network, Richard Elliot, told IPS, The concern with the INCB is that it is failing to do what it should be doing. It is obstructionist when governments attempt to implement policies which are proven to work and reduce harms.
It fails to discharge its policies and even places barriers on states which make substitutes such as methadone available. It is unbalanced and focuses on drug control and refuses to follow evidence-based approaches. It is part of the problem rather than the solution. It is choosing to prescribe failed policies rather than seriously consider health and human rights approaches that have proven to be medically effective.
Several calls to the INCB were not returned.
Supervised injection facilities currently operate in Switzerland, Germany, the Netherlands, Australia, Spain, Norway, Canada and Luxembourg. Britain and Portugal are considering them seriously.
*Am Johal is a supporter of the Friends of Insite Campaign.
