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WHO estimates that 71 million people worldwide were chronically infected with hepatitis C virus (HCV) in 2017. Globally, 23% of new HCV infections and one in three HCV deaths are attributable to injecting drug use (PWID). HCV is also a major concern for people detained in prisons and other closed settings – available data demonstrate that one in four detainees are HCV positive.
This policy brief highlights the current landscape of country hepatitis policies for harm reduction and HCV testing and treatment in PWID and people in prisons. It aims to capture how governments are translating the WHO Global health sector strategy on viral hepatitis, 2016-2021 into national plans, and provides a summary of the enablers and barriers to HCV testing and treatment in these populations.
In 2017, key populations (KP) and their sexual partners accounted for approximately 40% of new HIV infections globally (UNAIDS, 2018). A range of policy and legal barriers and harmful social dynamics increase the HIV vulnerability of KP and undermine their access to HIV and other services. The criminalization of sex between men, sex work, drug use and HIV transmission, as well as high rates of incarceration, homophobia, trans phobia, violence and social marginalization, all serve to influence risk practices and undermine access to services. People from key populations often migrate to cities in search of safer and more secure communities (UNAIDS, UN Habitat 2015). Women in key populations face specific challenges and barriers, including gender-based violence (GBV) and poorly tailored services. These factors further intensify their vulnerability to HIV.
The new UNAIDS report, Health, rights and drugs: harm reduction, decriminalization and zero discrimination for people who use drugs, shows that of the 10.6 million people who inject drugs in 2016, more than half were living with hepatitis C and one in eight were living with HIV. It outlines that ensuring that comprehensive harm reduction services are available—including needle–syringe programmes, drug dependence treatment and HIV testing and treatment—will kick-start progress on stopping new HIV infections among people who use drugs.
Almost a decade ago, the international community agreed upon a Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem. The Declaration included the decision to establish 2019 as the target date for the goals set within it, specifically for states to ‘eliminate or reduce significantly and measurably’ the illicit cultivation, production, trafficking and use of internationally controlled substances, the diversion of precursors and money laundering.
Drug control intersects with much of the 2030 Agenda for Sustainable Development and the UN Member State pledge to leave no one behind. In line with the 2030 Agenda, the UNDP Strategic Plan 2018-2021 and the HIV, Health and Development Strategy 2016-2021: Connecting the Dots, the International Guidelines on Human Rights and Drug Policy provide a comprehensive set of international legal standards for placing human dignity and sustainable development at the centre of Member State responses to illicit drug economies. The guidelines cover a diverse set of substantive issues ranging from development to criminal justice to public health.
The Universal Periodic Review (UPR), alongside other international and national human rights mechanisms, is an important tool for holding countries that are part of the United Nations, known as UN Member States, accountable for respecting, promoting and fulfilling the human rights of people who use drugs, as well as fulfilling the pledges countries have made through the Sustainable Development Goals (SDGs). The UPR has the potential to improve human rights everywhere, for everyone. Countries can use it to initiate national human rights processes, and it can provide a valuable opportunity for civil society to engage governments on issues relating to human rights in the context of drug policies and people who use drugs.
This report presents the results of the 2017-18 Integrated Biological and Behavioural Survey (IBBS), among people who inject drugs (PWID) in selected sites in Myanmar, including a formative assessment and population size estimations. A formative assessment was conducted in September 2017 in each site to inform the implementation of the IBBS. The assessment was conducted to assess the particulars of PWID populations in each setting, to provide information to tailor RDS and PSE methods and logistic approaches to the different PWID population and epidemic context.
The 2018 Global Overview outlines key trends across the at least 35 countries that retain the death penalty for drug offences in law, and analyses data on death sentences and executions from the last decade. Extensive examination is provided on the divergent trends witnessed in 2018 of falling execution numbers globally, and rising appeal for reimplementation of the death penalty in some countries, while considering the role public opinion plays in all of this.
The world drug problem has multiple public health dimensions encompassing vulnerability to drug use disorders and dependence, treatment and care of people with drug use disorders, reducing harm associated with drug misuse, and access to controlled medicines for medical pain relief.
In partnership with the UN Office on Drugs and Crime (UNODC), which is recognized as the leading UN entity for countering the world drug problem, the World Health Organization (WHO) has a pivotal and unique role in addressing the public health and human rights dimensions of global issues related to drugs.
Drug markets are evolving at unprecedented speed. The range of substances and combinations available to users has never been wider, and the amounts produced have never been greater. Cultivation and manufacturing of heroin and cocaine have reached record highs, synthetic drugs continue to expand, and the market for new psychoactive substances (NPS) remains widely diversified with a growing interplay with traditional drug markets. The non-medical use of regulated prescription drugs (either diverted from licit channels or illicitly manufactured) is becoming a major threat: in addition to the ongoing opioid epidemic in North America, there are signs of an opioid epidemic due to the non-medical use of tramadol in North and sub Saharan Africa, as well as in the Middle East. Drug-related deaths are on the rise. At the same time, access to controlled drugs for medical purposes remains a dramatic problem in most low and middle-income countries.