The 2008 High Level Meeting (HLM) on AIDS opened this morning at the United Nations headquarters in New York. Country delegations and civil society representatives from around the world have come together under the theme 'Uniting the World Against AIDS'.
The meeting opened with a plenary session addressed by the UN Secretary-General, among other speakers. This was followed by a Civil Society Hearing, in which selected civil society representatives were invited to present on key issues related to HIV. Harm Reduction International was one of the two speakers invited to address the issue of injecting drug use and harm reduction.
Harm Reduction International's Senior Policy Advisor, Rick Lines, is representing Harm Reduction International at the HLM. Below is the text of his speech this morning at the Civil Society Hearing.
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"Last month, Harm Reduction International published a report entitled The Global State of Harm Reduction, documenting the injection-driven HIV epidemic and the harm reduction response worldwide.
That report found the global state of harm reduction to be very poor indeed.
Approximately 11.6 million people inject drugs in 158 countries around the world. Most have little or no access to syringe exchange or opioid substitution therapy. The UN Secretary-General estimates that 92% of people who inject drugs in low- and middle-income countries have no access to HIV prevention services of any kind. For some populations, such as people in prisons, access to harm reduction is even worse.
This situation has real human consequences.
As many as 3.3 million people who inject drugs are already living with HIV, and in some countries up to 80% of HIV infections are linked to unsafe injecting. Still people who use drugs face significant barriers to accessing anti-retroviral therapies in many countries.
Harm reduction programmes and access to anti-retroviral therapies for people who use drugs must be massively and rapidly expanded, not only as an essential public health measure, but also as a matter of human rights.
People who use illegal drugs do not surrender their fundamental rights. The provision of harm reduction programmes is an integral element of State obligations under the right to health enshrined in the International Covenant on Economic, Social and Cultural Rights. As described by the UN Special Rapporteur on the Right to Health, Professor Paul Hunt:
‘[H]arm reduction stands as a clear example of human rights in practice. What began as a health-based intervention in response to HIV must today be recognised as an essential component of the right to the highest attainable standard of health…Every state therefore has an obligation to implement, as a matter of priority, national comprehensive harm reduction services for people who use drugs.’
Therefore, for Member States and for the UN system as a whole, harm reduction is not a policy option. Harm reduction is a legal requirement.
Yet in many countries, the development and mainstreaming of harm reduction programmes is hampered by punitive and prohibitionist drug laws and policies. Indeed, the Special Rapporteur has lamented that States too often suffer from what he calls ‘acute amnesia’ when it comes to issues like harm reduction.
For example, in addition to this UNGASS process on AIDS, there is also an UNGASS process on drugs, which will culminate in a High Level Meeting in March in Vienna. The UNGASS process on drugs has historically been resistant to harm reduction. Commitments on HIV prevention made by Member States this week in New York must not be forgotten when those same States meet to discuss drug policy in Vienna. Civil society organisations represented here this week must ensure that our voices are heard in that UNGASS process on drugs.
This High Level Meeting on AIDS must send a clear message in support of harm reduction. That message must be reaffirmed by the State delegations to the UNGASS process on drugs, and result in unambiguous support for HIV prevention and harm reduction at that meeting."
 P Hunt (2008) ‘Foreword’ – The Global State of Harm Reduction. Harm Reduction International.
 P Hunt (11 May 2008) ‘Human Rights, Health & Harm Reduction: States’ amnesia and parallel universes’ – Keynote Address at the 19th International Conference on the Reduction of Drug Related Harm, Barcelona.