Discrimination, HIV among People Who Use Drugs, and the UNGASS 2016 on the World Drug Problem.

Abstract

The United Nations (UN) General Assembly held a special session (UNGASS) in April 2016 on the world drug problem, with an aim to review the implementation of its global plan of action against illicit drugs and to approve practical recommendations aimed at accelerating the global fight against drugs. The UNGASS was meant to introduce adapted responses to the HIV epidemic among people who use drugs (PWUDs)— injecting and noninjecting. This UNGASS was the latest in a long series of multilateral conferences that focus on solutions to significantly reduce illicit drug use, combat the high prevalence of HIV and hepatitis among people who inject drugs (PWIDs), and address health and human rights violations faced by PWUDs globally. However, prior UNGASSs have resulted in the adoption of a consensual strategy that is far from representing the needs of PWUDs, the imperatives of the health community, or the requirements of international human rights law. People who inject drugs represent one of the key populations most at risk for HIV and hepatitis infection. Among the 15.9 million (11 million-21.2 million) PWIDs globally, about 3 million (0.8 million-6.6 million) live with HIV. The HIV prevalence is 28 times higher among PWIDs than the general population, and only 14% who are living with HIV were on antiretroviral therapy (ART) in 2014. Infection vulnerability and access to services among PWIDs are directly influenced by the global mechanisms addressing global drug issues. In this editorial, we (1) report the recent history of the UNGASS, (2) discuss the international response to the global drug issue, (3) share our concern with the persisting discrimination against PWUDs that we perceive as the source of the current inadequate drug policies, and (4) call on the follow-up to UNGASS 2016 to address the HIV epidemic among PWUDs as a human rights imperative.