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Wednesday 22 April 2009 – DAY THREE –
Daily Update
– 7
The
Dialogue Space
at IHRA provides the opportunity for all conference
participants to engage in the sharing of information, knowledge and open dialogue addressing
issues of harm reduction and HIV/AIDS, providing local and regional voices with a global platform.
The dialogue space will be the main venue for grassroots organisations and civil society to meet
and discuss with all other stakeholders involved in harm reduction how they can partner to
support locally-driven community development efforts. The space aims to fill the gap between
high level policy making and the realities of addiction and drug use.
The Global Fund, as the leading funder of harm reduction programs globally, is taking the lead in
organising this dialogue space,
located in the exhibition area
, in partnership with the UNAIDS
family, aiming to work with both community and technical partners.
The Global Fund is also organising a lunchtime session in the main programme of the
IHRA Conference: Scaling-up harm reduction: achievements and challenges
20th April, 12:45-13:45, Room Queen’s Park 3
Compulsory treatment denies human rights
Thai drug policy had the objective of treating addicts as patients not
criminals, diverting them to assessment and drug treatment. The
reality was somewhat harsher, said Richard Pearshouse of the
Canadian HIV/Aids legal network
,
who had studied Thailand's
compulsory drug rehabilitation system and contributed to Tuesday's session
on compulsory drug dependence treatment centres.
Conditions were deplorable in many of the 84 compulsory drug treatment
centres, 50 of which were run by the military. Most people were detained for
more than the maximum 45 days while they waited for the provincial sub-
committee to determine whether they would be given a custodial or non-
custodial sentence. They would be held in crowded conditions without water
or access to medical treatment. 'We had to sleep on our sides,' reported one
detainee. 'If I moved I might lose my space.' When the decision came, there
was no right of appeal.
'One of my urgent concerns is to eliminate the use of pre-detention
treatment while being assessed and enforce a minimum standard of care,'
said Mr Pearshouse. 'The system needs comprehensive and rigorous
assessment.'
Tran Tien Duc from the Futures Group in Vietnam reported that
government drug policy in his country was based on zero tolerance.
'Officially the government encourages voluntary rehabilitation, but it is
non-existent in the community – sooner or later you will go to compulsory
rehab for up to two years,' he said.
The law entitled people 'who are in danger of relapse' to be kept in
centres for up to two years, he said. They were channelled through stages
that included detox, behaviour education, liaison therapy, drug relapse
counselling, vocational training and post-rehab management, but there was
no harm reduction in these closed settings.
Health services were determined by the revenue available at individual
centres based on their previous running costs, rather than by health needs.
'Health of residents is not a priority,' he said.
'With the lack of understanding of drug dependence and high stigma,
the relapse rate is very high – 90 to 100 per cent,' he added. 'Things could
be changed more positively if they changed from being compulsory to
harm reduction.' The system was as costly as it was ineffective: 'With the
current approach of putting drug users in centres, 146.9m US dollars will
be required from 2006-2015.'
Delegates reacted strongly to treatment being described by governments
as a form of harm reduction – common to the presentations in this session.
‘Many of us have been advocates of treatment as harm reduction, but
when I look at some of the results of that I am appalled,' said Deborah Small
from the US. 'We should agree on a language to call these centres
concentration camps,' said another. A delegate from China described how
he had been in treatment 11 times, which involved enforced labour from
7am, to 11pm. 'Is this something you could genuinely call drug treatment?,'
he asked. 'We call on everyone who has suffered to speak out... we get
human rights by fighting – not being passive.'
Sonia Bezziccheri from UNODC summed up delegates' call for active
partnerships with all relevant international organisations: 'We want to see
drug dependence at the heart of drug policy.'