A/HRC/38/36 among others, lesbian, gay, bisexual, transgender and intersex persons, rebellious young persons, drug users and women exercising their right to make choices concerning pregnancy prevention and termination. Confinement has become an institutional response to complex social problems, particularly affecting groups and communities left behind by public and socioeconomic policies. Some argue that prison systems and institutions are powerful instruments aimed at silencing the opposition or the “other”, through either criminal sanctions or medical diagnosis and isolation. 9. The latter part of the twentieth century was marked by a rapid increase in rates of confinement within punitive legal and policy frameworks, including in relation to the drug trade, that laid the foundation for modern day, fast-track prison pipelines. Rapid deinstitutionalization in some countries, without corresponding investment in quality community-based services, occurred in parallel. People living in poverty and/or belonging to racial and ethnic minorities were caught in a widening punitive net with inadequate social, economic and legal protections. 10. The 2030 Agenda for Sustainable Development reflects the ambitious aspiration to end the vicious cycle of hopelessness, violence, exclusion and discrimination by addressing social inequalities and human rights so that no one, including persons confined or deprived of their liberty, is left behind.5 There is strong evidence that any form of violence, including inside prisons and centres of confinement, poses a risk for the full realization of the right to health.6 Many promising innovations are prioritizing investment in early childhood, healthy adolescence, competent parenting, good mental health and well-being, gender equality and the protection of women from violence, giving hope that the world can and will become less violent and that detention and confinement will decrease substantially. 11. For the first time, the field of mental health, supported by the Convention on the Rights of Persons with Disabilities other powerful political commitments, 7 is on the verge of freeing itself from a pattern of coercion and institutionalization in mental health settings. 12. Similarly, drug prohibition is increasingly acknowledged as a failed practice that has devastating consequences in terms of the right to health. A growing number of countries and municipalities are replacing punitive approaches to the use of drugs with modern policies based on public health and human rights principles, including decriminalization or legal regulation of drug markets and scaled-up investments in community-based social and health-care services, including harm reduction.8 These promising trends give hope that the practice of mass incarceration of drug users may end. 13. New and stronger international political commitments to reduce incarceration where appropriate have been established.9 A number of United Nations entities and human rights mechanisms have called for the immediate closure of all compulsory drug detention centres and/or movement towards the decriminalization of non-violent drug offences.10 The global study on children deprived of liberty commissioned by the Secretary-General at the 5 6 7 8 9 10 4 For more on the 2030 Agenda in the context of the right to health, see A/71/304. See, for example, World Health Organization, World Report on Violence and Health (2002). See, for example, Human Rights Council resolution 36/13. United Nations Development Programme, Reflections on Drug Policy and Its Impact on Human Development: Innovative Approaches (2016). For example, the Doha Declaration on Integrating Crime Prevention and Criminal Justice into the Wider United Nations Agenda to Address Social and Economic Challenges and to Promote the Rule of Law at the National and International Levels, and Public Participation. See A/65/255; A/HRC/32/32; joint statement by United Nations entities on compulsory drug detention and rehabilitation centres, issued in March 2012, available from www.unodc.org/documents/southeastasiaandpacific//2012/03/drug-detentioncentre/JC2310_Joint_Statement6March12FINAL_En.pdf; joint United Nations statement on ending discrimination in health-care settings, issued in July 2017, available from www.unaids.org/sites/default/files/media_asset/ending-discrimination-healthcare-settings_en.pdf; “Tackling the world drug problem: UN experts urge States to adopt human rights approach”, press release, available from www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?NewsID= 19833&LangID=E.