A/HRC/16/69 using drugs and/or living with drug dependency underwent forced labour and other human rights abuses in the name of treatment. ESCAP noted that children under the age of 18 years were sometimes confined to these centres and that the economic importance of the cheap labour that they provided could give these centres political protection. In its submission, Asia Catalyst reported that, in one Asian country, people could be held in such centres for up to six years with no avenues of redress or due process. Hepatitis C was also noted as a problem disproportionately affecting people who use drugs, for which they often had no access to treatment. UNAIDS reported that, in many countries, there was a lack of clarity as to whether basic coverage in public health services included hepatitis C treatment. The Director of the International Harm Reduction Association emphasized that opioidsubstitution therapy and the management of pain with legal opiates were both impeded by irrational restrictions on the use of opiates; about 80 per cent of people needing prescription opiates for pain management had no access to them. 28. A number of United Nations and Member State respondents credited Global Fund support for the ability to scale-up services, such as needle exchange and opioid-substitution therapy for people who use drugs. There was concern that declining donor support for the Global Fund could endanger these programmes. According to the income-level criterion of the Global Fund, some countries that had enjoyed this support might also be ineligible for future assistance. 29. Several respondents stressed the challenge of establishing or maintaining adequate HIV services in prisons and pretrial detention centres in spite of the epidemiological importance of HIV transmission in these settings. Some respondents recognized the lack of access to condoms in prisons as a major gap in the national HIV response. Some noted that drug injection took place in prison and that lack of access to sterile injection equipment undermined HIV prevention, particularly in the many places where people who inject drugs were overrepresented in prison populations. A few successes were noted. In Poland, all persons in State custody may receive free antiretroviral therapy. In India, the Bombay High Court ordered an expansion of HIV services for prisoners, including testing and counselling. F. Gender-based subordination and violence 30. At the Geneva consultation, nearly all respondents and several presenters highlighted women’s legal, social and economic subordination and violence against women as continuing concerns in national HIV responses, though often without detail about programmes to address these problems. The representative of the Young Women’s Christian Association asserted that gender inequality and violations of the rights of women were widely recognized as drivers of HIV epidemics, but programme budgets nationally and internationally did not reflect the urgency of addressing these abuses. The 2010 report on the Declaration of Commitment on HIV/AIDS concluded that only 46 per cent of countries had a specific budget for HIV programmes for women. 31. Gender-based violence was reported by respondents from all regions to be a widespread and entrenched problem. Several noted that laws against all forms of genderbased violence, including domestic violence and marital rape, were weak, non-existent or poorly enforced. UNICEF specified in its submission that as many as one in four girls in parts of Africa reported that their first sexual experience had been forced. In many parts of Africa, HIV prevalence among girls was as much as 4.5 times greater than that of boys. Where girls were much younger than their sexual partners or husbands, gender power relations were such that refusing to have sex or demanding condom use might not be possible. UNICEF also emphasized that, as difficult as it was to mobilize support for programmes to combat violence against women, it was even more difficult to address GE.10-17842 11