A/HRC/30/65
counters the effects of opioid overdose, can prevent overdose-related deaths and minimize
the harm associated with drug overdose (see A/65/255, para. 54).16
16.
Providing drug users with access to drug-consumption rooms can contribute to
preventing the transmission of diseases and to reducing damage to the veins, as well as
encourage users to make use of treatment and other services. Drug-consumption rooms
have contributed to reducing overdose rates and increased access to medical and social
services (see A/65/255, para. 54).
17.
As of 2014, needle and syringe programmes had been implemented in 90 countries
and opioid substitution therapy was available in 80 countries. However, needle and syringe
programmes have been confirmed to be absent in 68 countries where drugs are injected. In
2014, it was reported that there were 88 drug-consumption rooms worldwide, of which only
two were outside of Europe, Australia and Canada.17
18.
The lack of needle and syringe programmes, in particular, has a direct impact on the
spread of HIV. People who inject drugs account for approximately 10 per cent of all new
HIV infections and for up to 30 per cent of new HIV infections outside sub-Saharan Africa.
Worldwide, an estimated 12.19 million people inject drugs, of whom 1.65 million are living
with HIV.18 WHO has estimated, on the basis of data from 49 countries, that the average
risk of HIV infection is 22 times greater among people who inject drugs than among people
in the general population; in 11 of those countries, the risk is at least 50 times higher.19
19.
Among the benefits associated with harm reduction programmes is the increased
entry into HIV/AIDS treatment programmes (see A/65/255, para. 57). UNODC, WHO and
UNAIDS have recommended that a comprehensive package of harm reduction services be
integrated into national AIDS programmes, both as an HIV prevention measure and to
support adherence to antiretroviral therapy services and medical follow-up for people who
use drugs.20
20.
One study compared countries that comprehensively and consistently adopted
approaches based on harm reduction without punitive approaches with countries that
steadfastly resisted the harm reduction programmes and focused instead on punitive
approaches. It found that the prevalence of HIV among people who injected drugs in
Australia, Germany, Switzerland and the United Kingdom of Great Britain and Northern
Ireland was less than 5 per cent, whereas in the Russian Federation and Thailand HIV
prevalence among people who injected drugs was over 35 per cent.21
C.
Heath care in prison
21.
Drug use, including by injection, has been consistently documented to occur in
prisons throughout the world. High rates of sharing injecting equipment leads to an elevated
risk of transmitting HIV in prisons. Persons in custodial settings are entitled, without
discrimination, to the same standard of health care found on the outside, including with
regard to prevention, harm reduction and antiretroviral therapy. Continuity of care is critical
16
17
18
19
20
21
WHO, Consolidated Guidelines, p. 4.
Harm Reduction International, The Global State of Harm Reduction 2014.
UNODC, World Drug Report 2015 (United Nations publication, sales No. E.15.XI.6), p. ix.
WHO, Consolidated Guidelines, p. 5.
WHO, UNODC and UNAIDS, Technical Guide, pp. 10-21.
Global Commission on HIV and the Law, HIV and the Law: Risks, Rights and Health (New York,
July 2012) and the United Nations Development Programme (UNDP), Addressing the Development
Dimensions of Drug Policy (June 2015), p. 19.
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