A/HRC/39/39 the Elimination of Discrimination against Women,27 the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health 28 and the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment29 have all considered that harm reduction measures are essential for people who use drugs. 18. In 2017, needle and syringe programmes were only available in 93 countries, opioid substitution therapy in 86 countries30 and drug consumption rooms in 10 countries.31 People who use drugs continue to be severely impacted by HIV and hepatitis C infections. 32 A 2018 report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) indicates that the risk of acquiring HIV is 22 times higher for people who inject drugs than for people who do not inject drugs.33 19. In their submissions, Austria, Myanmar, Norway, Spain and Switzerland indicated that they supported harm reduction as part of their public health strategies. For example, Austria provided needle and syringe exchange facilities at fixed sites, outpatient drug services, client access to treatment for chronic hepatitis C infection, and overdose prevention measures that included awareness-raising, information and advice, and first aid instruction for drug users and for staff. In Myanmar, the new National Drug Control Policy promoted and expanded a comprehensive package of harm reduction measures, which included overdose prevention and treatment. 20. The Kenya National Commission on Human Rights reported that the country’s Ministry of Health had prioritized harm reduction strategies for persons who injected drugs, as part of its HIV prevention strategy. However, the Commission stated that enforcement of drug laws had a negative impact on the use of harm reduction services by drug users, because of fear of imprisonment. 21. According to the World Drug Report 2018, opioids continue to cause the most harm, accounting for 76 per cent of deaths where drug use disorders are involved. 34 In the United States of America, 64,000 people died from opioid overdose 35 and in Canada there were 2,458 known deaths from opioid overdose, in 2016. 36 Canada has recently adopted measures to counter opioid drug overdose. 37 In Poland, around 17 per cent of people dependent on opioids have access to substitution therapy,38 while Morocco introduced an opioid substitution programme in 2010.39 22. Opioid medications are essential not only for drug dependence treatment but also for pain management.40 The Committee on Economic, Social and Cultural Rights has expressed concerns at the restricted access to opioid substitution therapy, and has recommended that States take effective measures to guarantee the right to health care among marginalized groups such as persons who inject drugs, including access to opioid substitution therapy. 41 The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 In CEDAW/C/GEO/CO/4-5 and CEDAW/C/CAN/CO/8-9. In A/65/255. In A/HRC/22/53. Submission from the International Drug Policy Consortium. Submission from Harm Reduction International. Submission from the International Drug Policy Consortium. See www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf. See www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_1_EXSUM.pdf. Submissions from the International Drug Policy Consortium and the International Network of People Who Use Drugs. See www.globalcommissionondrugs.org/wp-content/uploads/2017/09/2017-GCDP-PositionPaper-Opioid-Crisis-ENG.pdf, p. 5. Submission from the Canadian HIV/AIDS Legal Network. Submission from the Polish Drug Policy Network. Submission from the Moroccan Association for the Fight against AIDS. See www.joannecsete.com/documents/lancet-july-2010.pdf. See E/C.12/SWE/CO/6, E/C.12/LTU/CO/2, E/C.12/PHL/CO/5-6, E/C.12/BLR/CO/4-6, E/C.12/IDN/CO/1 and E/C.12/POL/CO/6. 5