Harm reduction minimises the negative health, social and legal impacts of drug use and drug policies. Grounded in justice and human rights, it supports people without judgement, coercion, or requiring abstinence.

Although harm reduction is not addressed by the Conventions – the concept did not exist at the time – it is fully compatible with drug policy commitments and in fact required to fulfil international obligations. Looking comprehensively at all international commitments related to drug control – something this Panel is required to do, harm reduction is recognised as an essential component of the right to health, a necessary building block of the HIV response,and instrumental to realising the SDGs; and has been endorsed by the General Assembly,  CND, and the Human Rights Council.

It is also supported by the policies of 112 countries in 5 continents, in very diverse social, economic and cultural contexts.6
This strong support rests not on ideology, but on ever-growing evidence that harm reduction is effective and cost-effective for promoting individual and public health.

Yet opposition persists, shaped by the prohibitionist approach entrenched in the Conventions, and the ill-conceived pursuit of a ‘drug free world’:

• Services are often not available nor accessible to those who need them the most; especially already marginalised populations.
• Criminalisation is a critical barrier – and this has led to growing national and international support for decriminalisation, including by human rights and drug control mechanisms. But even where drug use is decriminalised, restrictive policies, stigma, discrimination, and pathologisation impinge full implementation.
• Funding is dire. Even before recent cuts, harm reduction in low- and middle-income countries received only 6% of required resources and relied heavily on international donors.8 Recent cuts have forced closures and reductions in services, which are more fragile than ever before. This is not a matter of lack of resources, but of allocation: in pursuit of a drug free world, massive amounts of funding have been misdirected towards repressive policies which have proven ineffective and harmful;9 at the expenses of lifesaving health interventions.
• The architecture compounds this. Despite its multifaceted nature, drug control remains largely governed from Vienna, under a reductionist ‘drugs and crime’ framework, while attempts for a more comprehensive response are resisted.

The panel has the opportunity, and the responsibility, to reaffirm that harm reduction is effective and non-negotiable to uphold international obligations; but also, to critically examine whether current shortcomings reflect only gaps in implementation, or deeper structural issues within the regime itself. And it must consider whether working within the current margins of the treaties is enough, or whether more fundamental change is needed to ensure drug policies advance, rather than undermine, the health and rights of people who use drugs and their communities.

There are practical pathways for reform the Panel should discuss and address:

• First, goals: the overarching aim of the system – promoting health and welfare – should be read through the prism of available science, to set up realistic and achievable goals for drug policies that prioritise health and rights. Success should not be measured through seizures and arrests alone, but through health outcomes including access to harm reduction and essential medicines, and reduction in prevalence of infectious diseases and overdose deaths.
• Second, architecture reform: moving beyond the ‘drugs and crime’ framework and towards a comprehensive response in which the UN truly ‘speaks with one voice’. This means consistent and integrated data collection, policy guidance and technical assistance, with all relevant UN agencies – particularly WHO and OHCHR – acting as full partners.
• Third, full domestic implementation through expansion of community-led and low-threshold services, sustainable domestic funding, full decriminalisation and an enabling legal environment.
• And finally, treaties: an objective, evidence-based assessment of whether the treaties as currently drafted can deliver these goals, or whether and how they can be modernised to ensure a consistent and effective international framework.

• Clearly acknowledge that accessible, fully funded harm reduction is essential to fulfilling international drug policy commitments and other relevant obligations; and recommend practical ways to expand services;
•  Recognise that the current drug control regime and its prohibitionist posture impinge full implementation of harm reduction and health-centred policies; and
• Recommend reforms to the drug control architecture necessary for the full implementation of effective, rights-centred responses.

After decades of evidence, people are still dying for lack of services we know work, while the global drug control regime is more often used to justify measures that kill people, rather than those keeping them alive. This panel’s work can help put this right.