HRI, IDPC, CDPE and Instituto Ria welcome the opportunity to contribute on “actions taken and to be intensified or initiated to meet the innovative targets on societal enablers” ahead of the High Commissioner’s report on human rights in the context of HIV/AIDS to be presented at the Human Rights Council in its 50th session.

This submission focuses on drug control policies and people who use drugs.

In 2018, around 269 million people used drugs and 11 million injected drugs, of whom 1.4 million living with HIV.

The risk of acquiring HIV for people who inject drugs is 35 times higher than for people who do not. While incidence of HIV infection globally declined by 23% between 2010 and 2019, HIV infections among people who inject drugs increased in Eastern Europe and Central Asia, Asia, Middle East and North Africa. In 2019, only 62% of people who inject drugs were aware of their HIV status; well below the 95-95-95 target.

A key gap towards achieving the societal enablers targets is the lack of adequate harm reduction policies, and/or policies actively restricting the provision of essential harm reduction services at national level. Harm reduction is endorsed by the 2021 Political Declaration on HIV and AIDS, actors including OHCHR, UNODC, UNAIDS, WHO, and the UN Common Position on drug policy; recognised as highly effective, cost-effective, and a key component of the right to health for people who use drugs. Nevertheless, the provision of harm reduction interventions is critically low, with only one percent of people who inject drugs living in countries with high coverage.

Where available, harm reduction services remain overwhelmingly gender-blind or male-focused, and do not integrate SRH services (including pregnancy tests, antenatal care, or other pregnancy-related services), leaving women underserved.28 Although women who use drugs are disproportionately exposed to gender-based violence, harm reduction services often do not address gender-based violence, and are ill-equipped to adequately address the interaction between drug use and experiences of violence.