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Lewis Calls for an End to the Medieval Treatment of People Who Use Drugs

A new report by the Eurasian Harm Reduction Network, with a foreword by AIDS-Free World Co-Director Stephen Lewis, reveals the brutal human rights violations against drug users and calls on governments to implement humane drug policies and promote effective responses to the HIV epidemic. The report presents results from the monitoring of human rights violations in Eastern Europe and Central Asia and offers recommendations on how to improve the access of drug users to HIV prevention and care.

The foreword by Lewis is below. The full report, titled ‘HIV and the Law in Eastern Europe and Central Asia,’ can be accessed here (PDF, 315KB).

To read this report is to drown in a tsunami of rage. The behavior of the governments of Eastern Europe and Central Asia towards people who use drugs — and there is not a single country without some degree of culpability — is both brutal and diabolical. I can scarcely believe what these pages yield. It is as though we were thrown back to medieval times when agony on the rack was the punishment for the most trifling of so-called crimes.

But in contemporary terms it’s much worse. The testaments in this monograph flow from people struggling desperately with illness — not crimes by any sane definition — but illness that has been criminalized with malicious intent. It is to weep. What in God’s name is wrong with governments that they should so savage basic human rights?

Conventional wisdom says that societies should be judged by the way in which they treat the most disadvantaged in their midst. If that is so, the AIDS pandemic has given us much by which to judge our societies and the policies and laws that are the expressions of our collective values. From its beginnings, AIDS has represented a clear choice for governments — to use policy and law to protect those at high risk of contracting HIV or to fail to do so — or, even worse, to allow law and policy to be an additional burden to people already disadvantaged by discrimination and stigma.

Thirty years into the pandemic, we can report that some countries have struggled with and met this challenge in ways that do credit to their commitment to the rights and dignity of all people. Some countries have removed harsh and senseless criminal laws against homosexuality, perhaps sooner than would have been the case had AIDS not brought the situation of men who have sex with men to the policy foreground. These countries have learned the fundamental lesson that protecting the rights of those living with or at risk of HIV is also the most effective way to contain the epidemic.

It is unfortunately only a minority of countries that have made a commitment to legal protections of the rights of people who use drugs and have provided legal grounding for basic health services for them. It is apparently politically acceptable — even politically advantageous — that people who use drugs are allowed to suffer without basic health care, to be stripped of their dignity by repressive policing, and to die from preventable deaths. The heart-breaking accounts in this report from the real experiences of people who use drugs in Eastern Europe and Central Asia epitomize this scandal.

As I read these moving and maddening accounts, I am overwhelmed by how unnecessary is the suffering documented here. No one can claim ignorance of what works and doesn’t work when it comes to reducing HIV transmission linked to drug use and ensuring access to services for people who use drugs. The continued resistance of some governments to ensuring access to clean injection equipment and to evidence-based and humane treatment for drug dependence is beyond comprehension. It is nothing short of criminal that states enable police to interrogate people in a state of drug withdrawal, to arrest people for possession of a syringe, and to gain what is virtually a second income by extortion of people who possess small quantities of drugs.

My colleagues on the Global Commission on HIV and the Law and I have been in awe of those who have been courageous enough to step forward to tell us their stories. When societies condemn drug use as a moral failing and governments treat drug addiction as a high crime, it is no small thing for people who use drugs to recount publicly the experiences of their daily lives. This report itself is a testament to the initiative and courage of people who use drugs, and I am grateful to the Eurasian Harm Reduction Network for the work of compiling these exceptional stories.

There will be a tendency, on reading this report to be paralyzed by the despair that is inevitably felt in the face of such a compendium of abuse. Somehow, we must all in our own ways be advocates for the fundamental reforms that are desperately needed to ensure that laws and policies on illicit drug use become instruments of justice and human dignity.