HRC Press conference: Special Rapporteur on the right to health - 26 June 2024
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HRC Press conference: Special Rapporteur on the right to health - 26 June 2024


Human Rights Council thematic report on drug use, harm reduction and the right to health



  • Tlaleng Mofokeng, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
Good morning, everyone.
And thank you for joining us at this press conference by Doctor Tang
who is the UN special rapporteur on the right to help.
Uh, Doctor Mofokeng
is a medical doctor with expertise advocating for universal health access,
HIV care, youth friendly services and family planning.
we'll begin as usual with opening remarks by the
SR and then open the floor for questions.
With that, I give the flow to the special rapporteur.
Thank you very much. Um, dear colleagues for joining this press conference at
a time where it's a great honour for me to have
presented my fourth thematic report to the Human Rights Council,
which focuses on drug use, harm reduction and the right to health.
And I want to particularly thank all of
the stakeholders for the contributions that have been received
in the drafting of this report. Greatly appreciated indeed.
And while the hour is already late
with nothing else left to say or do with the mandate
given to me by this Council on the right to health,
I continue to share in the collective rage and fury as we watch day after day
horrific genocidal acts unfolding and documented in real time.
And in this moment I continue to bear witness to many people around the world
who to another crushing weight of imperialism and colonial oppression.
No, neither
peace nor respite.
And I reiterate my call.
And I remain optimistic that the world
leaders will summon all the necessary political,
economic and diplomatic force
to bring an end to all wars around the world and specifically in urgencies.
Fires were desperately needed
in the occupied Palestinian territory.
Now focusing back on the report on drugs.
Uh, we know that drugs have been a part of human history for thousands of years,
whether for medical healing,
for religious and cultural ceremonies or as a commodity for pleasure.
And it is crucial to distinguish between drug use and drug use disorders.
And drug use is not a medical condition,
and the majority of people who use drugs do not have a dependency problem
and do not require medical treatment or intervention.
Drug use disorders, on the other hand, including drug dependency,
are a medical condition
and thus require dignified, appropriate quality, support
and treatment.
Together, the social, political, commercial and legal determinants of health
can recreate and reinforce health disparities.
With that in mind, I focus on how the availability, accessibility, acceptability
and quality of care
is therefore affected
by punitive approaches to drug use.
I explore how drug control compounds and disproportionately
affect certain rights and individuals,
and call on all of us to continue to examine the underlying power structures
that perpetuate systems of disadvantage
that have outlived formal colonialism
that continue to shape the underlying dynamics of both
drug use and how member states address it,
focusing a bit on state obligations under the right to health.
States have an obligation to respect, protect and fulfil human rights
in the context of drug use. The obligation to respect requires that states
not engage in any conduct that can result in drug use, related morbidity
or mortality.
This includes refraining from marketing unsafe
drugs or from applying coercive medical treatments
as well as, of course, for the treatment of mental illness.
The obligation to protect requires states to, among other actions,
adopt legislation
or take other measures ensuring equal access to health care
and health related services provided by third parties as well.
It's important that states remember their their
obligation to protect and ensure that scientific knowledge
and technologies
and their applications,
including evidence based interventions to prevent and treat drug dependence
in addition to related diseases
are available
and accessible without discrimination both in law and in practise,
and states have an obligation to implement evidence-based
interventions to minimise adverse health
outcomes, risks and harms associated with drug use.
The obligation on states to fulfil requires them, for instance,
to promote the right to health by undertaking actions that create,
maintain and restore health of the population.
This obligation includes fostering the recognition
of factors favouring positive health results,
such as research and the provision of information
that ensures that health care providers are trained to recognise
and respond with culturally acceptable services
to very specific needs
of marginalised groups and those who remain vulnerable.
And while these obligations may be
realised progressively due to resource constraints,
we must divest from the war on drugs
because it is effectively a war on people,
and divesting from a war on drugs will allow
us to have the innovation and the space to creatively
forge a way forward where we place the
dignity of people at the centre of our responses
and reinvest all of those important
resources and underlying determinants of health.
It's also important to understand the power asymmetries of major corporations
and their influence on policy making
in many in many jurisdictions around the world.
Decriminalisation of drug use
is the removal of criminal penalties for drug offences,
and it is a way of reducing negative health
impacts of punitive drug policies on the right to health.
And we have evidence from jurisdictions
that have taken a decriminalisation approach,
demonstrating that adopting less punitive policies do not result
in increase in drug use or drug related harms or any other crimes.
Divesting from
the ill advised war on drugs
frees up these resources to also reinvest in
public health that is grounded in human rights.
That supports and is based on the best available scientific evidence,
and also understands how supporting health care workers
is important to realising the right to health.
Now harm reduction as an approach
is part of
what is available to us in terms of policy tools.
It includes a wide range of policies, but also programmes
and practises
that are aimed at minimising negative health but also social
and legal impacts associated with drug use and drug laws and policies.
Harm reduction measures work best when they are available
to people in their context and their circumstances,
and it is important that they are modified and
tailored to the intersecting needs of those particular individuals
there may. In the report,
I've highlighted numerous examples, um,
non exhaustive lists of what harm reduction practical measures have been,
and I've also provided examples of good practises
coming from a number of member states.
Some of these measures include needle and syringe programmes,
drug checking,
overdose prevention and reversal,
housing and employment and education,
as well as, of course, focusing on underlying determinants of health
opiate agonist therapy,
as well as drug consumption rooms and supervised injection facilities.
It is important that at the domestic and international
levels to note that funding for harm reduction is inadequate
and it's actually shrinking.
And so we ought to think about what a harm reduction approach
within a human rights framework looks like
that needs to be sustainable, but also structural, because that will require
not just a paradigm shift,
but much resourcing
and in closing. I just wanna also draw your attention
to the conclusions and recommendations contained in
my report which are four pages long.
These are designed to give member states
at various levels of their own processes nationally
on policy level,
on legislative reform,
on funding and resourcing
on clinical care,
in underlying determinants of health and in health systems.
There are various measures which can be taken on
that are compassionate,
that are rights based, that are evidence based
that will lead us to a harm reduction process
in relation to drug use and drug use disorders.
There is no space for
discrimination for stigmatisation
or criminalization,
people who use drugs in particular.
Those who have been historically marginalised and criminalised
should be meaningfully involved in the development and design
of drug laws and policies, including
the harm reduction policies and services that are designed to help them
and on an international level. We ought to be looking urgently
at revising the international legal framework on drug control
to best align with international human rights norms and standards
with harm reduction approaches and the personalization of the
right to health approach in which services are available, acceptable,
affordable, accessible of quality.
And this means that even at domestic level,
we have to all of us centre the dignity of people respect
their autonomy
and also provide them with information to make informed decisions.
And those should be free from conflict of interest,
especially from the pharmaceutical
industry, in what we've termed commercial determinants
of health.
Ending criminalization, stigmatisation and discrimination
as they present structural barriers to
accessing services and establishing therapeutic relationships
leads to poorer
health outcomes, as people may fear legal consequences.
So we must end criminalization and stigmatisation
and discrimination in order to improve trust,
to improve dialogue,
to improve creativity and innovation. In
this moment,
that's very urgent for a paradigm shift,
but really structural changes in how we approach drug use and how we understand
who are drug users. Thank you very much.
Thank you. Uh, Doctor
uh, the special rapporteur will now take questions.
As usual,
we'll begin with questions from the room and
then move on to anyone joining us online.
Please state your name and your organisation before asking a question.
There are no questions in the room. Anybody online with a question for the better?
I don't seem to be any questions. Uh, Doctor Tang,
would you like to say anything else?
Just add anything or would you like to take uh, questions on any other subject.
If there are any questions on something
outside of the special rapporteur's report,
she is willing to take questions.
Otherwise I'll hand the flow back to her for concluding remarks. Thank you
so thank you very much. And I want to end, I think, on the basis of the
principles of human rights that, um, guide, um,
my work and my approach to the right to health mandate.
It is very important, um, to underscore the principles of substantive equality
transparency as it enables accountability
and for office bearers to explain where things have
gone wrong as often things do go wrong.
Transparency is also important so that rights
holders know the processes available for them
to seek redress,
meaningful and
consequential participation of civil society,
but also people who are most affected
by drug use and these policies is very, very important.
And I want to urgently call on all
UN member states to ratify the International Covenant
on Economic, Social and Cultural Rights
while paying attention to immediate interventions in the longer term,
the social transformation required
so as to recognise the right of everyone to the highest attainable standard
of physical and mental health.
The right to health remains one of
our most transformative solution orientated right,
as it not only looks at access to health facilities but also looks
at underlying determinants of health.
And we know without health we cannot realise any of our other rights
and in the context of drug use.
When we constantly put people in conflict with the law,
it means
they may be incarcerated.
They may end up with a criminal record
which may impede their access to education,
to housing,
to food security to many other state offered support, but also to travel.
And we know, especially when you are talking about Children and families,
that there is a risk there that families may
be separated and there may be issues of custody,
especially with young people and the youth.
We don't want to get them in a space where they are
in conflict with the law, because we don't understand how to best support them.
It's important to understand
how to support them when they transition from being childhood,
into teenagehood
and into adulthood,
and the one way of doing that is to absolutely approach this from a compassionate
evidence based and rights based approach.
And in closing, I do want to say
that I hope that all of the UN agencies,
all of the different treaty bodies and all of us
involved in this important work of drug use and drug controls
that we can really put the global advocacy
and all of the high level statements of intent
into action once and for all
to move from a war on drugs,
to uphold the right of dignity
and to truly ensure
that the realisation of the right of
everyone to the highest attainable standard of health
does not leave behind
people who are drug users. And with that, I would like to say thank you very much
and again reiterating the call for an immediate ceasefire
and to a call to end all wars around the world. Thank you very much.
Thank you. Uh, Doctor ZL
and thank you all for joining us at this press conference and
for taking an interest in the work of the special rapporteur.
Uh, we will now close this press conference. Thanks again.
And everybody have a good afternoon.