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INPUD Interventions at the 50th UNAIDS PCB – Addressing Methadone Crisis in Ukraine & UBRAF

21 – 24 June, 2022

Aditia Taslim delivering the first of two interventions on behalf of INPUD at the 50th UNAIDS PCB Meeting.

The following two interventions were delivered by Aditia Taslim on behalf of INPUD during the 50th meeting of the UNAIDS Programme Coordinating Board (PCB).

The first intervention was delivered on day one (21st June) of the 50th PCB under Agenda 1.3 – Report of the Executive Director, in response to the statement by UNAIDS Executive Director Winnie Byanyima concerning the ongoing methadone crisis in Ukraine due to the invasion by Russia. Currently, people who use drugs in Ukraine are putting their lives on the line to bring methadone to peers on the frontlines, and despite work conducted by the UNODC to mitigate the impact of treatment disruption, the situation is ominously reminiscent of the 2014 Crimea Annexation which led to many deaths in our community. Our intervention is a call to not let history repeat itself.

The International Network of People who Use Drugs stands in solidarity with the community of people who use drugs in Ukraine, peers, colleagues and friends against the invasion of human rights and freedom. We would also like to thank UNAIDS and UNODC for addressing the need to mitigate the impact of the war on Opioid Agonist Treatment (OAT) disruption as stated by Winnie in the previous agenda. Over 17,000 people on methadone and about 8,000 more private clients are at risk of this disruption due to the war and lack of supplies in Ukraine. We shall not forget the impact of harm reduction and OAT service closure after the Crimea Annexation in 2014, which affected over 800 people who were on methadone, led to the death of 80-100 people died. This is history repeating itself, but at a larger scale.

Similarly, close to 300 people on methadone in Kazakshtan have not received their dose since early this month without being provided with additional life-saving medications.  

We don’t need to find further evidence on how harm reduction and OAT service saves lives. And we don’t need to have more unnecessary lost lives to proof this.  

The second intervention was given on the third day (23rd June) of the 50th PCB under Agenda Item 4.1 – Unified Budget, Results and Accountability Framework (UBRAF) Performance Monitoring Report (2016-2021).

The International Network of People who Use Drugs commends the Joint Programme on their continuous support to the community of people who use drugs. We welcome the UBRAF report with some important notes.

First, 169 countries still criminalise drug use and possession.[1] And of the 25 countries claiming to have adopted or partially adopted decriminalisation, administrative sanctions and removal of rights such as child custody, housing, social protection and employment are still heavily imposed towards our community.[2]

Second, we have 3.5 years to go to achieve the 10-10-10 targets. Yet, we have only learned that the matrix to track progress of these targets is still being developed. In the last few weeks, we consulted with our network members in Asia, Africa and in the Eastern Europe and Central Asia region and found these targets have not been included in any of their national strategic plan or agenda, nor they were being discussed at key national dialogues. INPUD has started mobilising our community to raise awareness on these important targets since they were adopted. We build the capacity of people who use drugs to use these targets in their advocacy work to hold government’s accountability.

Third, despite the promises made on Key Populations, this is not followed by sufficient shift of resources to key population-led networks and organisations. In 2020, only 2.6% of the total HIV expenditures was spent on Key Population-led Programme in 61 low-and-middle income countries.[3]

Lastly, the Joint Programme evaluation on Key Population Programming published earlier this year includes some critical aspects to inform the Joint Programme in moving forward. However, they are not being addressed here. Some of the key findings include underutilization of resources in the Technical Support Mechanism (TSM) for key populations; and notable gaps in capacity and expertise in key populations among the Joint Programme at country level, particularly since the 2016 funding cuts.[4]

As we are presented with the new UBRAF indicators, we call on UNAIDS, the Joint Programme, Member States, Donors and other stakeholders to invest in Key Population-led networks and organisations, remove laws, policies and practices that deny people away from services, and to meaningfully involve people who use drugs throughout the process of policymaking. How many more lost lives do we need until we take the necessary actions?

[1] Data extracted from HIV Policy Lab under S3 Drug Use Non-Criminalisation, https://hivpolicylab.org/policy/S3

[2] INPUD, 2021. Drug Decriminalisation: Progress or Political Red Herring?. https://inpud.net/wp-content/uploads/2022/01/INPUD_Decriminalisation-report_online-version-1.pdf

[3] UNAIDS, 2021. Financial Estimates and Projection 2021. http://hivfinancial.unaids.org/hivfinancialdashboards.html

[4] UNAIDS, 2022. Joint Evaluation of the UN Joint Programme on AIDS’s Work with Key Populations (2018-2021). https://www.unaids.org/sites/default/files/media_asset/joint-evaluation-un-joint-programme-aids-work-key-populations_en.pdf