Time to put People who use drugs, evidences and Human Rights at the center of the response.

By Bikas Gurung and Rajiv Kafle

The CND is Dying – Time to put People who use drugs, evidences and Human Rights at the center of the response.

The 61st session of the Commission on Narcotics Drugs (CND) was held from March 12-16, 2018 in Vienna, Austria. It was a disappointment like any of the last sixty sessions. It has become an automated session that follows the same algorithm in which member states would come, present usual blah blah blah, praise for their stupid accomplishments on drugs seizures, field eradications and compulsory rehab programs rather than introduction to right-based programmes/policies and lives saved.

The world is far more progressive or regressive than the CND deliberations – but it is not what member states are allowed to see, hear and speak. It reminded us of Gandhi’s three monkeys – See no evil, Hear no evil and Speak no evil.

In 2009, the WHO, UNODC and UNAIDS technical guide recommended a comprehensive package of interventions for the prevention, treatment and care of HIV among people who inject drugs – widely known as comprehensive harm reduction package. In 2016, Harm Reduction International (HRI) reported that 90 countries implemented needle and syringe programmes (NSPs) to some degree and 80 had at least one opioid substitution programme (OST) in place.[1] Worldwide, at least 20 countries have allowed cannabis for medicinal purposes; some more of them have introduced decriminalization for possession of cannabis for personal use;[2] few have already introduced a regulated cannabis industry; and few have decriminalized all forms of drugs for personal use. The first thing anyone attending the CND would notice is that the CND does not resonate these facts – no mentioning of “harm reduction”, “medicinal cannabis” or “decriminalization”.

The other thing CND avoided mentioning in its formal sessions are the consequences and miseries brought by the horrible interpretations (contentious pluralism is what diplomats prefer to call it) of the 1961, 1971 and 1988 UN drug conventions. It really did not matter if the Philippines government’s nation-wide war on drugs was responsible for 20,000 deaths since June 2016; if the Indonesian government killed 107 people extra-judicially in 2017; if the Chinese government has been publicly sentencing and later executing more people than the rest of the world combined annually;[3] if the Cambodian government arrested 17,000 people suspected of drug use in 2017; if criminal justice systems are over-burdened and prisons are overcrowded; if at least 33 countries and territories prescribe the death penalty for drug offences in law;[4] and if the compulsory drug detention centres in East and Southeast Asia have detained more than 235,000 people who use drugs in an inhumane condition.[5] The CND also avoided seeing, hearing and speaking the failures of the 2009 political declaration and plan of action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem and yet member states would be willing to reaffirm their commitments.

Compared to the experiences from a decade back, many believe that the CND has become more open to the participation of community and civil society organizations but only to the extent of side-events and informal NGO dialogues – leaving plenaries and the committee of the whole (COW) sessions only for observation. Some have even started believing that the CND is a waste of time and resources. Advocates from the International Network of People who Use Drugs (INPUD), Asian Network of People who Use Drugs (ANPUD), European Network of People who Use Drugs (EuroNPUD), Eurasian Network of People who Use Drugs (ENPUD), from African, Latin America, and North America community groups attended the CND.

The plenaries and COW sessions are miserable. You really need to have patience and good grip of your temper to attend these. There are a minority of countries who are supportive of an alternative approach that is based on evidence and human rights, in which South and Southeast Asian countries do not belong. As explained above, despite the fact that harm reduction services exist in practice at country level, member states will not dare to challenge the “drug free world” rhetoric. At some point we were under the impression that UNODC country offices might have had a big role in drafting these statements because all of them sounded so similar. The COW sessions are playground of words and punctuation marks. Resolutions suggested by member states go through a consensual process in front of a big screen. If there are any good resolutions by progressive member states, the function of the COW is to basically water it down to a point where horrible interpretations can be made depending on country context.

Side-events are useful in that we are allowed to meaningfully engage in these events. You could use this platform to deliver your evidence and advocacy messages to the delegates. Most of the side-events of community and civil society organizations are full of like-minded people who may not need any further persuasion on our agenda – still it plays a vital role in information sharing and maintaining the solidarity & strength of our movement. Most importantly, attending side-events organized by governments and UN agencies would provide an opportunity to raise concerns and have dialogue with them following the session. On behalf of ANPUD, Rajiv gave his powerful speech on “Engaging communities to strengthen outcomes for all communities” on March 12, 2018. I spoke at the side-event “Hepatitis C among people who use drugs – the global sate and recommendations” on March 16, 2018 and promoted the contribution of our community to achieving the Sustainable Development Goals (SDG).

We attended several side-events, including those organized by Pakistan, Singapore, UNODC, WHO and few others that were focused on the situation of harm reduction, people who use drugs and the Philippines war on drugs crisis. It was hilarious that Pakistan considered themselves an opium free country and an estimated 6.7 million drug users were the result of spill over from their neighbor country – Afghanistan.

“Everyone calls themselves a transit country and blames their neighbors – it’s a classic sign of denial – 60 years of denial is leading us nowhere”, said Rajiv in a conversation with the Pakistan Director General.

A concerted advocacy effort of communities and civil society organizations successfully halted the finalization of the WHO and UNODC’s “International Standards for the Treatment for Substance Use disorders”. During the side-event, WHO official accepted that the standard document contained some of the most stigmatizing languages that could potentially harm people who use drugs. Both UNODC and WHO agreed to include people who use drugs network representatives to review the standard document.

“The language used in the standard document is validating the claims of President Duterte of the Philippines that the brains of people who use drugs are melted and therefore should be killed. We all know that ASEAN governments are waiting for this kind of document to justify their war on drugs”, said Bikas to Dr. Gilberto Gerra, Chief of Drug Prevention and Health Brach, UNODC.

Informal NGO dialogues are also important but we did not like the name itself. We came to know that these sessions are called “informal” because there will be no official record of the proceedings except for the CND blog by the International Drug Policy Consortium (IDPC) – which UN agencies might refuse to accept as and when they feel to do so. When you attend informal dialogues then you might feel that relatively honest discussions are being held and you may even start feeling pity on the speaker for her/his struggle within the UN system. It was the informal dialogues where the International Narcotics Control Board (INCB) President Mr. Viroj Sumyai commented on the Philippines war on drugs (without mentioning Philippines) and encouraged member states to make Naloxone available and accessible to prevent overdoses.

Particularly on Philippines war on drugs, he replied to IDPC by saying, “I have tried for about eight months to dialogue with the government and with the permanent mission here in Vienna. Luckily, at the CND session, we can reach out to the governments attending CND. We are concerned with the situation and would like to carry out a country mission there. Please bring this information back to your capital, we are very concerned.”

“… I can understand his [Duterte’s] state of mind, he has to keep his promises and he is at the highest position. He cannot sleep well at night. He must be using some psychotropic substances to get to sleep!” he added.

Why is the CND dying?

Because nothing happening in the sessions during those 5 days is real. The CND has become just an unrelenting insanity – repeating same mistakes and expecting different results. We repeat that member states resemble the three monkeys of Gandhi. High Income Countries who are mostly donors are out of UNODC’s grip and have already introduced better policies without violating the UN drug conventions. It is the low income; lower middle-income; and upper middle-income countries (mostly Asian) that are sandwiched between the conventions and national health focused approaches. Maybe some countries do believe in punitive approaches but it is a fact for almost every other country in South and Southeast Asia that they have been implementing some combination of harm reduction services, including NSP and OST. Are the Asian governments afraid thinking what will happen to their nation if they challenged the UNODC rhetoric? Are the Asian governments afraid that they will be punished by some diplomatic reasons to cut the foreign aid and to revoke trade agreements?

So, is the CND worth attending for our community?

Sure it is. For Rajiv and me, it was the first CND ever. Our impressions might be different than that of many others who have been attending for the last couple of years. Here, we must be mindful of the fact that CND is a process rather than an event happening in March and December every year. The process includes but are not limited to country reporting to the INCB and UNODC in the form of Annual Reporting Questionnaire (ARQ), suggesting resolutions to the CND, preparing country statements for the CND, engaging at the CND and translating resolutions into country policies. Merely attending the sessions on CND in March can be futile without country level preparations and engagements. The 62nd session of the CND in 2019 is important as the year marks the end as well as failure of the 2009 political declaration and plan of action.

We are cognizant of the reluctance of our governments in this matter but we could still relate it to how successfully our communities have been engaging and influencing the Global Fund (GF) country dialogue processes. Engaging with GF processes from as a service provider to a CCM member and to a community/NGO delegation to the GF Board was equally difficult journey in the beginning and it certainly has not become any simpler to pursue due to its constant evolution.

UNODC and UNAIDS country offices are perceived to be more receptive than their headquarters in terms of heeding community voices. In many countries, we have already been working with the national narcotics control board and ministries of home/interior and health. We need to find ways to influence our country statements and resolutions (if any) drafted for CND because these documents are almost impossible to be changed once the country delegate is at the CND. We need not be very radical at this stage but simple mentioning of existing health interventions besides the community-based treatment. Specifically harm reduction services or detailed names of the services that already exist in the country like Needle Syringe Programs, Oral Substitution Therapy, Overdose prevention and management etc would be a good start. Having more side-events with proper planning on getting co-sponsors and invitees would be a good strategy. As our long-term effort, we could advocate to be part of the country delegation. It is also important that the Ministry of Health is part of the delegation, as we have been working more closely with them.


[1] Harm Reduction International. The Global State of Harm Reduction. 2016.

[2] Medical Cannabis. Available from:

[3] Thousands in China watch as 10 people sentenced to death in sport stadium. Available from:

[4] The Death Penalty for Drug Offences: Global Overview 2017. Available from:

[5] Compulsory drug detention in East and Southeast Asia: Evolving government, UN and donor responses. Available from: