Thailand activist speaks out at 10th ICAAP Plenary

Good afternoon, sister and fellow delegates, and thank you to the conference organizers for the honor of being asked to speak about this critically important issue. I know I don’t look much like an Asian person who uses drugs, but in fact the barriers to their participation in this conference were extraordinarily high; and, in my opinion, we did not do enough to ensure their participation.

The absence of people who use drugs at this conference, which aspires to bring “diverse voices” together for “united action” on HIV/AIDS, only further compromises our ability to truly achieve universal access to HIV prevention and treatment; for without the rich contributions of people most affected by HIV, namely people who inject drugs, people in prison, undocumented citizens and migrants and ethnic minorities, men who have sex with men, sex workers, transgender people, and women, by not actively promoting their involvement in the response, we are denying them a right and we are perpetuating the bad practices of discrimination and denial that we deplore in others. I do hope that from the outset, the next conference will take concrete steps such as ensuring on-site access to medical care including opiate substitution therapy for people who use drugs as a matter of course and that a conference that does not provide this is not allowed to happen.

Here in Asia, where more than half the world’s opiate users live, home to over 16 million drug users and at least 6.5 million injectors, where HIV prevalence among injectors is among the highest in the world, where the HIV epidemic is largely driven by unsafe injecting practices, where less than 10% of heroin injectors are on methadone, and where injectors can access an average of just 2 sterile syringes per month, we also lack 90% of the resources necessary to provide the essential harm reduction services necessary for realizing the right to health. But while resources are a significant challenge, I would argue that even when we have the resources, it does not ensure access.

Unless and until we address and remove the legal and policy barriers to accessing services for people who use drugs, investing in harm reduction is tantamount to flushing your money down the toilet. No smart investor in harm reduction would ignore the repressive legal and policy environments in which harm reduction services in Asia take place. A good investor would want to understand and invest in interventions that work against the ways in which criminalization, strict law enforcement practices, and the failure to respect, protect and fulfill human rights for marginalized groups, collude to undermine and even undo the benefits of all the harm reduction services we are providing.

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