The Goa Declaration

Photo by bobbyramakantBy International Network of People Who Use Drugs, “Asia and the Pacific Region”

January 2008, India

Besides being the world’s largest producer of opiates and other drugs such as Amphetamine type substances (ATS), the Asian and the pacific region is home to the largest number of drug users. Although evidence-based, cost-effective approaches are endorsed and promoted by various agencies people who use drugs in the region continue to be oppressed by discriminatory government policies and non-evidence based ‘solutions’ to drug use, such as imprisonment and compulsory detoxification and rehabilitation. Without taking into consideration the socio-economic factors underpinning drug use in the region, people who use drugs will continue to be harassed, marginalised and discriminated against, stereotyped as dangerous and imprisoned.

The constant oppression, persecution and human rights violation contributes to HIV and hepatitis vulnerability of people who use drugs, particularly those who inject. In Asia, up to 89% of new HIV and 92% of hepatitis C infections are occurring among injecting drug users (IDUs). On average IDUs account for 30-50% of new HIV infections and 40-60% of the IDU population is estimated to be living with hepatitis C virus (HCV) as well. Even though it is obvious that drug users’ vulnerability to and experience with HIV and HCV make them one of the most important constituents in responses to HIV and HCV in Asia and the Pacific, the level of harm reduction, treatment, support services available as well as involvement of that particular community continues to be grossly insufficient.

If Asian and the Pacific governments, civil society, health care providers and other stakeholders are serious about halting the HIV/HCV epidemic, purposeful attention and action must be given to ensure evidence-based and non-oppressive approaches to address the needs and high vulnerability of the IDU population in Asia and the pacific. Policies on drug control need to be harmonized with HIV and HCV prevention, treatment, care and support efforts and standards of services for harm reduction would also be required in order to have an enabling environment for sustainable service delivery.

In this context, WE, the people who use drugs in Asia and the Pacific, thereby:

Call on governments, various agencies, bi- and multilateral organisations, civil society organisations (CSOs) and the general public to support in:

    * Empowering our communities to advocate and protect our rights and to facilitate meaningful participation in decision making on issues affecting us;
    * Promoting a better understanding of current drug policies that negatively impact on the lives and rights of people who use drugs, their families and communities;
    * Acknowledging and enhancing our knowledge and skills to educate and train others, particularly our peers and members of our community;
    * Advocating for Universal Access to harm reduction, HIV/HCV treatment and care programmes, including access to evidence-based and effective drug treatment, appropriate medical care, safer consumption equipment, safe disposal of syringes and needles, up-to-date information about drugs and their effects, and safer facilities for practicing harm reduction;
    * Protecting and eexercising our right to evidence-based information on various drugs including their side effects and complications, access to equitable and comprehensive health and supportive social services, safe and affordable housing and meaningful employment opportunities;
    * Establishing specifically designed program to address the issues of women who use drugs and allocate enough resources to ensure programs are sustainable while actively promoting their meaningful full participation in all policy, program design and implementation process.
    * Supporting local, national and regional networks of people who use drugs are incorporated at all levels of decision-making and equitably remunerated for their contributions;
    * Challenging laws, policies and programmes that disempower, oppress and prevent us from leading healthy and positive lives;
    * Distinguishing drug dealers from people using drugs who need support, care and treatment instead of oppression and prosecution;
    * Providing easy access to affordable antiretroviral medicines including second and third line treatments, TB and HCV treatment for all who need them; if necessary by enacting intellectual property laws to protect the rights of developing countries to implement the safeguards enshrined in the TRIPS agreement and Doha Declarations such as Compulsory Licenses, as endorsed by the 2007 WHO General Assembly;
    * Advocating for development and adherence to harm reduction service delivery such as NSP, OST, residential care, ARV/HCV treatment etc.

Affirm our duties and responsibilities as responsible citizens in:

    * Contributing to collective efforts against the HIV and HCV epidemics in Asia and the Pacific, including HIV and HCV prevention, and care and support of those already infected and affected;
    * Seeking understanding of issues, challenges and needs of drug users in Asia and the Pacific;
    * Promoting tolerance, cooperation and collaboration; fostering a culture of inclusion and active participation;
    * Respecting the diversity of backgrounds, knowledge, skills and capabilities, and cultivating a safe and supportive environment within the drug user community regardless of the types and routes of drugs consumption;
    * Supporting, strengthening and encouraging the development of organizations for people who use drugs in communities/countries where they do not exist.

State our position that:

    * The most profound need to establish a network of people who use drugs arises from the fact that no group of oppressed people ever attained liberation without the empowerment and involvement of those directly affected;
    * Through collective action, we will challenge existing oppressive drug laws, policies and programmes and work with government and our constituents to formulate evidence-based drug policies that respect human rights and dignity of people who use drugs.

Issued at the First Asian Consultation on the Prevention of HIV Related to Drug Use. Goa, India on 31 January 2008.

Bobby Ramakant-CNS