MDM is a French medical humanitarian NGO working in France and abroad. MDM-F programmes targeting drug users aim to build local capacities in order to scale up services (harm reduction, overdose management, mental health services, human rights watchdog) and hand them over to local organisations, while advocating for policy change.

MDM-F es una ONG médica humanitaria francesa, que opera en ese país y en el exterior. Los programas de MDM-F dirigidos a consumidores de drogas, se proponen desarrollar capacidades locales a fin de incrementar servicios (reducción de daños, manejo de sobredosis, servicios de salud mental, monitoreo de la situación de los derechos humanos) y transferirlos a organizaciones locales, al mismo tiempo que impulsar cambios en las políticas nacionales e internacionales.

MDM est une ONG humanitaire française qui vise à améliorer des services (réduction des risques, gestion des overdoses, services de psychiatrie, protection des droits humains), en mettant en place des moyens locaux qu’ils transmettent ensuite à des organisations locales.

Médecins du Monde (MDM)

Harm reduction services for people who inject drugs are essential interventions. There are many tools for HIV and HCV prevention amongst people who use drugs. Low dead space syringes and needles (LDSS) is one such tool.

This discussion will explore the uses and benefits of LDSS syringes for people who inject drugs.


Low dead space syringes: Analysis and benefits for people who inject drugs

By the London School of Hygiene & Tropical Medicine, Médecins du Monde and the International Network of People who Use Drugs (INPUD)

Unpack the harm reduction approach, its connection to public health and human rights, and how it works at addressing drug use.

Over the past decades, drug use is increasingly recognised through a public health and human rights perspective. The evidence-based harm reduction approach is based on years of global experiences and evaluated by extensive research. This three-week course provides great insight into why it is such an effective solution.

See how human rights and public health relate to harm reduction

Public health measures focus on improving the overall health of a population, changing regulations, and increasing government support.

You’ll learn how harm reduction is a vital part of this approach, using an effective intervention model that saves lives, as well as protecting dignity, individual agency and other human rights.

Understand the importance of support instead of punishment

At its core, the harm reduction approach is based on empowering people to better protect themselves from potential risks associated with drug use.

It acknowledges the role of people who use drugs as a vital component of a public health response and promotes the idea that government and community support decrease potential risk factors.

On this course, you’ll see real best-practice examples and explore how you can advocate scaling up harm reduction to make a real impact on individual and public health issues, as well as protecting the human rights of people who use drugs.

Study harm reduction at a recognised leader in global and public health

The London School of Hygiene & Tropical Medicine (LSHTM) is strongly connected to the peer-reviewed International Journal of Drug Policy, with much of the research in this field coming from the LSHTM, while also being a world-renowned leader in global and public health.

You can trust their expert guidance as you learn more about using harm reduction to address drug use.

Drug use and harm reduction - Online course

INHSU has collaborated with the International Network of People Who Use Drugs (INPUD), Médecins du Monde (MDM), and Harm Reduction International (HRI) to create a global declaration to inform development of the World Health Organization (WHO)’s Global Health Sector Strategies for HIV, viral hepatitis and STIs.

The World Health Organization is in the process of developing Global Health Sector Strategies for HIV, Viral Hepatitis and Sexually Transmitted Infections (STIs) for 2022-2030. As voted during the World Health Assembly May 2020, the new strategies will be combined into a single document that includes both integrated and disease-specific content.

WHO is conducting various stakeholder consultation activities to inform development of these strategies. It is in this context that we (INPUD, MdM, HRI and INSHU) propose a declaration from the global harm reduction community and its allies, to call for the WHO to uphold the core values we stand for.

The declaration is available to download here and to sign online here.

We strongly believe there is a need for brave and bold leadership to strongly challenge attempts of political interference that will hold back equitable progress towards HIV, viral hepatitis, and STI elimination efforts. We also request that clear focus be given to supporting decriminalization and removal of discriminatory laws and practices as they impact people who use drugs’ access to health services, ensuring the centrality of harm reduction services, and enabling, supporting and encouraging community-led responses and person-centred service delivery.

Declaration to inform development of WHO Global Health Sector Strategies for HIV, Viral Hep and STIs

Over the course of the last decades, peer work has been increasingly recognised as the most efficient model of intervention in any HIV or HCV cascade and is deeply embedded in the Harm Reduction approach. Despite this recognition and numerous global recommendations to expand peer work, adequate funding for peer work as well as ensuring the security, capacity building and meaningful participation of peer workers in programming and strategy-making spaces is lagging behind. Often, contexts do not have an administrative framework to recognise peer work in a job-structure, neither is peer work recognised as being part of the national health systems. Many peer workers find themselves in precarious and unfavourable employment situations and receive an extremely low daily wage, despite the fact that they are often the low threshold point of engagement for harm reduction services and exposed to the most risk.

It is recognised that peer workers’ expertise and engagement within the community is invaluable in delivering outreach and ensuring access to services. Peer workers are people with lived experiences who also have privileged access to marginalised communities and active drug scenes. As such, these models need to be scaled up in order to meet current health targets. Furthermore, the engagement of the community must be appropriately recognized and supported. Meaningful participation should be factored into all aspects of planning, design and implementation of harm reduction interventions. Peer workers are also essential in this process.

What can we do to strengthen and sustain interventions with peer workers for people who use drugs and sex workers?

This video summarises discussions from a multi-stakeholder consultation process organised by the International Network of People Who Use Drugs (INPUD), CoAct, the European Network of People who Use Drugs (EuroPUD), the International Committee on the Rights of Sex Workers in Europe (ICRSE) and Médecins du Monde.

Strengthening and sustaining peer work interventions for people who use drugs and sex workers

The following letter was drafted by a coalition of 29 civil society organisations and community networks in the European Union. The letter urges the German Presidency to propose to the EU Horizontal Working Party on Drugs (HDG) that the current draft EU Agenda and Action Plan on Drugs 2021-2025 be rejected, and measures are taken to ensure an appropriate and inclusive strategic development process for the next EU drugs strategy.

We are writing regarding the proposed EU Agenda and Action Plan on Drugs 2021-2025, published by the European Commission on 24 July 2020 (the “2021-25 EU Drugs Agenda”, or the “Agenda”). We have serious concerns regarding both the process for its development as well as with the substance of the document and urge the German Presidency to propose to the EU Horizontal Working Party on Drugs (HDG) that this draft cannot be accepted, and to outline an appropriate and inclusive strategic development process for the next EU drugs strategy.

The formulation of the 2021-25 EU Drugs Agenda through a unilateral Communication of the European Commission without consultation with EU Member States and other relevant EU actors, including civil society is deeply problematic. If the HDG accepts this document as it stands, a worrying procedural precedent will be set. To date, the ‘EU’s drugs strategies and action plans are developed through a rigorous process that allows Member States to work together on the development of strategic approaches. This involves a series of negotiations, evaluations and compromises so that consensus can be reached in the form of a new strategy document.’ The 2021-25 EU Drugs Agenda appears to be the result of a hasty, opaque and non-participatory policy-making process, and represents a drastic departure from agreed EU policies. The lack of appropriate consultation and engagement inevitably means that the different experiences and views of EU Member States and other relevant EU actors have less weight in the new document. It fails to adopt a balanced, integrated, and multidisciplinary approach to drug matters; it is not rooted on human rights, public health, and the key international drug policy documents; and it envisages a diminished role for civil society and affected communities.

The European Union has been a global leader in advancing a balanced, integrated, and multidisciplinary approach to drug policies. The 2005 and 2013 EU Drugs Strategies established a consolidated framework that has become a ‘central guiding model’ for national-level drug strategies across the EU. However, the 2021-25 EU Drugs Agenda proposes -in its own words- a ‘paradigm-shift’. It disproportionately focuses EU policy on law enforcement and supply control, to the detriment of the priority previously given to public health, human rights, international cooperation, and scientific research and evaluation. If implemented, it will signal a diminished support for evidence-based drug treatment and harm reduction services, and it will weaken the voice of the EU in international drugs fora, where it has been a key global actor in defending the balanced, rights-based approach adopted by the 2016 UNGASS Outcome Document.

In spite of the EU’s commitment to seek the ‘active and meaningful participation and involvement of civil society’ in the ‘development and implementation of drug policies’, the participation of civil society in the preparation of the 2021-25 Drugs Agenda has been deeply flawed. European NGOs were only allowed to provide input to the Agenda with the publication of the Road Map, on 10 June 2020, with no other opportunity to feed in the process, besides a call between the Commission and certain CSFD members in April. It should be borne in mind that the Road Map is a document of just over two pages that does not allow for a genuine understanding of, or feedback on, the Agenda. No draft of the Agenda was ever shared.

Furthermore, the European Commission disregarded the overwhelming majority of the 27 submissions sent by European NGOs, which urged the EU to retain the balanced and multidisciplinary approach that characterized the 2005 and 2013 EU Drugs Strategies. The fact that the deadline for submitting feedback was 15 July 2020, a mere nine days before the publication of the Communication, suggests that the consultation was not undertaken in the spirit of genuine inquiry, and that the Agenda was at least near completion when the Road Map was published.

Crucially, although the external evaluation of the 2013 EU Drugs Strategy was finalised in April 2020, the evaluation was not published or otherwise shared with civil society until three months later, on 24 July 2020, thus depriving stakeholders of crucial information when providing feedback to the Road Map. This is important, as there would appear to be a significant disconnect between the Agenda and the external evaluation. For instance, the evaluation consistently found that the 2013 Strategy had ‘sparked a considerable amount of progress’ in the cross-cutting areas of coordination, international cooperation, and monitoring, research and evaluation, which are precisely the areas now removed from the Agenda.

In addition to the grave concerns regarding the process and procedure, we felt it is important to bring your attention the key flaws in the draft Agenda:

. Although the Agenda explicitly claims to seek an ‘integrated, balanced, and multidisciplinary approach’ to drug policies, the draft is not balanced, as over half of its eight priority areas concern security and supply control interventions, with the rest distributed between prisons, prevention, treatment, and harm reduction. Public health measures aimed at reducing the harms that can be associated to drug use have been relegated from the first priority of the 2013 Drugs Strategy to the end of the new Agenda. The cross-cutting themes of coordination, international cooperation, and information and research, which have been successfully developed since 2013 to materialise the multidisciplinary and integrated approach, have been dropped. The many references to the balanced approach across the operative parts of the 2013 Strategy, for instance as the basis for increased coordination across all actors, interventions at the CND, and international cooperation, have also disappeared.

Deprioritising human rights and public health.

 Human rights have practically disappeared from the draft Agenda, which contains no reference to the relevant international or regional human rights instruments, including the Universal Declaration of Human Rights. Furthermore, there is no mention of the International Guidelines on Human Rights and Drug Policy, a critical document developed with the leading support of Germany that lays down, for the first time, a set of clear and comprehensive international standards for articulating rights-based responses to illegal drug economies. In contrast, the 2013 EU Drugs Strategy explicitly referred to the Universal Declaration of Human Rights and the European Convention of Human Rights, amongst others, and human rights were mentioned several times in the section on international cooperation. Public health has been relegated from the first policy field in the 2013 Strategy to the last priority areas of the Agenda, and has been replaced by ‘drug-related security’ as the first goal of the document.

Dropping support for key international documents.

 Equally surprising is the little attention paid to the 2016 UNGASS Outcome Document - only a footnote in the preambular part of the Agenda, and a mention in the Action Plan, outside its priority areas -, even though it has been consistently described by the EU as ‘the most comprehensive policy agreement of the international community and a milestone in the discussions on international drug policy’. It is also inexplicable that the Agenda would completely fail to reference the 2018 UN System Common Position on Drugs, a watershed document championed by the EU and EU Member States, as it establishes for the first time a coherent position across all UN entities on key topics like decriminalisation and harm reduction.

Reducing the space for civil society and people who use drugs.

 Whereas the 2013 EU Drugs Strategy contained a commitment to promote and encourage ‘the active and meaningful participation and involvement of civil society’, the EU Drugs Agenda only mentions ‘engagement’ with the CSFD. Involvement with civil society beyond the CSFD has been omitted, and there is no reference to engaging with people who use drugs and clients of drug services, which the 2013 Strategy did.

Weakening the external dimensions of drug policy.

 The 2021-25 Drugs Agenda risks weakening the external action of the EU in bilateral and multilateral drugs fora, as it does not set clear guidelines for EU coordinated intervention, and it does not provide strong support for the key international documents that the EU has been forcefully defending and promoting in the last years. For instance, the Agenda does not provide any concrete principle or guideline for intervening at the CND, even though it is arguably the centre of the international drug control system, and the role of the EU there is more important than ever. This contrasts greatly with the 2013 Drugs Strategy, which committed the EU to a ‘strong voice’ in the Commission on Narcotic Drugs, with the aim of promoting the balanced approach. Another case in point is the only reference to alternative development in the whole Agenda, which can be found under the heading ‘dismantling drug production’, and is not deemed to warrant even one of the 24 priority areas set in the document. This is especially surprising considering that the 2018 Council Conclusions adopted exclusively on this topic committed the EU to a ‘leading role (…) in the funding and implementation of alternative development’, and stated clearly that the success of alternative development goes ‘beyond an exclusive focus on illicit drug crop monitoring’.

 In spite of the EU’s leading role in fostering scientific knowledge and research on drug markets and drug use through the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the 2021-25 EU Drugs Agenda has dropped the cross-cutting theme on monitoring, research and evaluation, and science-based drug policies are scarcely mentioned in the operative parts of the document. Again, this makes a striking contrast with the 2013 Drugs Strategy, which featured a whole theme on research and evaluation for ‘a better understanding of all aspects of the drug phenomenon’, and provided a role for the EMCDDA in supply reduction, international cooperation, and the overall implementation of the document, among others.

 Although the 2021-25 Drugs Agenda explicitly seeks to reduce drug-related stigma, the European Commission press release accompanying the publication of the proposed Agenda was deeply stigmatising, as it puts drug policies at the same level as child abuse and firearms trafficking. Furthermore, the Agenda contains some instances of stigmatising language (‘substance abuse’ and ‘substance misuse’) that did not exist in the 2013 Drugs Strategy.

In light of the above and following established practices for the development of previous EU drugs strategies, we urge you, as the Council Presidency, to take political leadership and encourage the HDG to reject the draft proposed by the European Commission. A new process for strategy development should ensure that the new document reflects in a balanced manner the existing EU and the latest international commitments (in particular the 2016 UNGASS Outcome Document), the views of the EU Member States and all the relevant actors within the EU institutions, and engages meaningfully with civil society.

We would also be grateful if you could share this letter with your HDG colleagues before the 9 September meeting.
We remain at your disposal for any further discussion on this matter, and look forward to our continued cooperation on this and other topics during the German Presidency.

Drug policy experts raise concerns regarding the draft EU Agenda and Action Plan on Drugs 2021-2025 - Open Letter

Ahead of the UNAIDS Multi-Stakeholder Consultation on 16 September, 33 civil society and community-led organisations working on drug policy and harm reduction are urging the UNAIDS Programme Coordinating Board (UNAIDS PCB) to uphold the rights of people who use drugs and harm reduction in the new UNAIDS Strategy.

This letter includes six key recommendations from our community and sector and we asking UNAIDS PCB to advocate for these at the upcoming Consultation.

Now, more than ever, we need their leadership to be strong, bold and unrelenting in ensuring that key populations, including people who inject drugs, are prioritised in the new UNAIDS Strategy; harm reduction services are available, scaled-up and fully funded to meet the HIV prevention and health needs of people who use drugs wherever needed; communities, including community-led services, and civil society are at the front and centre of the HIV response; and barriers to services, including criminalisation, stigma, discrimination, punitive laws and policies, are removed.

The new UNAIDS strategy will have profound implications - either by compounding or alleviating the political invisibility of people who use drugs. We need them to show a commitment to people who use drugs in your engagement in the Strategy process.

We will not end AIDS if we keep leaving people who inject drugs behind.

Call to uphold the rights of people who use drugs and harm reduction in the new UNAIDS Strategy

This fifth webinar will focus on women and tackle the issues of service access, sex work, domestic violence and decarceration. The event will take place on 

Speakers include Gloria Lai, Lindsay Roberts, Jules Kim and Vielta Parkhomenko.

Webinar #5 on COVID-19 and Harm Reduction Programme Implementation - Women who use drugs and COVID-19

This fourth webinar in the series takes a deeper dive into issues of access to housing, shelter and health services for people who use drugs during COVID-19, and the amplified challenges faced during this time. The aim of this webinar is to share experiences and facilitate an interactive discussion on both existing services that have been adapted, and new initiatives that have been established to address the challenges faced by the community related to housing and shelter. The speakers will discuss how COVID-19 has affected their programmes, the role and mobilisation of civil society, and advocacy for housing, shelter and survival support for PWUD.

Webinar #4 on COVID-19 and Harm Reduction Programme Implementation

The COVID-19 pandemic is having a profound effect on the provision of health services across the globe and is further magnifying the existing barriers faced by people who use drugs in accessing harm reduction services. Programmes have had to adapt, and efforts are being made to enhance accessibility and ensure the continuity of harm reduction services in a context that is changing daily. But what does this look like in reality, and what practical measures can be put in place to ensure that people who use drugs continue to have access to essential services and support?

The aim of this third webinar in the series is to facilitate an interactive and more in-depth discussion on harm reduction responses to 

particularly people who use stimulant drugs

 in a time of COVID-19. This will build upon previous discussions and aims to encourage a positive and proactive response to people who use stimulant drugs during this time.

Click here to register to the 09:30 session

Click here to register to the 16:00 sesstion

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