The Ozone Foundation facilitates sustainable community-based delivery and expansion of health service access for people who use and inject drugs in Thailand towards an integrated national response to HIV and other health issues in which the human rights of everyone are protected and recognised.

La Fundación Ozone asegura la puesta en marcha de servicios comunitarios y la expansión de servicios de salud para las personas que utilizan e inyectan drogas en Tailandia, aspirando a una respuesta nacional integrada para el VIH y otras cuestiones de salud en la cual los derechos humanos de todos sean protegidos y respetados.

La Fondation Ozone facilite la prestation des programmes communautaires et l'expansion des services de santé pour les personnes qui consomment et injectent des drogues en Thaïlande, avec le but d'avancer vers une réponse nationale intégrée concernant le VIH et d'autres questions de santé qui respecte et protège les droits humains.

Ozone Foundation

“I first started taking drugs when I was 15,” says 49-year-old Prapat Sukkeaw. “I smoked marijuana, but it was laced with heroin. I felt like I was floating, and it meant that I could forget about all the problems that I faced as a teenager. It was a beautiful feeling.”

Prapat Sukkeaw is one of an estimated 57,000 people who currently injects drugs in Thailand. His drugs of choice, marijuana and heroin, reflect a period in Thailand’s recent history when both illegal narcotics were the main stimulants being trafficked out of the storied Golden Triangle, a remote and somewhat inaccessible region which includes northern Thailand as well as Myanmar and Laos.

Employed by a non-governmental organization (NGO), he has on occasion wanted to give up heroin due to pressure from family and friends. Now, he has recognized that, even if he admits to being addicted, taking drugs “is my preference and my right”. He has now started taking the synthetic drug methamphetamine, as heroin has become progressively more expensive.

His focus has moved from abstaining from drugs to living with the side effects and managing the potential harm of their prolonged use, for example by not sharing needles.

Like all Thai citizens, Mr. Sukkeaw has access to universal health care, but he found that as a person who uses drugs, he was stigmatized and discriminated against by health care workers. He was referred to Ozone, an NGO based in a suburb of the Thai capital, Bangkok.

Ozone’s goal is to reduce the health and social impacts of drug addiction, promoting abstinence, but also supporting clients who want to carry on using and ensuring that they have access to the health services they require.

Thailand: Moving from punishment to treatment of people who use drugs

To: Ms Ghada Waly, Executive Director, United Nations Office on Drugs and Crime

Subject: Open letter on UNODC statement on International Human Rights Day 2021

We urge you to mark International Human Rights Day 2021 by calling on Member States to change drug policies and practices that violate human rights and perpetuate inequality and discrimination.

We are writing to you ahead of International Human Rights Day 2021, which will take place on the 10th December amidst escalating global demands for the reform of laws and practices that entrench racial discrimination and social inequality, including drug policies. Last year, IDPC – together with dozens of other civil society and community organisations – called on you to issue a statement on International Human Rights Day urging Member States to change drug laws and practices that undermine health and human rights. A year later, we ask you to seize this day as an opportunity to show UNODC´s alignment with other UN entities in calling for an end to drug policies and practices that perpetuate inequality and discrimination, and violate human rights.

For decades, punitive drug policies have driven widespread human rights abuses, as has been amply documented by the UN. These include the death penalty for drug offences; extrajudicial killings; arbitrary detention, often masquerading as ‘rehabilitation’; the denial of access to life-saving harm reduction services; widespread barriers to accessing controlled medicines for pain relief; the criminalisation of people who use drugs, subsistence farmers and others groups in situations of vulnerability; corporal punishment; and mass incarceration. In all of these cases, draconian drug policies have disproportionately affected people marginalised on the basis of their gender, race, ethnicity, and economic status, thus entrenching inequality and discrimination.

Along 2021, a broad range of UN entities called on Member States to reform drug policies with discriminatory outcomes. In June 2021, the UN Working Group on Arbitrary Detention released a landmark study on arbitrary detention and drug polices, which found that ´

the war on drugs may be understood to a significant extent as a war on people. Its impact is often greatest on those who are poor, but also frequently overlaps with discrimination in law enforcement directed at vulnerable groups

´. At the same time, the UN High Commissioner for Human Rights published a new ‘Agenda towards transformative change for racial justice and equality´, highlighting that ´

The discriminatory application of criminal law must be tackled at every stage, including by reforming drug-related policies

´. The High Commissioner´s proposal led to Human Rights Council Resolution 47/21, which contains key commitments to uproot systemic racism in the law enforcement and criminal justice systems. The Political Declaration on HIV and AIDS, adopted in June 2021, also showcased the international community´s commitment to ending inequalities as a step towards ending AIDS. Lastly, the new UN system Common Position on Incarceration, led by UNODC in partnership with other UN entities, notes ‘

the overrepresentation of minority and marginalized groups among prisoners, many of whom are charged with petty and nonviolent offences

support reform efforts aimed at ensuring proportionate and individualized sentencing and alternatives to conviction or punishment in appropriate cases, including for minor drug-related offences

These various commitments emerging across the United Nations are aligned with the 2018 Chief Executives Board’s UN System Common Position on drug-related matters, which makes clear that ‘

should be designed and implemented by States in accordance with their human rights obligations

’, and commits all UN agencies, including UNODC, to support drug policies ‘

that put people, health, and human rights at the centre

Similar human rights concerns have been highlighted in the just-released Global Drug Policy Index, which measures and ranks the national drug policies of 30 countries according to how well they align with the UN system Common Position on Drugs and its Task Team report of March 2019.

The theme of the 2021 International Human Rights Day is ‘Equality: Reducing inequalities, advancing human rights’, and is aimed at ´

addressing and finding solutions for deep-rooted forms of discrimination that have affected the most vulnerable people in societies

´. As such, it presents a crucial opportunity for UNODC to align itself with other UN entities in calling for the end of policies that perpetuate inequality and discrimination, while highlighting its commitment to the promotion of human rights, in line with the UN system Common Positions.

It is in this context that we urge you to issue a strong statement on International Human Rights Day, calling on states to change the drug laws, policies and practices that violate health and human rights, and entrench inequality. To be credible, such a statement should explicitly acknowledge the disproportionate impact of drug laws and drug control on people marginalised on the basis of their gender, race, ethnicity, and economic status, and urge Member States to:

Abolish the death penalty in all circumstances. Imposing capital punishment for drug offences has been found to be contrary to international human rights law by the Human Rights Committee, and the Human Rights Council.

Put an immediate end to extrajudicial killings committed in the name of drug control, as has been repeatedly called for by the Human Rights Council and UN human rights experts.

Permanently close compulsory drug detention centres, including those that masquerade as ‘rehabilitation’, and implement voluntary, evidence-informed, and rights-based health and social services, as recently called for by sixteen UN agencies, including UNODC.

Stress the urgent need to provide accessible, affordable, and adequately funded harm reduction services in community and closed settings, to fulfil the right to health and the right to life of people who use drugs, as demanded by several UN human rights bodies and experts. This is also central to UNODC’s core role as lead UNAIDS co-sponsor regarding prisons and HIV amongst people who use drugs.

Take immediate measures to address prison overcrowding, as already recommended by UNODC and the UN High Commissioner for Human Rights in the wake of the COVID-19 pandemic, by promoting alternatives to incarceration, and ensuring proportionate sentencing for all drug offences, including by taking into account mitigating factors – in line with the basic principle that prisons should only be used as a last resort in all circumstances.

Ensure that people who use drugs are not subject to arbitrary detention, torture, or ill-treatment – whether in state custody or public or private drug services. While under detention, people with a drug dependence or health problems associated with their drug use must be offered evidence-based treatment, harm reduction and other drug services on a strictly voluntary basis.

Promote the end of all punishment for drug use, and drug possession and cultivation for personal use, as permitted within the three drug control conventions. Such policy shifts will help to end the stigma, criminalisation, and exclusion faced by people who use drugs, and to facilitate access to health and social services, as called for by the UN system Common Position, UNAIDS, and UN human rights bodies.

Make sure that drug policies incorporate a gender-sensitive perspective. This should be done by tailoring drug services to the specific needs of women, and by ensuring that criminal laws take into account the circumstances of women involved in drug offences, as most of them come from backgrounds of poverty, marginalisation, and oppression.

Clearly outline the ways in which UNODC will work to achieve these changes, and the measures being taken to ensure that human rights are effectively embedded as a core strand for all of the Office’s work.

As the lead UN agency in drug-related matters, UNODC has the responsibility to promote drug policies that respect, protect, and fulfil human rights, in a way that is consistent with the standards developed by the UN system, and in line with the commitments set in the UN system Common Positions on drugs and on incarceration. A strong statement in the forthcoming International Human Rights Day would be an important and welcome step to signal UNODC’s unequivocal commitment.

We look forward to discussing these concerns and recommendations with you.

NGOs urge UNODC's Executive Director to mark Human Rights Day with a call to reform drug policies that entrench inequality

As Thailand battles another wave of COVID-19 infections, government authorities and businesses must prioritize the health of people, without neglecting marginalized groups who are systematically targeted by law enforcement, criminalised, and discriminated against.

During this unprecedented period, community organizations are right at the coalface of issues of inequity and inequality that Covid-19 has amplified. In December 2020, APCOM, the International Drug Policy Consortium (IDPC), Health Opportunity Network (HON), Ozone Foundation, and the Asia-Pacific Transgender Network (APTN) in partnership with Rangsit University Department of Criminology organized a dialogue on issues faced by LGBTQI people who use drugs in Thailand.

In the tourism sector, the work environment faced by LGBTQI people became even more insecure with the onset and prolonged closure of the country because of the COVID-19 pandemic. Many entertainment venues suspended their business operations or closed entirely, which in turn affected employees, many of whom were forced out of employment without compensation. Pattaya, a well-known tourist haven for transgender people, especially transgender sex workers, face systematic discrimination, violence, and oppression from law enforcement.

UNDP and APTN assessed the impact of COVID-19 on Thailand’s LGBTQI community in April 2020 and found that 47% had lost their income and jobs or were forced to go on unpaid leave, and 51% did not receive any COVID-19-related government assistance. They either did not qualify or too afraid of discrimination should they apply for government assistance. The reduced income has also made it difficult for many transgender sex workers to maintain their hormones medication regime, which can have long term impacts on their health. Employees say that they are less afraid of getting infected by COVID-19 than not having any income. They are more afraid of dying from their dire financial situation than from COVID-19.

He has worked for many years to provide health and harm reduction services to people who use drugs throughout the country. “If our laws are written on the basis of panic, then it’s a problem for all our health – thinking only of punishing people,” he concluded.

This is in line with a scoping review undertaken APCOM to better understand the socio-sexual context of sexualized drug use among men who have sex with men (MSM) and transgender women (TGW). It was found that privacy, anonymity, and secrecy were main concerns due to an environment where there are punitive drug laws, death penalties, incarceration and enforced treatment, as well as peer and family exclusion. Not only does this mean there are data gaps but it leads to public health implications, including transmission of HIV, hepatitis C, HPV, syphilis, gonorrhoea, and shigellosis, and psychosocial health. Issues of mental health were identified in APCOM’s report Surveying LGBTQI+ situation in Thailand during Covid-19 Pandemic.

Today, with almost 400,000 people in prisons, Thailand has one of the largest numbers of people imprisoned in the world, and the largest in Southeast Asia. Ann Fordham, Executive Director of IDPC – a global network of civil society organisations advocating for drug policies grounded in principles of public health, human rights and social justice – pointed out that over 80% of people in prison in Thailand are held for drug offences. Prisons are overcrowded at a rate of about 200%, and not surprisingly became a hotspot for Covid-19 infections.

Having a dialogue is an important start but implementing inclusive measures and reforms in policies and practices require active effort from across sectors.

“I can see that the tourism trends are changing. Thailand is one of the few destinations in the world that welcome LGBT tourists.” Pol.Col. Surasak Surinkaew from the Tourist Police Bureau acknowledged.

HON works to provide health and support services for transgender people, including those who use drugs in Pattaya.

He encouraged companies and organizations to consider quotas for hiring LGBTQ+ people not only to improve employment prospects for LGBTQ+ people but also because it benefits businesses.At the intersectionality of social justice, public health, human rights and drug use experienced by LGBTQ+ people, APCOM plans to continue working in collaboration with communities, civil society, academia, policymakers and the private sector to advance the well-being and welfare of LGBTQ+ communities in Thailand and beyond.

LGBTQI people who use drugs during COVID-19 in Thailand: Health, equality, and intersectionality

(This blog post was originally published on the Prachatai website, available here)

By Pattamon Wattanawanitchakorn (International Drug Policy Consortium - IDPC), with Thissadee Sawangying (Health Opportunity Network) and 

The life of a transgender sex worker in Pattaya is not easy. On the one hand, 'Pattaya is a paradise for transgender people, a place where many transgender sex workers feel they can openly express their identities,' says Thissadee of the Health Opportunity Network (HON). On the other hand, transgender sex workers face widespread discrimination, violence, and oppression, especially from law enforcement.

I am attending HON’s workshop on harm reduction for transgender sex workers who use drugs – the first such event organised for this group in Pattaya by HON, with support from the Ozone Foundation. HON was established in 2010 to provide peer-based health and support services for men who have sex with men (MSM), transgender people and sex workers living with HIV in Pattaya, Thailand. The Ozone Foundation is an NGO that provides community-based harm reduction services for people who use and inject drugs in Thailand. Responding to a gap in existing services, HON has begun to focus on better understanding the experiences and needs of transgender sex workers who use drugs.

The workshop is supported by VOICE as part of the year-long 'Strengthening and empowering women who use drugs in Southeast Asia' (SPIRIT) project (covering Indonesia, Malaysia, the Philippines and Thailand). The project seeks to empower cisgender and transgender women who use drugs to establish and strengthen community-led networks and advocate for gender equality, legal rights, and drug policy reform. Under the SPIRIT project, HON works in collaboration with the women cluster of the Thai Network of People Who Use Drugs to empower women who use drugs to advocate for their legal rights and build their capacity to integrate a harm reduction approach in their work.

The 20 transgender sex workers in the room are initially hesitant to share, but they are quick to empathise with one another as their stories take a similar turn. 'I thought I was the only odd one,' a participant reflected. 'But meeting everyone else here today, I could see that we all have similar experiences and that I’m not the only one who is different.' They share experiences of being stopped at checkpoints and forced to undergo urine tests on the spot, and of facing extortion by the police of up to 300,000 Thai Baht (USD $ 10,000) per month to avoid imprisonment and further harassment.

The women describe precarious working conditions. Getting through a regular work day often requires drinking alcohol or taking other substances to increase stamina. The daily wages earned by the sex workers are frequently the only source of income supporting their families. For a higher wage, sex workers may be asked to sell drugs, usually crystal methamphetamine (commonly known as 'crystal meth', or 'ice' in Thailand), as well as to use drugs together with clients as a part of their services. Using crystal meth before or during sex can intensify and prolong sexual experiences, but in the absence of prevention measures such as use of condoms or pre-exposure prophylaxis (PrEP), there is a high risk of exposure to sexually transmitted infections, such as HIV and hepatitis C. Some sex workers also use crystal meth for weight loss.

Although sex workers may prefer not to use crystal meth in sexual settings, it is challenging to refuse an offer of 10 times the amount of a regular fee, especially in times of economic hardship. One participant calls the nature of the work a 'hard job' and a 'burden in life', especially in relation to the constant risk of being targeted by law enforcement.

COVID-19 restrictions and economic hardship

The perilous work environment in which transgender sex workers operate has become more insecure with the onset of the COVID-19 pandemic. In response to COVID-19, the Thai government declared a nationwide state of emergency, while the Pattaya area had already been affected by an abrupt decline in tourists since early 2020. Many entertainment venues suspended their business operations or closed entirely, which in turn affected employees, many of whom were forced out of employment without compensation.

Because entertainment businesses were closed and tourism – including sex tourism – has come to a standstill, many sex workers are struggling to get by. Transgender sex workers have faced compounded challenges: In addition to now being unable to work, many were denied access to basic support from the government since they do not have identity documents. Throughout the lockdown, HON conducted house visits to provide food and hygiene supplies to over 200 transgender people in the Pattaya area, as well as conduct interviews to better understand their situation and how to best respond to it.

It is difficult for transgender people to talk about their drug use freely. Pervasive stigmatising narratives on drug use mean that disclosure could expose them to judgement, discrimination and shunning. For people already targeted by multiple forms of oppression, the risk of jeopardising existing relationships with their support network can be unbearable. 'Once they know [that I use drugs], my friends look at me differently, they treat me differently; even though I’ve always been using drugs the entire time. I haven’t changed. They have,” one participant shared.

In the two-day workshop, HON fostered a safe space that allowed transgender people who use drugs to discuss their unique challenges. Harm reduction training approaches such as Ozone’s Drug User Environment (DUE) tool were followed to improve understanding about the harms of various types of drugs and ways to manage their use in safer ways. The participants were encouraged to be more conscious of the type of drug they are using and their effects, as well as their surrounding environment. Monitoring these factors will help them to assess the associated risks and reduce potential harms, which can range from forgetting to eat and sleep, to negative mental health impacts.

One of the participants' testimonies illustrates some of the ways how patriarchal violence impacts transgender sex workers who use drugs. 'I was thin and beautiful when I used drugs. I won pageants and worked at an entertainment show on the border of China and Myanmar for around 10 years. Because it was so easily accessible there, everyone used it. But then one night, I hallucinated and found myself lying in the middle of the road. Not long after that, I decided to come back to Thailand. I stopped taking drugs and I gained so much weight.' Oot shares with me two pictures of herself as if to underscore the point. I acknowledge it. Across Asia, especially in the entertainment business, significant societal pressure is placed on women to maintain a certain type of appearance. Dominant values that associate beauty with thinness also promote stigma and shame around weight gain.

For Gift, her experience has a darker, harrowing beginning. 'I grew up around drugs. My brother, I was very close to him… and he was, let's just say, he was one of the biggest dealers in the East area. Drugs were as normal to me as eating rice, so when I was 12 I tried it. I didn't feel anything. It was just something the people around me did and I just wanted to fit in.' Gift’s brother died tragically while she was still young, leaving her on her own.

The most senior person in the room, Jim, holds the honorary title ‘Mother’, a name given to her by the community as a sign of respect. She sits at a lunch table across from Boong, who appears more reserved. Asked about her experience with drugs, Jim says, 'I went to prison for five years for using and selling drugs. She was the one who told on me' – and she gestures to Boong – 'but I don’t blame her. You have to do what you have to do.'She clarifies that getting caught by the police leaves one with two main choices: either surrendering to arrest, detention and sentencing (which likely lead to years of imprisonment), or acting as an informant for the police in exchange for a lighter sentence. Both of them seem to acknowledge that, faced with the potential violence of prisons, prioritising friendships rather than survival becomes nearly impossible. Sitting across the table from one another, there is no apparent trace of animosity between the two.

However, not every incident resolves itself this way. There are others who describe similar experiences which leave relationships among friends, families, and community members harmed beyond clear possibilities of repair. Hostile interactions with the police, encouraged by the ongoing criminalisation of drug use and the over-reliance on harsh policing, have bred distrust and resentment towards law enforcement within the community.

Death was also a common topic. Gift admits that awareness of harm reduction and accessible services could have saved her friend's life. 'We were taking drugs together. And our friend next to us who was sleeping took a gasp in her sleep. We continued to play cards until morning. We didn't know but that was the last breath that she took. We even moved her body upstairs, not knowing that she was already dead.' If they had access to harm reduction education and services, they likely could have helped their friend and prevented a tragedy.

For HON, empowerment means 'strengthening power from the inside' and 'building value, pride, and self-respect' through activities that help reduce internalised stigma for transgender people who use drugs. Transgender people who use drugs have limited 'bargaining power' and often experience rights violations, including violence from law enforcement.

HON continues to work closely with the transgender community to empower transgender sex workers through trainings on reducing stigma, building a network of transgender people who use drugs, creating a safe space to exchange experiences, developing understanding of relevant laws and mechanisms for protection, and building alliances with international organisations to advocate for more humane and less punitive policies at the national level.

Although the topics shared as part of this gathering were heavy and difficult, by the end of the second day, the atmosphere grew more relaxed. 'I compare myself to a messy room. HON is like a key that opened my door and gave me perspective to open the windows. I can breathe,' Gift tells the group.

'Drugs were as normal as eating rice': Understanding the experiences and needs of transgender sex workers in Pattaya, Thailand

By Mary Catherine Alvarez, Regional Coordinator, IDPC Project on Women, Incarceration and Drug Policy in South East Asia

In 2009, the United Nations Office of Drug and Crime (UNODC) produced a report assessing one hundred years of drug control since the 1909 Shanghai Opium Commission. The report identified and recognized the negative ‘unintended consequences’ of drug control policies: the creation of a criminal black market; the shift of policy focus from public health to law enforcement; enforcement in one geographical area resulted to diversion of illicit drug production to other areas; pressure on one type of drug led to the promotion of the use of other alternative drugs; and, the marginalization of and stigmatization against persons who use drugs.

Almost a decade after this UNODC report, these negative consequences of drug control continue to be suffered by a growing number of women incarcerated for drug-related offenses worldwide, and particularly in South East Asia. This policy guide aims to provide civil society organisations and stakeholders in Indonesia with information and policy recommendations on the situation of women incarcerated for drug-related offences.

In 2018, the International Drug Policy Consortium, in partnership with Ozone Foundation in Thailand, LBH Masyarakat in Indonesia and NoBox Transitions in the Philippines, embarked on a project called ‘Women, Incarceration and Drug Policies in South East Asia: Promoting Humane and Effective Responses’.

The project aims to encourage reforms towards reducing the levels of incarceration of women for drug offenses. The project also seeks to increase civil society engagement; gather support for proportionate sentencing and reduction of death penalty sentences especially for low-level, non-violent offenses; increase understanding of the extent and profile of women incarcerated for drug offenses and its wider socio-economic consequences; and to promote alternatives to incarceration.

To these ends, the project partners in three countries in South East Asia conducted research studies on women incarcerated for drug related offenses. They also provided workshops and meetings for civil society organisations involved in women’s rights, drug policy reform and prison reform. National stakeholder’s consultations were held for relevant public institutions, organisations and communities to come together and discuss the research outputs while sharing their best practices, experiences and challenges as well as provide recommendations for national policy reforms. This policy guide is a consolidation of the outcomes of these project activities in Indonesia.

Women, incarceration and drug policies in South East Asia: Promoting humane and effective responses - A policy guide for Thailand

The numbers of women in prison and pre-trial detention in Indonesia, Philippines and Thailand have been steadily increasing in recent years. More than half of all the women in prisons in these countries are held for drug-related offences. In Indonesia and the Philippines, over 60 percent of incarcerated women are charged with drugs cases, while in Thailand, the figure goes up to over 80 percent, many of them for low-level non-violent offences such as possession and drug consumption. This data is presented and discussed in policy guides for the Indonesia, the Philippines and Thailand and that are being launched today at the 7th Asia Pro Bono Conference held this week in Hong Kong.

The three policy guides also present research findings about women incarcerated for drug-related offences conducted by LBH Masyarakat in Indonesia, Ozone Foundation in Thailand, and NoBox Transitions in the Philippines, with the ultimate aim of reducing the numbers of women held in prison and on death row in Southeast Asia under the IDPC project ‘Women, incarceration and drug policy in Southeast Asia.’

The project also aims to engage affected community stakeholders, especially women in prison and formerly in prison, therefore national consultations were held in each of the three countries. Representatives from government and civil society were presented with the research study results and they came up with recommendations on how to address the most pressing concerns involving women incarcerated for drug offences. Some of these concerns include access to legal assistance, access to health care and other services while in prison, the women’s experiences of stigma and discrimination and the urgent need for alternatives to incarceration. These issues are addressed in the policy guides with recommendations anchored on international human rights instruments including the Mandela Rules and the Bangkok Rules for the protection of the rights of incarcerated women and the outcome document of the United Nations General Assembly Special Session (UNGASS) 2016 on drugs.

IDPC and project partners, together with civil society and community allies, will use these policy guides to continue to advocate for reforms in drug and sentencing policies in Indonesia, Thailand, the Philippines and other parts of South East Asia, towards reducing the number of women incarcerated for drug-related offences and protecting the rights of those who are already incarcerated.

Drugs, crime and punishment: Women and the need for access to justice

By Pascal Tanguay (LEAHN — Law Enforcement and HIV Network) and Verapun Ngamee (Ozone Foundation)

In 2016, the Kingdom of Thailand formally decided to re-allocate responsibility for drug dependence treatment from the Ministry of Justice (MOJ) to the Ministry of Public Health (MOPH) by the end of 2018. The reforms are designed to increase voluntary access to client-centred drug dependence treatment where the MOPH will be expected to develop guidelines, operati ng standards and monitoring and evaluati on indicators to assess performance. Although Thailand’s drug treatment system has raised significant concerns over the past 15 years, this change is intended by the Government to indicate a shift in the overall approach to drug use and dependence to one based on health and human rights.

For the transition from public security to public health management of drug dependence treatment to generate positive results, the MOPH will require significant support to ensure adequate capacity to deliver drug treatment services that accord with scientific and international standards. Challenges to an effective transition lie in two key areas:

1. The objectives and guiding principles for a national drug treatment system based on principles of health and human rights are yet to be established, and need to be improved and aligned with international guidelines and good practices in order to generate better health outcomes for people who are dependent on drugs.

2. Diversion of people caught using drugs to drug treatment will still be managed and coordinated under the 2002 Narcotic Addict Rehabilitation Act, which retains punitive and coercive elements such as forced urine testing by law enforcement officers.

This paper offers a brief analysis of these two challenges in light of current policies and practices, along with recommendations for overcoming them to ensure the implementation of a drug treatment system that can result in improved health and human rights outcomes for people who use drugs and people dependant on drugs.

Ozone Foundation

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