International feature: Harm reduction and drug policy in ASEAN
An uneasy but critical partnership for health and human rights
At a high-level meeting of Association of Southeast Asian Nations (ASEAN) countries, held in Malaysia in October 2015, ministers yet again reiterated their commitment to rid the region of drugs:
‘While some drug-related support services may be implemented, ASEAN is committed to a zero-tolerance approach to realise its regional vision of a Drug-Free ASEAN, so as to provide our people and communities with a society free from drug abuse and its ill-effects.’
Consistent with ASEAN’s prior work plan on drugs, ‘some drug-related support services’ likely refers to drug use prevention and rehabilitation, while the aim of achieving ‘a society free from drug abuse’ directly contradicts the provision of harm reduction measures for people who use drugs.
ASEAN’s unwavering commitment to achieving a drug-free region has justified the brutal criminalisation and punishment of people who use drugs, along with unbalanced investment in law enforcement at the expense of health and harm reduction interventions, thereby fuelling HIV and hepatitis epidemics among people who inject drugs in the region.
Over a decade after harm reduction programs were introduced in several countries throughout South East Asia, ASEAN’s drug policy makers clearly have not shifted their stance in support of them. Yet efforts to build collaboration between law enforcement, harm reduction, civil society and communities of people who use drugs have taken root in certain localities throughout the region.
In the context of global shifts away from criminalisation and punishment, such developments provide further evidence of the need for ASEAN to update their policies in response to drug use.
ASEAN’s contradictory approach to HIV and drug use
As with many other parts of the world, drugs are regarded first and foremost as a security threat to South East Asia. In its drug strategy and work plan, ASEAN portrays drug markets as a key security concern, and as a cause of individual suffering weakening ‘the social fabric of nations’, direct and indirect economic costs to governments, along with criminal activities that could threaten the stability of states.
The 1998 Joint Declaration for a Drug-Free ASEAN outlines a broad strategy for eradicating the production, trafficking and use of controlled drugs in the region by 2020. In 2000, to highlight the urgent need to tackle expanding drug markets for use and supply, the target year for achieving a drug-free region was brought forward to 2015.
Regional policy makers adopted the ASEAN Work Plan on Combating Illicit Drug Production, Trafficking and Use (2009–2015) (the Work Plan) to set out agreed priorities for eradicating supply through the ‘elimination’ of syndicates involved in the production and trafficking of drugs and their precursors, and for reducing the prevalence of drug use, primarily through preventative education programs.
The ASEAN Senior Officials on Drug Matters, comprising senior officials from agencies with responsibility for drug-related issues from each member state, has responsibility for coordinating, monitoring and evaluating implementation of the Work Plan.
Despite high levels of HIV prevalence among people who inject drugs throughout the region (see Table 1), there is only one mention of HIV/AIDS in the entire ASEAN Work Plan on drugs: as a component of preventative education programs for the general population and people who use drugs.
Table 1: HIV prevalence among people who inject drugs in ASEAN countries
* The HIV prevalence rates among people who inject drugs in some cities are significantly higher than national prevalence rates, for example, 56% in Jakarta (Indonesia). The HIV prevalence rates among people who inject drugs in Brunei and Lao PDR are not known.
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