What does Universal Health Coverage mean for people who use drugs: A technical brief

As UHC becomes a reality, communities such as people who use drugs must be allowed to continue their role as independent watchdogs. Communities must lobby for an accountability framework that enables governments to be held to account. Stigma and discrimination towards people who use drugs in health care settings must be challenged and addressed through investment and training of appropriately skilled health care workers and other medical staff. For Universal Health Coverage to truly work for people who use drugs, the following should be taken into consideration:

• Processes must be implemented to remove legal and policy barriers to inclusion and access to health services, including criminalisation of people who use drugs.
• Harm reduction interventions, such as needle and syringe programmes, opiate agonist treatment and naloxone must be included in UHC driven national health benefit packages
• The financing of UHC must ensure access to quality, comprehensive health care services for all, regardless of ability to pay
• To ensure people who use drugs are not left behind, states must invest in community and drug user-led organisations, building on what already exists and capitalising on the knowledge communities have about what works.
• People who use drugs need to stay informed and find out what UHC platforms for planning and implementation are taking place in their respective countries. Moreover, the building of partnerships with other key populations and allies is needed to demand inclusion within UHC and ensure it addresses community needs and priorities.

UHC can work for people who use drugs and can be used to ensure people who use drugs are not left behind. But this will not happen unless communities are vocal, visible, coherent, knowledgeable and assertive in their demand to be included. It is their right, but this does not mean that it will be automatically respected. As always, communities will have to work and agitate for their rights to be respected.