World Report 2021 is Human Rights Watch’s 31st annual review of human rights practices around the globe. It summarizes key human rights issues in more than 90 countries and territories worldwide, drawing on events from the previous year.

In his keynote essay, “Biden’s Challenge: Redeeming a US Role for Human Rights,” Human Rights Watch Executive Director Kenneth Roth addresses the shortcomings and human rights violations of the outgoing Trump administration, while setting forth recommendations for how the incoming Biden administration may help the US reclaim its role as a world leader through global partnerships and recommitting to human rights at home.

One step, as Roth suggests, is to set such commitments to upholding human rights via legislation. Narrow Democratic majorities attained in both houses of Congress from the 2020 election will be invaluable to Biden as he hopes to hit the ground running in his first 100 days. Other commitments, however, such as the ratification of core human rights treaties, will require a degree of bipartisanship not seen during Trump's term in office, since they will require the support of two-thirds of the Senate in order to be passed. As Roth summarizes, "Biden’s task is to find a way, through policy and practice, to make upholding human rights more central to US government conduct in a way that has a better chance of surviving the radical changes in policy that have become a fixture of the US political landscape."

Perhaps the greatest challenge before Biden, is the task of reframing how fundamental human rights are understood in the US. In Trump's final year at the helm, thousands of families seeking asylum at the US-Mexico border were forcibly separated from each other and children were segregated into cages, systemic racism was brought into the spotlight once again as deep-seated racial injustices continued to act with apparent impunity, and the COVID-19 pandemic revealed glaring deficiencies in the country's ability to provide universal access to health care and other basic necessities during a crisis.

The rest of the volume consists of individual country entries, each of which identifies significant human rights abuses, examines the freedom of local human rights defenders to conduct their work, and surveys the response of key international actors, such as the United Nations, European Union, African Union, United States, China, and various regional and international organizations and institutions.

More specifically in relation to drug policy, the report highlights numerous human rights violations, including:

Drug policy shortcomings disproportionally punishing those who have the smallest influence in sustaining the illicit drug trade (in Azerbaijan, Georgia, Mexico, the Philippines, Russia, Saudi Arabia, Singapore, Thailand, and the United States).

False drug charges and police raids weaponised for political purposes (in Azerbaijan and the Philippines).

Racial disparities in policing (in the United States).

Widespread violence and killings perpetrated by state and non-state actors (in Colombia, Democratic Republic of Congo, and Syria).

Lack of access or limited access to essential medicines due to conflicts, global health crises, or stigma (in Argentina, Brazil, Bangladesh, Indonesia, Iran, Israel and Palestine, and the United States).

Human Rights Watch: World Report 2021

By Orsi Féher (SSDP) and Juan Fernández Ochoa (IDPC) / Support. Don't Punish

The latest UNODC World Drug Report estimates that the number of drug-related deaths reached 585,000 in 2017. That’s over 65 deaths every hour. Most of these deaths are related to overdose and untreated hepatitis C, which speaks volumes of the multiple health crises at the heart of drug-related harm. Only 1% of people who inject drugs lives in countries where basic harm reduction services are within adequate reach.

Moreover, these tragic numbers do not account for the trail of pain and death resulting from other forms of violence fuelled by the “war on drugs”: disappearances, police and extra-judicial killings, death penalty executions, arrests, incarceration, lack of access to controlled medicines, among many others.

These harms and these deaths disproportionately impact communities already targeted by intersecting forms of oppression. And they can be reduced and prevented through responses that prioritise health and welfare. These include diverse, effective and accessible harm reduction initiatives and services that respond to community needs.

For the last eight years, Support. Don’t Punish campaigners across the globe have mobilised with this purpose, advocating for drug policies and narratives that centre human rights and dignity. For the benefit of all in our communities.

Solidarity that cannot be confined – Support. Don’t Punish 2020 Global Day of Action – Summary report

Virtually every country of the world has been faced with the COVID-19 pandemic. As learning developed as to how to combat transmission of the virus, countries increasingly resorted to national ‘lockdowns’ during the first wave of the pandemic from around March to June 2020. After coming out of the first wave of COVID-19, countries have used local, regional and national ‘lockdowns’ to once again prevent further transmission during the second wave and similar approaches are expected in the future in the event of further waves of the pandemic hitting countries until every country can vaccinate a high proportion of their population.

For those people who are highly drug dependent, with a resulting compromised immune system, COVID-19 presents a serious threat to life regardless of age. Governments, non-governmental (NGOs) and communitybased organisations (CBOs) working to support people who use drugs, and other vulnerable and marginalised people in society, have had to react rapidly to the massive increase in COVID-19 transmission across countries and continents.

The ten case studies presented here provide a snapshot of the responses of specific organisations and communities who work with people who use drugs and some other marginalised groups around the world, including Afghanistan, Australia, the Czech Republic, Kenya, Poland, Russia, Spain, Switzerland, Ukraine and the United Kingdom.

The objective of presenting these case studies is to provide details as to how changes in service delivery were implemented in response to COVID-19, and why, together with the impact of such innovative approaches. In so doing, governments, organisations and communities around the world can learn from the experiences presented in these case studies for possible application, and adaptation, to their own context and environment.

Harm reduction service delivery to people who use drugs during a public health emergency

Harm Reduction International (HRI) and the International Drug Policy Consortium (IDPC) welcome the opportunity to submit information to the Office of the UN High Commissioner for Human Rights for the preparation of its report under Human Rights Council Resolution 42/11 on human rights in the administration of justice. This submission addresses some of the current and emerging challenges specifically faced by people detained for drug offences and people in detention who use drugs.

Of the 11 million people currently behind bars worldwide, close to half a million people are incarcerated for mere drug possession, with an additional 1.7 million incarcerated for other non-violent drug offences,). That means that about 21% - or over one in every five prisoners worldwide - are being held on a drug charge. Punitive drug laws have fuelled mass incarceration and have impacted marginalised communities disproportionately, often on the basis of race, ethnicity, and/or poverty.

The criminalisation of drug use and possession and the adoption of disproportionate criminal penalties for all drug offences have resulted in the over-representation of people who use drugs in detention settings. According to global figures, people who use drugs make up about one-third to one half of the world’s prison population, and an estimated 56-90% of people who inject drugs will be incarcerated at some stage. People in detention report higher lifetime rates of drug use, including injecting drug use, than the broader community, along with more harmful patterns of use, such as sharing injecting equipment. One in three people in detention is estimated to have used drugs at least once while in prison.

For these and other reasons, including overcrowding, poor sanitation and inadequate health care, prisons represent high risk environments for the transmission of HIV and hepatitis C. Prevalence of these infections in prison populations is substantially higher than in the non-prison population. An estimated 3.8% of prisoners are living with HIV and 15.1% with hepatitis C.

This makes prisons important settings for the provision of evidence-based harm reduction services, including needle and syringe programmes (NSPs) and opioid agonist therapy (OAT), which have been proven to prevent the spread of HIV and hepatitis C. Sadly, only ten countries currently provide NSPs in at least one prison, while 59 countries provide OAT in at least one prison. Coverage of and access to these essential services remain inadequate where they are available.

Human rights in the administration of justice - Report to the OHCHR prepared by HRI and IDPC

By Cynthia Semá Baltazar et al. / International Journal of Drug Policy

People who use drugs (PWUD) which includes both people who inject drugs (PWID) and non-injection drug users (NIDU) are marginalized, experience high levels of stigma and discrimination, and are likely to have challenges with accessing health services. Mozambique implemented the first drop-in center (DIC) for PWUD in Maputo City in 2018. This analysis aims to assess the prevalence of HIV, viral hepatitis B (HBV) and C (HCV) and tuberculosis (TB) among PWUD, and assess their linkage to care and associated correlates.

Click here to read the full article (restricted access).

Prevalence of HIV, viral hepatitis B/C and tuberculosis and treatment outcomes among people who use drugs: Results from the implementation of the first drop-in-center in Mozambique

By Maria Plotko, J. Stola, I. Molnar, P. Sarosi, T. Jovanovic, R. Karczewska, K. Smukowska, M. Arlauskaitė, Y. Georgieva

A report developed within the LEt’s Talk about drugs – new MEthods of communication with youth – LET ME project funded by the European Commission (ERASMUS+ program)

In June-July 2020 Rights Reporter Foundation, YODA, Re Generation, Young Wave and Center for Humane Policy conducted an assessment of drug education in Bulgaria, Hungary, Lithuania, Poland, and Serbia based on the methodology developed by EHRA within the LEt’s Talk about drugs – new MEthods of communication with youth – LET ME project funded by the European Commission (ERASMUS+ program). The goal of the study was to assess existing drug education and its effectiveness, look at what information on drugs is available and how it is perceived by young people, examine the methods and tools used by different actors to talk about drugs with youth, and gather best practices.

The stakeholders interviewed—young people and representatives of harm reduction, prevention, and youth organizations—all agree that existing drug education is ineffective and fails to address the needs and patterns of drug use among young people.

The report will be used to design and create the manual, but also for the advocacy activities related to the promotion of prevention and harm reduction services in the youth work.

Let's talk about drugs - Assessment of drug education in Bulgaria, Hungary, Lithuania, Poland, and Serbia - Regional report

Since the beginning of 2020, the world has been experiencing an unprecedented public health emergency caused by the coronavirus disease (COVID-19) pandemic, which has led to progressive introduction of social distancing and other control measures by national governments. To investigate the effects of the pandemic on and the implications for drug markets and people who use drugs in the European Neighbourhood Policy (ENP) countries, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) launched a trendspotter study. This briefing provides a snapshot of the state of play with respect to the impact of COVID-19 on drug markets and people who use drugs in south ENP countries (between March and June 2020).

Impact of COVID-19 on drug markets, drug use, drug-related harms and responses in south European Neighbourhood Policy countries

The strategy aims to ensure a high level of health promotion, social stability and security and contribute to awareness raising. On the basis of this strategy, the Council will prepare an action plan which will set out concrete measures to achieve these priorities.

With this strategy, the EU and its member states reaffirm their commitment to an approach which is based on evidence, comprehensive and balanced between demand and supply reduction of drugs, with the preservation of human rights at its core. At the same time, this strategy uses the lessons learned from the COVID-19 crisis in the drugs area and takes a future-oriented approach, promoting research, innovation and foresight to respond more effectively to increasing challenges and to anticipate them.

 drug supply reduction/enhanced security

 the strategy targets all aspects of the illicit drug market, and includes the prevention of, dissuasion from and disruption of drug related crime, in particular organised crime, through judicial and law enforcement cooperation, intelligence, interdiction, confiscation of criminal assets, investigations and border management. This priority area has been further enhanced as compared to the 2013-2020 strategy, to respond to the challenging developments in European drug markets. These are characterised by a high availability of various types of drugs, ever larger seizures, increasing use of violence and huge profits, as well as the use of social media platforms, apps and the internet and darknet for illicit drug trafficking. Such features have not faded during the COVID-19 crisis, to the contrary.

 policy area consists of a range of mutual reinforcing measures including prevention, early detection and intervention, counselling, treatment, rehabilitation, social reintegration and recovery. Such action needs to be appropriate to the local social context and the needs of the target population, be informed by scientific evidence and be safe and effective. It needs to be developed through the close collaboration of a number of health and social support services. The COVID-19 crisis has further revealed the need to ensure continuity of these actions.

A new, dedicated chapter has been added on 

. This section includes measures and policies to prevent or reduce the possible health and social risks and harm for users, for society and in prison settings. It covers aspects such as reducing the prevalence and incidence of drug-related infectious diseases, preventing overdoses and drug-related deaths and providing alternatives to coercive sanctions.

The strategy also identifies three cross-cutting themes in support of the policy areas:

: enhancing the role of the EU as a global broker for a people-centred and human rights-oriented drug policy through cooperation with third countries, regions and international organisations, while strengthening the commitment to development-orientated drug policies and alternative development measures.

: providing the EU and member states with the necessary comprehensive research and foresight capacities to address drug challenges in a more agile and proactive manner, increasing preparedness to respond to future challenges.

coordination, governance and implementation

: ensuring optimal implementation of the strategy, including via the key action of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and of Europol, involving civil society and providing adequate resources at EU and national level to achieve this.

European Union Drugs Strategy 2021-2025

As with any condition, it is critical that people with a substance use disorder have access to medically appropriate care, taking into account their individual needs and circumstances. More than eight in ten people with a substance use disorder (82.6%) who need treatment do not receive it. Moreover, among those with an opioid use disorder, many still do not receive MOUD even though evidence is clear that MOUD helps save lives and has numerous benefits; the US surgeon general continues to emphasize that MOUD is the “gold standard” of treatment for OUD. Patients who use MOUD remain in therapy longer and are less likely to use illicit opioids. The result is that SUD treatment helps decrease overdose deaths, reduces the transmission of infectious diseases, including HIV and hepatitis C, and leads to reduced recidivism and other benefits to society, including lower rates of crime.

Despite the evidence base for MOUD, barriers to it persist, including inconsistent coverage of all US Food and Drug Administration (FDA)-approved forms of MOUD, inadequate provider networks, stigma that keeps some individuals and providers from using MOUD, lack of provider education and comfort with providing MOUD, high cost sharing for MOUD, and prior authorization requirements. These barriers can make the difference between a person being willing to pursue treatment or continuing to misuse opioids and risking death by overdose.

National roadmap on state-level efforts to end the nation’s drug overdose epidemic

By John Hopkins Bloomberg School of Public Health

The COVID-19 pandemic — responsible already for more than 16 million infections and 300,000 deaths in the United States —arrives at a time that the nation is still battling another crisis: the rising rates of fatal overdose from opioids and other drugs. Drug-related deaths have skyrocketed in the past few decades to levels that are four times greater than in the 1990s. Unintentional injuries—which include overdose deaths—are now the third leading cause of death in the country.

The COVID-19 pandemic has the potential to make the overdose crisis worse. Even before the pandemic began, only a minority of people with opioid use disorder (OUD) received evidencebased treatment with medications, and many people who use drugs struggled to get access to lifesaving harm reduction services like syringe service programs. Early reports show that states are already cutting budgets for these critical substance use services as attention is turned to combatting the COVID-19 pandemic.

However, with the recent economic downturn, even more people may be in need of harm reduction, treatment, and other substance use resources than before. Historically high unemployment rates and preventative physical distancing measures have also exacerbated social isolation and despair, known risk factors for substance use disorders. Many models indicate that COVID-19 will cause increases in suicides, substance use, and overdose deaths.

Saving lives from overdose during a pandemic

This year’s International Overdose Awareness Day has seen the movement continue despite the disruptive effect of the COVID-19 pandemic. The report explores the outcomes, impact, and success of IOAD, studies the events and their attendees, and examines how COVID-19 impacted IOAD and how event organisers and participants responded. It also tells the stories of some of those who chose to be involved. The findings in the Partners’ Report are based principally on data gathered from the IOAD 2020 Partners’ Survey, which had 204 respondents.

This is a global sample representative of this year’s 602 registered events in 37 countries. The Survey was created and shared with our IOAD Partners on the 15th of September and closed on the 8th of October. Many of the respondents noted that COVID-19 had made it difficult to hold physical events because of restrictions in their areas.

A vision to end the global overdose crisis - International Overdose Awareness Day Partners' Report 2020

An increase in the open sale of cannabis products in Europe has raised questions around the possible legal and commercial status of these products. The products are marketed for their low THC (tetrahydrocannabinol) content, which sellers claim exempt them from control by drug laws, or as sources of CBD (cannabidiol). This publication presents an initial overview of the situation, covering the types of low-THC product available, user profiles, associated harms and regulatory responses in Europe. Low-THC products that take forms similar to illicit cannabis products, such as smoking mixtures, oils and edibles, are a primary focus of this study. The report highlights the challenges facing policymakers and suppliers of low-THC products, including the legal status of the products and the regulatory frameworks that may apply to their sale.

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