 Good morning and afternoon to everybody and a warm welcome to the official press conference For the opening ceremony of the harm reduction international conference is our 27th international conference And I'm so so excited to be in person with you here today My name is Naomi Berkshine. I'm the executive director of harm reduction international also known as HRI I think I speak for everybody when I talk about the Excitement of being able to gather after the pandemic. I love the accessibility of zoom But it's it's never gonna to make up for the chance to be in a room together I know press conferences in particular are much more dynamic when you get the in-person time Really excited to have six representation six representatives of Southeast Asian media outlets with us in the room today And welcome to the journalists online as well Briefly reflecting and setting some context before I turn to our esteem's panelists So I want to acknowledge the past three years have been particularly difficult for everybody with COVID We thank the convention center for enabling us to put together the event of this size throughout some very uncertain times and acknowledge the You know the loss and suffering that came with the period of the pandemic Particularly for the people in the city of Melbourne who experience more lockdown days than any other city in the world This week we're going to hear some results of some really solid evidence That continues to build upon the evidence base for sound public policy on drug policy and harm reduction Particularly significant will be the studies around fentanyl checking and an inaugural controlled study on drug consumption rooms Both are being presented at Tuesday's official scientific press conference Both of these studies are really groundbreaking in our field and we hope we're really optimistic They'll have big impact on public policy going forward We'll also hear the results of some studies around hepatitis that paid a very worrying picture I've just how neglected and discriminated against people living with HIV and hepatitis are in so many parts of the world. I Think a big problem we have is is misunderstanding around drugs stigma and disinformation My colleagues here with me today Will help us to affirm that we need a solid evidence base and a right spaced approach to forming our public policy on drugs Finally to housekeeping This live press conference is being broadcast on zoom will be recorded and made available on HRI YouTube page as soon as we possibly can We're going to be hearing brief remarks from the panel Down the line and then I'll open for Q&A afterwards I've also got access to a laptop so at some point I'll be able to turn to the Journalists who are dialing in online and take any questions that are submitted by writing To media who are present in the room, please indicate your media outlet and who you'd like your director question to and we'll turn to them So with that let's begin our first week today is Jason Grebelie Jason is the head of the hepatitis and drug use group at the Kirby Institute in Sydney and Part of a team of researchers that have published the latest five-year global systematic review on injecting drug use estimates Really important data set to inform programming around the world. So we're really delighted to have you with us today Jason Great. Thank you very much. Good afternoon everyone I just like to begin by acknowledging the traditional custodians of the land on which we're meeting today That we're in Jari where we're on people of the Kulin nation and pay my respects to elders past present and emerging I'd also like to acknowledge our collaborators at the University of New South Wales the National Drug and Alcohol Research Center and the Kirby Institute the University of Bristol and the University of Queensland in particular I'd like to thank Scientia professor Louisa Degenhardt Who's been leading this work, but was unable to be present here today due to family reasons I would also like to thank all the people internationally including those from the UN organizations who helped compile the data for this review People who inject drugs are exposed to various and changing risk environments and are at risk of multiple harms that may relate to injecting drug use In this study that I'm going to be presenting published two days ago in the Lancet Global Health We aim to undertake a global systematic review of the prevalence of injecting drug use key harms that may relate to injecting drug use including HIV hepatitis C and hepatitis B virus infection and overdose and key sociodemographic characteristics and risk exposures for people who inject drugs We systematically search for data published between January 1st 2017 and March 31st 2022 in databases of peer reviewed literature and gray literature as well as various agency or Organizational websites and disseminated data requests to international experts and agencies We search for data on the prevalence of characteristics and risks of people who inject drugs including gender age sexuality drug use patterns HIV HCV and hepatitis B infections non fatal overdose and injecting related disease Additional data were extracted from studies identified in our previous review that was published in 2017 Meta-analysis were used to pool the data from this study where multiple aspects were available for a country So overall we screened 40,427 reports published between 2017 and 2022 and 870 eligible reports identified were added to the 11,000 or 1100 for 47 documents from the previous review So key finding one evidence of injecting drug use was documented in 190 of 207 countries and territories representing 92 percent of the countries globally Among which 102 54 percent reported an estimate of injecting drug use prevalence Overall 14.8 million people with a 95 percent uncertainty interview of 10 to 21.7 million aged 15 to 64 years were estimated to inject drugs globally Compared with our earlier review in 2017 10 additional countries were added that reported injecting drug use including 8 in Sub-Saharan Africa and 2 in the Caribbean Key finding two The amount of data on socio-demographics and key health and social risks among people who inject drugs varied widely across countries and regions We estimate that 19 percent were women 24 percent were under the eight under 25 years of age and 9 percent identified as lesbian, gay or bisexual We estimated that 25 percent of people who inject drugs globally had experienced recent homelessness or unstable housing 58 percent had a lifetime history of incarceration and 15 percent had recently engaged in sex work with considerable very geographical variation Injecting and sexual risk behavior varied considerably geographically as did the risk of harms key finding three globally we estimated that 39 percent of people who inject drugs have current hep C infection 15 percent are living with HIV 8 percent are living with HBV and 19 percent had recently overdosed and 32 percent have had a recent skin or soft tissue infection The limitations of the review included a lack of high quality data in some countries limited availability of data on some characteristics and wide variations in data across countries in Conclusion injecting is being identified in a growing number of countries and territories that comprise more than 99 percent of the global population Injecting drug use related harms are common and people who inject drugs continue to be exposed to multiple adverse risk environments In a companion paper that was published in the journal in the same time We demonstrated that only two percent of people who inject drugs have access live in countries with access to high coverage Opioid agonist treatment and needle and syringe programs So the quantification of many of these exposures and harms is inadequate And it must be improved to allow for better targeting of harm reduction interventions to address risks that may relate to injecting drug use Investment in enhanced surveillance and harm reduction activities such as needle and syringe programs and opioid agonist treatment, which has multiple effects Including reducing HIV and HCV transmission non-fatal and fatal overdose and probably also injecting related in diseases and the provision and treatment and care for Those living with HIV and HCV are Imperative these interventions should also widely widen beyond the individual level interventions to address these Environmental risks and social inequities that often an intersect including the decriminalization of drugs. Thank you very much for your time Thank You Jason you finished on the point that has struck me I really appreciate that the data is looking at the intersecting issues that come with drug use. It's our never never a single issue Our next speaker needs no introduction to anyone in the room We are honored and delighted to have former president Helen Clark with us Helen is here with us in her capacity as chair of the global Commission on Drug Policy a Handover to Commissioner Clark just speak to the Commission's work and share some thoughts with us on the state of drug policy today Well, thank you Naomi. I'm very pleased to be here with President Motlante from South Africa Also a global commissioner for the global Commission on Drug Policy And we stand of course in total support of all the efforts of harm reduction Services around the world. We also take on a bigger challenge and that is to advocate against prohibition and criminalization of drugs which we think is a futile strategy mandated for so long by the UN drug conventions, which are extremely damaging and when I say damaging you look at the the range of consequences which come from International law mandating a punitive and prohibitionist approach For example, as our colleague just said that the numbers of people who who inject drugs who also Have also contracted HIV or hepatitis C the Difficulties in so many countries of getting adequate services to support people to keep themselves safe and healthy when they using drugs We look at the over-incarceration around our world driven By the criminalization of drugs. We look at the use of the death penalty a disproportionate treatment or sentence for people Who are associated with drugs and and in our view? Clearly illegal under international law and applied to to drug offending So they're very very serious consequences for for human rights health and well-being of the current international approach But let's also remember how badly the prohibitionist approach has failed in these more than six years since the global drug conventions began in 1961 the prohibitionist even up to their relatively recent programs of action agreed in Vienna Have sought to eliminate the use of drugs or substantially reduce it Clearly total failure could never succeed The latest figures that came out of UNODC's World Drug Report last year Indicated that since 2010 the numbers of people using drugs were up by 26% and a forecast to rise by another 11 by percent by 2030 none of this should surprise us human beings have been using substances For whatever reason they have used them for thousands of years. There was a recent news item about latest research on Human remains from Spain of 3,000 years ago, which found these traces. I mean, we're not dealing with new issues here But we are dealing with totally inappropriate and wrong ways of of tackling them So that brings me back to the mandate of of our Commission Which was begun in 2011 and it was begun with a lot of impetus out of the Latin American countries where the quote war on drugs that had full license and was so damaging and to to populations It's set out to break the taboo on raising these issues and these these arguments and I think we've succeeded in doing that Actually quite a lot of momentum now Around these issues, which is very very encouraging We set out to be a voice for exposing the harmful effects of repressive drug control policies mandated by the Global conventions We set out to call for an end to the criminalization of drug use and possession and to call for the legal regulation of all drugs And that that is that is our position the government should step up to their responsibilities To regulate responsibly in in this this area So much more that that could be said but in essence, that's our mission We acknowledge and salute all harm reduction if it's how much easier they would be if the global and national legal environments We were more conducive and I salute those jurisdictions I know we have ACT with us have really stepped up and said we're going to do what we can within the legal frameworks We've got to make a difference for for people and we're seeing this kind of movement in so many jurisdictions now back to you Thank you so much commissioner Clark I think it's enormously powerful when we have commissioners from the global commission People have actively governed in their own countries in the case of commissioner Clark and her capacity as head of UNDP as well Who can reflect in reality and in real time how public policy played out under under their time in office? So we are harm reduction international And so that's why it's so so important to us that we're not just presenting studies from Australia from Europe From America. So it is really really a great great pleasure to have President Keglema Modlanti with us today President Modlanti was South Africa's third president between September 2008 and May 2009 he's also a member of the global Commission on Drug Policy and Really excited in fact. He has recently launched and is the chair of the Eastern and Southern African Commission on Drugs Just launched in Cape Town and Commissioner Modlanti is going to take us through some of the challenges and his perspective from South Africa Thank you very much Naomi and let me start off by thinking the harm reduction international for Urbanizing this 27th conference where it offers us an opportunity to share perspectives and Look at you know the latest research in terms of Harm reduction and and of course we bring different experiences you know the southern and Eastern seaboard of the African continent is awash with drugs particularly The islands within the Indian Ocean where these drugs emanate from Afghanistan Pakistan and We we were persuaded really to establish the Eastern and Southern Africa Commission on on on drugs because the old approach of Prohibition and criminalization only serves to divert resources scarce resources to Enforcement where efforts and and the recommendation of the global Commission on on on drug the policy It's basically to Firstly Ensure that we put people's health and safety first In in in in our approach and and we persuade governments to And then key stakeholders to adopt that approach also to ensure that this access to Essential medicines and pain control that lead to And criminalization and incarceration of people who use drugs And and fourthly to get The enforcement to refocus on mainly drug traffickers and manufacturers basically and Lastly to Get the the governments to take control by focusing on Regulating the drug market Because the efforts of prohibition Basically drives government to focus on the end user ordinary people who use You know various drugs end up being the main focus which leads to incarceration on really You know Flims the grounds and and that's why the harm reduction approach Is is the way to go where in this current Conjunction and and we draw lessons from how We mobilized Society to Deal with HIV and AIDS those lessons pertinent in terms of how we approach this issue of a harm reduction and So we need a global movement we need to mobilize and rally the progress cross section of society to Focus on harm reduction as a solution because it's a cost-effective it deals with many social problems that Ordinarily would not receive any attention and and that's why We we are here and as Our chair of the global commission has indicated The efforts are gaining momentum And ironically it started in in Latin America in Colombia where you know is regarded Columbia is regarded as one of these countries in Latin America that At first, you know activities in in production of Hard drugs is is well established and and for for President Alonso to Have had the guards and courage to raise this issue of where the failure of war on drugs policy because it hasn't achieved a drug-free society instead it is compounded The social problems as it were here. Thank you. Thank you. No You know the the world turned to South Africa for leadership In the HIV movement and the courageous activism changed how we approach access to medicines globally And so we very much look forward to your leadership from eastern and southern Africa So every time we have a conference. We've got to have a partner and See on a crop as a CEO of harm reduction Victoria has been the most spectacular a formidable partner I'm so so pleased to be working with you over this long period and the lineup to the conference See on he has lived experience the whole of harm reduction Victoria is an organization which is about lived experience I'll turn it over to you to give some remarks from the community Thank you, Naomi. First of all, I'd like to acknowledge Recognize and respect the ancestors out as families of the traditional owners of the lands that we're meeting on today So the bonawarang bonawarang and we're injury we're roaring People's of the East inculination I'm a visitor to this land. I'd like to Acknowledge that this land was stolen. There's never been seated I'm proud to be part of the Victorian organization of people use drugs harm reduction Victoria One of we are one of many Organizations in a national network of organizations in Australia and there are other representatives here during this conference as well So I urge you to seek seek them out our national peak is able and we have a global network called input as well With that I'd like to also acknowledge the community of people who use drugs and those who lived in living experience who give that that movement its strength The war on drugs as others have talked about the war on drugs and prohibition And the prohibition and criminalization that this war enables has claimed many lives including those of our friends And we can't rest until it's until it's ended We've been looking forward to hosting this conference since 2019 and a global pandemic interrupted those plans obviously Naomi spoke about in the meantime this city became famous for being the longest lockdown city in the world And for 262 days we had 8 p.m. Curfews and we're allowed outside for one hour a day While this may have meant we avoided the huge death tolls that others Have that others suffered in we've seen globally had direct and long-lasting impacts on people to use drugs And those you didn't have a home do you locked into and we're already the most visible To law enforcement and it just accentuated all of the inequity and evils of prohibition and criminalization It's particularly at the start when everyone was racing around for solutions And those solutions often look like the police, which I know we had some Tower lockdowns very near here in Flemington And coincidentally those towers are having to be for people who have migrated to Australia and people who use drugs as well And so over and over again people in most vulnerable situations tend to get the Hard end of the prohibition stick But it's 2023 now and the conference is made here for a lot at last And we're although we're really excited to get into the program between new people and and and have our Learn more and learn more about harm reduction around the world And we're excited and want to be optimistic We know that one conference can't solve everything and we do hope that the part of the legacy of this conference is that decision-makers come to better understand What harm reduction is and it's not We hope they can see for example that far from being radical drug consumption rooms are relatively common elsewhere in the world And can coexist alongside the broader community, especially if the implementation is done Well and affected communities all affected communities people to use the services people who have to live around them And people who support them Our state Victoria is one of the most progressive one of the most progressive We have got a branch of lived experience in the State Department of Health Our organization is funded to provide really innovative peer-based Programs harm reduction activities the state's finally making the locks on available through every new insertion program here and Has accepted the people who lived in living experience should lead on the future of mental health service delivery on the other hand our opioid assisted treatment program, which is often lauded around the world as Australia's as gold standard is in crisis and falling to pieces It's lit is genuinely easier to find a drug dealer than a method over Scriber in some parts of Victoria And we're still being put in jail for drug use despite politicians claiming that dependence should be treated like a health issue And our most senior politician has ruled out the harm reduction response of drug checking despite the fact that our people continue to Die from preventable overdoses It often feels like here in Victorian Australia generally we take one step forward one step backwards in Relation to harm reduction and for us in the community the most important steps have not yet even been taken and are often actively denied us So for all those reasons and more I'm really happy for the harm reduction comments to be here Really happy to really glad for the opportunity to speak some truth to power to be fair We get those opportunities We're an organization that's riding on the back of many many years of activism in this space And we are an accepted partner with government, but it sometimes feels really difficult just to make those last final steps towards true Decriminalization and pro and elimination of prohibition and we'd love this to be another step along the way towards that goal Moving along the table to our movement's favorite Australian jurisdiction I'm so so pleased to have Rachel Steven Smith with us here today, Rachel is the Minister for Health at the Australian Capital Territory And we'll talk to us today about the decriminalization legislation that will come into effect in ACT this coming October and the Australia's first standalone pill testing site as well. So jurisdiction making everything happen, please over to you Rachel Well, not everything and thank you very much Naomi And I also want to start by acknowledging the traditional custodians of the land that we're on today and paying respect to elders past and present and acknowledge any Aboriginal and Torres Strait Islander people who are here today And I just want to acknowledge that Victoria is probably the most progressive state in the country For those of you who are International and not so familiar with the Australian Capital Territory We are a very small jurisdiction landlocked in New South Wales the home of our National we are the national capital the home of our Parliament and national institutions and a self-governing territory So the ACT government has responsibilities that normally sit with both state and local governments in Australia We've only got a population of about 460,000 people and we have a very wealthy highly educated and progressive Population in the ACT and that does enable us to do some things that other Australian Jurisdictions and other jurisdictions around the world are not always able to do And one of those is taking a really clear harm reduction approach to our to the response to drugs and alcohol use in our community but I also recognize we have a lot to learn and a long way to go and We've made some really significant strides in the last few years But it's great to be here at the harm reduction international conference along with a lot of our policy makers and Our key advocates to really learn from other jurisdictions as well as to share our own experiences Our commitment the ACT government's commitment is to invest in Evidence-based and practice informed policies to reduce alcohol and other drug related harm for individuals for families and for the broader Canberra community We have a very strong relationship with our alcohol and other drug sector and I think to your final points the Voices of lived experience in forming policy and practice and implementation Have been absolutely key to us and I would just like to touch on the response to COVID-19 in the ACT We did have the advantage of not being overwhelmed Early on in the pandemic with a large number of cases And so we learned a lot from the early Victorian response But I do want to take a moment to acknowledge our partners in the Canberra Alliance for Harm minimization and advocacy and directions health services who really Were built a bridge between government and community to ensure that we were supporting people when we did have to go into lockdown With what they needed to to stay well in the community And we definitely took a supportive rather than an enforcement response And in fact, I just have to tell the story because this is this is way off script But one of one of the best One of the best stories coming out of COVID was we our health director at work very closely with With drug use with the drug-using community where there was COVID spreading and Made a phone call one day to someone who said who was it wasn't was known to to deal drugs and Their response was oh So disappointed because I tried really really hard to make my deliveries contact for contact so So, yeah, we have we have progressive responsible drug-using community in the ACT as well So back to what I was supposed to be talking about We really do take harm reduction as a guiding principle for our policy And I wanted to talk about a couple of things today that Naomi mentioned one is the decriminalization Changes that we have made recently so in 2020 legislation was implemented in the ACT to entirely remove penalties for adults possessing up to 50 grams of dried cannabis or growing up to two plants at home for individual use and That reform was really welcomed by advocates by health experts and by service providers and by an overwhelming majority of the Canberra community But in an Australian first from late October last last year Well in late October last year we passed legislation that will be implemented from late October this year That will make the possession of small amounts of nine of the most commonly found illicit drugs Decriminalized in the ACT as well So that includes MDMA silo cyber and heroin and methamphetamine and not you won't be surprised to hear that Methamphetamine was the most controversial in that list People that means that people found with small amounts of these illicit drugs will no longer be exposed to potential prison sentences Instead may be issued a caution a $100 fine or referred to an illicit drug diversion program And this reform is an Australian first and it has been supported by extensive consultation and input from policy experts from local and national drug and alcohol sector advocates from service providers from our ACT government directorates across the board and from ACT policing But most of them importantly really informed by people with lived experiences and Advocated for by families and friends for drug law reform and they really have been the driving force behind this change Which was introduced not as a government initiative, but as a private members bill by my colleague Michael Pedersen On the Labor Backbench The reform is intended to reduce stigma and fear for people who are using drugs to access health services really diverting people to Health supports rather than the criminal justice system treating drug use genuinely treating drug use as a health issue rather than a criminal one We also as Naomi mentioned have been leading the nation in trialling drug checking services in the ACT So in 2018 and 2019 we supported and enabled festival-based drug checking services at two music festivals And in July 2022 we funded and launched Australia's first fixed site health and drug checking service as a six-month pilot And I know a number of a number of you may have visited can test this week Which is run by Directions Health Services? We've now extended that to August this year following positive findings from an interim independent evaluation And we are considering obviously throughout coming budget process the future of that service But look forward to receiving the final evaluation The service is funded by the ACT government It's run by Directions Health Services and But in partnership with PIL testing Australia and the Canberra Alliance for harm minimization and advocacy and provides free on-the-spot chemical analysis of drugs and pills that people bring in for testing as well as drop-in nurse consultations offering general health sexual health and mental health advice and from a policing perspective That was really important that they couldn't form a reasonable suspicion that someone was going to this service solely for because they have had drugs on in their possession And that they there was a reasonable expectation that they may be accessing other health services So it's also co-located in a building with other health services and the services delivered 436 health and alcohol and drug interventions in its first four months and some clients have received multiple interventions So we're really confident that this service is Actively reducing harm in the community and for many people who are using it They're indicating that it is the first time that they have spoken to anyone any kind of health professional or peer support About their drug use so it's not only about the checking. It's actually about access to that support So I'm really proud and pleased to be here. I know I've spoken my too long memory. So apologies for that But it's great to see our little jurisdiction punching above its weight in such exalted company Thank you so much minister Final speaker of the day is Jeff Gallop. I was delighted to meet Jeff by a zoom earlier this year And you know astonished at his extensive knowledge of the drug policy harm reduction and social justice movements across Australia Jeff is also with us today in his capacity as a member of the Global Commission on Drug Policy And I think it's fitting that we end today's remarks with a reflection on where Australia's come in its harm reduction movement over the past few decades Thank you very much And I too acknowledge the traditional owners of the land on which we're meeting and I would urge all of you that have come from overseas To look into the debate we're having in Australia at the moment about the position of our indigenous people within our Constitution and through that within our broader community There's been an extensive consultation throughout indigenous Australia about what would be a Perfect and good form of Consultation and secondly what would be a proper recognition of the historical importance of thousands of years of existence here in Australia So for those who are from overseas, I urge you to have a look at the the debate that we're having and hopefully as a result of that you can Go back to your home countries and say that Australia is really making an effort here to deal with the consequences of what was colonialism And its impact on the lives of people whenever I Go to a function like a press conference like this one Dealing with a social movement, which I really do regard harm reduction as a social and political movement And and what we need to do is as an agenda following that is that wonderful Incident that's been recorded in the biography of Lyndon Baines Johnson And Johnson was not without his blemishes, but he was a pretty smart man And he achieved some very important things as part of the great society in the Kennedy then Johnson governments in the United States He was being lobbied very very heavily by the feminist movement to say they wanted him to extend The range of rights that needed to be recognized in the American system And he said he listened and he said look I agree with a lot that you're saying but I want you to make me do it In other words, he said we need a movement We need people out there pressuring the government so that they know that when they stand up to to make a change They have people there supporting them and in my experience of politics 20 years in Western Australia There's no doubt that there's a lot of sense in what Johnson was saying whenever you stood up in the Parliament To make a case for something that was new and something was different and at that time We were moving to decriminalize the personal use and possession of cannabis You knew you had people behind you and not only were they behind you but they were willing to go out and to use a cricketing expression to bat for you and They did and I have enormous respect for the harm reduction movement And I'm sure the same it was the case in in the ACT and in New Zealand when Helen was obviously advocating for changes there When you stand up and know you've got people behind you It's so important in terms of the way in which we achieve change in our society So a big thank you from me to the harm reduction movement. It's great to have you here At this conference. I think I've been to Beirut and Vilnius I think to harm reduction conferences and I learned a lot from those one of the things that's happened I think is the involvement of user groups now And it's impacting on the way we look at change. I think we're going to have a good debate at this conference about yes There are some things you can do in terms of the legal issues But have you really changed some of the attitudes and that exist behind those legal issues? And and I know that for example, there's a debate that goes on that really decriminalization as good as it is It is moderate and if it's not backed up by other things it can be quite oppressive as In institution so there are issues we're going to have to debate And I just end by once again thanking harm reduction for coming here to Australia to harm reduction Australia for Supporting it and I think as a result of this debate I think we'll come out of everything clear on our objectives to continue with the harm reduction approach and Better with better knowledge about how to do it well and how to do it properly So thank you very much, and I look forward to the proceedings over the next few days. Thank you Thank you so much Commissioner Gallup And for any foreign press if you've got any question about cricket metaphors. We've got our Australian partners standing by Fill in the gaps for you I should also say you know harm reduction Victoria has been you know front and center because we're meeting here in Melbourne But we're really really grateful to be also partnering with the international network on hepatitis and substance use in shoe Aval the the peak body of people who use drugs in Australia and Asham conference organizing Body so with that we can turn to questions. We have I think about 20 minutes left If you'd like to um, is there a microphone in the middle Michael? Got a microphone to you if you want to let us know your name and your outlet and If there's a particular panelist you'd like to direct the question to Hi, my name is Solin I'm the editor in chief of co blue, which is a health news website based in KL Malaysia So my question is for Commissioner Clark. Um, so you are calling for the Regulation of all drugs and narcotics if I understand it clearly does that mean you're calling for legalization or decriminalization? And if that's the case, I mean, I understand that the war on drugs has failed Spectacularly and we do need to expand health care services to reduce HIV in HDV infections among people who inject drugs, but if but with complete legalization or decriminalization Um, is there a fear that when governments do that they're sending the message to their people that? Drug use is completely permissible When the role of the state really should be to protect society from from harm Is addiction and I mean addiction and substance abuse. These are also serious public health issues So is there a chance that with complete decriminalization or legalization that it could inadvertently lead to higher substance abuse and addiction which are by itself very serious public health issues. Thank you My name is Rachel Ward. I'm from Australian Associated Press I have a follow-up question on that for Commissioner Clark as well Could you please clarify if that includes drugs that are considered as perhaps more harmful like methamphetamine and heroin? And how likely you think it is that we will see Drug use decriminalized all over the world or in certain countries just a time frame on that one, please Fantastic the third question for the panel if you'd like to pick on somebody other than Commissioner Clark That's okay Worse I'm a funder Thanks, um, can you hear me? So my question is also for Commissioner Clark, but actually for any of the commissioners who spoke I want to thank you for your leadership in drug policy reform. My name is Sarah Evans I'm with the drug policy team at open society foundations and my questions for you today are what role if any Do you see for the global Commission to uplift the nexus of indigenous peoples and indigenous rights with harm reduction and drug policy? Reforms and how can we press international bodies to do the same? I just want to expand a little bit I personally grew up as a white settler on Treaty 6 land in Edmonton, Alberta, Canada And I worked for almost 20 years in harm reduction services in Vancouver, British Columbia on the unceded stolen territories of the Muscovite Squamish and Slewa two's nations and So now in my work at open society, we have efforts around various things Advancing legitimacy of psychoactive substances for healing working with cultivators to end crop eradication Advancing drug policy reforms for people policy reforms for people who actively use drugs I could go on you get the picture in all of these areas of engagement We always need to do more We are really not doing enough to center the wisdom of indigenous elders to respect their use of traditional plant medicines To forge links between work with cultivators and broader land-back movements to center cultural survival and overcoming the history of Colonization within our harm reduction efforts. So that's where I'm coming from when I asked this question And again my question is just what can we do? what can the Commission do to uplift indigenous rights and How can we press global governance bodies to do the same? Yes, well responding to the first two questions firstly the the evidence is is very Solid I believe for going down the path that ACT has gone down, which is to decriminalize procession for personal use In general Now the case I think is also reasonably clear that a drug like cannabis Should be subjected to a form of regulation that's probably similar to that for tobacco by the way tobacco is more dangerous more deadly But nonetheless we're going from a period of illegality to you know to something different So in New Zealand when there was a law drawn up which went to referendum The model was a tobacco plus regulation if you like it created a legal market But with a lot of restraints around it only dedicated sellers Yeah, a lot of a lot of constraints. So What I think we would say is a full legal market properly regulated For cannabis and then with the others start going down this path as ACT has with decriminalization of use and possession a massive investment in harm reduction Services these ways you're going to be able to protect people's health and well-being you're going to lower the prison population very Substantially and wouldn't that release resources for harm reduction and actually you know working just to support people to To be able to improve their lives So that's where we're coming from we don't see any evidence that the Legal and policy reforms in these areas are leading to any blowout in use You know, that's not the case people are using drugs regardless of the legal environment actually the question is Are they using them safely or not? And because a prohibition creates a very unsafe environment We actually put people's life and well-being at risk. So you know focusing on conducive legal and policy reforms for harm reduction because Everything's got some potential for harm. I mean tobacco is very deadly Alcohol has huge harm potential. Yeah, everything's somewhere along the spectrum, but you need to regulate Access to in line with that the chair of the global Commission before me was Ruth Dreyfus a former Health minister and president of the Swiss Confederation and It was under Ruth's watch watch that the legal prescription for heroin came in so that people weren't buying heroin Illegally on the street of unknown problems So, you know again Through the range of services you have you can provide for a use to those who? Have have developed a dependence of you like and keep people safe We are totally motivated by what keeps people healthy and safe regardless of the choices They are making you can put up a supportive environment Around that now on the very important issue raised from Canada about indigenous People, I mean, I'm not the best qualified to speak on this and to are the put the key from the New Zealand Foundation said me is and I want to say Kiki order to are the and your colleague But you know the New Zealand example in New Zealand, and I'm going to say this in my speech at the opening indigenous people are clearly vastly disproportionately impacted by punitive and pro-aportionist approaches to drugs Māori in New Zealand are estimated around 15 15% of the population They make up 48% of those convicted for drug possession offences and Almost 62% of those who go to prison for them This is a hugely disproportionate impact And it is a story that could be told for indigenous peoples around our world and for people of color in general for people of African American descent Everyone who is marginalized in our societies is likely to get the full force of the law thrown on them for these kinds of quote Offences, you know very helpful if you have a discriminatory justice system to have search and stop right stop and search So it's it's a huge issue and and I think looking at it Through the lens of the the critical importance of voice coming from indigenous communities themselves for a form is So vital in in New Zealand methamphetamine is Really the the drug which is probably the greatest interest in the harm reduction services there was a Really a very enlightened Pilot in the Northland region of the New Zealand of New Zealand, which has a large indigenous population Te Aro Oranga method meth amphetamine harm reduction initiative Launched with support from Iwi Māori tribes Government departments the police the community To divert people from the reach of the criminal law to services and it's been successful But we need it rolled out across New Zealand But these issues are very much top of mind in New Zealand where Māori have significant voice I think I can say too early, but still many many challenges and battles to fight and We look on this as just something so significant in the whole debate about Getting rid of punitive and prohibitions to purchase Thank You Commissioner Clapton Commissioner Motlanti or Commissioner Gala, would you like to respond to those questions or I don't need any comments there? Yes, I thought I should add my voice in addressing the weather Legalization or decriminalization leads to more people You know experimenting and perhaps even getting addicted and so in South Africa the our apex court the constitutional court ruled to legalize cultivation of Cannabis For personally use so people are have the right to grow it in their baguettes for personal use and and for recreational purposes and Whereas in the past when it was prohibited Many many many people many many many people used to get arrested and they actually be convicted and incarcerated for possession of small quantities But we haven't seen you know the spread of Experimentation and usage of Cannabis since it's it was legalized instead. I mean we see many products on the shelves in supermarkets Of processed oils and all kinds of stuff soaps and so You know based on on cannabis here so so the point I'm making is that Decriminalization doesn't necessarily lead to widespread Usage No, no, no in fact They was even at some point the private members bill piloted through parliament Where the motivation was for you know people who have Suffer from cancer. They could use it for medicinal value Thank you commissioner And commissioner garlic if you wanted to take the AAP question as well Which asked about any predictions on you know timeline for Decrim change around the world where you might see it look at the point I was going to make following on from what what Helen said about the diversion Idea that's been implemented not necessarily backed up by decriminalization, but implemented at the administrative level it reminds us that We have a framework of law and policy within which we operate and That that framework of law and policy Over the recent decades has been dominated by the prohibition Concept but slowly but surely harm reduction has been beavering away and having some very important reforms But the one thing in response to the question Sarah made about indigenous practices and you know background and involvement in change Etc. If you if the legal framework you're working when it is still prohibitionist and Still makes illegal the personal use of drugs It's it's not a good environment to experiment a lot of people don't want to come out They don't want to know other people to know that they're using and that was wonderful Achievement in in in South Africa where the Constitutional Court ruled that as a result of the privacy That people had they should as President Montlarty said they should be able to grow a few plants at home and and do it in the Privacy of their own home so but unless that framework of law Changes it because it's very very hard to implement health promoting reforms and in as much as all drugs have potential for harm How do we tackle that do we say oh we're going to we're going to make it Illegal and then do nothing or do we say let's change the framework within which we're operating and start to deal with those health issues And I think what the New Zealand experience as I understand it and and Helen can tell me if I'm wrong on this Once there was a sense of well the government of the day that you know they want these things to happen they started to happen and They had results and what we're missing with indigenous Australia at the moment In respect of a lot of the programs They're not as effective as they could be and I suspect one of the reasons for that is is the framework within which they Placed is still a prohibition one and I repeat a point. I made earlier that attitudes and still matter in this area in Australian state law many of the states have diversion systems But you know what we've found if an aboriginal person presents a first offense 80% still go through the system of criminal law white fellas 50% and you can see that the attitude issue in the administration of the law is Import that was a law designed to make things a bit better But the way it's administered from if you're an aboriginal or Torres Strait Island a person You wouldn't think that because the racist attitude still exists So I don't know whether that answers the question that Sarah put But I think the framework of law and policy is really important and when we decriminalize and then we move to legal regulation I think we'll find a lot of solutions that people won't even consider Popping up because the fear is not there The exposure that comes the fears associated with exposure won't come I can just add very quickly One of the reasons that we were absolutely committed to including methamphetamine in our decriminalization Despite some quite strong advocacy against it was exactly that point that Jeff just made That we were seeing massively higher rates of diversion by police in relation to cocaine MDMA then in relation to heroin and methamphetamine Which tend to be the drugs that are used by people who are much more marginalized and vulnerable in the community I Think there's there's that phrase about Well, the drug control conventions are set up under the auspices of the health and the well-being of mankind And there's that idea if you continue to do the same thing over and over again and expect a different outcome Um So I think I'm gonna ask for one last scientific perspective on criminalization and then we can close our press conference Yeah, thanks I just wanted to emphasize one of the points that Commissioner Clark raised and I think it's really important to the question you asked I think you know one of the issues is that criminalization and incarceration for drug possession actually puts people at risk of a range of harms and We know that in prison There's an increased risk of HIV and hepatitis C transmission and you know This is partly in relation to the lack of access to proven harm reduction intervention such as needle and syringe programs and Opioid agonist treatment and we know that these interventions reduce HIV and hep C transmission So I just think that it's really critical that we think about the fact that decriminalization could actually play a major role in Reducing a range of harms for people who inject drugs and there's mathematical modeling to show that that this would be possible So I think it's just really important to think of that perspective as well when when considering the issue So I just want to emphasize what you were saying So I Encourage Everybody to access the latest systematic review as Jason said it was published in Lancet Global Health just two days ago Really exciting evidence You're very welcome to approach the panelists again on the point of indigenous rights The the global Commission is involved in in work at UN human rights advocacy around the the new general comment on drugs And that will provide a new kind of human rights guidance tool, which will allow us to explore things including indigenous rights And Yes, welcome to the harm reduction international conference. That's a good to go, right? You