 Lynn is the Director and Founder of the National Advocates for Pregnant Women Organization in the USA. That's an organization that works to protect the rights and human dignity of all women, particularly pregnant and parenting women. And those are most vulnerable, including low-income women, women of color, and drug-using women. I'm very honored to give the floor to you. Thank you so much to Harm Reduction International. I want to say thank you to Olga and especially Kasha, who has taught me so much, and to the women of Inwood and the women of Harm Reduction International. As you heard, I'm the Executive Director of National Advocates for Pregnant Women. And I haven't faced discrimination because of the drugs I use or the work that I do. But I do want to share some things about myself before I talk to you about some of the work and why I see issues as connected. So I'll start by mentioning that I was exposed prenatally in my mother's womb to a drug that has been shown over and over and over again to create severe risk of harm to the children exposed prenatally. And that, of course, would be cigarettes. And that adorable redhead there is me. And that's my mother with a cigarette in her hand. And I always like to say maybe if she hadn't smoked cigarettes, I'd be a corporate lawyer and making a lot more money. I also, as a white woman from North America, have enormous privilege. But I've had some experiences that have given me exposure to certain kinds of discrimination. I spent a day, not that long ago, in a family drug court in New York City. And all day long, people were talking about folks who were either clean or dirty, terms that I'm thankful that I have not heard here. This is a picture I, you know, it's always good to show humiliating pictures of yourself. I was 13. I was being bought mitzvah. But in the fourth grade in chorus, a girl leaned over and called me dirty Jew. And given the privilege I've had, that one experience back then stuck with me and taught me that you cannot divide people into dirty and clean because those who are defined as dirty are those who do not deserve human rights, who may not be treated like human beings. Also, I run national advocates for pregnant women, even though I myself have never been pregnant. That was in part because my partner tried to get pregnant first and she got pregnant with twins. These are our kids. And I have been part of the lesbian, gay, transgender movement in the United States of America and seen the achievements that that movement has gained. So that just last year, my children, my 23 year old twins, now 23, were the efficiency at our wedding in our living room in New York. So enough about me. Now I want to talk about Ethan Nadelman. So he gives me a chance to make a transition. So as you saw during the morning of the opening, Ethan likes to say no one should be punished for what they put into their bodies. And I agree. I think that also I agree completely and I take it literally and seriously. So that means not only drugs, but also sperm. And that it should not be that because somebody has had sperm in them and become pregnant or anything else that they can be subject to the loss of civil and human rights. The work for equality for women has been long and hard and there's much remains to be done. But the work of ensuring that women are considered full persons entitled to human rights is particularly challenged by drug policies and attacks on drug users that play a significant role in continuing to undermine the status of women worldwide. In the US, policies that are put are being put into place that are increasing discrimination against women, creating a separate and unequal status for them are based on drug punitive drug policies. In the US, a panic about pregnant women in the late 80s and 90s using particularly cocaine, the smokable form crack became the subject of news stories and hysteria claiming that those children would be permanently damaged in unique ways. Even after stories were finally published saying that those expectations of harm really are not supported that none of the criminalized drugs create harms greater than those caused by risks of harm created by cigarettes, not as bad as alcohol, those particular drugs have become the basis for punishing pregnant women. We did a study in which we looked at arrests and forced interventions on pregnant women in the United States from 1973 to 2005 and identified over 400 cases. The vast majority more than 80% involving women who became pregnant and were claimed to have used a criminalized drug. You'll see that the highest point of arrests and prosecutions theories of if you become pregnant and use a criminalized drug, you're a child abuser. You're abusing the unborn child or you're delivering drugs to a minor or you're committing an assault with a deadly weapon. So you see the height of these arrests during the particular scare around pregnant women and cocaine use, but it continues. The response wasn't, is it really, let's look at the science, let's look at the evidence-based research. Is there enough treatment? Is there enough compassion? The primary response was proposals of punishment and arrest of women who love their children, women who look like this. And as you've heard, drug policies are not enforced equally and they're not enforced equally against women. Either the overwhelming targets have been women of color, particularly in the United States, African American women. But using fear around drugs and pregnancy, there's a precedent that's established that doesn't stay limited to pregnant women who use certain drugs. It has provided legal precedent in the United States for arresting women who are pregnant and HIV positive for a woman who fell down a flight of stairs while she was pregnant, for a woman who refused cesarean surgery, for a woman who refused prenatal care, for a woman who is in a dangerous location with bad air. Oh, I'm in Kuala Lumpur today. Anybody pregnant, breathing this air? Those principles have also been used in the United States to say if you are not allowed to risk harm to an embryo or fetus, then you also lose your right to medical decision-making while pregnant and can be forced to deliver the way somebody decides you should deliver, which results in an enormous number of unnecessary and coerced cesarean births in the United States. The other thing that happened in the United States is child welfare laws, the civil laws involving your right to parent. Many states amended their laws to create a presumption of parental unfitness based on nothing more than a positive drug test. In one state, so parents like these who love their children have been forced into a system that searches for abuse and neglect and defines parents that way. Wisconsin, one of our states, has a particularly bizarre law that allows state officials to take a woman into custody if she habitually lacks self-control in the use of alcohol or controlled substance to a severe degree, creating a serious risk of harm to her fetus or child. None of those terms are defined. And both of the women pictured here went for early prenatal care. One said, I'm so proud, I've overcome my dependency on Percocets, I used some Suboxone on my own and now I'm not using. And the next thing she knew, she was taken into custody by police officers brought to a courtroom in handcuffs and shackles where her 14 week fetus had a lawyer and she had none. And she who was no longer using any drugs was told she had to go to a 90 day residential treatment program that provided neither prenatal care nor the Suboxone that they insisted she might, she should continue using, taking. Another, the other woman went because she had a severe thyroid problem. She had no money to treat that problem at the time. She was using a little meth and marijuana to deal with it. But the minute she thought she was pregnant, she went for help. And rather than getting the help she needs, she was told she had to go not for the thyroid treatment she needed, but to drug treatment. And when she refused to go, a lawyer for her 11 week fetus, I think it was 11 weeks, it might have been 14, said she was in contempt of court and asked to have her put in county jail. And when she went to county jail, they wanted her to take a pregnancy test. And when she refused, they put her in solitary confinement for two days and threatened to taser her. In New Jersey, women are being told that they're abusive because they get the method on treatment that the World Health Organization says is the gold standard of treatment for pregnant opioid using women. Since 19 2005, new arrests have happened. I'm happy to tell you that this woman was, we just won a case in which a woman was sentenced to 20 years for testing positive for methamphetamine while pregnant. That conviction was overturned, although she's already served 18 months. Panic about methamphetamines has helped persuade court in another state, Alabama, to make women guilty of chemical endangerment of a child for using any controlled substance, even one prescribed to them by their physician. And the new opioid scare and with newborns who might have a treatable withdrawal syndrome is leading to new new arrests in Tennessee and elsewhere. So I want to talk to you about coming together beyond harm reduction and drug use and engaging, asking each of you to engage in your countries with whatever women's rights organizations or reproductive rights organization exists in your state, reproductive health, reproductive rights and reproductive justice. So here are some connections that I make and hope you will too. Prohibition is prohibition is prohibition. You prohibit people from using alcohol, it doesn't stop them. You prohibit people from using drugs, it doesn't stop them. You prohibit women from taking responsibility for their reproductive lives, which sometimes includes having an abortion, and they still have abortions. So it doesn't stop people from doing the things they need to do. What it does do is give the state power to control certain populations or alternatively population control. And as Dr. Karl Hart talked about this morning, these issues empower the government and the media to distract our attention from government failure to ensure economic justice and human rights for everyone. So we have prohibition that operates the same. It takes people around their very personal sex lives. The people have always used drugs, people will have sex, and we create a mechanism for controlling and punishing them. Abortion is illegal still in many parts of the world, and even where it's legal, it's less and less accessible. So like certain drugs, certain actions women take, whether they're using drugs or controlling the reproductive lives are criminalized. And there are health harms in both serious health harms, maternal mortality. About 800 women die from pregnancy or childbirth related complications around the world every day. Many of those are from unsafe abortion and from the fact that we don't value women enough to ensure safe maternity care and safe motherhood. Women are arrested, as are drug users around the world, for having abortions. And that is not, that is true even in countries like Malaysia, where a woman was recently arrested, even though abortion is legal. And in the United States, even though abortion is legal. To give you a good idea of how these things are connected, as abortion becomes less and less accessible in the United States of America, women are turning to the drugs myzoprostyl and mythopristone. Drugs, myzoprostyl and mythopristone, that when safely used can and terminate pregnancy safely. Can Lysia Jones use those drugs or was accused of doing so? She did so later than she realized, ended up in a hospital, delivered or ended the pregnancy, and she was arrested in the United States of America, Georgia, the state, not the country, for malice murder. Now based, within two days, based on our work and a national outrage, they released her. But there's a crime that she's still pending against her. And you know what that crime is? Possession of a dangerous drug. So the same tools of control are being used and the same labels are being used. Increasingly women around the world, women in Brazil, where abortion is criminalized, figured out that myzoprostyl can be safely used to terminate a pregnancy. And women on web provides information about how to do that. And that's where the principles of harm reduction that apply to both movements, to both concerns apply. Harm reduction is this brilliant, beautiful concept that, well, I just want to point out that I come to these conferences and I go to workshops and panels that beautifully combine science researchers, academics and people who are directly affected and the experts in their own lives. But those of you who are doing studies, I always find that the conclusion is all the same. It doesn't matter what you're studying, hep C, HIV, needle exchange, certain kinds of treatment. The conclusion is always, if you treat people compassionately and with respect, you have better outcomes. And I just want to say, I'm sorry that you have to spend so much time quantifying compassion. Harm reduction is also something that Professor Noemi Brain talks about as filling in illegal public health. Where there is our public health policies and practices that work but have been criminalized or are in legal gray areas, we have to turn to harm reduction. And one of the things I'm particularly excited about in the world of reproductive health rights and justice is that harm reduction isn't just for drug users anymore. That the things that you are have taught and learned and demonstrated around the world have applications and intersections with safe abortion. And this is a group of us who did the talk at the National Harm Reduction Conference. I hope that the next international conference, these two movements will be together. And IPASS has provided a paper that explains how the principles of harm reduction that have been used to reduce HIV infection, that have been used to improve health outcomes, apply to access to safe mechanisms for terminating pregnancies. So now for the theme of this conference, the call to leadership. We have been called. My organization that I founded 14 years ago, National Advocates for Pregnant Women, we've been encouraged to take a lead anticipating UNGUS 2016. And what that looks like for us is we have prepared and I'm announcing today a declaration from women's rights and reproductive rights and health groups, asking them in their capacities and groups that have never taken a position on drug policy or harm reduction to sign a declaration that we will deliver in 2016 to the United Nations saying that low punitive global drug policies undermine women's fight for equality, for healthy families, for healthy lives. And not only do we have this declaration ready, but I want to announce two of the groups that have already signed on just this week. One of them is Women's World, Link Worldwide. They're an international organization. They have offices in Latin America and Europe and are working across East Africa. And if you look at the issues they work on, discrimination against women and girls, sexual and reproductive rights, gender based violence, drugs, drug policy, harm reduction are not listed there. And they have signed onto this statement joining everybody in this room in challenging punitive global drug policies and calling for harm reduction approaches. This organization is here in Mexico. And though I don't speak Spanish, if you look at each of the issues that they work on in Mexico, none of them are drug policies. And yet they are joining with everyone here in demanding that there be policies that are based on human rights that include the people who are directly affected and that ensure public health. And yesterday I had the privilege of meeting with two organizations here in Malaysia, both of which are considering signing the declaration. And I just wonder how many of you who work on drug policy in Malaysia have met with the women who run RAM, Reproductive Rights Advocacy Alliance, Malaysia or Arrow. And if you haven't, I'm asking for your commitment to reach out to them as I ask everybody in your country, even if you go and speak to the women's rights group and they say, Oh, our issue is too controversial. We can't join you. There is power in numbers. There's power in recognizing commonality. There is power in joining forces. And even if the first time they say no, ask, ask again, because if you are trying to do harm reduction and you are not paying attention to the women who are using drugs, who need access to harm reduction services, who need access to methadone. And if you are providing those services and not providing them addressing their reproductive health needs, the things that make us women or people who have the capacity for reproduction, then you are not doing your job. I want to know whether your leadership will include women and whether your leadership will include reproductive health, rights and justice because pregnant women who use drugs have human rights because we need to keep families together because pregnant women who use drugs deserve treatment, not punishment because the war on drugs is a war on people because pregnant women who use drugs have human rights because pregnant women need affordable and effective treatment. And because moms like this one need support, not judgment by any of you, no matter what non science stigma they tell you about drugs and pregnant women and who is the worst of the worst, we are all the best of the best who can make a difference. So thank you and please join the declaration.