 My name is Angela McBride. I am the Executive Manager of the South African Network of People Who Use Drugs. My name is Nelson Madeiros. I'm currently a Senior Technical Advisor for a home reduction programme in Victoria. I'm also the Co-Chairman of Sandput. My name is Sean Shelly. The organisation I'm currently with is the South African Network of People Who Use Drugs, which is Sandput. I do fulfil a number of other roles in the field though. I'm with the Department of Family Medicine at the University of Pretoria. I work for an organisation called TBHIV Care in their Policy, Rights and Advocacy section. I was 10 years old. First time I used a substance. I remember the moment quite clearly. My best friend was a Russian friend. It was in Halens, a benzene actually to be precise. He said to me, try this, it will make you laugh. I remember her and I started laughing. I immediately got a hook on to it. I enjoyed it. I liked it. It was fun. Things progressively carried on moving on and I tried other substances. I remember every time I tried a new substance, the kick was a bit better. The high was better. I was like, oh yeah, I like this one. 16 years old I ended up in my first treatment centre. It was just before my 16th birthday. I went into the treatment centre and back then there was no youth treatment centre. I was 15 years old and a rehab was 25 plus on average. I heard about heroin and crack cocaine and all these other drugs that I'd never tried. What I'd done up to then was basically cocaine, LSD, ecstasy, marijuana and halens. But I'd never done heroin or crack cocaine. You actually couldn't even get it in the city where I was living at that time. I heard about this drug and on the day I left treatment, I made a plan to hook up with this girl that I met there. On that day, we went and tried it. She gave me some low load at a park and gave me my first hits of crack cocaine. That took me somewhere and then she shot me up with heroin. There was one of the moments I don't think I'll ever forget until I die. My eyes rolled to the back of my skull literally for about three hours solid. All I remember feeling was, wow, that was it. What I'd been looking for, this was it. I don't know why I had this tape in my head. Three months on that, my parents ended up throwing me out the house. This whole tough love thing. I was quite a variety of a child. I was quite a hectic child when I look back now. I ended up being homeless. I started my career doing that for the next 12 years. Injecting heroin and doing other drugs, mainly heroin and crack cocaine. All throughout the country in South Africa. I'm a bit of an anomaly because I've never used drugs before my 30s. That includes cannabis and that. I've been drunk once in my life, which obviously is a drug as well. So I've used alcohol, but never even a cigarette or anything like that. In my 30s, I discovered stimulants, which really worked for me because I've got a diagnosis of ADHD, which impacts quite severely on my life. The stimulants certainly helped me. I've been a stimulant drug user for most of my adult life from there onwards for the last 25 years, certainly. I've used pretty much every other drug that there is to be used as well. But it was the stimulants in particular that I became dependent on. I started using drugs when I was a teenager around 13 or 14. About five years ago, I was introduced to home reduction. The rights of people use drugs, the rights I have as a woman and a woman who uses drugs. I realized that drug use is not bad. I'm not bad if I use drugs. I'm not a bad person if I use drugs. I have incredible human beings in my life who support me and who are understanding. If I feel like I'm losing control or whichever the case is or my substance use is causing me harm, I lean on those people. In the minds of the general population, drug users don't have any rights. They feel that once you start using drugs, you put yourself outside the norms of society and therefore you deserve whatever comes your way. Unfortunately, that's the way a lot of people see it and they forget about the context of drug use, the purpose of drug use and of course they forget that they use drugs themselves every day. No person in the world survives without using a drug of some sort or another. That moves beyond the alcohol and nicotine to things like sugar and certain food types. Drugs are around us and they've been here since the beginning of time and they're going to be here forever. But in South Africa, there's a failure to acknowledge that. I think that everybody's a drug user on one label or another. People don't like to admit it but there is no scientific definition of the term drug. As Derrida said, it's a social construct. It carries with it a history, carries with it a weight of society. And I think that if we take the broad sense of drugs, everybody is undoubtedly a drug user. If we look at the drugs that are scheduled by the UN, we know that those drugs have been scheduled by accidents of politics or intentions of politics rather than dangers because if it was about danger, we wouldn't allow free climbing for example. It's not about danger at all. It's about which drugs, which people use in what ways. So I would say we all drug users quite clearly but only some of us suffer the consequences of using drugs. If you think about the Wall Street banker who uses copious amounts of cocaine to work long hours and to party hard, he doesn't get the same consequences as, for example, somebody who's living on the street who decides to use heroin to ease the pain of daily existence. For anybody to really be involved in this movement, you have to have a strong motivation. And my motivation came from a realization I came to a number of years ago. I'd just come through a period of really chaotic drug use. I joke and say it was an embedded ethnographic study into the criminal underworld of Cape Town but in reality I was living the life of a low-level dealer and user. My life was pretty chaotic and when I came to the end of that period and I looked back on it, I realized that in my friends who were mainly black and brown friends, I was the only one who hadn't ever been arrested for any length of time. I'd been arrested once and held for about 40 minutes but every other person had been arrested multiple times, had been to jail for multiple times. And I realized it wasn't because of my street smarts that prevented me from being arrested, it was simply because of the color of my skin and the privileged position that I held within society, even as a drug user and somebody who's involved on the fringe of the drug trade. That was a big motivation for me because I realized that something was wrong and really the war on drugs was a war on particular people and in particular people with black and brown skins. Fortunately, we partnered with an organization that was quite prepared to support us fully and to give us the space to operate without imposing their standards or their ideas on us. What they did impose on us was the levels of governance and the reputation that they carried. So we were very thankful to an organization called TBHIV Care, which is a large non-profit organization, which has since 1929 specialized in providing services to marginalized people. And they did the same with people who use drugs and encouraged the development of a network of people who use drugs without interfering in that process. We've advocated for drug user networks to be seeded in the country. They are being seeded. They do exist. The way we fought for harm and action programs to be available and for services to be available. A lot has changed in just a few years. Ten years ago there was no needle syringe programs and now there are multiple across South Africa. There were no OST maintenance programs and now there are multiple as well. There's a needle syringe program that has distributed millions of sterile needles and syringes. Commodities that never used to be available to people who use drugs are now available. I remember what it was like not to have access to a syringe, being chased out of a hospital, being told I've done this to myself, not being able to access a service and it really pissed me off. When I found myself in a position to actually change that, it was a privilege and I've been privileged ever since. I was homeless and destitute at 16, you know. Literally I was on the gutter and when I was 16 years old it was quite a bad heroin problem by the time I was 18. It was bad, I mean, constantly getting arrested. I had to change cities and we fast forward to that when I'm like 30 and it's affected me like my parents are proud of me. I actually have a relationship with my mother and my father. I've got two children. I managed to keep a job. I have a house, I have a car. I have a lot of things that I don't think I ever thought I'd have. So the harm reduction program started and I think it took about 18 months for a protocol approval back and forth for us to actually just start delivering services and when we did start, no one even knew still if needle and syringe programs were legal. No one had a cooking clue but we started. We only work within the community and if we have budget or we find more money we go and capacitate and we hire. So what that generally means is that people are homeless and show up for work and people show up at 8 o'clock for work and people work the entire day and go home at 4. And people are using drugs and people are injecting drugs and people start to learn to function. Just showing people that they matter and that they care, it's actually that simple. We didn't design one element of the program without the community. The community basically designed the program and I think that speaks to one of the successes that we have up there is that there's ownership of the project. It's not my project, it's our project. I think we've been pretty successful in some aspects of what we were planning on doing. In the National Drug Master Plan, for example, we've achieved a number of goals. We've changed the aim of having a drug-free South Africa to having a South Africa free of drug abuse. I'm not a fan of the term drug abuse, but it is a big victory when you think about it from a philosophical point of view or from the idea of what is their policy. Their policy is no longer to stop all drug use, it's to stop problematic drug use. And I think that we'd all like the world to be a place where people who use drugs don't develop unnecessary dependencies or chaotic dependencies or obituated dependencies on a particular drug. So I think that's a big achievement. We were also for the first time consulted as a drug user movement on the development of the National Drug Master Plan. We held a series of workshops between the Central Drug Authority, Executive Committee members and people most impacted by drugs. And we were able to really humanize the face of drug users in South Africa, which is something which is lacking. We're reduced to non-human entities within society. So I think we've achieved a lot there. We've also managed to engage with the police and visible policing in particular have changed their attitude towards people who use drugs and we no longer seeing the arbitrary arrests. We've also just seen an order coming out from South African police services saying that quota systems are no longer allowed, they're illegal. So previously police had to arrest a certain number of drug users whose amount was going up every single year by as much as 27%, which is a huge percentage considering we already had 295,000 people a year being criminalized for drug use. Also an important one is that people who use drugs feel that they have a voice now and that's very important. They feel like there's a chance that the rest of society can acknowledge them as people, that their families can reunite with them and that there's hope for the world ahead. And when they have hope, we see changes in behaviors and attitudes and also we see that the rest of society is starting to treat people who use drugs as human beings as it should be. Organizations and programs are becoming more aware of women who use drugs. Women who are injecting drugs, women who are using drugs in general, they are with and they are being sensitized. We were able to sit down with some of the home reduction projects and alert them and let them know that this is what women use drugs for facing. It's the abuse from their partners, it's the abuse from full enforcement, it's the abuse from society in general. Kind, generous human beings, women who have been told that they're not, who have had their children taken from them, who have had their womanhood taken from them, who have been told if you recycle plastic and that you're not a woman, who get told like when they try and open a case of rape, did you really get raped or did you just not get paid? Women who use drugs are not taken seriously. I was using drugs to cope with my trauma and when I went through a period of abstinence, I was told that I use drugs because there was something wrong with me and being involved in this movement, I realized that there's something wrong with the system. The people who suffer most under drug policy are communities of brown and black people who are historically marginalized and what we're doing is we're perpetuating that. I often say that drug policy is the perpetuation of imperialism and colonialism through the myth of international consensus on the use of drugs and what that means is there's international consensus which is presented, which is actually no consensus at all. It's actually a point of view that comes out of a very moralistic background and history formulated mainly in the United States that says that people who use drugs are evil and shouldn't have rights. But this of course plays out in socioeconomic circumstances, mainly in South Africa in particular and in the rest of the world as well where those that can't afford to have the protection from the police just don't get it. So for example, if we look at the new cannabis laws in South Africa, they say that it's not illegal to consume cannabis in private spaces. Now, there are lots of people who don't have private spaces in South Africa. If you live in a highly populated township for example, it's very difficult to find the space to do anything in private and so you're immediately marginalizing a large group of the population. Also, they don't have access to lawyers, they don't have access to legal rights and we know for example in some of the courts in South Africa you're not allowed to get legal aid if you're on a drug related offense. The criminalization of people who use drugs is at the center of all harms related to drugs. In summary, nothing good has ever come from arresting somebody for the use of drugs. Nothing good. If they happen to have resolved their drug use issues while in prison it's because they've been arrested. It's despite the fact that they've been arrested, despite the fact that they've been put in prison. Criminalization has robbed people of opportunities of resolving their drug use. It's robbed them of economic opportunities in their life. It's robbed them of the ability to transcend their history and the economic suffering that they've experienced in life. And we have to advocate for the decriminalization of the use and possession of drugs. As South Africans, we shouldn't be alienating other human beings because of the choices they make. It's our body, it's what we decide to do with it. Being arrested, being harassed because of a choice I make about myself which isn't harming anyone else, that's not fair. Identifying as a person who uses drugs means you break the law. So you're in constant conflict with the law and someone is in conflict with the law. It starts becoming pretty common sense. You can't rely on the system for anything. In other words, you can't get healthcare. The criminal justice system sees you as a criminal. So if you want to go report a crime, you get laughed at, you get looked at, like, what do you mean you get robbed? So aren't you the one who does all the robbing since you use drugs? Drug use is often used as a proxy for an excuse for many other things. You know, if we look at the Philippines, for example, it's not about drugs. It's really about political opposition. But the war on drugs justifies any means to stop drug use. And so you can shift that wall to be actually get rid of opposition parties, get rid of people. And so if you look at the legislation around it in the Philippines, for example, they say it's an excuse to bring back the death penalty. But the second line of the death penalty act is basically you can be executed for political insurrection. And that's the actual end aim of it. But there's a very sad story in that because it basically says that as a society, we are prepared to let anything happen when you're fighting against drugs. And we see that played out in South Africa. We see the inexcusable violence of police and apartheid style policing being used. And the general population accepted when they say, you know, okay, this is against war. This is against drugs. This is a war on drugs and gangsterism. And therefore we support these apartheid style policing actions. Whereas in actual fact, those are the things that drive gangsterism and the use of drugs because they alienate people further. They can feel totally isolated, excluded and psychosocially dislocated. And when we have psychosocially dislocated people, they find meaning in drug use and dependent drug use. And so the problem is the cause and the cause is the problem in a lot of spaces. And so I think we've got to be very careful how we frame the so-called war on drugs, which in one level has been abject failure. But on another level has served the purposes of governments around the world to keep the press depressed and the marginalised marginalised and to silence the masses so that they don't rise up and counter the normative argument that is out there. It's really a terrible thing to say. But without HIV, people who use drugs would never have received any services. It was only through the absolute horror of the deaths of people from AIDS and HIV-related complications that motivated people with any sort of heart to do something about it. You can't write a grant and say, hey, I'm going to go treat my fellow drug user as a human being under a bridge and go tell him, hey, Brewer, you're a human and you have some syringes and you have some antibiotics and take care. No one cares. When you're going and saying, well, we want to go prevent HIV and this is the angle and the people at high risk and in our country with the prevalence rates worse in the world, we have to act. So, I mean, obviously, if it wasn't for HIV and that we can actually go out and prevent HIV amongst our community, there is no movement, there is no programme. It's one hand in hand. I'm constantly labelled as the one who's promoting something that shouldn't be promoted. In fact, I'm not promoting anything apart from human rights. Constantly you're hearing how what you're doing is killing people, how what you're doing is enabling people and yes, I am enabling people, but I'm enabling people to stay alive rather than die on the streets like the rest of the world are prepared to let them do. As a drug user movement, we have got a very clear vision and that is we look forward to a world where all people, despite the drugs that they choose to use or not use, the way that they choose to not use them or use them, we believe that they should enjoy equal rights with everybody else and they shouldn't be criminalised for that kind of behaviour. We don't mean just people who use drugs. We're also talking about people such as sex workers. We're talking about people, the LGBTIQ community. We're talking about all marginalised people and we recognise that people who use drugs are spread across those movements but they're also amongst the general population as well and it's everybody's rights that we're looking to protect. We're still a very small group. It's not as big as where it needs to be. That's challenging and then again funding, trying to find money. I mean, if you know what the challenge is that we face on a yearly basis to find funding for needles and syringes because the government won't pay for it. This is a unit that costs 85 cents and we need about almost 2 million syringes a year so you need to find 2 million round. Basically, the government won't give it to us no matter how we prove what it does, what the intervention is. They agree with the intervention. It's in the National Strategic Plan but it says needle and syringe programmes must be delivered by NGOs. So they note it's there but they still wash their hands of it. We like it, we know it's there. The NGOs, you guys do it. You guys deliver it, I'm not paying for it. And that's one of the biggest limits is that until funding becomes core and it's from the local government it's one of our biggest limitations for sustainability because at the moment the whole movement is reliant on donor funding. So people use drugs with people. It doesn't matter what they put in their body. No one deserves to be treated like worse than an animal. No one deserves to be treated like they don't exist, ignored. I'm not broken because I use drugs. I use drugs because I want to use drugs for whatever reason other than that doesn't matter. We see a lot of people really suffer because of this narrative that they have to stop using drugs before they can be included in the world which is just not true. So I think that the big lesson for me is and the biggest strategy would be to humanise people who use drugs to make them human to the rest of the population and that happens through media and media content through the common narrative and so we have to disrupt all the time and we have to show a different reality. So my call would be to new people coming into this movement is don't relax when you think you've won the battle. The battle is not won. This is not sort of a temporary situation. This is an ongoing situation and until the world is a place where all people have autonomy over their bodily rights I don't think we can relax.