 Welcome to the first plenary of the conference. I'm Judy Chang, Executive Director of the International Network of People Who Use Drugs, otherwise known as INPUD. I'm very honored to be invited to chair this panel, comprised of community and harm reduction advocates who've been working for many years to progress changes in drug policy reform, scaling up life-saving services for people who use drugs and for decriminalization. We all know that working for change is a hard and long path. In the midst of this, we're also facing a new set of challenges, shrinking civil society space, decreased resources, horrific political repression, played out most notably in the Philippines. And these are forcing us to work to defend and protect the gains we had thought we could take for granted. In this climate, we need political action and global priorities for action. We need researchers to create an evidence base. We need drug user and allied advocates and activists to translate that research into action and also to define priorities and track any needed changes in priorities. Global priorities should be grounded in local realities and lived experience. And in this sense, people who use drugs need to be placed front and center in the response. So to kick off the next three days, we have a fantastic group of advocates and activists, researchers, and harm reductionists. First off, we have Katie Stone. Katie is a research analyst at Harm Reduction International and is the author of the last two editions of the Global State of Harm Reduction. And she'll be presenting a global overview of the harm reduction response from the latest 2016 edition. Hello, everyone. Thanks for the opportunity to speak at this conference. I'm gonna be going through some of the main findings of the Global State of Harm Reduction 2016. And before I do, I'm gonna give you a very brief intro to the report. So the Global State is a biennial publication and the only independent civil society-led monitor of the response to drug-related epidemics. Since 2008, Harm Reduction International's Global State has become a key publication for researchers, policymakers, civil society organizations, and advocates mapping harm reduction policy adoption and program implementation globally. The publication on which the data I'll be presenting is based, integrates updated information on needle and syringe programs and opioid substitution therapy based in the community and in prisons. It also gives information on anti-retroviral therapy for people who inject drugs, regional overdose responses, policy developments, civil society developments, and information relating to funding for harm reduction. Over the last five editions of the Global State of Harm Reduction Report, the evidence of the failures of the so-called war on drugs is today further magnified. The Global State 2016 highlights the effects of this failed campaign in every corner of the globe and illustrates the continuing lack of an appropriate harm reduction response. Needle and syringe programs, opioid substitution therapy, and overdose prevention and reversal, to name but a few, are evidence-based, cost-effective, and continue to be vital. Although the harm reduction response is well established and recommended as a key pillar of the HIV response by the World Health Organization, it is an approach that sadly necessitates a continuous struggle. In a changing political climate, there is no room for complacency. In a recent report, UNAID stated that an estimated 11.7 million people who are in direct drugs worldwide. Yet our latest figures show that no new countries have established needle and syringe programs since 2014. This figure has remained stagnant at 90. It is the first year since the inception of the report when no increase has been reported. Although 17 countries have increased their NSP site provision, 20 have witnessed a decrease. Making these figures even more worrying is the increase in injecting of amphetamine-type stimulants, which has been a factor linked to HIV outbreaks in some countries. The frequency of injecting of ATS, amphetamine-type stimulants, is much more regular than for opioids, highlighting the need for urgent attention and a global scale-up of this service. Slightly better news stems from opioid substitution therapy provision and the initiation of drug consumption rooms. OST has been initiated in three new countries, Kenya, Senegal and Monaco. However, in both Senegal and Monaco, this is limited to just one site. Drug consumption rooms, also known as safer injecting facilities, now operate in 10 countries around the world. All but two of these are found in Western Europe. The others are in Canada, with two opening very shortly in Montreal and Australia. When the global state was launched in 2016, there were in fact nine, hence the infographic, but since then a new DCR opened up in Paris. It's a good sign that our information on this is already out of date. There's also hope for DCRs to finally open up in the UK, with one in Scotland and hopefully one in Dublin. With overdose and AIDS-related mortality continuing to be the leading cause of death for people who use drugs, DCRs have been shown to reduce morbidity amongst this population. Naloxone, a highly effective opioid antagonist, forms another line of defense against overdose. This is available, by the way, from Jill in the well-being room on floor four, floor three and a half, floor four. Although more countries now implement the peer distribution of Naloxone than ever before, on a global scale, this response continues to remain extremely limited. Evidence by the figures behind me, with a 327% increase in drug-related deaths linked to heroin and morphine in Canada since 2008, and a 137% increase in the US over the last decade and a half. Where these figures should be going down, regretfully, we are witnessing them increase. With harm reduction stagnating in the community, things look particularly inadequate in prisons. Currently, only eight countries implement a needle and syringe program in at least one prison. These are Armenia, Germany, Kyrgyzstan, Luxembourg, Moldova, Spain, Switzerland, and Tajikistan, while only 52 provide opioid substitution therapy. This is despite the fact that up to 90% of people who inject drugs will be incarcerated at some point. Although there has been some momentum around decriminalization in the last years, mass incarceration continues to be the favored approach to drug control. Globally, one in every five prisoners is held on drug-related charges, the vast majority for personal use or possession. Nowhere are the human consequences of these figures more striking than in the United States. Human Rights Watch recently revealed that 1.25 million arrests for drug possession were made in the US alone. That's one every 25 seconds. Prisoners are also disproportionately vulnerable to drug-related overdose, both during their sentence and in the immediate post-release period. In Puerto Rico, for example, almost half of the prison population have witnessed an overdose in prison, with one third knowing someone who have died of an overdose whilst incarcerated. HIV and hepatitis C prevalence are also substantially higher in these settings. The provision of harm reduction both inside and outside of prison is a legally binding human rights obligation. The facts can no longer be ignored and they are begging us to direct our attention and funding away from the so-called war on drugs and into a harm reduction approach that protects health, well-being, and dignity of all human beings. Globally, an estimated 100 billion US dollars are spent on drug control every year with little impact on drug consumption. At the same time, funding for harm reduction is shrinking and services to reduce drug-related harms are failing to keep up with the growing need and emerging trends such as ATS injecting. A UN target to halve HIV among people who inject drugs by 2015 was not only missed, but HIV is actually increased by a third between 2011 and 2015. The sustainable development goals now pledge to end AIDS by 2030, but there is no way we'll ever achieve this goal in the current climate given the lack of leadership and funding for harm reduction for people who inject drugs. Funding for harm reduction remains critically low in many parts of the world, with donor contributions dropping 7% between 2014 and 2015. It takes political courage to look at these figures and bridge the widening gap of an increasingly unnerving politics of exclusion, which sees the most stigmatized and discriminated groups left behind in terms of their public health and human rights needs. In light of this, HRI launched a campaign in 2015 called 10x20, urging governments to take 10% out of their punitive drug control budget and divert it into vital harm reduction services by 2020. Analysis has shown that if this is done, new HIV infections among people who inject drugs would be virtually eliminated by 2030. Lastly, I'd just like to say thank you to all the people who contribute to this report, many of whom are in this room. I've given a small snapshot of the main findings, but the report contains a load of information and it's available from our booth upstairs. Thank you.