 Good morning ladies and gentlemen My name is Michelle Kazachkin. I am the UN Secretary-General's special envoy on HIV AIDS in Eastern Europe and Central Asia a former Executive Director of the Global Fund to fight HIV and malaria but I'm speaking today as a member of the Global Commission on Drug Policy as this press conference is to introduce a Session that will take place at 1 p.m. That is co-hosted by the International AIDS Society and the Global Commission on Drug Policy The global the Global Commission Has 20 members of which the names are shown on the screen It is chaired by the former president of Brazil Fernando Enrique Cardoso And it is a commission What we do is advocacy at the global and the political level for drug policy reform We advocate for evidence-based human rights based Public health based approaches to drug policy Joining me for this press conference is a remarkable panel Justice Michael Kirby who needs no introduction here in in Australia But I'd like to Mention that Justice Kirby has been a member of the commission the UN AIDS Commission on HIV and the law because I find it remarkable how much Overlapped there is between the conclusions of that commission and those of the commission on drug policy also joining us the honorable Peter Dunn MP from New Zealand Minister of Internal Affairs and Associated Associate Minister of Health Who will talk about some of the? Extremely innovative approaches that New Zealand is taking to new psychoactive substances Alex Vodak a Physician I guess well known also here in Australia a pioneer in harm reduction Judy burn who will be the voice of the people using drugs and In about 20 minutes or so we will be joined by Svetlana morose Who is from the network of women living here with HIV in Donetsk in Ukraine? and we will have part of this press conference also devoted to the disastrous Consequences of the discontinued discontinuation of harm reduction and opiate substantive therapy in Crimea Following the annexation of Crimea and and the new authorities the session On drug policy will take place at 1 p.m. For that session We will be joined by video by another of the global commissioners and that will be sir Richard Branson who will talk to us on I mean he'll be by Skype or whatever new technology Intervening and and and talking to us and and responding answering questions Let me just frame the issue by saying that The international drug regime is a prohibitionist regime That so that in most countries in the world The user possession of drugs is a criminal offense The way the regime functions is that it has generated aggressive law enforcement across the world A war on drugs and often a war on users that has had disastrous consequences First it has failed its own objective of decreasing Drug use and drug availability as drugs are more easily available now Be them the conventional drugs heroin or the new psychoactive substances and synthetic drugs Prohibition and law enforcement have resulted in a major health crisis At least one in five people injecting drugs across the world is infected with HIV two out of three Infected with hepatitis C Co-infections rates are somewhere around 70 to 90 percent It has generated huge social violence think of the 50,000 deaths in in Mexico alone since the war on drugs has started It is undermining human rights. It is sparing crime. And of course it is Generating a huge Over 300 billion dollars black criminal market parallel market It is undermining development and security. It is wasting billions of precious resources on ineffective prohibition law enforcement In short, it is time to reform and and that is what we will be talking about Of course because this is an AIDS conference The focus will largely be on health drugs health and and HIV a large focus on harm reduction and How countries that have early implemented harm reduction see basically no more Infections with HIV among people who use drugs whereas countries that have resisted Implementing at large-scale health-based interventions and harm reduction see still expanding epidemics as it is the case in Eastern Europe and Central Asia We were here as I said before from Minister Dunn on the Courageous I would say and certainly very innovative approaches that New Zealand is taking to in regulating psychoactive substances and then we'll come back to the issue of opiate substantive therapy and harm reduction by focusing on This scientifically and from a human perspective unjustifiable discontinuation of opiate substantive therapy in that happened in Crimea after The new authorities took over we have a few people also in the audience including Andrei Klepikov who is the head of the HIV AIDS Alliance in Ukraine So we can have more of that debate We have also in the audience a few people that are very knowledgeable on harm reduction That can intervene. Let me just also draw your attention To the fact that you will find leaving this room copies of Three reports that the Global Commission has already published the first one was called the war on drugs and war is erased here Basically, it's the war on drug has failed 2011 then how the war on drugs is fueling the global HIV pandemic 2012 a report on hepatitis C 2013 the next and Report of the Global Commission will be launched in New York on September 9th this year So without further ado, let me now ask The panel to come with their comments and maybe we'll start with you Michael thank you very much Michel and good morning everybody. I am here because I was a member of the other Global Commission. That is the Global Commission on HIV and the law and Common membership between the two commissions was established by former president Cardozo of Brazil who was the Chair of the Global Commission on HIV and the law Here is a Report of the Global Commission on drug policy, which is outside on the table and available to you Here is the report on of the Global Commission on HIV and the law on risks rights and health and As our chair has said this report and This report are both written in the context of the epidemic of HIV and AIDS and what is said by me today is Is restricted to that area? This is the legitimacy of the report of the Global Commission on HIV and the law addressing the HIV AIDS epidemic There were basically two big common themes of this report The first was that the law as it affects certain vulnerable populations is playing a very adverse effect having a very adverse effect and playing a counterproductive role in respect of the Epidemic and in respect of the rollout of the antiretroviral drugs The essential common theme of these marginalized groups is this that if you criminalize and penalize people in the marginal groups MSM men who have sex with men mostly gay men Sex workers People who use drugs prisoners refugees and other Vulnerable groups if you stigmatize and criminalize them then first you don't get into their minds so that they Know about an epidemic that might affect them. They know about what they should do to protect themselves They know about how important it is to take the test they know about the Care and treatment including antiretrovirals that will be available if they take the test and They know about the fact that if they take the test and get on to the ARVs This will not only be very good for them, but good for society by Acting as a prevention of other people getting the virus and reducing their viral load so that they are not a risk to others particularly in sexual or Drug related activities So that's the first common theme the second Theme of this report the global Commission on HIV and the law is on another area where the law intrudes in a hostile way to the AIDS epidemic and that relates to global intellectual property law patent law eyes tend to glaze over when you talk about that because people think it's boring and it's Hard to understand and to some extent that's right But it's tremendously important in the field of HIV and AIDS because of the huge costs of antiretrovirals and other drugs and the way in which the law protecting patent rights Protects disproportionate profits that can be made in that area But that's not an area that is of immediate concern to this press conference or the issue of Drugs, it's a very important theme of this report But the aspect of the report of the global global Commission on HIV and the law that is critical to the press conference entered the session at one o'clock today is People who use drugs as a minority vulnerable group and Helping them to protect themselves and thereby to protect society Now the recommendations of the global Commission on HIV and the law in this area were Basically very simple and they were basically only five first of all that all systems of compulsory detention of People who use drugs should be abolished Because having that system makes people Alienated from their society and outside the messages that are essential to protect them and thereby to protect society Second the systems of national registration of drug users should be abolished again Because that's a hostile discriminatory way of acting. It's not a harm reduction way of acting It's a hostile way that alienates people from the messages Central to their own protection and thereby the protection of society Thirdly that there should be a ban on all laws and policies that restrict Needle exchange that is to say the capacity of people who used drugs by a needle injection to Secure sterile needles in exchange for any used needles and thereby to take out of the market needles that might Be a way of Extending the HIV virus the human immunodeficiency virus the fourth is the enactment of laws that Decriminalize the possession of drugs for personal use And the removal of the heavy hand of the law in that area in the so-called war on drugs Prime Minister Tony Abbott of Australia recently made a statement in which he said that in Australia the war on drugs has failed He didn't draw an inference from that that the war should be stopped The inference he drew is that we still have to keep on with this war because it's a it's a war that has to be fought Even if it can't be won However, many people will draw the inference that something better than a war has to be adopted and That is the inference from the Prime Minister's Statement but mr. Abbott is the first Prime Minister of Australia ever to acknowledge that the war on drugs is being lost And the inference that many draw from that conclusion is that some new and different policies should be adopted the fifth Recommendation was that international law should be reformed. There are basically three great international treaties well, there are three big international treaties great in the sense of big that bind member countries To adopt the prohibitionist model. It's actually quite interesting to study the history of the prohibitionist model It emerged in the state of Maine in the United States of America in the 1830s The good citizens of Maine thought it would be a good thing to prohibit the use of alcohol and they They enacted laws and they began promoting the copying of those laws throughout the United States of America and that led on to the amendment of the Constitution of the United States to ban the alcohol that led to the The debates during the 1920s and 30s That led ultimately to the repeal of that provision of the United States Constitution but the legacy of it is we're still stuck with the prohibitionist model in the international field and The question is whether we don't need the same sort of repeal as the United States adopted in early 19 1931, I think it was to get rid of the prohibitionist Maine Provision in the United States laws so these are what the global commission on HIV and the law has proposed It's actually quite interesting if you follow international media the Economist in recent weeks has been analyzing first of all The repeal of in many states of the United States of the ban on marijuana in some states a complete removal of the criminalization of marijuana in some states a removal of the criminalization where marijuana will be used for medicinal purposes medical purposes so and the economist editorial line is supporting the type of recommendations that have been proposed by the The global commission so what appeared to be a minority view is Increasing to becoming a view that is Accepted and in particular in the context of AIDS the injection of drugs is an extremely serious way of presenting the The virus to many people Michael the I will now give the floor to Judy Byrne Long-time activists fighting for the rights and the health of people using drugs We're joined by Svetlana morose from the network of women living with HIV in Ukraine And I'd like to ask the members of the panel to Please stick to three minutes or so so that we make sure we have enough time for discussion with the With the audience and with the press Judy I'm chair of the international network of people who use drugs I've been an injecting drug user for the last 40 years and You know, I don't think it's unfair to say sometimes in countries like Australia that HIV saved my life Because without HIV there would have been no methadone program that I could have accessed and that's kept me free of Overdose, I mean most of us have hepatitis C that was inevitable because hepatitis C was around long before HIV and Drug users weren't in contact with many services before HIV came around So although, you know, it's killed many of my community It's been a means by which we've been able to get harm reduction happening needle exchange OST in many countries. There's a lot of work still to be done I don't think we're anywhere near where we need to be I mean as chair of this network my day is often punctuated with litneys of abuses from people around the world Who are members of my community who are beaten up by police locked in detention centers had their children taken away from them Lost their jobs lost their houses lost their only means of living because what they do is take a different drug Or take a drug by a different means Drug use is part of the human condition. Most people use drugs in one way shape or form We have to stop pretending that we can make a war on something that people want to do and sometimes need to do The structural issues around people who use drugs trying to access services trying to make their lives even vaguely Liveable are just so profoundly Negative that we even struggle in countries like Australia and in England to make reasonable and successful lives for ourselves Because the stigma people feel against us and the fear people are really afraid of us You know, I wonder what it is about us. It is so frightening Different people people are different. None of us have to be the same or act the same or live the same way And if people have access to the things they need the drugs they need in a timely reasonable humane fashion Everybody can just get along in a much more Civilized way a war on drugs is a war on us and we're really tired of it We've lost too many millions of people people know what to do the global Commission on the law the global Commission on drug policy It's laid out Words words words. We need some action to go behind the words. We've had enough death. It's time for it to finish. Thank you Thank you very much Judy Alex, thank you very much and good morning everybody There are many connections between HIV infection and preventing that spreading among and from people who inject drugs and the global policy of drug prohibition one of the connections is that the That we learned very quickly how to respond effectively to control HIV spreading among people who inject drugs Soon after the epidemic was first recognized in the 1980s and those measures are by and large pretty effective They have very few Important negative adverse consequences They have a lot of other secondary benefits and they're pretty inexpensive and this is in sharp contrast To the efforts to try and control the supply of drugs and the world during the 20th century Set its mind to trying to control drug use trying to prevent the supplies of drug use getting to people who wanted to use drugs and that has as Professor Kajakstein has already mentioned has been an abject failure It's been an abject failure in the sense that the drug market has steadily expanded That high higher more dangerous drugs and more risky practices have replaced less dangerous drugs and less risky practices And the outcomes have been truly shocking in terms of increasing numbers and we've heard some of this already increasing numbers of death's disease crime corruption violence Threats to national security and undermining important civic institutions supreme courts the judicial system and not only has the war on drugs been Comprehensive failure, but it's also been extraordinarily expensive so the contrast couldn't be more stark between the Inexpensive effective and safe harm reduction approach to drug use that has helped control the spread of HIV and The war on drugs approach and for this reason we are seeing the slow collapse now of the global drug prohibition system Minister Dunn on my left from New Zealand was Instrumental in bringing a policy of regulation of new psychoactive substances into his country in New Zealand in July last year and In the and I recommend you read the wonderful speech that was made in the New Zealand parliament on July the 11th by the minister introducing that bill and he talked about the the The bill was being introduced to protect New Zealanders particularly in a young New Zealanders I'm quoting them almost word for word and he said the central problem is Untested drugs in an unregulated marketplace and that indeed is the central problem untested drugs unregulated marketplace and what we have to do now and starting to happen is move from a law enforcement defined problem to a problem that is defined as Primarily a health and social problem because the health and social Interventions work. They're much cheaper. They don't have the nasty consequences Whereas the criminal justice approach customs police courts and prisons crop eradication These things don't really work In the way that harm reduction works and they're very expensive. So we're starting to see as Michael Kirby has say has been saying we're starting to see this system slowly Collapsing with Colorado and Washington States in the United States starting to regulate cannabis January the first and then earlier this month in Washington State in Uruguay and we also seeing what's happened in Jamaica this year and In New Zealand last year with the newly with a new psychoactive substances being regulated a world first So it's a it's a very important time And we can't move fast enough to get rid of the global system of drug Prohibition prohibition and replace it with a system which is more effective less expensive more humane and more respectful of human rights and In that way, we'll find that people like Jude who Have really struggled in the prohibition environment Many more of them will lead normal and useful lives as full members of the community Something that's not possible to achieve at the moment. Thank you Thank you, Alex. May I just add that the debate? Is even more will become even more intense in the next months as the General Assembly of the United Nations and the Secretary General have called on special session of the United Nations General Assembly on Drugs that will take place in March 2016 and that will be the first time for 18 years That is the United Nations at the level of heads of states and governments will meet on the world drug problem So we have one and a half years, you know of intense debate Hopefully to move the the issue minister done Thank you for joining us. Well, thank you and good morning I simply want to give you a very quick outline of the path that New Zealand has been down and some of the issues that we face in doing so When the flood of new psychoactive substances that's going worldwide became obvious in New Zealand About three years ago our initial reaction was to seek to do what everyone was trying to do and that was ban them And we introduced legislation at that time that allowed me as the minister to issue a 12-month ban That could be rolled over for another 12 months for identified products and our products were coming in and being tested To show that they contained new combinations of substances and the ban was being applied And I kept thinking of the image when you're standing at an airport at dusk And you're watching the aircraft land and you see the lights of the one coming into land You see the lights of the one behind it and behind it and behind that I knew that every time we banned something within days a variant appeared on the market We were quite happy in one sense to carry on playing that game of skittles. You put them up We'll knock them down But it was essentially pointless and so we decided fairly early on that we had to change the game Given that the volume of these substances was not going to diminish given that the Public appeal if you like of them for certain groups of the population was probably not not going to diminish What was a better way of dealing with it? So we decided to take an approach which was essentially to say that if you a manufacturer or supplier can prove that your products are of low risk Yet to be defined but of low risk. We will allow them on the market So in other words, we shifted the onus of proof to the manufacturer and the supplier rather than making a decision ourselves That's the theory the psychoactive substances act which has already been referred to which was passed last July essentially did a couple of things firstly Provided for the establishment of this new regime second. It said that all products that were on the market at that point Would effectively come off until such time as they could be tested Therein lies what has been the controversy we've had in the last 12 months because pragmatically We decided actually there were about 40 Apparently low-risk products on the market that we could allow to remain on the market while the new regime the regulatory regime was developed Which we expected would take weeks to months at most Sadly by early this year that process had not been completed a public Attention was mounting and being stirred up by various groups in the community about how in fact the psychoactive substances Act wasn't working because we still had all these substances on the market. Why didn't we just move and ban them all? Ironically two years earlier when we said we were going to move away from bands people said no, that's right That's a sensible approach So we got caught in a bit of moral panic and I had to introduce I was faced at that point with a potential political crisis in that the pressure was coming from all Courters even though Parliament with the exception of one voted voted for the original legislation We're having an election campaign in New Zealand at the moment So everyone got cold feet and suddenly decided they had to get on the side of Communities and therefore why didn't we just ban the stuff outright and I thought to preserve the psychoactive substances act We we made amendments in May which essentially were very minor but significant We simply removed the interim approvals for the existing products and said that they would have to be withdrawn Pending their submission to the testing regime and because of a mounting but separate issue Relating to animal testing. We said that animal testing would not prove would not be part of that regime So the psychoactive substances act is still in place The regime that has established is still the law the government will shortly pass regulations to give effect to a whole lot of It's technical provisions and a further set of regulations early next year to set in place the the retail market But it just would make the observation that we made the choice originally because we knew what we had in place previously It wasn't going to work long term We've embarked upon a new path It has not been up with our difficulty But we are determined to stay the course because we know realistically There is no other way of dealing with this issue and if it means that we have a situation where some of these Products become available and are of low risk to end users. So be it that's not a choice that we actually wish to make That's for manufacturers suppliers and consumers to make whether that has wider implications is another story for another time Thank you. Thank you very much Peter as I said earlier within days after the new authorities took over in Crimea The decision was taken to discontinue methadone programs opioid substance therapy in Crimea since as you May know methadone and opiate substance therapy are illegal in the Russian Federation that has is having disastrous consequences on the cohort of people Who were on OST in Crimea 800 people in that cohort? At the same time as there are Around 15,000 people in needle exchange programs in Crimea and we will now see a short video that we just received From Crimea. It's about four minutes And then we'll have a few comments from you as Vietlana Which I introduced you prior you coming in the room a few comments from you and then will open it for for questions and comments I have been in the state of my life that I have been recovering for five years I was trying to get better and I was watching the authorities everything stopped and I don't want to live anymore besides what I understood because of the methadone I was in the special care I received the retrovir therapy, anti-vascular therapy. It was a success. I had a heart attack. I had a heart attack. I had a chronic disease. Everything was stabilized before. I didn't feel any pain. I'm fine now. My nose hurts a lot. I didn't feel any pain. But it seems to me that there is some kind of relief. We have a lot of diseases, such diseases that are in the third or fourth stage, in the last stage. I think I need to find a job. It's because of such efforts, because I need to support my family, three children, and I need to feed them. After the therapy was closed, two recipes for trauma were written. We received 20 capsules. After that, doctors said that they had taken him to the hospital. They came to the Ministry of Health with a promise from Russia that they would not leave us in trouble, that we would die. They would help doctors. It would be very painful. They would not only support us in our treatment, but also in our rehabilitation. They would help us with our life. We received nothing. They came from Leningrad, from Moscow, two psychologists came. They told us that we need to run away from here. Where to go? They promised that they would give medicines and detox. But I did not receive it. I am not familiar with it. Everyone is studying here. Everyone is suffering. Everyone is back to work. We had a lot of problems. I think half of the patients died, because the rest of the patients had a very difficult time. Maybe someone would continue to work if possible. Because now it is very difficult. I personally do not know for myself that without Earth therapy it is all so tough. Because in such a difficult time it was not possible to restore everything. I did not think that it would be so deep. That there were such pain. Now in the spring you are not happy, even yourself are not happy. I do not want to breathe. I think that, for example, people who were on the program who had a lot of diagnosis, death diagnosis, hepatitis, cirrhosis, HIV-infection in the fourth stage, because it is so difficult to throw away. Or we have already gathered and turned on the light. Or we have turned on the light so that we do not get sick, we do not get sick. We are suffering not only on the other side of the Earth, but also on the other side of the Earth. At least 20 people in that cohort have already died. And I would also like to say that in addition to the reports from the Global Commission which I mentioned earlier, you will find as you go out a paper that was published in the BMJ a few two months ago on this Crimean crisis. But let's have Svitlana add a few comments and then open all of this for discussion. It's really difficult to comment this because I have only one question who is responsible on this. A couple a day ago I met here my colleagues from St. Petersburg from NGO IWA. It's women NGO. They received a hotline call from pregnant women from St. Petersburg. She said what I have to do, I have no money, I have no support, I have no place to live. I am from a substitution program client. What I have to do please help me. At the same time for the next day IWA will have an entity because they collect information about all former patients of OST programs without advising any support for them. Currently we have a good programs and thank you for that for International AIDS Alliance. You can ask more comments about this. These programs continue substitution of your treatment for former patients from Crimea. I think Andrei Klepekov can give you more information on this. And of course it's a big tragedy for these people and it illustrates how drug policy, influence on real people lives and also how it's contribute into AIDS epidemic in our countries. You know I'm from Donetsk province where now military conflict and some of my colleagues was forced to move to Kiev to continue OST treatment because we are the threat of treatment interruption and many Sloviansk patients now in different cities of Ukraine also to prevent treatment interruption. So it's really important by intention of this issue because it's directly, very directly related to drug policy to criminalization and also political will in our region. Thank you. Thank you very much, Sveta. I will now open it for discussion and questions. I'm sorry we spoke a little longer than we thought but these were so we had so powerful messages from all speakers that I guess everyone will agree it was worth listening to. So please questions and do please come to the microphone. Yes, please. Could you be kind identifying yourself? Sure, I'm Tim from Vice Magazine, my questions for Peter Don. Just wondering how you're planning on changing the public perception on the legality of drugs that seems to still be a very conservative culture and not want to even drug takers themselves often. I think time will be the healer there. The public mood earlier this year was just get the stuff out of sight, out of mind. Because of the way that we made the law change and the introduction of the new testing regime and to some extent that's dealt to that concern. Another important element of what we've done is we've required our local authorities, our local councils to develop plans within their areas for where these products might be able to be sold. One of the little ironies of the whole thing was that that's what the councils asked for was the power to regulate things locally. When we gave them that power they said this was central government dumping its power. But I think once they work out their own plans and what suits their own situations and products start to re-emerge over the next couple of years or so, I suspect we'll find that there's a much calmer environment than the hysteria that we dealt with earlier this year. And at that point I think that people will begin to wonder what all the fuss was about, frankly. Thank you. Just from the German newspaper Frankfurt, I was wondering what are the people doing when they are not on OST anymore? Are they going back to the drugs? And my second question is what is on the CRIM with ARTs? Are they still getting ARTs? People who are HIV infected? Sveta, I guess you can answer those questions and then Andrei if you wish to add a comment after Sveta's. Yeah, like it was said in the video. I'm going to come back to the illicit drugs, street drugs and some of them now move to Ukrainian Ukrainian continental part of Ukraine for instance in Kiev some Poltava cities where they can continue and about a re-treatment I know it's still available in Crimea and also it's available in continental part of Ukraine so people can continue since God they can continue and also TB treatment HEPSYS treatment. Yeah, I would like to add if I can. I would like to add I would like to add I would like to add I would like to add because out of 800 patients in Crimea only 57 moved to continental part of Ukraine we have only also patients from other regions from Donetsk and Lugansk where Svetlana is from so totally but the patients facing huge pressure from Russian authorities not to move even from their families so several of them committed suicide basically because psychologically they faced huge pressure because from one side they were forced to stop the treatment which can be considered as a torture torturing from another side they had huge pressure from the environment to stay in the country in Crimea and their homes I have the list of people but not willing to share it for confidential reason but truly this committee drug policy committee is quite important because it's not only about big politics it's not only about papers it's about saving human lives and in Crimea we saw how policies can be changed literally overnight unexpectedly and how it affected human lives including a number of deaths Thank you Andrei any other comment or question of course if this is agreeable to the panelists anyone in the next few minutes before the session will be available for questions or individual interviews any other comment at this time if not I'd like to thank all the panelists particularly Svetlana for joining us as she ran out of another session but your testimony was extremely powerful and I think many of us are still under shock after watching that video thank you all for coming and please disseminate the message it is time to reform drug policies