At a meeting this week of the United Nations' main drug policy-making body, the Commission on Narcotic Drugs (CND), the UN Office on Drugs and Crime (UNODC) caved to pressure from U.S. drug warriors to stop promoting scientifically sound harm reduction policies that prevent HIV/AIDS transmission among intravenous drug users.

The CND meeting, held annually in Vienna, has garnered a lot of attention this year because of the UNODC's shift in stance - a change that is especially worrisome given the office's role as the current chair of the joint UN Program on HIV/AIDS.

At last year's Bangkok International AIDS Conference, the Executive Director of the UNODC, Antonio Maria Costa, said, "During the past decade, we have also learned that the HIV/AIDS epidemic among injecting drug users can be stopped - and even reversed - if drug users are provided, at an early stage and on a large scale, with comprehensive services such as outreach, provision of clean injecting equipment and a variety of treatment modalities, including substitution treatment. ...In too many countries, drug users are simply incarcerated. This is not a solution; in fact, it contributes to the rapid increase in the number of people living with HIV/AIDS."

The office started backpedaling on this position after a November 2004 meeting with the U.S. Assistant Secretary of State for International Narcotics and Law Enforcement Affairs, where Costa was told UNODC's funding could be cut if he did not pull back from UNODC’s support of needle exchange and other harm reduction programs. As the U.S. is the largest funder of the UNODC, it appears that Costa took the threat to heart.

UNODC’s reversal of its commitment to needle exchange contradicts the general UN consensus on the usefulness of harm reduction in HIV/AIDS prevention, as well as that of the U.S. scientific community.  The American Medical Association, American Public Health Association and National Academy of Sciences all  have endorsed needle exchange as an effective means of HIV-prevention, and noted that such programs do not increase drug use. The U.S. government’s contrary position was articulated in remarks by drug czar John Walters at the opening of the CND meeting when he spoke against "acquiescing or practicing appeasement with addiction."

The ability of Walters and a small cadre of other reactionary politicians to manipulate the global response to HIV/AIDS because of an ideological bias spells disaster for places such as Central Asia, Russia, China and Iran, where the majority of HIV cases are attributable to injection-drug use. Leading up to the CND meeting, both the Washington Post and the New York Times editorialized against the U.S.'s attacks on needle exchange, and over 300 organizations worldwide signed a letter to the delegates of the CND asking them to resist pressure to withdraw support from proven HIV prevention strategies. Despite this high-profile condemnation of the U.S.' tactics, Mr. Costa's opening speech at the meeting included the message, "We unequivocally reject any initiative, well intended as it may be, that could lead to the perpetuation of drug abuse."

Information for thisreport comes from the Transnational Institute. For a more in-depth discussion, please see their briefing, The United Nations and Harm Reduction.

See also Aryeh Neier's piece, "U.S. Ideologues Put Millions at Risk," in the International Herald Tribune.