Harm reduction should be integrated into universal health coverage plans: UN expert

NEW YORK – Harm reduction services within models for universal health coverage are key to ensuring that many groups who are pushed to the fringes of society are not left behind, a UN expert said.

“In line with universal health coverage, harm reduction should incorporate comprehensive quality services that are accessible and affordable,” said Tlaleng Mofokeng, the Special Rapporteur on the right to health.

In her report to the General Assembly, Mofokeng explored the model of harm reduction as applicable to cases of drug use, HIV exposure, transmission and non-disclosure, abortion, same-sex relations, and sex work. She highlighted populations that are often stigmatised, criminalised and discriminated against to the detriment of their enjoyment of human rights and urged States to “divest from punitive approaches, move away from criminalisation and employ regulatory tools to improve health outcomes.”

“There is no path to sustainable peace and development without the meaningful participation of populations that face historic and ongoing forms of discrimination and marginalisation,” the expert said.

The Special Rapporteur called for the decriminalisation of abortion and guarantees of access to quality care; the repeal of laws, policies, and practices that criminalise sex work and the adoption of measures to ensure sex workers’ right to health; the repeal of laws that criminalise HIV exposure, transmission and non-disclosure and; the decriminalisation of the use, possession, purchase and cultivation of drugs for personal use.

She stressed that universal health coverage should make essential medicines accessible and affordable and should extend beyond health care programmes and services to encompass the social determinants of health. “Crises are often used as a pretext to increase policing or criminalisation of already vulnerable or marginalised populations, often adding to, rather than mitigating, the harms of the crisis itself,” the expert warned.

“The report is a compilation of good practices from a range of different actors,” Mofokeng said.

“In working towards sustainable peace and development, all stakeholders must incorporate human rights and harm reduction approaches into evidence-based and stigma-free legislations, policies, programmes and practices, linked with universal health coverage in order to create conditions that are conducive to a life of dignity of all people,” she said.