Transcript Powerpoint

Human rights as a key component
of harm reduction strategy
targeting people using drugs in
Morocco
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Drug use and Harm Reduction in Morocco

Dramatic increase of PUD esp. in North Morocco* Rapid assesment on
HIV risk among PUD in Morocco, Ministry of Public Health

HIV prevalence (7% to 22%) and HCV prevalence (80%) associated
to injection route* Prevalence study, MoPH (not published)

MoPH and NGOs have been implementing needles and syringes
program (since 2008) and methadone maintenance treatment
(since 2010)
 On behalf of positive outputs from evaluation of the first national
Harm Reduction strategic plan (2008-2011), decision to scale up
access to harm reduction services
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
The challenge of Human Rights

Legal obstacles (including drug use criminalization) are a main
barrier for
• Access to care and treatment
• Access to prevention and Harm Reduction*Strathdee and all. The
Lancet, 2010

Assumption endorsed at high level:
• Vienna Declaration
• Global commission on drug policy*Report of the Global Commission on
Drug Policy, June 2011

Human Rights of people using drugs are neglected despite those
evidences

Need to asses legal and social barriers in Morocco and to design a
more comprehensive approach to mitigate and reverse HIV/ HCV
infections among PUD
 ALCS, with the support of OSF, cross sectional study project
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Design
Sites: 3 cities of the north of the country (Tangiers, Tetouan, Nador)
 10 inquirers recruited among outreach teams and trained
 Structured questionnaire

• Administred to 300 PUD recruited through outreach programs, in
2011
• 21 questions investigating 4 dimensions:
• Sociodemographic profile
• Drug use
• Inmate story
• Human right violations from law enforcement, health professional
and closed environment

Data completed with:
• 3 focus groups (one per site)
• Individual incident reports collected among PUD (408 reports)
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
General profile
Men
Women
Total
91%
9%
100%
37.3 [18-60]
35.2 [20-52]
37.1 [18-60]
31%
11%
29%
4%
4%
4%
71%
7%
65%
–Beggars
9%
7%
9%
–Illegal activity
9%
68%
15%
–Family support
7%
14%
16%
Sex work (regular +
occasional
8%
96%
16%
Education
level=<primary school
62%
85%
62%
Gender
Age
Homeless
Major income source
–Formal activity
–Non formal activity
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Drug use



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Heroin: 97% / Two thirds are injecting
Injection (any drug)
• in timelife: 81%
• last month: 64%
Multiple use: 94%
• Cannabis:
84%
• Benzodiazepines: 45%
• Cocaine:
38%
Alcohol consumption higher among women (39%) than
men (13%)
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Prison
82% have been incarcerated
 Average number of prison stays: 4 (1- 30)
 Life setting (cf. income source) seems play a major role:

26%
Only drug offences
33%
Only other offences
Drug offences AND other
offences
41%
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Human rights violations / Overview
• 9 specific situations were investigated to assess the
level of human rights violations
– 3 associated to law enforcement officers behaviors &
practices
– 3 associated to health professionals behaviors &
practices
– 3 associated to behaviors & practices of people from
close environment
• Only 0.6% had never face any of those 9 situations
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Human right violations / Law enforcement officers
83%
65%
violence from police
officers
illegal custody
www.aids2012.org
61%
non human right
based custody
Washington D.C., USA, 22-27 July 2012
Human right violations / Health professionals
45%
26%
12%
Barriers to access to
health system and
professionals
non human right
based medical
practices
www.aids2012.org
break in confidentiality
Washington D.C., USA, 22-27 July 2012
Human right violations / Close environment
60%
14%
9%
Sent by familly in
forced detox centre
victim from illegal
networks
www.aids2012.org
Sex against drugs
Washington D.C., USA, 22-27 July 2012
Self perception of people using drugs
« There is no place for us in community except prison
or death »
Key words used by PUD:
Injuries, physical and psychological violence,
rudiness, denial of care and treatment,
stigmatization, rape, forced closing, racketeering,
denial of basic rights, extortion, etc.
www.aids2012.org
Washington D.C., USA, 22-27 July 2012
Conclusion

This study has clearly assessed violations of human right
among PUD due to the fact they intake illegal drugs

It is worth to raise that this break in basic human rights’
respect are wider that the ones generated by drug offences:
• HR violation due to activities generating incomes
• Denial of health services
• Stigmatization from famillies

Those legal and social barriers counteract with real and
enhanced access to harm reduction services in Morocco.
National Harm Reduction strategy should include a core
action plan regarding human right issue .
www.aids2012.org
Washington D.C., USA, 22-27 July 2012