Case Study: Drug User Advocates Mobilise around WHO/UNODC International Treatment Standards

26 August 2021

Over the last several years, INPUD has engaged in global advocacy with the WHO and UNODC regarding the development of the 'International Standards on Drug Use Disorders' ("The Standards"). While recognising the clear need for international guidelines on drug dependence and treatment, such a document can produce more harm than good if it does not include community perspectives, promotes an over-medicalised approach and perpetuates harmful, stigmatising ideas about people who use drugs.

This case study tells the story of how INPUD and our global peer community successfully challenged and changed the Standards to reflect a more humane and scientifically accurate approach that can serve as an effective accountability mechanism in the monitoring of national drug treatment programmes, particularly in countries where human rights abuses in treatment centres are common.

Read the full case study here.

In January 2018 INPUD was asked by the WHO to provide input into the draft Standards, which was already in the final stages before being sent out for in-country field-testing. Upon review it was evident the Standards were extremely problematic, and were heavily shaped by the agenda of the Russian Federation and United States of America. INPUD's review of this initial draft, which were identified in an open letter signed by 188 community and civil society organisations, laid out three major concerns:

  • Stigmatising and pathologising statements referring to people who use drugs, in contrast with the emphasis on ethical standards in treatment and non-discriminatory approaches stated by the authors.
  • Lack of meaningful inclusion of people who use drugs in the review. Even when INPUD had been invited to provide comments, they were not taken into account as the text had to closely follow the principles agreed to by member states. 
  • Lack of mention of harm reduction or key health interventions for people who use drugs.

This open letter called for the postponement of the planned release of the Standards at the 61st Commission on Narcotic Drugs in March 2018, which allowed INPUD and other drug user-led networks an opportunity to submit more detailed feedback on the Standards. Mobilising a working group comprised of representatives from the International Network of Women who Use Drugs (INWUD), the Asian Network of People who Use Drugs (ANPUD), Eurasian Network of People who Use Drugs (ENPUD), Latin American Network of People who Use Drugs (LANPUD) and the South African Network of People who Use Drugs (SANPUD), we were able to successfully influence the revised version of the Standards to better align with the purported aim of steering countries away from rights-violating and discriminatory practices in drug treatment. 

There were several key factors that made this advocacy successful and three key lessons INPUD took away for future peer-led advocacy efforts:

  1. Successful advocacy usually requires a multi-pronged but focused effort, where multiple tools and outputs can be used, from open letters to membership coordination committees, to holding and participating in dialogues.
  2. Mobilisation is a key political tool of influence. Not only were we able to bring a diverse range of peer input from across the globe, but we were able to unite and mobilise civil society working at national, regional and global levels.
  3. It is important to identify key actors to influence in advocacy; in this case Heads of Departments were the focal points, but it can also be effective to reach Executive Directors of agencies in a public forum in order to gain public attention, as well as other internal allies within agencies. In this way both upstream and downstream pressure is applied, increasing the chance of success. Even though we did not plan this advocacy and instead remained alert and flexible for opportunities, for future efforts, we will apply lessons from this in our future advocacy efforts.

While still imperfect, The updated and improved Standards can provide drug user-led networks with a more effective monitoring tool for evaluating treatment centres in their country. Being able to point to centralised guidelines on treatment that do not include the harmful brain disease model or perpetuate stigmatising languages and stereotypes can help advocates begin to address and rectify human rights abuses which have gone unheard for far too long. Moving forward INPUD and the global community of peers will continue to seize opportunities to further improve the Standards when they arise, and also take the lessons learned from this advocacy into other critical pieces of work.