In Malaysia, as in 21 other countries in the world, people who use or possess relatively small quantities of drugs, including cannabis, are sentenced to death. These sentences are mandatory: judges have no possibility to invoke any extenuating circumstance. Furthermore, the usual burden of proof is reversed so that an individual is presumed to be guilty unless he or she can prove otherwise.

International Conventions on Human Rights, various UN Human Rights Bodies and the UN Secretary General have expressed that the “death penalty should only be considered in cases where the crime is intentional and results in lethal or extremely grave consequences, not in cases of economic, non-violent or victimless offences. In those cases a death sentence may be considered as an arbitrary execution.”

The use, sale or trafficking of drugs is not intended to have a lethal outcome. People use drugs to feel good or to feel better, and as long as there is a demand there will always be a supply. Also in Malaysia, drug use has continued to rise in spite of the death penalty. The people who are occasionally caught by authorities do not have major responsibilities in this business. Killing them will not scare the drug gangs away. On the contrary: thanks to these punishments, the leaders in the drug business can continue to justify extraordinary high prices for their goods

Legitimized by the United Nations, drug prohibition continues to drive repressive policies and legislation including death sentence. These policies are typically rooted in moral in stead of rational arguments, and impede the development of progressive and effective responses to any problems that the use of drugs may cause.

Dear Malaysia

As a European coalition of NGOís and individuals concerned with the global drug issue, we would like to inform you herewith of our deepest concerns about the confirmation of several death sentences in your country recently.

On December 8, Abd Jalal Mohamad, 38 years old was sentenced to death for trafficking 4,8 kilos of cannabis three years ago.

• On December 11, Ramli Kasron, 41 years old, was sentenced to death after he was found guilty of trafficking over 4 kilos of cannabis in 2006.
• On December 17, Muhammad Khairul Esa Jemali, 22 years old, was sentenced to be hanged until death after finding him guilty of trafficking 316 grams of cannabis, in 2008
• On December 28, Shahrul Izani Suparman, 25 years old, was given the death sentence after he was found guilty of trafficking 622 grams in 2003, when he was 19 years old.

We refer to these cases because they were reported in the Malaysian press. The exact number of those executed remains unknown.† Amnesty International has estimated that some 300 convicted prisoners await execution on death row,†most for drug-related offences.

The use of the death penalty as such runs counter to the universal protection of human rights and is at odds with the worldwide recognition that the death penalty has never been proven an effective deterrent to serious crime any more than other punishments. Very few countries currently carry out executions: provisional figures compiled by Amnesty International indicate that only 11 of the United Nationís 193 member states carried out state killings in 2008.
Moreover, the†presumption of guilt and a mandatory death sentence in specified drug-trafficking cases places the charge on the accused to prove his or her innocence and leaves a judge with no discretion over the sentence.† Mandatory death sentences clearly violate international standards for a fair trial.†† †

We are aware of the argument of your government that drugs cause misery in Malaysian society. But in spite of the year-long practice of executing drug offenders, the country is not and will never be drug-free. Many people in your country want to consume cannabis and other drugs, so obviously, other people will continue to supply them. Taking the life of some individual traffickers will not change that situation.

There is enough evidence available that harsh repression is not the right answer to drug-related problems. In fact it can even be a hindrance to the implementation of effective policies to address these problems. Drug trafficking is the core business of globally organized criminal organizations. The traffickers who are occasionally caught by authorities with relatively small amounts do not have major responsibilities in this business. Killing them will not scare the drug gangs away. On the contrary: thanks to these punishments, the leaders in the drug business can continue to justify extraordinary high prices for their goods.

The above mentioned people were all sentenced to death for trafficking cannabis. Cannabis is a natural product, a non-lethal substance. Its consumption is widespread around the world, as it has been for thousands of years among many different cultures and people. In most European countries, cannabis possession for personal consumption is not penalized anymore. In some countries, such as Spain, the Netherlands and the Czech Republic, adult persons are even allowed to grow and distribute it. Interestingly, the level of cannabis consumption in the Netherlands, where adults have had legal access to this product for the past 35 years, is lower than that of its neighboring countries, which have applied repressive policies.

We believe that the drugs problem can only be reduced by effective social and health policies, not by harsh repression. Innovative and intelligent strategies for addressing the issue both globally and locally are needed, and the continuation of tough prohibitionist policies that have failed until now is a major impediment to the introduction of these strategies. In the coming years this may also increase the lack of credibility of authorities in the opinion of the general public.
If you believe that Malaysia needs to execute drug traffickers to please the international community, this is a huge mistake. The international community is ready to support Malaysia in the creation of structures which would allow for the reduction of harm that the production, trade and consumption of illicit drugs can cause, without applying such outdated measures such as the death penalty.

We call upon your wisdom to apply principles of sound governance and abolish the death penalty.

encod.org

Anthrax is a rare and very serious bacterial infection that is acquired when spores of the anthrax bacterium get in to the body. The spores can be found in soil but may also be present in contaminated supplies of street drugs such as heroin. Drug users may become infected through injecting the contaminated drugs into the skin and muscles or through injecting the drugs into the bloodstream. It may also be possible to become infected through the lungs by inhaling or smoking contaminated drugs. Once infected, it is extremely rare for anthrax to be spread from one person to another, and there is no significant risk of airborne transmission. Anthrax can be cured with antibiotics, if the medical treatment is started early. It is therefore important to know what sorts of symptoms and signs to look for, so that there are no delays in obtaining the necessary treatment. The symptoms and signs include: severe swelling or redness around a wound site, which may be painless; pain at a site where you have previously injected; an open sore or wound; pus collecting under the skin; or a more generalised and severe flu-like illness (with muscle aches, headache, tiredness and high fever). If you have used heroin and suspect that you have any or all of these symptoms, especially if the infection seems different to others you may have had in the past – seek medical attention as a matter or urgency, either from your GP or local Accident & Emergency Department.

What to do to reduce the risk of getting this infection:

• There is no way to tell if your supply of heroin (or other drugs) is contaminated with anthrax.
• There is no safe route for consuming heroin (or other drugs) that may be contaminated with anthrax as there is a potential serious risk from inhaling or smoking the anthrax, as well as from injecting it.
• Drug users currently in drug treatment, should stop using heroin altogether.
• Heroin users not in drug treatment should stop using heroin if possible and talk to a doctor or someone at a drug service about starting on a prescribed alternative drug (such as methadone or buprenorphine) and/or other treatment options.
• If you continue to use heroin then: If you get symptoms of an infection you should get a doctor to check it out immediately as a matter of urgency. Always use a clean needle and syringe. Don’t share needles, syringes, cookers/spoons or other ‘works’ with other drug users.

AFGHANISTAN, KABUL – some observations by Andria Efthimiou-Mordaunt MSc

HUNDREDS of thoughts, memories and insights are flooding my consciousness about my week in Afghanistan, mainly Kabul. While the few bacteria settle down in my gut and bloodstream, let me try and articulate some of this to you all around the world.

First of all, I want to address the gender-sex-’equality’ issue, as it is the one that I assume will bother some Westerners and/or be of profound interest to others. On the penultimate day of my stay in Kabul, my incredibly patient host Ahmed W took me to his Father-In-Laws home, where his wife seemingly spends most of her time with other women. Ladies in Afghanistan rarely go out alone – very rarely. His wife is many months pregnant and this was a special week in this household as two of the young men had been wed. Wedding celebrations do not begin and end on one day in this ‘less-developed’ country. They go on for several days: this tribe knows how to party. I was taken into a room full of men and boys (14-63yrs old approx). As guest of honour – visiting scholar if you will, from U.K, I had privileged access to this room. No other women were there. (I am still wondering whether Ahmed had a semi-conscious motive to use my drug policy and other policy and social justice ideas to influence his huge family; time will tell.) Within minutes, I was given the floor to address “why the U.S bombs our country for so long?” and the role of Opium in the economic, agricultural and peace & war brew that is this country’s predicament

Some of you know me as Andria, the enraged widow who will never let go of the lingering visual memory of a dying junky-husband with AIDS; a woman who makes sure other IDUS will always have access to clean needles and G.O.D…Good Orderly Direction, also know as Harm Reduction .

Few of you (including me!) will know that I am slowly getting educated around global drug policy issues.

To the question, why does the U.S. bomb our country? I could only respond, “very good question.” Then I began rapidly connecting the dots between Afghanistan as producer of over 90% of the world’s heroin ultimately – 86% of the U.K’s apparently. I said that the profiteering of Afghan war-lords, narco-traffickers, the corruption of Afghan politicians, law enforcement officers and other officials only gave more excuses to the U.S./U.K to pursue the Opium-eradication policies, which have been endemic for a long time. The truth is that the world does indeed need a lot of pain control: people living with chronic and or intractable and/or terminal pain should have access to Opium, Heroin, Morphine and any other necessary opioid pain-killer in order to live in some comfort. The fact that a small minority of human beings had found themselves dependent upon these substances, and thus caught in the criminal trap was not an excuse to punish nations who produced coca and/or opium and/or cannabis products. The lies that uphold the global prohibitive drug system are enormous. They seemed to like that a lotJ. The patriarch of the large group raised his hand to attract the interpreter’s – medical doctor’s – attention, and said, “I want to learn how to cultivate and grow opium!” Everybody laughed, or smiled impishly.

I continued, “but one thing I am concerned about in your great country Sirs, if you don’t mind me saying so is this. Why are the women not allowed to go out alone? If I lived here, which I would like to, I think I might go insane if I had to stay at home all the time with or without the children.” The physician responded. “Actually the women are allowed to go out together, in twos and threes.” That didn’t really answer my question but at least I was reassured that I would be at liberty to go out with others.

Ahmed made it obvious that I had been single for too long and two appropriate (single men) were pointed out for me to choose! Neither of them spoke any English and I don’t speak Dari so.. The cop I met later, who eradicates opium and smokes hashish insisted we get together. I said, through the interpreter, “only if you stop eradicating opium! It’s a silly policy and doesn’t seem to be helping anybody.”

Rapidly I was then brought to the women’s party room. Women and girls, I was delighted. Instead of the sober though passionate debates that ensued in the 99%-male lunchroom, here was a sardines-packed room, full of females from babyhood to 70ish. A few of the younger ones banged drums, many sang and/or chanted. Everybody smiled through the sweat and heat and joy of the wedding celebrations. Two women danced alluringly in the middle of the room and of course, I could not resist. I was on my feet, surrounded by ecstatic Afghan women, dancing, trying to entertain these, the private property of men, a wondrous creature. They are the producers of the family, the nurturers, the clothes washers, the love-makers to tired (or not) men at the end of the day and they surely make-love a lot as each family has four children (as a low average.) I swayed my voluptuous body and twisted my arms and hands in that way I had seen gorgeous Indian women do in the Indian dancers café in Dubai only six days before. Nobody threw money but many women giggled. One even filmed this ‘event’ – in their lives; a Western female-stranger dancing for them, uninhibitedly. Women are not allowed to have photos taken of themselves at all normally.

Many embraces and grins later, I was with the Physician interpreter again, exclaiming, “Hey, your women are wild here. I had a fabulous time with them just now!”

“Yes” he emphatically responded, “Why in America, they fight for women’s rights?” In a rushed moment – he was running off to work at his private clinic – I replied, “Yes I wonder why…” and since then I have thought a lot.

The deal for us Gals in this “Islamic Republic” is that we serve the boys, girls and men till death do us part. We tolerate our husbands having several wives on occasions, we get used to remaining in the home engaged busily with domestic chores shared with the other women and we are grateful when our husbands finally return home in the evenings and make love to us tenderly or not.

And I also noted the very childlike and naïve process that the males are also engaged in. They too must accept centuries of tradition that enable them to have this ‘privileged position.’ They are undoubtedly dependent on the women and girls in a way that was indicated by each morning’s ritual, when Tanamor, a ten yr old girl would bring breakfast to Ahmed and me in a darkened room (there were afternoon powercuts everyday in Kabul) and not think twice about the fact that she was never assisted. When I was leaving, I gave her Silver ring as a thank-you gift, but she kept refusing to accept it, not understanding why I was giving it to her: I don’t speak Pashtoun/Farsi and she cannot speak English. In the end, I shoved the ring on her small young thumb and kissed her foreheadrepreatedly saying “tashakor, tashakor” thank you in the local dialect. She finally understood something… I hope.

This is a land I will return to. This is a land I felt necessary in. This is a land where the children love their elders, not because they are older but because they understand the critical roles that are clearly demarcated: my Dad goes to work and brings the Baksheesh back to us in food, clothes, home and safety. My Mum stays busy making sure the unseen and often-unappreciated essentials are done: well and on time.

Finally, this is the ONLY land where a doctor working with drug dependency issues told me clearly, his centre is my home. I can go there anytime. As an ex-injection drug user and AIDS widow, and one who believes, after 10yrs in grief, it is time to move on – I think it is time I said YES! To that kind of suggestion

Users' Voice editor Andria Efthimiou-Mordaunt giving it some volume

We are people from around the world who use drugs. We are people who have been marginalized and discriminated against; we have been killed, harmed unnecessarily, put in jail, depicted as evil, and stereotyped as dangerous and disposable.

It is now time to raise our voices as citizens, establish our rights and reclaim the right to be our own spokespersons striving for self-representation and self-empowerment:

To enable and empower people who use drugs legal or deemed illegal worldwide to survive, thrive and exert our voices as human beings to have meaningful input into all decisions that affect our own lives.

To promote a better understanding of the experiences of people who use illegal drugs, and particularly of the destructive impact of current drug policies affecting drug users, as well as our non-using fellow-citizens: this is an important element in the local, national, regional and international development of these social policies.

To use our own skills and knowledge to train and educate others, particularly our peers and any other fellow-citizens concerned with drugs in our communities.

To advocate for universal access to all the tools available to reduce the harm that people who use drugs face in their day-to-day lives, including, i) drug treatment, appropriate medical care for substance use, ii) regulated access to the pharmaceutical quality drugs we need ii) availability of safer consumption equipment, including syringes and pipes as well as iii) facilities for their safe disposal, iv) peer outreach and honest up-to-date information about drugs and all of their uses, including v) safe consumption facilities that are necessary for many of us, e.g. those who are homeless.

To establish our right to evidence-based and objective information about drugs, and how to protect ourselves against the potential negative impacts of drug use through universal access to equitable and comprehensive health and social services, safe, affordable, supportive housing and employment opportunities.

To provide support to established local, national, regional, and international networks of people living with HIV/AIDS, Hepatitis and other harm reduction groups, making sure that active drug users are included at every level of decision-making, and specifically that we are able to serve on the boards (of directors) of such organizations and be fairly reimbursed for our expenses, time and skills.

To challenge the national legislation and international conventions that currently disable most of us from living safe, secure and healthy lives.

Well aware of the potential challenges of building such a network, we strive:

• For values which respect diversity and recognize each other’s different backgrounds, knowledge, skills and capabilities, and cultivate a safe and supportive environment within the network regardless of which drugs we use, or how we use them
• To spread information about our work in order to support and encourage development of user organizations in communities/countries where there are no such organizations
• To promote tolerance, cooperation and collaboration, fostering a culture of inclusion and active participation.
• For Democratic principles and an organisational structure that promotes maximum participation in decision making,
• For maximum inclusion with special focus to those who are disproportionately vulnerable to oppression on the basis of their gender identity, sexual orientation, socioeconomic status, religion, etc.
• To ensure that people who use drugs are not incarcerated (and that those who are incarcerated) have an equal right to healthy and respectful conditions and treatment, including drug treatment and access to health-promoting supplies such as syringes and condoms and medical treatment or at least equal to that they would receive outside
• To challenge execution and other inhuman treatment of people who use drugs worldwide

Ultimately, the most profound need to establish such a network arises from the fact that no group of oppressed people ever attained liberation without the involvement of those directly affected by this oppression. Through collective action, we will fight to change existing local, national, regional and international drug laws and formulate an evidence-based drug policy that respects people’s human rights and dignity instead of one fuelled on moralism, stereotypes and lies.

Users’ Voice

I started this journey by accident when I was told about a meeting at Rockefeller University. Most of those attending the meeting were methadone patients and then, the small community-newspapers in New York City were anti-methadone. This meeting would grow into one of the first methadone advocacy organizations The Committee of Concerned Methadone Patients (CCMP). I would say that I had a real epiphany at these meetings because I realized that I could seize opportunities that I had not thought I had. I made the decision to go back to school and get a graduate degree and even went into neuroscience “because I came to believe that I had the right to live and work where I wanted to and that I had the support to back it up.”

A group of us worked hard for CCMP, who were very much involved with the NYC Transit Authority Case in which several methadone patients were fired for taking methadone. Another was the Harlem Medication Case over an inferior methadone formula that was being used in one of the clinics. CCMP got a court order to stop it. And we registered methadone patients to vote and visited newspapers to provide positive articles about it, and talked to politicians and policy makers. This was during the 1970s when everyone was “doing their thing” so we thought we should have that right also.

By 1988 with the AIDS epidemic growing in New York City and very little being done on the behalf of users, it was decided that it was time for another advocacy organization. This was how the National Alliance of Methadone Advocates – NAMA came into being. It was patterned after the growing mental health advocacy movement and their organization the National Alliance of the Mentally Ill or NAMI. We are now in our seventeenth year. NAMA has survived on a budget of about $130,000, for entire seventeen years. But money is only important when that is what you want and we at NAMA don’t want money – we want civil rights and respect. During the first few years NAMA was New York based and only a small group. However as word got out NAMA was contacted from other states and similar groups were started. As methadone expanded in other countries NAMA was looked to for guidance and the result was an affiliation of fourteen international groups. Today there are close to 50 groups that are considered part of the NAMA network and while each may have their own separate mission they must follow the goals of NAMA.

I would say that the greatest accomplishment of NAMA was when patients were included in policy making. Prior to NAMA methadone patients were never asked about their issues. Today a number of our chapters meet with their state methadone authority and have been involved with drafting state regulations. I helped with the national regulations and insisted that patients be able to have 30 day take home privileges and that each clinic should have a mechanism for patient to be involved in clinic policy.

NAMA has also been involved in ending some treatment malpractices that were common in the US. In 1992 D’Aunno and Vaughn published a study in JAMA on methadone treatment practices. They found that one-third of the programs they surveyed did not tell patients what dose they were on. The practice called “Blind Dosing” was done to disguise low dosing. Today no clinics blind dose patients and most professionals would not even consider defending it. Around the same time another survey found that the average dose was about 37 mgs/day, which is far from adequate. What had happened over the years as rural programs opened they hired staff from “drug free” treatment who believed that less was better. This has now been reversed and the average dose in the US has increased to almost 60 mgs/day.

Some issues remain the same and the criminal justice system has always been backward when it comes to methadone. Many jails do not provide methadone if a patient is arrested and there have been a number of deaths because of this. It is not uncommon for Parole Officers to make, getting off of methadone, part of the probation or parole. If you don’t, they will put you back in jail. We would not allow this to happen to animals but users have been so stigmatized that this is not even viewed as inhumane treatment. It is actually worse because it is depraved indifference over the welfare of another.

And now with thirty day take homes the clinics have created a procedure called “Call Backs”. This means that at any time the clinic can call you and within 24 hours you must report to the clinic to bring in your bottles, both empty and full for them to count. And you have to have taken your dose on the day that it was prescribed or some clinics will revoke your take home privileges if you have taken your medication not on the day prescribed.

As I see it there will always be a lot of work for advocates because just when you think you have stopped the program from doing horrible things to patients they devise some new torture.

It is 15 years since the US biotech company Chiron Corp first identified the HCV virus, and engaged in certain dubious practices in an attempt to wholly own it and any spin off. In that time the virus has went through a metamorphosis, from a being believed to be a benign infection that was thought to have little consequence for long term health, to the serious global health concern it is now known as today. For their efforts Chiron Corp have benefited to the tune of a hundred million dollars or so in patent royalties payments (as I said , they even tried to patent the virus itself!).

The LA times recently reported that:

Chiron, (a Californian firm), has introduced a new policy for companies wishing to license its HCV patents. Chiron holds over 100 patents related to the HCV genome, which won’t expire until 2015. Any company that develops a new drug targeting hepatitis C (such as a protease inhibitor), or a diagnostic test to detect and measure HCV (viral load; tests for screening the blood supply), needs to license Chiron’s patents, typically by negotiating a licensing fee and royalties on product sales. Chiron typically charges each company millions of dollars in licensing fees during research and development alone, and makes millions more each year in royalties from HCV tests.

This went beyond the realms of ethical science and their were a number of litigations, before Chiron brought in their new policy which is tied to future sales, so potentially allowing them to make even more money for themselves.

This obviously annoys the companies presently at the forefront of treatment products, who are having to divert large chunks of their profits, but the fact is that it is not only the financial gains that upset’s people in the HCV field, but also, scientists have complained for years that Chiron Corp has hindered the fight against hepatitis by creating a virtual commercial monopoly over drug research.

Now, federal health officials are reviewing the 14-year-old government agreement that gave Chiron so much control over research that seeks to help the millions of people afflicted with the disease. It is this that has led to Chiron introducing the new royalty payment method reported above, a sort of buy now pay later.

Chiron currently hold 100 patents in 20 countries related to hepatitis C. Competitors had complained they’ had abandoned plans to enter the field because Chiron demanded too much money to access its technology. (Chiron successfully sued many companies for infringing its patents related to the virus).

Those patents credit Chiron scientists with discovering the hepatitis C virus — despite the fact that a scientist from the Centres for Disease Control and Prevention contributed much to the original research.

But the CDC signed away to Chiron most of the commercial control of the virus for a little more than $2.2 million in 1990.

There are, however, now over 50 medications in clinical trials for potential use relating to hepatitis C. In 15 years hep C has moved from an insignificant virus, akin to EBV, to being a mass cash cow for the pharmaceutical industry. For instance if the UK prevalence was low, say 200,000 with viral RNA, then based on current statistical models around 60% could be eligible for treatment, which would work out at 120,000 at £6000 per 24 wk treatment cycle, would be £720,000,000. Their would obviously be drop outs, non responders, etc, however, if factoring a percentage that will require 48 weeks treatment, £720 million, would not be far of the mark. This is only considering the current available treatments of Peggylated Interferon Alfa and Ribavirin, which has less than 50% success rates! So in the UK alone this a multi million pound industry, and this is just treatment, the economic costs of lost working years, other hospital treatments for the disease and it’s many associated conditions, then there is the costs of benefits, mental health care and areas in drug rehabilitation failures I will address later.

Meantime there is still concern and tension between the U.S. patent system and free scientific inquiry.

The CDC now, for instance, claims ownership of the SARS virus and its entire genetic content after its researchers helped map the bug’s genome. Rather than try to profit from it, the CDC wants to prevent others from monopolizing the field the way Chiron does with hepatitis C.

It certainly raises some questions about the morality of so much profit at the expense of those affected, not that this is anything new.