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27 January 2012

Cure and Care : 24th IFNGO World Conference

Recommendations from the 24th IFNGO World Conference

Strength, Unity and Diversity:
Time for an International Voice for NGO's


The 24th IFNGO World Conference was held in Kuala Lumpur from 8 – 11 November, 2011.  Delegates from NGOS, Governmental and Intergovernmental organizations and from academic and research institutions, coming from X countries met to present and exchange ideas, experience and knowledge on effective responses to problems related to substance misuse.  The vast majority of those present were involved with organizations directly delivering a wide range of services including, but not restricted to primary prevention, low threshold, harm reduction, treatment and rehabilitation.  They are committed to working to assist people achieve recovery where they gain or regain participation in a fruitful and fulfilling personal and social life.  Those gathered at this conference represent a valuable resource to comment on, review and contribute to the development of effective policies and practices.

As a contribution to the continued development of responses to the problems related to substance misuse, from this conference we have noted a number of specific areas and issues which deserve greater attention in the development of policy and practice.

The Big Picture

We know that treatment works and that investment in prevention and treatment can have a significant impact on the health and social well-being of society as a whole.  An intensified health and public health response is required.

Prevention and treatment systems need to be further developed.  A balanced response is needed which incorporates all elements of drug demand reduction from primary prevention through early intervention, low threshold and treatment services to recovery.  There is an urgent need for more evaluation and an expanded evidence base to build on effective prevention programs and to identify new approaches, monitored and evaluated. 

Treatment systems need to be transformed to meet the needs of drug users, families and communities.  The development of “Cure and Care” in Malaysia represents an example of such a transformation which should be replicated in other countries as a move to replace compulsory detention.  The challenge is to go further in providing pathways to recovery and to offering ways of sustaining progress to and achievement of recovery.  For this to occur, all relevant government bodies must work together, and with a wide range of civil society organizations, so that stigma, discrimination and punitive measures do not act as a deterrent to effective measures to reduce substance misuse and related problems.

We recognize the importance of community engagement in efforts to prevent substance misuse through education and the provision of alternative activities.  We also note the importance of involving those most affected by substance misuse in developing policy and services, including families, community based organizations, those in recovery and user networks.  Involving women and children and addressing gender specific issues is an important element in the provision of effective responses.

NGOs

In most countries, NGOs are significant providers of prevention, early intervention, harm reduction treatment and rehabilitation services.  In many countries they are the main providers.  Their expertise and experience needs to be utilized in the development of policy and practice.   They should work together towards the development of a humane and integrated set of services with the goal of establishing multiple pathways to recovery.  The Declaration and Resolutions from “Beyond 2008”provide a common basis for such a development and for engaging with policy makers at national and international levels.

NGOs are in a position to most effectively engage community participation for prevention, but also to challenge stigma and discrimination which can act as a barrier to access to services and to recovery.  They need to take up this role to an even greater extent.  They also need to develop their monitoring and evaluation capacity so that they can contribute more fully to the evidence base and demonstrate their effectiveness.

Ethics

We recognize that responses to drug related problems are based on the provisions of the three UN drug conventions and that all signatory countries should respect the requirements and intentions of these conventions.  We also note that the drug conventions operate within a wider framework of the UN Charter and other conventions, including the Universal Declaration on Human Rights, the Constitution of WHO, and the Convention on the Rights of the Child and that there should be complementarities between these international instruments and the respective UN bodies responsible for them.  We further note the importance of the WHO Framework Convention on Tobacco and the WHO Global Strategy to Reduce the Harmful Use of Alcohol.

In this context, we consider that compulsory detention under the guise of treatment should end and the resources be utilized to provide evidence based treatment designed for recovery.  We reject the notion that addiction is a sign of moral deficiency or criminality and recognize that such views can undermine rather than support effective drug demand reduction and the prevention of transmission of blood borne disease.

The number of drug misusers in closed custody settings has continued to increase.  Too often in such settings there is limited or no access to treatment and recovery services but high risk behaviours continue or are initiated.  We consider that much greater use should be made of the provisions within the drug conventions for the offer of alternatives to imprisonment

We believe that the purpose of all responses should be the prevention of substance abuse and the promotion of recovery.  To this end policy and practice should be guided by the principle “Above all, do no harm”.

Challenges

Many challenges remain in our capacity to respond to the problems associated with substance abuse.  The world economic crisis has placed challenges on public and private expenditure.  At the same time, there has not been a down turn in the illicit drugs economy.  Thus, at a time when our ability to respond is being curbed, the very problem we are seeking to tackle remains and is expanding.

One major challenge, therefore, is to build the alliances and networks which will allow us to pool resources and work together.  The separation between providers, for instance between HIV/AIDS services working with injecting drug users and drug treatment services, needs to end so that together we can build pathways to recovery. 

A second major challenge is the link between and the impact of the development sector and the drug policy sector on each other’s agenda and work.  The Millennium Development Goals are relevant to our work and equitable social and economic development can have immense impact on prevention of and recovery from substance abuse.

A third major challenge is the rapid increase in the availability and use of amphetamine type stimulants (ATS).  However, the majority of services are still designed to respond to the needs of opiate dependents. New and adapted services are required which are attractive to this population.

We face the challenge of developing and maintaining our capacity to build an effective and knowledgeable workforce and require additional support to ensure that the gains which have been made in our capacity are not undermined.

A further challenge is how we utilize new technology, such as social media, to promote health and support prevention and recovery.  Exciting new initiatives have been developed and these need to be expanded and evaluated so that we can reach additional populations.

We recognize that the challenges and issues we face present new opportunities for the development of accessible, effective and humane responses.  We look forward to working together, with other sectors and with government partners to develop ever more effective to a global crisis.

We call upon NGOs and IFNGO to consider how, in their own settings and within their own competence, they may take forward these recommendations from the 24th IFNGO World Conference in their meetings with government and intergovernmental organization officials and ask that reports on action be sent to IFNGO so that it may provide a coordinated report to the 25th World Conference in Macau, 2013.


For any further details on this conference please visit www.ifngoconference.org





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