Maternal health and human rights impacts of Russian drug policy.

This article describes how Russian drug policy defies international ethical standards in patient care and violates the human rights of pregnant people who use drugs. While the CEDAW Committee previously found Russia to be in violation of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) by failing to ensure that pregnant people have access to gender-sensitive drug dependence treatment, to date the Committee has refused to address the role of drug criminalization in enabling this human rights violation. This article outlines the gendered impacts of Russia's punitive approach to drug use, including its detrimental effects on maternal health, and concludes by urging the CEDAW Committee to follow the approach of the UN Committee on Economic, Social and Cultural Rights, the UN Chief Executives, the World Health Organization, and UNAIDS, as well as senior UN lawyers and international legal experts to assess drug criminalization critically through the prism of the CEDAW convention.

"The Law Doesn't Protect Me": Examining the Effectiveness of Good Samaritan Drug Overdose Legislation.

Background: Amid an unprecedented overdose crisis in Canada, the federal government passed the Good Samaritan Drug Overdose Act, which provides immunity from simple drug possession charges to overdose witnesses who phone 911. The law was meant to address the barriers posed by police presence and to encourage bystanders to seek emergency supports. Objectives: Our goal was to examine the effectiveness of the Good Samaritan law from the perspective of people who use drugs. We wanted to find out how aware they were of the law's protections and limitations, if first responders were adhering to the legislation, and if it ultimately had an impact on bystanders' helpseeking behaviors. Methods: We engaged a participatory research process that included surveys and focus groups with 109 people who use drugs in Ontario, Canada. This article focuses on the qualitative findings from focus group with 40 individuals in three cities. Results: Our results reveal that people who use drugs are confused about the law's safeguards, and based on their negative experiences with police, do not trust police to uphold the letter or spirit of the legislation. As a result, many engage in strategies to avoid contact with law enforcement. Conclusions/Importance: Greater knowledge of the law is beneficial, but even with such knowledge, mistrust of police and fear of criminal charges continue to deter people from calling 911. Good Samaritan laws would be more effective if they included a broader range of protections beyond simple possession and if police did not routinely attend overdoses.

"That's why people don't call 911": Ending routine police attendance at drug overdoses.

Research has shown that police attendance and the corresponding threat of criminal charges are major deterrents to people seeking emergency medical assistance in the event of an overdose. In response to these barriers, Canada passed the Good Samaritan Drug Overdose Act in 2017, providing immunity from prosecution for simple drug possession to overdose victims or bystanders who phone 911. In theory, this should make people more comfortable seeking emergency supports, but in practice our research found that many remain hesitant because police continue to be routinely dispatched to the overdose site. Based on focus groups and surveys with 109 people who use drugs across Ontario, Canada, our findings show that the vast majority of participants have negative interactions with police, which discourages them from seeking medical assistance at future overdose incidents. Almost all questioned the necessity of dispatching law enforcement to a health emergency that requires medical intervention. As such, this commentary draws on the study's qualitative data to argue that ending routine police attendance at drug overdoses in Ontario would remove a major barrier to calling 911, and thus prevent the further, unnecessary loss of life in the ongoing overdose crisis.

Human rights in patient care: drug treatment and punishment in Russia.

An inherent feature of drug control in many countries has been an excessive emphasis on punitive measures at the expense of public health. At its most extreme, this approach has reduced health services for people who use drugs to an extension of the drug control system. In these environments, health services are punitive rather than supportive for people who use drugs, especially those who are drug dependent. In Russia, the government's official policy towards drug use is one of "social intolerance," which seeks to legitimize and encourage societal ill treatment of people who use drugs. In practice, this policy has materialized as widespread and systematic human rights violations of people who use drugs, including by subjecting them to unscientific and ideologically driven methods of drug prevention and treatment and denying them access to essential medicines and services. While such human rights violations are well-documented, there have been no attempts to date to consider the consequences of this approach through the lens of human rights in patient care. This concept brings together the rights of both patients and providers and interrogates the role of the state on the relationship between two core groups: drug-dependent people and drug treatment doctors or "narcologists" in Russia. In this article, we apply the concept of human rights in patient care to consider the narcologist's role in punitive drug policy and human rights violations against people who use drugs and to analyze how punitive drug policy manifests as human rights violations against narcologists themselves, who lose their professional independence and their ability to work according to professional standards and ethical norms. We conclude that both people who use drugs and narcologists suffer from punitive drug policy and should unite their efforts to ensure drug policy does not undermine patients' health and human rights.

Proposed EU-India free trade agreement could impede manufacture of generic HIV drugs.

Medical experts are warning that an international trade agreement being brokered between the European Union (EU) and India could greatly restrict the access of people living with HIV in the developing world to life-saving antiretroviral medication.

Ontario: prostitution-related provisions of Criminal Code struck down.

In September 2010, the Ontario Superior Court of Justice held that three provisions of the Criminal Code dealing with prostitution violated sex workers' constitutional rights, were not in accordance with the principles of fundamental justice and must be struck down.

British Columbia: sex workers granted standing to challenge Criminal Code.

On 12 October 2010, a majority of the Court of Appeal of British Columbia allowed the appeal of Shari Kiselbach and the Downtown Eastside Sex Workers United against Violence Society (SWUAV) regarding their standing to challenge provisions of the Criminal Code concerning prostitution.

Swazi man's refugee claim rejected: PHAs not a "particular social group".

On 14 July 2009, the Refugee Protection Division of the Immigration and Refugee Board (IRB) rejected the claim for refugee protection of B.L.H., an HIV-positive man from Swaziland. B.L.H. made a Convention refugee claim on the basis of his membership in a particular social group, claiming a fear of persecution based on his HIV-positive status. B.L.H. also claimed that he was in need of protection in accordance with Section 97 of the Immigration and Refugee Protection Act (IRPA).

Federal court allows application for judicial review of HIV-positive woman from Jamaica.

On 26 January 2011, the Federal Court allowed an application for judicial review by Ferona Elaine Mings-Edwards, who based her application for permanent residence on humanitarian and compassionate grounds, including the hardship that she claimed that she would face in Jamaica from her former domestic partner and because of her HIV-positive status.

Federal Court: incarcerated man did not have right to choice of doctor.

In December 2010, the Federal Court rejected a former prisoner's request for judicial review of a decision of the Correctional Service of Canada (CSC) regarding his choice of physician while incarcerated.

B.C. Court of Appeal upholds supervised injection site's right to operate.

On 15 January 2010, the British Columbia Court of Appeal held that Insite, North America's first supervised injection site, was a provincial undertaking that did not undermine the federal goals of protecting health or eliminating the market that drives drug-related offences. As such, the Court held, the drug possession and trafficking provisions of the Controlled Drugs and Substances Act (CDSA) did not apply to it.

Ontario court strikes civil suit against Toronto and Ontario for failing to protect plaintiff from contracting HIV.

On 10 March 2010, the Ontario Superior Court of Justice struck in its entirety Percy Whiteman's statement of claim against Ontario and Toronto for negligently failing to protect him from contracting HIV from his spouse, holding that it disclosed no reasonable cause of action. Whiteman's claim that Canada was vicariously liable for the acts of immigration agents and employees was allowed to proceed, as it was not plain and obvious that no private law duty of care could be found to exist between Whiteman and Canada.

HIV-positive Zimbabwean couple's refugee claim accepted on the basis of their political affiliation.

On 23 November 2009, the Refugee Protection Division of the Immigration and Refugee Board (IRB) found two citizens of Zimbabwe to be Convention refugees based on their political affiliation with Zimbabwe's opposition party and the impact this had on their access to antiretroviral treatment in Zimbabwe. The refugee claims of their children, who were not infected with the virus, were rejected.

Federal Court dismisses appeal in permanent residence case, says personal commitments to pay for HIV treatment are unenforceable.

On 16 February 2010, the Federal Court dismissed the judicial review application of Al-Karim Ebrahim Rashid on the basis that personal commitments to pay for required health services such as HIV treatment are non-enforceable.

Federal Court orders review of prospective immigrants' plan to obtain private insurance for HIV medication.

On 31 December 2009, the Federal Court allowed the judicial review application of Ricardo Companioni and his common-law partner on the basis that the ability and willingness of the applicants to defray the cost of their out-patient prescription drug medications is a relevant consideration in assessing whether the demands presented by an applicant's health condition constitute an "excessive demand".

Panel: rights of people in prison to HIV prevention, treatment and care.

This article contains summaries of the five presentations made during this panel. Ralf Jürgens provides an overview of the issue of needle exchange programs in prisons, and reviews the international experience with such programs. Sandra Ka Hon Chu advances the legal and human rights arguments for establishing needle exchanges in Canadian prisons. Giselle Dias describes the inter-sectoral strategy for HIV/AIDS is prisons being developed by the Prisoners HIV/AIDS Support Action Network (PASAN). Finally, two former prisons turned activists, James Motherall and Greg Simmons, provide their personal perspectives on prevention and treatment behind bars.

European Court of Human Rights rejects prisoner's plea for prison needle exchange.

On 4 January 2008, the European Court of Human Rights declared inadmissible an application from prisoner John Shelley alleging a violation of his rights under the Convention for the Protection of Human Rights and Fundamental Freedoms (European Convention).