A/79/177 VI. Harm reduction: legislation, policies and programmes for sustainable peace and development 68. In her report to the Human Rights Council on drug use, harm reduction and the right to health, the Special Rapporteur described regulatory tools as existing on a spectrum. 144 On one end, States proscribe certain conducts and impose sanctions for non-compliance, including criminal penalties. 145 On the other end is liberalization, whereby States pull back and allow different actors in society to self -regulate, including through voluntary corporation-led initiatives 146 that are often adopted to stave off Government regulation. 147 A. Decriminalization 69. In the context of health and human rights, criminalization is multifaceted. While there are instances in which international human rights law mandates the use of criminal law (e.g. torture, forced disappearance), 148 in other instances it prohibits it (e.g., same-sex relations, blanket bans on abortion) 149 or cautions against an overreliance on it (e.g. drug use). 150 Human rights mechanisms have indicated that the use of criminal law, particularly when it targets people seeking health services, can negatively affect public health. 151 70. The use of criminal law can itself give rise to harm, either by exacerbating harm or causing harm, with decriminalization emerging as the self-evident harm reduction approach and a regulatory option to mitigate harm and promote health. 1. Drug use 71. WHO, 152 the Global Commission on HIV and the Law 153 and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommend the full decriminalization of drug use and possession for personal use in order to respond effectively to HIV. 154 The provision of, and access to, harm reduction care is critical to ending AIDS as a public health threat by 2030. 155 However in 2019, fewer than 1 per cent of people who inject drugs lived in countries that reported providing the recommended level of opioid agonist therapy and needle/syringe provision services. __________________ 144 145 146 147 148 149 150 151 152 153 154 155 16/28 A/HRC/56/52, para. 56. Darren Sinclair, “Self‐regulation versus command and control? Beyond false dichotomies”, Law and Policy, vol. 19, No. 4 (October 1997). A/HRC/56/52, para. 56. Alexandra Finch, “Sweet and sour: a responsive strategy to strengthen sugar-sweetened beverage regulation in Australia”, Journal of Law and Medicine, vol. 29, No. 1 (March 2022). Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, art. 4; and Mattia Pinto, “Awakening the leviathan through human rights law: how human rights bodies trigger the application of criminal law”, Utrecht Journal of International and European Law, vol. 34, No. 2 (2018), p. 161. A/72/172, para. 32; Committee on Economic, Social and Cultural Rights, general comment No. 22 (2016); and Committee on the Elimination of Discrimination against Women, general comment No. 35 (2017), paras. 29 (c)–(i). A/HRC/14/20, para. 47. See A/HRC/14/20; A/66/254; and OHCHR, “Statement by the UN expert on the right to health on the protection of people who use drugs during the COVID-19 pandemic”. WHO, Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention . Secretariat of the Global Commission on HIV and the Law, Global Commission on the HIV and the Law: Risks, Rights and Health – Supplement (New York, UNDP, 2018). Submission from UNAIDS. Ibid.; and UNAIDS, “Political declaration on HIV and AIDS: ending inequalities and getting on track to end aids by 2030”, June 2021. 24-13226