Let me start my intervention with two personal memories. The first one directly refers to my first visit to your Country, more than 25 years ago, when I came here to meet and speak about the problem of drugs with Professor Zdenek Kreyci, director of the Hygiene and Epidemiology Department at the Olomouc University.
Thanks to Professor Kreyci's skills and broad mindedness, at that time Czechoslovakia was the only Communist country in which not only drug problems were not denied, but also a scientific debate was possible on the issue. Today, after some years from his death, I want to commemorate Professor Kreyci, whose commitment and passion gave your Country competences and leadership in the field of drug treatments.
The second one is that on May the first, this year, I celebrated my first 30 years of drug, in the sense that the first of May 1974, freshly graduated in medicine, I met my first drug addict patient in the Anti-Drugs Centre the Municipality of Rome had opened a few weeks before. Since then, I met and treated over 25.000 drug addicts, a task-force who made me erase any prejudice on the subject and helped me to have some certainties.
My first certainty is that the drug phenomenon is dramatically complex, difficult to face and difficult to explain. It is for this reason that political systems throughout the World are facing difficulties in elaborating efficient strategies taking into consideration:
1. That use & abuse of substances is old as the world itself and it's part of human destiny that seeks in nature, or in a laboratory, a relief from pain, death and imperfection.
2. That use & abuse of substances express the human inner desire to modify his consciousness, to look for pleasure and to escape from pain while relieving his suffering, either physical and psychical, researching for the pill of happiness to win diseases, pain until death.
3. That use & abuse of substances implies ethical and scientific backgrounds; cultural, traditional and economic scenarios, from needs to care for, from freedom to power and the law, desires, fears and pleasure.
My second certainty is that caring for people is far for effective than punishment and inhumanity. I cannot bear this attitude that beating up the sicks will cure them. Where have people got this cruel idea? We can use our response to drug issues to build a caring society, or allow it to be exploited so that we end up at war with ourselves. It is a question of what kind of world we want to live in.
Finally, my third certainty is that knowing and taking care of all drug addicts is a part of any State's and any Government's interest troughout the World. Creating Anti Drug Centres, Centers for substitutive therapies, Day and Night Reception Centers, but also looking for drug users in the streets and sqares in which their daily tragedy is consumed, is an exellent investment for Public Health. While trasforming the fight against drugs into a fight against drug addicts, forced to clandestinity and social exclusion, worsens everybody's quality of life and is not a wise decision.
The Red Cross and Red Crescent Movement
In December, last year, the Red Cross and Red Crescent Movement held an International Conference. Many of you may not know that we sit down like this every four years with all governments who have signed the Geneva Conventions, and negotiate an agenda for humanitarian action.
At this most recent meeting we focused on how government action can help or hinder public health, and in particular how forcing certain groups such as migrants and injecting drugs users to the margins creates the perfect circumstances for the spread of HIV and other public health disasters. When this happens, not only is our humanity compromised, but the health of the whole community suffers.
A HIV, but also HCV, epidemic amongst injecting drug users quickly becomes a self sustaining epidemic in the broader population. This because drug users are not an epidemiologically closed community, but they are an open one, able to transmit the virus to several parteners, mainly trough sexual relations.
For this reason, preventing that an IVDU gets infected by reusing contaminated syringes can prevent several more infections, and is a good public health practice. Also for this reason, the 2003 agenda for humanitarian action urges all the States to ensure a wide range of prevention programmes, including access to sterile injecting equipment, and harm reduction efforts related to drug use. All 181 Governments and national Red Cross and Red Cresent societies which are members of the Federation, and the International Committee of Red Cross, agreed to this.
It is a Red Cross Red Crescent tradition to be guided by the science - the evidence of what works, because our motivation is to save lives and reduce suffering. We do not have time to get embroiled in ideological crossfires, and we do not believe people in need of care should be either.
We are fortunate indeed that the evidence for what works for preventing HIV amongst drug users is extremely clear, and very cost effective. If this work is carried out, the whole society greatly benefits. And this work does not increase drug use, as hundreds of studies realized all over the world have demonstrated.
The harm reduction approach
I have been an active humanitarian since I was a child, and I became a doctor to continue this work as an adult. I regret that the benefits of the harm reduction approach are not immediately understood by many people, but they do understand if the evidence is presented clearly, and leaders use their charisma to build social cohesion.
We are all in serious trouble when politicians prefer instead to play on peoples fear and prejudice, and attempt to turn this into electoral advantage through building contempt for the marginalised and vulnerable. We have seen this tactic employed by racists, and we should not tolerate it when any vulnerable group is being exploited in this way.
There is no doubt that a power base can be built through social division but ultimately humanity appreciates leaders like Nelson Mandela who raise us all above such tactics.
Intolerance and exclusion of sections of humanity is fundamentally against what Red Cross Red Crescent, and all decent people, stand for, and we see it as a duty to speak up in defense of the sick and marginalised who do not easily have a voice.
Decisions about HIV policy and drug policy should be guided by evidence of what works, and this is why the Federation stand is clear and strong. Too much is at stake for these issues to be played with by cynics who are prepared to risk the health of the whole community, just so they can gain some tainted popularity. Such people demonstrate they do not have the maturity to be trusted with power.
The Czech National Drug Strategy
To focus on the local situation for a moment, I applaud the Czech national drug strategy because it is based on scientific evidence rather than assumptions. Yes, you have embraced harm reduction, as you know there is no other effective option. Treatment and rehabilitation are at the heart of my own work, and I am delighted that you have included them in sensible ways. And you clearly understand that these approaches fully complement prevention programmes and suppression of illicit drug supply. An entirely rational and appropriate approach.
You are to be congratulated, and I believe you will provide leadership within your entire region. Your positive influence will save many lives. Due to its geographycal position and traditons, Czech Republic can be considered as a bridge towards Eastern European Countries like Ukraine and Russia, where it is extremely urgent to establish new anti-drug policies, inspired by your experience, and I whish today's meeting would stimulate you to undertake actions towards this direction.
An increasing concern of the Red Cross Movement, my own work in Italy, and more recently the United Nations Office of Drugs and Crime, is prisons. Heavy handed law enforcement approaches that drive up prison numbers are a waste of money, and ultimately do harm.
A large amount of the volunteer effort of my Red Cross Foundation Villa Maraini in Italy is focused on looking after intoxicated people in prison cells. Even if we always have to distingush between who commits a crime in order to take drugs from who take drugs in order to commit crimes, I have close experience over many years of how dangerous it is to mix drug addiction and the criminal justice system. It is a disastrous and irresponsible combination.
All over Eastern Europe, prisons are playing a major role in the spread of HIV/AIDS, not only amongst prisoners but also in the community those people return to. To this extent, it is important that Governments' political agenda includes the decriminalization of possessing small amounts of marijuana for personal use.
In respect of the Fundamental Principle of Neutrality, I can not and I do not want to venture into political considerations. It is anyhow reasonable to hypothesise that decriminalization could take young people away from contacting with serious criminals, and could free up police resources for tackling the tough work of applying the law to the privledged and wealthy who run the illicit drug trade.
The choice is clear. If you want to look after the public health, respect human rights, and promote humanitarian values, social inclusion and harmony, then a rational approach based on evidence is the way to go.
Spread the light of science
In 1919, the International Federation's founders minuted their objective to spread the light of science and the warmth of human sympathy into every corner of the world. As a Vice President of the Federation I am proud to continue this long tradition, and I welcome the Czech Repubic as a key ally in this important humanitarian endeavour.