Since 2011–2012 Kenya has successfully introduced and implemented a comprehensive harm reduction programme to tackle a sub-epidemic of HIV among people who inject drugs (PWID).

People who use drugs are highly stigmatised in Kenya. Cultural, religious and social norms were against harm reduction, which was widely perceived as encouraging drug use.

To overcome this, advocacy work was done to place harm reduction within a public health context and emphasise the benefits for all society. On a government level, the Kenyan Ministry of Health established a policy framework for a national HIV and harm reduction response targeting PWID. The National AIDS and STI Control Program (NASCOP) developed standard operating guidelines for initiating harm reduction.

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Thumbnail: CC Community Action On Harm Reduction

Achievements and challenges in bringing harm reduction services to Kenya

In 1998, a special session of the United Nations General Assembly agreed to set a 10-year deadline to make the world “drug free”. After an embarrassing failure to achieve this goal, the deadline was extended a further 10 years, setting the world up for another inevitable failure in 2019.

In the intervening years, the use, availability and variety of illicit drugs have escalated exponentially. It is estimated by the UK charity Transform Foundation that 300 million people worldwide used illegal drugs in 2012, contributing to a global market with a turnover of $US330 billion a year.

The vision of a drug-free world has faded. We are instead presented with a nightmare scenario, where a multi-billion dollar black market funds organised crime and terrorist organisations.

A drug-free world is an impossible dream

You are invited to submit information covering developments since 18 December 2014 relevant to the question of the moratorium on the use of the death penalty. Send (maximum 1500 words) by 15 May 2016 with subject [SG report - moratorium - death penalty] to: registry@ohchr.org.

OHCHR’s work on the death penalty issue

Moratorium on the death penalty: Call for inputs

After a long gestation, the UN drug reform experiment suffered a miscarriage. It seems the UN is not the catalyst of change but its mirror. Reformers can learn many lessons - but can also be proud of their achievements.

Those who hoped this would be a watershed event must be feeling disappointed, after the closure of the UN General Assembly Special Session. As we reported earlier, the UNGASS adopted a weak and vague outcome document on the first day, in the opening plenary, without a debate. So the plenary debates and round-table discussions, which were supposed to shed new light on the world’s efforts to control drugs, were essentially no more than lip-service, and had no real impact on the system.

I have always been among the sceptics who didn’t believe that the UNGASS would bring much change, so this was not a real disappointment for me. I think drug policy reform has never come from the UN, and it never will. The UN is only a mirror that reflects the power structure of the world and what is happening at a national level. Its systemic inertia does not permit it to be the catalyst for change.

That said, it doesn’t mean that all advocacy efforts targeting the UN are necessarily meaningless. The UN is an important forum for power-play among world powers, and provides a platform for interaction between civil society and member states. What is more, it is a stage which NGOs can use, in order to highlight the flaws of the system in front of the watching eyes of the public. That’s why we, the Rights Reporter Foundation, attended the event and produced a movie about it.

The UNGASS on drugs: reform aborted

On the final day on UNGASS 2016, the UK’s Transform Drug Policy Foundation brought their Anyone’s Child campaign to a packed conference room at the UN.

In stark contrast to an event they were due to be involved in earlier in the day – ‘Drug Policy, Dirty Money, and Development: Why the UNGASS should care about the Panama Papers’ – which had to be called off after only a handful of people (myself included) managed to get through the police barriers to attend, this deeply emotional event was so popular that many attendees ended up sat on the floor, or stood around the edges of the room.

The question being asked here was ‘How can the international drug control system provide a better tomorrow for today’s youth?’. Unsurprisingly, the resounding answer was that, given the abject failure of the UNGASS outcome document to address the important issues, it can’t. At least not without wholesale changes.

How can the international drug control system provide a better tomorrow for today’s youth?

At the urging of Mexico, Guatemala and Colombia, world leaders met at the United Nations in a special session last week to discuss saner ways to fight the drug trade. They did not get very far toward a shift in approach. Nonetheless, there was a consensus that investing in health care, addiction treatment and alternatives to incarceration would do more to end the drug trade than relying primarily on prohibition and criminalization.

“A war that has been fought for more than 40 years has not been won,” President Juan Manuel Santos of Colombia said in an interview. “When you do something for 40 years and it doesn’t work, you need to change it.”

Mr. Santos and the presidents of Mexico and Guatemala argue that the war on drugs, which has been largely directed under terms set by the United States, has had devastating effects on their countries, which are hubs of the cocaine, marijuana and heroin trade. “When two elephants fight, the grass always suffers the most,” President Jimmy Morales of Guatemala said, referring to the drug cartels and American law enforcement agencies.

Thumbnail: Flickr Office of Public Affairs

Rethinking the global war on drugs

The excesses of the global war on drugs are often so brutal as to seem like parody: think of Singapore’s macabre antidrug illustrations for children, or the recent news that Iran had executed all the men in a single village in the name of drug control. Latest in the ominous, believe-it-or-not category was watching Russia host a side event on science at the UN General Assembly Special Session on the world drug problem in New York on April 20. To informed observers, this was akin to watching climate change denialists host a look at global warming.

Russia has been among the nations most committed to denying scientific evidence on effective drug dependence treatment. The country has banned methadone and buprenorphine, widely researched medicines that the World Health Organization deems essential in the treatment of dependence on heroin and other opiates. Russian “narcology” — the sub-discipline of psychiatry charged with treating drug dependence — has instead promoted such approaches as “coding,” where patients are hypnotized and told that they will fatally poison themselves if they use alcohol or drugs, or induction of comas in drug-dependent patients followed by administration of electroconvulsive shock. St. Petersburg scientists piloted an approach — adapted and practiced in China — that involves drilling holes in the skull and destroying portions of the brain thought to be associated with craving. This “neurosurgery” is irreversible, and has raised the same ethical questions as lobotomies performed on mentally ill patients in the Europe and the United States in the 1930s and 1940s.

Russia, science, and the global war on drugs

The biggest United Nations summit on drugs in almost 20 years is over, and while there are signs many countries are stepping back from the destructive “war on drugs” approach to drugs, it’s hard not to conclude that overall the meeting was a missed opportunity.

Three years ago, Colombia, Guatemala, and Mexico called the meeting, arguing that the cost of the “War on Drugs” had become too high and a new approach was urgently needed. Unfortunately, the document the UN General Assembly approved on Tuesday does not represent a real break with the past but rather business-as-usual, with some shifts in emphasis.

The increased focus on health and human rights in the document is welcome, but as long as the dominantly courts-and-cops approach to fighting drugs continues, the toll from the fight will far outweigh the damage from the drugs themselves. There is little doubt that tens of thousands of people will continue to suffer from drug-related violence and human rights abuses in the coming years; that drug users and those involved in minor trafficking will continue to fill our jails; and that HIV and hepatitis C will continue to wreak havoc among people who inject drugs.

A missed opportunity to end the war on drugs

I have just watched the closing plenary session of the 2016 UN General Assembly Special Session on the world drug problem here in New York. Presidents and Prime Ministers will now move on to the climate change summit that opens tomorrow, and the thousands of government and NGO delegates who have filled the UN building in Manhattan over the last 3 days will catch their flights back to all corners of the globe. So was it worth it – three years of preparation, tens of millions of dollars of travel and meeting costs, and countless hours of debate and negotiation. Is the international community any better placed to reduce the health, social and economic problems associated with illicit drug markets?

Judging by the consensus declaration agreed here by all member states, the answer has to be no. It is 14 pages of dense text that, despite some welcome statements on some issues, is broadly a recommitment to current policies, and fails to engage with the serious questions facing a drug control regime that is no longer fit for purpose.

There have however been some signs that the presumption in favour of repression and law enforcement approaches to drug markets and drug use is breaking down. A strong opening speech by Margaret Chan (Director General of the World Health Organisation) set the tone for many, by making a clear call for prioritising resources and attention to protecting the health of drug users, rather than criminalising them. Many countries took up this theme, some specifically calling for decriminalisation of drug consumption, and others condemning the application by repressive regimes of the death penalty for drug offences. In a sign of the growing rift between reforming and hardline countries, Indonesia responded with a statement on behalf of a group of around a dozen death penalty states, arguing that the use of the death penalty was effective, and it is the sovereign right of governments to decide whether to use it.

he UN headquarters – it could just as well be describing their approach to drug policy (Source: Henry Fisher)

A small number of progressive member states went further in their calls for an entirely new approach. Leaders from Colombia, Bolivia, Uruguay, Mexico, Jamaica, the Czech Republic, New Zealand and Canada, for example, all made it clear that they favoured urgent and significant reforms – including the introduction of regulated markets – and some of them will continue to pursue these reforms, despite the lack of agreement at UN level.

The UNGASS was called by the Presidents of three Latin American countries – Mexico, Colombia and Guatemala – who were increasingly concerned that the war against drug production and trafficking in their region was making the problems of organised crime and violence worse, and that a serious review of the dominant policies of the last 50 years was therefore needed.

Meanwhile, the real world of drug markets and consumption was not waiting for any UN agreements. Rates of drug production, supply and consumption are continuing to increase (no sign of that drug free world that the previous UNGASS hoped for in 1998); the introduction of new drugs – and new methods of production and supply – is far outstripping the ability of governments to respond; and many governments and local administrations are pursuing policies that call into question the principles behind the drug control regime, or (in the case of regulation of recreational cannabis markets) are actually in breach of the UN drug treaties.

In the light of these realities, the most remarkable thing about the UNGASS, and specifically the outcome declaration, is what has been left out.

There is no discussion on the hottest topic of drug policy debate around the world – whether legalised and regulated markets can effectively undermine the harms of an illegal market, without creating greater new problems. These are crucial policy questions that need to be carefully reviewed, particularly as 6 jurisdictions are already implementing legal markets for cannabis, and several others are planning to. These policies are in clear breach of the UN drug control treaties. But no country wants to talk about it.

There is no discussion of the reality that, despite decades of massive political commitment and investment, the illicit drug market is now larger, more diverse, and established in more countries, than ever. Prices to consumers are lower, and profits to organised crime higher, than when the drug control treaties were enacted. Despite all the surreal talk of creating a ‘drug free world’, or a ‘society free of drug abuse’, it is clear that some form of market for psychoactive substances is here to stay – the question is, what sort of a market is least harmful? There are a number of possible answers to that question, but I’m almost certain that none of them is ‘a market controlled by criminals’. But no country wants to talk about it.

There is no discussion of the right to health. One of the human rights obligations that all member states have signed up to is to take all reasonable steps to promote and protect the health of their citizens. The scientific evidence on how to achieve this – in treating drug dependence, in preventing HIV and Hepatitis infections, and in preventing overdose deaths – is clear. But many countries refuse to implement evidence based interventions because they think it undermines a zero tolerance approach to drugs. As a result, they are breaching the right to health of their citizens, and knowingly exposing thousands of their citizens to early and avoidable deaths. But no country wants to talk about it.

There is no discussion of the fact that all the relevant UN agencies – those that deal with health, development, human rights, gender and families – all made clear calls to member states to use the UNGASS to signal a clear turning point in global drug policy – ending the repressive war on drugs approach, and integrating drug policies into the wider objectives of the international community. All UN bodies joined in a call to member states to decriminalise drug consumption – while the drugs and crime agency failed to join this call, it did also provide member states with much progressive advice on how to reform their domestic policies. But very little of this advice found its way into the UNGASS declaration, and no country wants to talk about it.

This avoidance of difficult topics arises from the increasing polarisation of countries’ views on how to deal with drug markets and drug use. There are some powerful countries that are determined to preserve the war on drugs – Russia, China, Pakistan, Indonesia and Egypt form a formidable barrier to change – while others are desperate for change. Significant powers such as the USA and the European Union stayed on the sidelines – the USA because it is in the embarrassing position of having for decades been the cheerleader for the war on drugs, but now one of the first countries to be in breach of the drug control treaties. The European Union because drug policy is not high on their political agenda, and because they themselves find it hard to get any sort of consensus between their 28 member states.

So, the idea that all governments can get together and agree a common way forward through the United Nations seems rather unlikely now. They will meet again in three years time, and a reasonable prediction is that many of these diplomatic dynamics will be the same – this inertia in the face of such urgent situations on the ground is indefensible, and runs the risk of making the UN system irrelevant as countries just get on with the policies that they think are best for their citizens.

Click here to read this article in context.

Why does the United Nations find it so hard to talk about drugs?

Last week, Davao City Mayor Rodrigo Duterte, a candidate in the upcoming presidential election, pledged to declare drug-related problems as a national security threat and to allocate two divisions of the Philippine Army and 3,000 policemen to fight it. It is highly questionable whether this is an effective response. Despite already significant investment of state resources in law enforcement for police to conduct raids, arrests and seizures to tackle drugs, a violent criminal market continues to grow in the Philippines.

It seems that harsh penalties are not a deterrent, as despite having some of the harshest penalties for drug offenses in Asia, more and more people are arrested for drug use and possession every year in the Philippines. These tough sanctions are also unjustly disproportionate. Possession of drugs alone can lead to a sentence of life imprisonment, while the maximum sentence for homicide is 17 years imprisonment. These measures have led to the highest prison overcrowding rates (over 700 percent in some regions) in Southeast Asia. Over half of those in prison are held for drug-related crimes, mostly low-level offenses. It is often those who are already poor and vulnerable that suffer most from these punitive policies. For example, while women are a minority in the prison population, one out of every two women is incarcerated because of a drug-related crime.

The unbalanced investment in heavily punitive measures has diverted attention and resources away from ensuring access to evidence-based drug treatment and harm reduction services, such as the provision of needle and syringe programs to prevent the spread of HIV among people who inject drugs. This lack of investment in health services means that those who are looking for help with problems relating to their drug use cannot get it. The Philippines now has a health crisis on its hands, with the world’s second highest rate of HIV prevalence among people who inject drugs.

In other parts of the world, governments are turning away from the use of harsh punishment to manage drug-related problems. After a century of prohibitionist drug policies, with vast resources poured into law and military enforcement and increasingly severe punishments imposed for drug use and supply, the world is very far from achieving the “drug-free world” envisaged by the last UN General Assembly Special Session (Ungass) on the world drug problem in 1998. The reality is that even in countries that have meted out the most excessive brutality in an attempt to eliminate drugs—from Thailand’s 2003 “war on drugs” (which resulted in 2,800 people dead from extrajudicial killings in the first three months) to Mexico’s militarization of its drug war in 2006 (which provoked outbreaks of violence with drug cartels leading to over 164,000 homicide victims between 2007 and 2014)—no claim of success in even suppressing drug markets, least of all eliminating them, can be made. Year after year, the UN Office on Drugs and Crime reports expanding and diversifying drug markets, especially for methamphetamine in Southeast and East Asia.

It is the devastating consequences of prohibitionist and punitive drug policies that motivated the heads of state of Mexico, Guatemala and Colombia to call for the first Ungass on the world drug problem in almost two decades, which started in New York April 19 and will end today. The Ungass was envisaged as a critical juncture to evaluate the effectiveness of existing drug policies and to debate alternative strategies that could achieve better outcomes for the health and welfare of humankind—the objective of the international drug treaties. In the lead-up to the Ungass, many governments including the United States, Uruguay and Colombia, called for a shift in drug policies from a focus on law enforcement toward public health. Notably last year, Thailand’s minister of justice, Gen. Paiboon Khumchaya, publicly acknowledged the goal of eradicating drugs as counterproductive, leading only to systemic police corruption, and prisons overcrowded with low-level drug offenders from impoverished backgrounds.

With the Ungass, the Philippines was similarly presented with an opportunity to revisit and revise its drug policy and move away from punitive drug laws that are ineffective in addressing drug problems and are detrimental to public health. It should review its laws criminalizing people who use drugs and disproportionately punishing low-level offenders, and create new policies that allow evidence-based harm reduction services such as needle-and-syringe exchange programs.

In this context, it is disconcerting that Duterte is proposing to divert resources toward militarizing the drug enforcement response. Such action risks escalating violence, at great cost to human life and the security of communities, with virtually no chance of success in even suppressing drug markets. This is the lesson learned by governments around the world that have attempted to fight drug problems with violence and punishment. Many of them are now calling for drug policies based on health and human rights. For the Philippines to go against this trend is to perpetuate the devastating consequences of unjust and ineffective drug policies, and the waste of already scarce resources, without improving outcomes for the health and security of communities.

Harsh solutions to drug problem a total failure

This week, at the biggest UN drug policy summit for a generation, a mother who lost her child to drugs and is now campaigning to end the global drug war, inspired the Canadian Health Minister to call for a humane drug policies that better protect citizens.

Donna May, from Canada, is part of Families for Safer Drug Policies, a group that includes mothers, fathers, siblings and friends from all over the world who have lost loved ones as a result of drug policies that punish, rather than protect, those most in need. She told her story to the Canadian Health Minister – and it had a lasting impact.

Addressing the UN General Assembly Special Session(UNGASS), the Honourable Jane Philpott, Minister of Health, said:

“In preparation for this event, I met with a group of NGOs... But the most powerful voice of all belonged to a mother. She was there to tell the story of her young daughter, who lost her life due to complications of substance use. She described watching her daughter slip away, as she struggled to access the treatment and services that may have saved a beautiful, fragile life. Stories like this are far too commonplace. Today, I stand before you as Canada’s Minister of Health, to acknowledge that we must do better for our citizens.”

Donna May and other family members impacted by the war on drugs have been brought to New York to meet with officials from the UN and national governments, as part of a joint campaign by UK-based group Anyone’s Child: Families for Safer Drug Control and the US-based Moms United to End the War on Drugs.

Donna May said: “Today was the fulfilment of my promise to my daughter that in death her life would have meaning. Today I am proud to be Canadian. I hope other member states watch closely as Canada leads by example and provides the model that will go far toward saving the lives of our children.”

For the first time at a UN drug summit, countries have voiced their opposition to punitive, drug-war policies and called for fundamental reform. Alongside the Canadians, who announced that they will legally regulate cannabis in spring 2017, Mexico, Colombia, Jamaica, Uruguay and New Zealand all supported legal regulation of drugs, and called for reform of the outdated UN drug treaties at or in the run up to the UNGASS.

Similarly, the UN Office of the High Commissioner for Human Rights criticised the summit’s outcome document for its failure to prioritise human rights. They and every other relevant UN body also called for people who use drugs to no longer be treated as criminals.

Anyone’s Child Coordinator Jane Slater said: “We are delighted that the Canadian government has listened to its citizens, including Donna May, and responded in such a principled and pragmatic way. The old drug-war consensus has gone. Countries from across the world are decriminalising and legally regulating drugs. The countries that have stood up and called for reform deserve our heartfelt thanks for leading the world out of a sixty-year long war, and toward peaceful solutions that will promote health, reduce crime, protect young people and save money.”

Cara Lavan, from the UK, who lost her partner to a heroin overdose, and is part of Anyone’s Child, said: “Whilst the Canadians can be rightly proud of their government’s position, the UK government still supports the failed global drug war. Neither the Conservatives nor the Labour party have engaged with the fact that it is a criminal justice approach to drugs that led to the deaths of our loved ones. We families call on the major UK parties to follow Canada’s lead and advocate for evidence-based policies that promote peace and protect ordinary families.”

Bereaved mothers inspire health minister

WITHOUT NEW POLICY SOLUTIONS WE CANNOT END AIDS

From 19 till 21 April hundreds of government officials, representatives of non-governmental organizations and individuals from civil society are attending a three-day special session at U.N. to review drugs policies. Due to criminalization of injecting drug use, discrimination and lack of funds, many countries face an enormous and unnecessary exacerbation of the HIV epidemic among people who use drugs. UNGASS on drugs constitutes an unprecedented opportunity for civil society to inject new thinking into the debate. Jamie Bridge (representative of The Harm Reduction Consortium) explains: “

For us, it is clear – we cannot end AIDS until we end the criminalisation of people who use drugs. We also cannot end AIDS until we fully support and implement harm reduction.”

TOGETHER WE CAN ENSURE EFFORTS ARE COMPLEMENTARY, STRATEGIC AND IMPACTFUL

Towards the special session on drugs the RCNF grantees The Harm Reduction Consortium and The Consortium of Networks of People who Use Drugs engaged civil society, influenced policy makers and worked out a joint position. Nearly 200 civil society organizations, representing drug policy experts and involved communities aligned to express serious concerns over the failure of governments in recognizing the damaging consequences of the current prohibitionist drug control system. 

“The key has been coordination, both within the Consortium but also with the broader group of drug policy partners, to ensure that our efforts are complimentary, strategic and impactful.” 

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