The wars of Africa are fueled by narcotics. That is an exaggerated over-simplification, but what is less well known than it should be is that many of the internal conflicts of today’s Africa are driven in part, sometimes a substantial part, by profits being made from the trafficking of hard drugs and precursor chemicals. The battles in Mali, in the Central African Republic, in the Democratic Republic of Congo, and Somalia are influenced by criminal drug syndicates allied to al-Qaeda-linked insurgents. The Boko Haram insurgency in Nigeria also has its narcotics component. “Follow the money” is an aphorism relevant for Africa as well as the Middle East.

In the last decade, there has been increasingly big money made from moving cocaine, heroin, methamphetamines, marijuana (hashish), and similar drugs first from Colombia and Venezuela into Africa and north to Europe and, more recently, from Pakistan and India through East Africa to Europe. Once largely confined to West Africa, both the narcotics trade and personal use of such hard drugs has spread to eastern, central, and southern Africa. Almost none of Africa’s 54 nations is without a drug problem, the crime and criminal gangs that shepherd and promote it, the vast proceeds and corruption that accompany and facilitate both trade and abuse, and the social ills that follow.

According to the United Nations Office of Drugs and Crime (UNODC), about 30 tons or $2 billion worth of cocaine passes through West Africa from Latin America to Europe every year, up from about half that amount in 2010. Those totals represent 35 percent of all cocaine smuggled into Europe. About 2000 West Africans are arrested in Europe for cocaine trafficking, about 30 percent of the total number of foreigners caught in Europe for this offence. Bolivia, Peru, and Colombia grow coca and transform coca leaves into cocaine. Where it was once flown directly to West Africa from Colombia, now most of the Europe-bound cocaine that passes through Africa is spirited across the Atlantic Ocean from Venezuela, where crime and corruption are rampant and controls lax. A decade or so ago, ship transport was in vogue. Propeller aircraft followed. Now most of the cocaine from Venezuela to West Africa arrives by jet aircraft, sometimes even combined with otherwise legal cargo.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Drugs, crime, and terror in Africa

Experts are calling it the African “Smack Track”: a circuitous route to smuggle heroin from Afghanistan to Europe, passing through east Africa. Two drug busts in November, netting 712kg of the stuff, closed a record year for heroin seizures off the coast of Kenya. The haul is less a sign of improved policing and more evidence of the growing importance of the route. The largest seizure took place in April, when an Australian warship found more than a tonne of heroin hidden among sacks of cement on a dhow in international waters.

Most heroin from Afghanistan travels to Europe by two main routes: a northern one through Central Asia and a western one via Iran. The minor “southern route” through east Africa has existed since the 1980s, but last year’s seizures—totalling some 3,500kg, according to the UN Office on Drugs and Crime (UNODC)—point to a growth in traffic.

Alan Cole of UNODC says the shift was caused by “improved law enforcement in central Europe and the conflict in Syria”. Stricter border-security checks along the Balkan Route, combined with the increasing risk of getting caught up in expanding wars in the Middle East have made the overland passage less attractive.

Instead smugglers have taken to the seas. Shipments of heroin are unloaded from dhows and cargo ships off the shores of Kenya and Tanzania, and taken ashore on small speedboats. They are then broken up into still smaller packages before being “muled” to Europe from international airports in Kenya and Ethiopia. Sometimes they are consolidated and sent by lorry to South Africa for onward shipping. Some of the heroin enters the African market to feed nascent demand, particularly in Zanzibar, Mombasa and Dar es Salaam, where heroin use is slowly rising. Heroin is also smuggled to consumers in South Africa and Nigeria.

East African states are being undermined by heroin smuggling

Women are frequently marginalized from harm reduction services in Iran despite the growing number of females battling problematic drug use. A handful of media organizations recently ran the story of a "rising" number of women in Iran addicted to drugs, drawing attention once again to an issue that piqued the press' interest earlier last year.

Accurate figures on people suffering from addiction in Iran are notoriously difficult to come by, thoughThe Washington Post reported last May that Iran's Drug Control Headquarters put the number at around 3 million, of which 700,000 are women. Most jarring among the statistics is the fact that the number of female problematic users has doubled in a two-year period.

Opium and its derivatives, along with crystal meth, or 

 (meaning “glass”), are the most popular drugs among Iranian women. Targeting the country's flourishing female middle class, the selling of under-the-counter meth as a slimming aid even used to be relatively widespread among beauty salons until a crackdown in the past couple of years. And, this phenomenon of course says nothing of society's marginalized -- homeless women, sex workers -- who suffer from addiction.

One might imagine that given Iran's track record on drug policy -- the country has some of the most draconian measures in the world and still imposes the death penalty for drug offenses -- services for those addicted would be virtually non-existent. Somewhat surprisingly, this is not always the case, with harm reduction programs such as needle exchanges, opioid substitution, and rehabilitation centers all available, if only on a small-scale.

However, many of these initiatives have been designed solely with the male population of drug users in mind, making them extremely hard to access for women. Drug use -- particularly addiction -- in any society is typically faced with stigma and discrimination, but for Iranian women this is amplified considerably.

Drug addiction in Iran: Women marginalised from services

Asia Catalyst is now accepting applications from community-based organisations in Cambodia, China, Myanmar, and Viet Nam that wish to develop advocacy strategies and implement community-led activities to address challenges that people living with HIV (PLHIV) and key populations encounter when seeking medical attention.

The Regional Rights Training Program, conducted in English, is an intensive one-year capacity-building program aimed at building skills in developing community-based advocacy campaigns to respond to discrimination in healthcare settings through a series of hands-on workshops, peer support and individualized coaching. The aim of the program is that each organization will develop knowledge and a set of skills to better analyze the barriers that lead to challenges for PLHIV and key populations to access quality healthcare services; learn how to design a community-based research project; and develop and implement a local or national campaign using their research results.

Please see below additional details, and for the application form for this program. Applications are due by January 24, 2015.

Call for applications: Asia Catalyst Regional Program

A recent large-scale online study entitled “Clubbing and Youth Health” concluded that recreational drug use is very common in party settings among Serbian youth. The younger generations, driven by their curiosity, often lack adequate harm reduction tools and information, leaving them unprepared to face numerous risks related to unsafe drug and alcohol use. The study brings evidence for the need to make party harm reduction services widely available across the country. This led Re-Generation in cooperation with Drugreporter to dedicate the latest episode of our Drugfacts infographic series to the issue of harm reduction in party settings in Serbia.

Infographic: Harm reduction in party settings in Serbia

Rates of new HIV infections and AIDS-related deaths are rising faster in the Middle East and North Africa than anywhere else globally. According to the latest data available from the Joint UN Programme on HIV and AIDS (UNAIDS), there are 230,000 people living with HIV in the 21 countries that make up the organization’s definition of the Middle East and North Africa (MENA).

This is still a very low prevalence of 0.1 percent - compared to parts of southern Africa where one in four people have HIV. Yet while the most-affected regions are now reducing their new infection rates and AIDS-related deaths, and increasing their treatment reach, the opposite is happening in MENA.

In 2013 the region lost 15,000 people to the disease, a 66 percent increase on 2005, and despite new infections declining globally by 38 percent since 2001, in MENA they have risen over the same period. “It’s not the absolute level of HIV in the region that we should be concerned about - serious though it is - but it’s the slope of the growth curve that is alarming,” said Shereen El Feki, a leading HIV activist and former vice-chair of the Global Commission on HIV and the Law.

“For the moment HIV in MENA is a concentrated epidemic among certain key populations - such as men-who-have-sex-with-men, female sex workers, people who use drugs,” she explained. “They are engaged in practices and behaviours that are socially and religiously condemned, and in the vast majority of countries in the region, all three are illegal.”

“These populations are in the shadows, and governments have difficulties engaging with them because even if the Ministry of Health stretches out one hand, then the Ministry of Interior may stretch out the other and put them in prison,” El Feki, the author of Sex and the Citadel, a book exploring sexuality in the Arab world, added.

Owing to stigmatization around the behaviours that expose people to HIV/AIDS in MENA, there are no totally reliable figures on infection rates, and even UNAIDS gives a range of between 160,000 and 330,000 of people living with HIV. “It’s very difficult to know the actual incidence and prevalence rates because people are afraid to be tested if they are in those risk categories for all sorts of reasons, including that they may end up in prison,” Paul Galatowitsch, an adjunct professor in the School of Public Health at New York Medical College and executive director of New York-based disease strategies consultancy Health Clear Strategies (HSC), told IRIN.

Dr Ali Feizzadeh, regional strategic information adviser with UNAIDS MENA acknowledged there were surveillance gaps. “Syria, Lebanon and Iraq, plus a few others in the region, have not been able to have any estimation of the size of their HIV epidemic, and for the case of Syria and Iraq even any report on the actual number of people receiving treatment,” he said.

Highest global rise in HIV and AIDS reported in Middle East 

The Indian government has taken a significant step to help alcohol and drug abusers by launching a national toll free helpline number - 1800-11-0031. The Social Justice & Empowerment Minister Thaawar Chand Gehlot launched the helpline with the technical support from a public sector enterprise. The ministry works towards reducing drug dependency and enhancing the rehabilitation of victims. The newly launched helpline would provide assistance six days a week between IST 9:30 a.m. to 6:00 pm.

According to a survey by the Social Justice and Empowerment Ministry and UNODC, India has more than 70 million drug addicts, and the major reason seems to be easy availability and cheap rates. The low rates are essential due to the nation’s close proximity with drug areas in countries such as Afghanistan, Pakistan and Bangladesh.

Indian government launches helpline for drug users

The forthcoming special issue of the International Journal of Drug Policy (IJDP) will have the focus on drug use and Africa. The primary focus of the call is illicit drug use, but we the IJDO will also consider abstracts for papers with a focus on alcohol and tobacco.

The call is initially for outline abstracts, with a deadline of January 15th, 2015.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

International Journal of Drug Policy calls for papers for special issue focused on Africa 

The past couple of years have been game-changers for harm reduction. The movement to reclaim the health and dignity of people who use drugs has celebrated the rapid passage of overdose prevention and syringe decriminalization laws, expanded access to the life-saving overdose reversal drug naloxone, and welcomed endorsements from such prominent, previously skeptical agencies as the Office of National Drug Control Policy, the American Medical Association and the Centers for Disease Control.

Big Pharma’s new interest in naloxone is a key development to watch this year. When naloxone first debuted on the market in 1961, emergency departments and ambulances scrambled to stock the miracle drug and pharmaceutical companies rushed to make it. But once this very specific demand was met, the drug was no longer considered profitable and interest in manufacturing petered out. By 2008, one company, Hospira, held a monopoly on injectable naloxone, while another, IMS/Amphastar, sold the only form of naloxone that could be adapted for intranasal use.

Why 2015 is a huge year for harm reduction?

The Minister of Health and Quality of Life, Mr A.K. Gayan, announced today during a press conference in Port Louis that as from Saturday 10 January 2015 the methadone substitution therapy programme will be further decentralised in the sense that there will be more than just one site for the distribution of methadone in a particular region.



Taking the example of Beau Bassin -Rose Hill region where some 900 patients are converging to just one site he announced that as from this coming Saturday some seven sites will be used for the distribution of methadone.

Minister Gayan pointed out that this decentralisation has been made possible with the help and support of the police as most of the new sites will be in the yard of some police stations where caravans will be used for the distribution of methadone. He also underlined that henceforth the distibution of methadone henceforth will be from 06 00 hours to 08 00 hours instead of 09 00 hours.

Those who will benefit from this program after recommendation from the Non-Governmental Organisations will be handed over a card containing their details and must bring along their identity card to benefit from the programme said Minister Gayan. He added that the Ministry of Health and Quality of Life reserves the right to remove the card of any patient if that person does not abide to the set of rules under this programme.

Mauritius: Health Minister announces decentralisation of the methadone substitution therapy programme

The Civil Society Forum is a broad platform for a structured dialogue between the Commission and the European civil society which supports policy formulation and implementation through practical advice.

The Directorate General Migration and Home Affairs (DG HOME) of the European Commission invites non- governmental organisations and networks to apply for membership of the EU Civil Society Forum on Drugs (CSF) 2015-2017.

Click here to read more information and download the application form.

Call for the expression of interest to become a member of the EU Civil Society Forum on Drugs

At the national harm reduction conference in Budapest, presenters from Greece, Romania and Hungary reported that there are similar problems and challenges in relation to injecting drug use in Southern-Central Europe, but there are huge differences between government responses. Lack of political leadership is leading to growing HIV and hepatitis C infections among drug users all over the region.

In Budapest, on December 16, at the national harm reduction conference organised by the HCLU, a number of service providers, activists, law enforcement professionals, and researchers gathered to discuss the key challenges lying ahead for harm reduction. The opening speech pointed out that there is a global funding crisis within harm reduction: the UN estimates that 2.3 billion USD are needed to fund HIV prevention programs among injecting drug users, but only 160 million USD are actually being spent. International donors are retreating from middle-income countries, where most IDUs live, and national governments are not providing adequate funding for harm reduction programs. The consequences are obvious: life-saving services are being shut down, access to existing services is restricted, and the risk of blood-born infections is growing.

In Hungary - an EU member state that is not eligible to receive Global Fund money - lack of political and financial support led to the closure of the largest needle and syringe program, and other NSPs are in danger too. This happened in a neighbourhood where eight out of ten IDUs are living with the hepatitis C virus, and new HIV transmissions have been reported as well.

While Hungarian government regulations require NSPs to employ at least 3 full-time and 1 part-time professionals, the annual core grant (appr. 25.000 USD) for these programs is not even enough to pay the salaries of these employees, not to mention growing overhead and equipment costs. Therefore NGOs submitted a proposal for a new progressive funding mechanism for harm reduction programs - suggesting an increase in the core grant, to 50.000 USD, and provision of additional funds for supplementary services, such as drop-in, as well as for supply of good-quality needles and syringes.

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