A decade of drug policies: where does the world go from here?

By Bangyuan Wang

By Bangyuan Wang, the Alliance’s senior technical advisor on HIV and harm reduction

Next year, it will be time to take stock of where the world stands on drug control, a decade after the 2009 Political Declaration and Plan of Action on illicit drugs was made. At the UN Commission on Narcotic Drugs (CND) ‘Ministerial Segment’ meeting, countries will come together to assess the past ten years and shape the next decade of targets.

<p>There are only two methadone facilities in Kenya's Coast province and Winnie Nyawira, 32, travels from Watamu to Malindi every day to recieve her medication.</p>
<p>"Methadone isn&rsquo;t sweet to the taste, and its reactions are as strong as any other drug. But those who are determined to arrest drug use must brave it to the very end. Two years of methadone is easier than a life time in drug-use."</p>
<p>Winner is a mother of a 18-year-old boy and says that she is proud that she brought up her son even though she was using drugs.</p>
<p>"My son is one of my reason to quit drugs."</p>
<p><span style="font-size: 13px;"><span style="background-color: white;">&nbsp;</span></span></p>Winnie Nyawira, 32, recieving methadone in Malindi, Kenya © Corrie Wingate for the Alliance 2017

The impact of these discussions on the lives of people most affected by HIV should not be underestimated. With people who inject drugs 28 times more at risk of HIV than the general global population – a risk that arises from sharing needles and injection equipment but is reinforced through criminalisation, marginalisation and poverty – there is much at stake.

Along with the International Drug Policy Consortium (IDPC), Alliance Linking Organisations and partners involved in our PITCH programme are now working to bring four key advocacy asks to the attention of the officials who will attend the CND meeting. So what is it, exactly, that we are asking for?

Move away from ‘drug-free world’ targets

Since the 2009 Declaration much has happened. In 2016, the UN General Assembly Special Session on Drugs (UNGASS) led to a set of commitments that moved away from punishing drug use to focus on protecting the health and human rights of people who use drugs. The UNGASS 2016 outcome document containing these commitments is very progressive. Although it doesn’t specifically use the phrase ‘harm reduction’, it contains a comprehensive list of harm reduction interventions, such as needle and syringe exchanges, education on safe injecting practices, and opioid substitution therapy.

Yet a number of countries, including some with great power and influence such as China, Russia and Pakistan, want to push back the agenda and refer to older conventions that use ‘a world free of drugs’ as their final target. The greater number of countries that work to 2016 targets, the more likely we are to create an open dialogue about what progress should be defined as, and what the point of drug policies should be.

End punitive approaches to drug use: put people and communities first

We are currently preparing contributions to a review by the UN’s Human Rights Office of the High Commission (ONCHR) to show how the target of a drug free world has been used as an excuse for countries to crack down on drug use and violate human rights, including extrajudicial killings.

In countries where PITCH operates we are implementing REAct, a tool for documenting and responding to individual human rights violations among key populations. We hope this will provide a rich source of evidence for the review.

For example, in Zimbabwe, Indonesia and Vietnam, if a person who uses drugs seeks health services, and a nurse or doctor realises they use drugs, not only will they not provide assistance, they will call the police. The police will then force that person to do a urine test and they will end up in prison or a compulsory rehabilitation centre. If they are living with HIV this means they are more likely to become ill and more likely to pass HIV on to others. This situation helps no one, but unless we end punitive approaches to drug use, it will continue.

Reflect the UN goals of health, human rights, development, peace and security

Drug policies that focus on health and human rights are possible. Although the majority of countries that have progressive approaches to drug use are in the global North, some countries in the global South are starting to reflect UNGASS 2016 commitments in their drug policies, such as Myanmar and Ghana.

The 61st CND, which took place last month, provided an opportunity for these countries to show others that changes are possible. A packed side-event, which the Alliance held with IDPC and Harm Reduction International, saw the director of Myanmar’s Central Committee for Drug Abuse Control describe the process that led the country to decriminalise drug possession and use in February. Officials from Kenya, Malaysia and Nigeria were all in the room and, we hope, were listening.

The next step is to work, not only within side events, but at the main CND and ministerial segement. We want countries like Myanmar to publically state that they are in the process of changing, or have already changed, the law, or at least started a national debate for more scientific, evidence-based drug policies that prioritise the human rights and health of people who use drugs, rather than policies based on ideology that continue to chase the notion of a drug free world.

Reflect the positive and negative realities of drug policies on the ground

In 2017, UNODC’s World Drug Report described the drug market as ‘thriving’. When countries gather next year to evaluate the progress made on drug control in the past decade, we need to present evidence generated through a transparent, scientific, and inclusive evaluation process; one that honestly reflects the reality of what has, and what hasn’t, worked.

To this end, Alliance Linking Organisations and PITCH partners are working with IDPC to write a shadow report that evaluates both the negative and positive realities of current drug policies and identifies possible new ways to measure success over the next decade.

Looking beyond 2019 to the next decade

There is much to be done, but these four key areas show the way forward. As preparations continue for 2019 and beyond, I am hopeful civil society will continue to increase its influence on policy makers so the changes needed in so many countries can happen, and the lives of millions of people who use drugs will improve as a result.