Pubdate: Wed, 20 Apr 2016
Source: Star, The (South Africa)
Copyright: Independent Newspapers 2016
Author: Kerry Cullinan


Many members of the UN General Assembly are tired of the problems 
borne of criminalising drug users, and will be making the case 
instead for harm-reduction programmes, writes Kerry Cullinan

For the first time in 20 years, the UN has convened a special session 
on "the world drug problem" amid fierce international debate about 
whether drug users should primarily be punished or rehabilitated.

The UN General Assembly Special Session on drugs, which started 
yesterday and runs until tomorrow, was called after Mexico, Colombia 
and Guatemala appealed to the body to revise the global approach to 
illegal drugs.

After two decades - and a trillion or so dollars - later, the 
war-on-drugs approach of criminalising drug users has failed to 
prevent the distribution and use of illegal drugs.

Many countries and organisations are calling for the global approach 
to be tilted in favour of harm-reduction strategies that help drug 
users to deal with their addiction rather than imprisoning them.

Harm-reduction strategies include opioid substitution programmes, 
where injecting heroin users are offered oral methadone instead to 
help them to reduce their drug dependency and needle exchanges, 
offering injecting drug users clean needles to reduce their chances 
of getting HIV and hepatitis C.

But there is an almighty war about future policy in a world where a 
person can be executed in Indonesia for drug possession, but use the 
same drugs without imprisonment in Portugal and the Czech Republic.

South Africa has been pulled in different directions by the lobbying.

Russia, a key advocate of the punitive approach, held a joint meeting 
with African countries in Durban recently in an attempt to sway this 
continent to support the punitive status quo.

But it appears that the harm-reduction approach adopted last year by 
the AU is gaining traction.

South Africa's Deputy Social Development Minister Hendrietta 
Bogopane-Zulu has played an important role in promoting harm 
reduction as chairwoman of the AU's technical committee on health, 
population and drug control.

The AU common position emanating from this technical committee 
stresses a harm-reduction approach that is "evidence-informed, 
ethical and human rights-based" and offers "dependence treatment and 
after-care services".

At a meeting in Vienna last month, Bogopane-Zulu said: "I would 
strongly support an approach where drug users form their own network 
to discuss their problems, that they have focal points in police 
stations and at hospitals with whom they can interact on their 
concerns and very importantly, that religious and traditional leaders 
be trained alongside criminal justice system professionals on, among 
others, harm-reduction approaches."

But South African policy on the ground at the moment is quite 
different. The TB/HIV Care Association offers clean needles to drug 
users, but reported almost 250 cases of police harassment in just 
three months last year.

Meanwhile, there is only one site in the entire country that offers 
opioid substitution for heroin addicts.

Unfortunately, the "outcome document" negotiated prior to the UN 
General Assembly makes no mention of harm reduction and has been 
condemned by almost 200 civil society organisations headed by the 
International Drug Policy Consortium.

The Vienna meeting that prepared the outcome document was dominated 
by Russia, which takes a heavy-handed approach to drugs.

Drug addiction is a huge and growing problem in Russia, which has an 
estimated 8 million heroin users  about 6 percent of its population.

According to the civil society organisations, the draft outcome 
document's goal of "a society free of drug abuse" by 2019 "is 
delusional and dangerous, framing and distorting the entire policy 
response, prioritising the elimination of drugs above health, 
well-being, human rights and the reduction of drug-related harm".

They say that if the UN General Assembly endorses the current 
approach to drugs, it will be a huge waste of money as the current 
approach has caused a litany of problems including:

Human rights abuses, including the death penalty for drug offences.

The exacerbation of HIV and hepatitis C transmission.

Inadequate access to controlled drugs for medical purposes.

187 000 avoidable drug-related deaths each year.

Violence, corruption and killings perpetuated by criminal drug markets.

The stigmatisation of people who use drugs.

The destruction of subsistence farmers' livelihoods by forced crop eradication.

Last month, a 22-person commission of experts convened by Johns 
Hopkins University and the medical journal The Lancet,called for the 
decriminalisation of all non-violent drug use and possession.

The Hopkins-Lancet commission said drug prohibition was not 
evidence-based and was causing harm, namely:

Exacerbating violence between criminal networks and authorities: "In 
Mexico, the striking increase in homicides since the government 
decided to use military forces against drug traffickers in 2006 has 
been so great that it reduced life expectancy in the country."

Driving infectious diseases, particularly in prisons: The "excessive 
use of incarceration as a drug-control measure" brought drug users 
together in prisons where "HIV and hepatitis C virus transmission 
occurs among prisoners and detainees and is often complicated by 
co-infection with tuberculosis".

Displacing rural communities who produce crops of coca leaf, opium 
poppy, and cannabis, while the spraying of their crops with poisons 
had caused "respiratory and dermatological disorders and miscarriages".

"Policies meant to prohibit or greatly suppress drugs have 
contributed directly and indirectly to lethal violence, 
communicable-disease transmission, discrimination, forced 
displacement, unnecessary physical pain and the undermining of 
people's right to health," concluded the commission.

The UN negotiations are likely to be complicated and technical, but 
the insertion of two words  "harm reduction"  will make a huge 
difference to people struggling with drug dependence as it will 
compel authorities to see them as people with a health problem rather 
than criminals.
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MAP posted-by: Jay Bergstrom