Saturday, January 31, 2009

The Future of Harm Reduction: The US and the countdown to Vienna

The latest on this story from Reuters (including transform quote) and more importantly, given the high level audience in the States, a New York Times editorial ( below).

Update: The Guardian 03.02.09: Rift with EU as US sticks to Bush line on 'war on drugs' (including Transform quote)

from Reuters

U.S. and Europe split over drugs policy

By Luke Baker

LONDON (Reuters) - U.N.-sponsored negotiations on a new global drugs strategy are close to breaking down, with profound divisions between Europe and the United States on key policy issues, participants at the talks in Vienna say.

The problem is that U.S. negotiators are trying to push through anti-drug programmes that were promoted during the former Bush administration but which are no longer advocated by President Barack Obama, they said .

Whereas former President George W. Bush believed in a zero-tolerance approach in the war on drugs, one of Obama's first moves was to back the lifting of a ban on federal funding for needle-exchange programmes. He also gave tacit support to so-called "harm-reduction" strategies that are seen as crucial in the fight against drug-related diseases such as HIV/Aids.

The Vienna stand-off, which threatens to scupper a March summit at which the new drug policy declaration is to be signed, has prompted Democrats in Congress to write to the new U.S. ambassador to the United Nations calling for intervention.

Drug policy campaigners say that without a change in the U.S. position, anti-drug strategies could be set back for the next decade and have a knock-on impact on the spread of HIV/Aids and other diseases.

"We understand that the U.S. delegation in Vienna has been actively blocking the efforts of some of our closest allies -- including the European Union -- to incorporate in the declaration reference to harm reduction measures, such as needle exchange," read the letter, sent to Susan Rice on Wednesday and signed by California Congressman Henry Waxman, among others.

The U.S. delegation should be given new instructions from the new administration, it said.

"Otherwise, we risk crafting a U.N. declaration that is at odds with our own national policies and interests, even as we needlessly alienate our nation's allies in Europe."

Officials close to the U.S. negotiators in Vienna denied that Bush-era policies were being "rammed through" but said instructions from Obama administration had not been received.

"We are currently hearing out proposals, keeping options open and Washington informed. Our new administration will continue to review and develop our negotiating positions," a spokeswoman for the U.S. mission in Vienna said:


The Vienna negotiations, under the auspices of the U.N. Office on Drugs and Crime, have been going on intermittently for several months but are due to wrap up before a summit on March 12-13 when the new declaration is due to be signed.

While the United States is the chief proponent of a zero-tolerance approach to the estimated $160 billion (111.9 billion pound) illegal drugs industry, it has support from Russia and Japan, neither of whom support 'harm reduction' policies, which can include medication-assisted therapy and drug legalisation.

The European Union's policy position is supported by Australia, Latin America and Iran, among others, all of whom favour policies that include harm-reduction measures.

Drug policy campaigners believe that if the United States could be brought closer to the European position, Japan, Russia and others including China and India would follow, potentially producing consensus on a new global drugs strategy.

"Time is very tight and the race is now on to change the instructions from U.S. officials before the ink dries on the previous administration's line," said Danny Kushlick, head of policy at Transform, a British drug policy foundation.

"The implications of changing the political line is enormous for those who have suffered under the U.S. administration's refusal to support basic harm reduction measures."

U.S. sources said that while it was not impossible that the negotiating position could be changed, it would only happen once new instructions were issued from Washington.

At the same time, while the Obama administration differs from Bush, it does not advocate all 'harm reduction' strategies, which can include drug consumption rooms, safe-injecting rooms, and providing heroin and needles in prisons.

(Additional reporting by Mark Heinrich in Vienna)

(Editing by Angus MacSwan)

from the New York Times:

Time lag in Vienna

"Programs that give drug addicts access to clean needles have been shown the world over to slow the spread of deadly diseases including H.I.V./AIDS and hepatitis. Public health experts were relieved when President Obama announced his support for ending a ban on federal funding for such programs.

Unfortunately, Mr. Obama’s message seems not to have reached the American delegation to a United Nations drug policy summit in Vienna, where progress is stalled on a plan that would guide global drug control and AIDS prevention efforts for years to come. The delegation has angered allies, especially the European Union, by blocking efforts to incorporate references to the concept of “harm reduction” — of which needle exchange is a prime example — into the plan.

State Department officials said that they were resisting the harm-reduction language because it could also be interpreted as endorsing legalized drugs or providing addicts with a place to inject drugs. But the Vienna plan does not require any country to adopt policies it finds inappropriate. And by resisting the harm-reduction language, the American delegation is alienating allies and sending precisely the wrong message to developing nations, which must do a lot more to control AIDS and other addiction-related diseases.

Some members of Congress are rightly angry about the impasse in Vienna. On Wednesday, three members fired off a letter to Susan Rice, the new American ambassador to the United Nations, urging that the United States’ delegation in Vienna be given new marching orders on the harm-reduction language. If that doesn’t happen, the letter warns, “we risk crafting a U.N. declaration that is at odds with our own national policies and interests, even as we needlessly alienate our nation’s allies in Europe.”


Martin said...
You may like this video.

David Raynes said...

Steve & Danny
according to my information which is very well sourced, "Obama's people" were intimately involved in preparing the respnse/position for Vienna and consulted all along the way. There is an element of spinning going on no doubt. It would not surprise me at all if the US position does not change. The UK Government has stated emphatically it wishes no change in the conventions.

Steve Rolles said...

Obama's public position on needle exchange for example clearly differs from the Bush position though. He has a much more pragmatic public health approach than his dogmatic drug war predecessors who refuse to even use the words harm reduction - let alone discuss anything around convention reform. Having been at the Vienna NGO conference and last to UN Commission on Narcotic drugs events it certainly seems to be a welcome change in tone not reflected in the position of the US representatives at the UN.

Also no changes in the conventions are required for harm reduction measures. That includes supervised consumption rooms - as made clear by a legal opinion commissioned by the INCB.

There is an active debate about making the conventions 'fit for purpose', in no small part started by the paper Costa (UNODC director) wrote called, unambiguously, 'making drug control fit for purpose'. Given the stunning failure of the conventions over the past 40 years this can only be a good thing. Its a debate based on looking at evidence and how the world has changed since the 40s when most of the single convention was drafted. I hope all would welcome this.

in Costa's paper he says;

“There is indeed a spirit of reform in the air, to make the conventions fit for purpose and adapt them to a reality on the ground that is considerably different from the time they were drafted. With the multilateral machinery to adapt the conventions already available, all we need is: first, a renewed commitment to the principles of multilateralism and shared responsibility; secondly, a commitment to base our reform on empirical evidence and not ideology; and thirdly, to put in place concrete actions that support the above, going beyond mere rhetoric and pronouncement." (p.13)

“Looking back over the last century, we can see that the control system and its application have had several unintended consequences - they may or may not have been unexpected but they were certainly unintended.” (p.10)

“The first unintended consequence is a huge criminal black market that thrives in order to get prohibited substances from producers to consumers, whether driven by a 'supply push’ or a 'demand pull', the financial incentives to enter this market are enormous. There is no shortage of criminals competing to claw out a share of a market in which hundred fold increases in price from production to retail are not uncommon”. (p.10)

“The second unintended consequence is what one night call policy displacement. Public health, which is clearly the first principle of drug control…was displaced into the background”. (p.10)

“The third unintended consequence is geographical displacement. lt is often called the balloon effect because squeezing (by tighter controls) one place produces a swelling (namely an increase)in another place…” (p.10)

“A system appears to have been created in which those who fall into the web of addiction find themselves excluded and marginalized from the social mainstream, tainted with a moral stigma, and often unable to find treatment even when they may be motivated to want it.” (p.11)

“The concept of harm reduction is often made into an unnecessarily controversial issue as if there were a contradiction between (i) prevention and treatment on one hand and (ii) reducing the adverse health and social consequences of drug use on the other hand. This is a false dichotomy. These policies are complementary. (p.18)

“It stands to reason, then, that drug control, and the implementation of the drug Conventions, must proceed with due regard to health and human rights.” (p.19)

Anonymous said...

Dave you are sounding more desperate with each post.
An Obama in the harm reduction hand is worth thousands of prohibitionists in the Bush.
There is an air of hope and change in the wind and the chances are that this will translate into reform over the next few years. And if Obama remains for two terms we could see the beginning of the demise of the whole prohibitionist structure.
Your plans are shot and your sick legacy will stand for what it was - death for hundreds of thousands.

Jason Farrell said...

Until Obama lifts the federal ban on funding needle exchange programs there will not be much change. Even when the federal ban is lifted, i expect there will still remain infighting among legislators on state level to implement such programs in there respective state. Additionally due to the current economic situation herein the US, there is no money to fund new programs let alone keep existing ones well funded.

To date the fact that Obama has removed restrictions attached to global AIDS and USAID funding on abortion, abortion education, and condom distribution is a great beginning.

Lets hope that the Obama drug and HIV policy will influence a new direction of utilizing humanistic pragmatic scientific proven approaches. Hopefully the new US drugs and HIV policy will be as enlightening as the election of an African American president.

Will said...

David Raynes,

this isn't the 1980s,you know.Back then,all your tough talk and heartless posturing was state-of-the -art drug policy.
The world has moved on,and so should you!
Prohibition will fall within the next 15-20 years,and i am very much looking forward to your comment on this blog when it happens.
Mind you,WHEN,not IF...