FT weekend magazine cover story: "Legalise the Lot"

We mentioned this excellent recent article by Mathew Engel in the Financial Times in the miniblog but I thought it was worth posting a scan* of the FT weekend magazine cover.




That this article appeared in the FT is significant given its readership and prestige within the media, and the fact that it made the magazine cover so prominently is testimony to how mainstream the reform arguments have become.



* sorry the scan is a bit rubbish - my only copy got a bit crumpled

United Nations Drug Policy - the Skeptics Chime In

This short flim produced by the HCLU in conjunction with uber-blog Boing Boing provides commentary from various figures in the drug policy reform movement on the current events at the UN in Vienna where the Commission on Narcotic Drugs is meeting to determine global drug strategy for the next ten years. (Danny from Transform appears in the film).





See also

• Fear prevails at the UN as voices for drug law reform are smeared
  
  
• UN bodies betray principles of peace by supporting the war on drugs

Mexican Drug War – El Paso raises debate on prohibition

As the UN member state delegations gather their forces for the upcoming UN drug strategy review, it is vitally important to recognise the value of local activity in raising the debate on alternatives to global prohibition.

In response to the Mexican drug war taking place on their border, El Paso City Council, Texas, has taken the courageous step of calling on Congress to discuss drug legalisation as an option for ending the damage caused by prohibition.

Last Tuesday the Council voted 8-0 on a resolution drafted by the city's Border Relations Committee, outlining 11 steps the U.S. and Mexican governments can take to help El Paso's "beleaguered and besieged sister city."

All city representatives also supported an amendment by South-West city Rep. Beto O'Rourke that added a 12th step: the encouragement of the U.S. federal government to start a "serious debate" on the legalization of drugs.

See O'Rourke in action in this video, making a hell of a lot of sense.

Followed by more coverage:here, here, here, and here

Why not send a message of support to the Council.

The El Paso initiative shows how a city-wide initiative can impact internationally. This was the case when London Borough of Camden Council recommended legal regulation to the Home Affairs Select Committee drugs inquiry of 2001:

"Given the failure over several years, and across numerous agencies and countries, to have any significant effect on the supply side of the drug market, we feel it is time to consider seriously the option of undercutting the illicit market with a regulated legal market."

And, given that the drug war is creating havoc everywhere, why not contact your local council representative and try and start something like this near you. Here is one of our trustees, Gary Wallace, doing just that in his local paper: The drugs debate

Camden Council's was one of the submissions (that included Transform's), that influenced the Committee in making its final recommendation, calling for a debate on legalisation and regulation. And is worthy of note in the run up to the UN drug strategy review in March this year.

"We recommend that the Government initiates a discussion within the Commission on Narcotic Drugs of alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma."

David Cameron, perhaps our next Prime Minister, then a back bench MP, was a member of the committee and voted for this recommendation. You may want to drop him a line too...

The El Paso initiative is in advance of talks that will take place between President-elect Obama and Mexican President Calderon that will focus on the Mexican drug war. For more on the way that the drug war horrors have escalated in Mexico over the last few months see:

• Mexico’s Unsuccessful Drug War, Painfully Preserved and Hidden
• U.S. war on drugs has failed, report says
• Mexico's Violent Drug War Wreaks Havoc on Innocent Lives
• The War Next Door
• The £15bn drugs war that has cost 7,000 lives in 2 years
• Strategies for Mexico's drug war

Experts and public figures in the U.S. and Latin America offer a range of views, from stepped-up policing to legalization. And drug war created havoc continues as the knock on effect takes place:

• Mexico Rejects Guatemala’s proposal on War Against Drugs
• Drug smugglers threaten to destroy democracy in Ghana

And, just to bring the story home to us, here in the US of England, Lily Allen told the Mail: 'Drugs won't kill you', insists Lily Allen ('and yes, I've given up')

"Lily Allen was condemned last night for suggesting that the risks of cocaine are overstated. The 24-year-old singer said: 'The only story is that drugs are bad and they will kill you - you will become a prostitute, a rapist or a dealer. But that's not true. 'I know lots of people that take cocaine three nights a week and get up and go to work everyday, no problem at all."

I was called for a comment on the Lily Allen story. I suggested that the furore was about a culture clash, whereby drug use is normalised in certain subcultures. Whilst, to the outsider this behaviour appears aberrant and worthy only of condemnation. I went on to say that the most important point was to accept the reality that millions use drugs and that the priority was to keep users safe. Predictably they preferred Dominic Grieve of the Tory Party and David Raynes from the National Drug Party Prevention Alliance.

Alex Wodak defends harm reduction, under attack from the World Forum Against Drugs

Following the recent World Forum Against Drugs in Sweden, the Executive Director of the US based Drug Free Schools Coalition , David Evans, sent an email to a number of colleagues in the field encouraging them to sign the declaration from that event (which you can read here in pdf). It is an extraordinary document in many ways, not least because of its inexplicable misunderstandings of the UN legal system (un-picked on the IHRA HR2 blog here), but also because of the alarming and sweeping disdain it demonstrates for harm reduction. We may discuss it further on the blog at some point but really, it's so exotic as to render itself almost completely irrelevant to real world debate. It's actually self neutering. And if it really is going to be the banner for the remaining defenders of the drug war, then the drug peace is probably nearer than we might have hoped.

Anyway, one of the colleagues in the drugs field who received the letter was Alex Wodak, long time harm reduction practitioner, researcher and campaigner, and board member of the International Harm Reduction Association. Unsurprisingly perhaps, he declines Evan's invitation to sign the declaration, and his considered and detailed response is copied below.

Dear David,

While I am pleased that you have opened up this dialogue, I cannot accept your invitation to support the Declaration of World Forum Against Drugs.

Let me explain some of the reasons why.

(1) In the 1300 word WFAD Declaration about illicit drugs and drug policy, neither HIV nor AIDS were even mentioned once. Yet AIDS is now the fourth major cause of death in the world. The sharing of needles and syringes now accounts for 30% of new HIV infections outside Sub Saharan Africa (or 10% of all new global HIV infections). The only known effective way of controlling HIV infection among injecting drug users is a harm reduction package including explicit and peer-based education about HIV, needle syringe programmes, drug treatment (especially methadone and buprenorphine treatment for heroin injectors) and community development of injecting drug users. Needle syringe programmes and methadone and buprenorphine treatment have been shown to be effective in reducing HIV and also to be safe and cost effective. Yet the WFAD Declaration does not even mention these interventions. The effectiveness and safety of needle syringe programmes have been confirmed by more than half a dozen reviews commissioned or conducted by agencies of the US government and a review commissioned by the WHO. WHO, UNAIDS and UNODC have endorsed methadone and buprenorphine treatment and the WHO has included these medications in their Essential Drugs List. The important association of injecting drug use and HIV has changed the way we now think about drug policy. It should also influence the way that the WFAD thinks about drug policy.

(2) In virtually all countries, the health, social and economic costs resulting from the legal drugs, alcohol and tobacco, dwarf the serious problems associated with the use of illicit and psychotropic drugs. Yet the WFAD Declaration does not even mention alcohol or tobacco, let alone the problems associated with prescription drugs.

(3) The use of mood altering drugs has been found in virtually all countries and cultures throughout history. Accepting this reality is not an endorsement of mood altering drugs. It simply reflects a preference to deal with the world as it really is rather than some fantasy world some would prefer to live in. If the WFAD believes that the objective of a drug free world is realistic and not utopian, WFAD should list the countries or cultures that have already achieved an enduring drug- free state.

(4) The WFAD Declaration ignores the substantial and growing international support for harm reduction. UN and international organizations supporting harm reduction include WHO, UNAIDS, UNICEF, the Global Fund for AIDS, TB and Malaria, the World Bank. The UNODC increasingly supports harm reduction (although this organisation still has some senior staff critical of harm reduction). About 70 countries provide needle syringe programmes and a larger number provide methadone or buprenorphine treatment. Why does the WFAD still need to refer to harm reduction as 'so-called'? Why still refer to harm reduction in quotation marks? The scientific debate about harm reduction is now over. That is why support for harm reduction is now so strong and growing so steadily. In contrast, support for zero tolerance is steadily shrinking because zero tolerance is based on belief, not science. At the 'Beyond 2008 NGO Forum' held in Vienna 7-9 July 2008, 300 NGO delegates from around the world endorsed a Declaration which supported harm reduction, the protection of human rights and the involvement of affected communities.

(5) Supporters of harm reduction recognize the importance of promoting abstinence. In some ways, abstinence is the ultimate form of harm reduction. But some are unable and others are unwilling to aim for abstinence. As a doctor it is my duty to still try and help these patients. Also, abstinence is often precarious. And when relapse occurs, it is often accompanied by very severe harms, sometimes even death. The assertion that harm reduction undermines 'the international efforts to limit the supply of and demand for drugs' is ludicrous. What undermines international efforts to limit the supply of and demand for drugs is the law of supply and demand. As former US Secretary of Defense Donald Rumsfeld said in January 2001 'If demand [for drugs] persists, it's going to find ways to get what it wants. And if it isn't from Colombia, it's going to be from someplace else.' If a kilogram of heroin is worth $US 1,000 in Bangkok and $US 300,000 in New York City, why will that kilogram of heroin not end up in Times Square? If we cannot keep drugs out of prisons, and we are unable to do this, how on earth can we keep drugs out of our communities?

(6) The assertion in the Declaration that harm reduction 'violates the UN Conventions' is also absurd. Which Conventions does harm reduction violate? The INCB commissioned a study from the Legal Affairs Section of the UNDCP entitled 'Flexibility of Treaty Provisions as regards Harm Reduction Approaches' E/INCB/2002/W.13/SS.5. 30 September 2002. This document concluded that harm reduction interventions do not breach the international treaties (with the possible exception of pill testing).

(7) The Declaration claims that there 'can be no other goal than a drug-free world. Such a goal is neither utopian nor impossible'. How can the same goal be appropriate for every country in the world despite such diverse conditions and problems? Is a drug-free world really feasible? Since the 1998 UNGASS meeting, global opium production has more than doubled from 4,346 tons to 8,880 tons while global coca production has increased by 20% from 825 tons to 994 tons. Remember the UNODC slogan for the 1998 UNGASS? 'A Drug Free World - we can do it!' Now the UNODC speaks of 'containment' and making 'drug policy fit for purpose'. As President George W. Bush said on February 12, 2002 'As long as there is a demand for drugs in this country, some crook is gonna figure out how to get 'em here...'

(8) Harm reduction is a universal approach, common in public health, clinical medicine and public policy generally. Wearing a safety belt when traveling by car or encouraging the use of motor cycle helmets is harm reduction. 'Never let the best be the enemy of the good' is a strong tradition in public health. It is also the essence of harm reduction. Nicotine gums and skin patches to assist smokers to quit smoking are other forms of harm reduction, no different in principle from the use of methadone or prescription heroin to assist heroin injectors and inhalers. I recently visited the former Nazi concentration camp in Terezin. Oscar Schindler in nearby Crackow saved many lives but did not shorten the war by a single day. We rightly revere the actions of the Allies in defeating Nazism just as we also greatly value the Oscar Schindlers of this world who reduced some of the harms of that terrible period.

(9) The WFAD Declaration rejects rigorous scientific trials evaluating heroin assisted treatment published in some of the top medical journals of the world. These trials have focused on treatment-refractory and severely dependent heroin users. Randomised controlled trials in Switzerland, the Netherlands, Germany and Spain have shown that the group receiving heroin assisted treatment did better than the control group. Trials are now underway in the United Kingdom and Canada. In the trial in the Netherlands, 58% of the group prescribed heroin improved compared to 22% of the control group. Where is the morality in denying drug users, their families and their communities the benefits of treatments demonstrated scientifically to be effective, safe and cost-effective?

Yours sincerely,

Dr Alex Wodak FRACP, FAChAM, FAFPHM,

Director,

Alcohol and Drug Service,

St. Vincent's Hospital,

Sydney, NSW 2010, Australia

UN special rapporteur documents systematic torture of drug suspects in Indonesia

I recently came across a UN report, published in March, by Manfred Nowak, the UN's Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, in which he chronicles the shocking mistreatment routinely meted out by police upon drug suspects in Indonesia. The report makes for grim reading and whilst not specifically focused on drugs policy it comes as little surprise that drug suspects form a substantial proportion of the abuse victims he details. Nowak notes that:

"Indonesia has not outlawed torture under its criminal legislation. Indonesian law does not contain an explicit prohibition of torture. This, combined with the absence of procedural safeguards against torture, the lack of independent monitoring mechanisms and of effective complaints mechanisms results in a system of quasi-total impunity."

It is hoped that this report, and its public dissemination, will lead to a change in enforcement culture in Indonesia, and highlight that everyone has inalienable human rights, including not being tortured whilst in custody, regardless of the offense. The UN declaration of Human Rights preamble states that:

'Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.'

'Everyone' includes drug users, drug suspects, and drug criminals.

The following are directly quoted from Nowak's report:

"22. The overwhelming majority of the detainees interviewed indicated that the ill-treatment was used primarily to extract confessions or, in the cases of drug-related crimes, to receive information on drug suppliers. In a number of cases detainees were offered to be spared in return for the payment of a substantial amount of money. Those interlocutors who had been already tried reported in unison that their coerced confessions had been used during the court proceedings and that objections they had raised were not considered by the judge, prosecutor or even their own legal aid clerk. Furthermore, they were not aware of any complaints mechanism to which they could address their grievances expecting any kind of outcome."

"64. Whereas in some police stations he did not receive any allegations of ill-treatment, in other facilities, in particular in urban areas, torture and ill-treatment is used routinely to extract confessions or in the context of drug charges to reveal dealers/suppliers. In three police stations, the Special Rapporteur arrived while beatings were taking place, and in several places he found persistent medical evidence of several types of ill-treatment, which are in line with reports by prisoners and various other credible sources received prior and during his visit."

"23. Achmad Alfian, aged 20, was arrested by officers of Polsek Tanabang in July 2006 while buying drugs. Although he did not resist, he was handcuffed and beaten with the but of a gun on his head. He was then transferred to the Polsek. During the ensuing interrogation he was beaten with a rubber stick all over his body, but particularly on his head and back in order to force him to confess to being a drug seller. Mr. Alfian refused and was charged. Furthermore, he had to pay 500 000 IDR (about 53 $US) for being put in a cell which was supposed to be of better quality than the others. In September 2006, Mr. Alfian was transferred to Pondok Bambu pre-trial detention facility. He constantly feels dizzy and has headaches."

"73. Detainee, aged 40, accused of a drug crime, was arrested on 27 August 2007 by seven drug police officers under the command of Iptu Alawah in his room in Jayapura. Upon his arrest he was handcuffed, forced to sit and beaten and kicked by them. They reportedly also stepped on his body and legs. He further complained about the lack of food."

"80. R., aged 25, from Makassar, was arrested on 25 May 2006 by the drug police. He was kicked in the stomach and hit on the face in the street for one hour, when he refused to tell where his drugs came from. He was then transferred to POLSEC Mamadjanj, where the beatings continued and he was hit with wooden sticks and hands all night until he told the names of the drug sellers."

"109. Mr. Zulfiqaraw, aged 40, from Lahore, Pakistan, was arrested at Jakarta Airport in November 2004 on allegations of drug related offences. While he was abroad the police raided his apartment in Jakarta which he shared with a friend who possessed drugs. Despite the friend’s confession and assurances that Mr. Zulfiqaraw was not involved in any drug related matter, the police took Mr. Zulfiqaraw from the airport to a private house, where he was tortured for three days. He was frequently punched, kicked and threatened with being shot unless he would confess. Nobody knew his whereabouts. After three days his health deteriorated so much that he had to be taken to the police hospital, where he was treated for 17 days. Subsequently, he was transferred to Polda Jakarta where he spent two and a half months in official police custody. The prosecutor in charge, Mr. Hutagaol, offered to drop any charges for a payment of 400 million IDR (about 42,700 $US). Mr. Zulfiqaraw perceived his ensuing trial as strikingly unfair and biased against him since he is a foreigner. No convincing evidence was presented; during the trial session his judge fell asleep. He did not receive any legal aid although he was not able to finance a lawyer; his embassy was wrongly informed and failed to support him. He was sentenced to death."

"121. Eko, aged 28, law student from Blora, Central Java, was arrested by six police officers at his home on 23 December 2006 based on the order of the head of the drug unit of Polres Sleman. He was kicked and punched by the officers and then taken to the Polres where he was interrogated in the office of Mr. Kurniawan. During interrogation he was electrocuted, got hammer blows on his fingers and was beaten by four police officers for one hour. The police officers also banged a chair on his body and put it on his toes. Following this treatment, he confessed, and Mr. Kurniawan offered him to drop some charges in exchange for money. He did not receive any medial treatment for his wounds and scars but the other detainees gave him some medicine. He was kept in Polres police custody for two months and then transferred to the prison LP Cebongan where he spent six months. At the Polres visitors had to pay 10 000 IDR (1 $US) to see him. The Prosecutor at the District Court offered mitigation in exchange of money. The Prosecutor was informed about the ill-treatment and the confession under torture, but this did not affect the outcome of the trial."

"127. On his way to the debriefing meeting with the authorities, the Special Rapporteur found Mr. Zulfikar, aged 20, accused of a drug related crime, who had just been tortured in office No. 50. He had been beaten with a stick and a white plastic pipe by four police officers named Briptu Arika (Reskrim); Briptu Safari S.Y. (SAT NARKOBA); Briptu Agmeg Jatmiko (SAT NARKOBA); and Briptu Opar S. (SAT NARKOBA), which left very clear and distinguishable marks on his arm. The Head of the Narcotics Unit (Andri Triasfoetra, SIK) tried to deny the Special Rapporteur access, arguing that his mandate does not cover persons outside detention places (i.e. under interrogation).

128. The findings of the forensic expert (who recorded the evidence) as well as Mr. Zulfikar’s girlfriend, whom the Special Rapporteur interviewed, confirmed that Mr. Zulfikar had been tortured. She had been arrested together with him and put in the room next to the office where Mr. Zulfikar was ill-treated. She reported that she had heard his screams. She was extremely afraid of the police officers and cried repeatedly when interviewed by the Special Rapporteur. Although Mr. Zulfikar and his girlfriend were both extremely afraid of reprisals for speaking with the Special Rapporteur and begged for protection, the request of the Special Rapporteur to release them was not complied with. "

"139. Suhenry, aged 34, from Aceh, was arrested by five officers of Polres South Jakarta District in November 2006 in connection with a drug related crime. In the course of the first three days he was repeatedly interrogated by two officers in an ordinary office room on the second floor with the aim of identifying his supplier. When Mr. Suhenry refused to indicate his name they pressed his hand on the desk and beat his palm and fingers with a hammer. Furthermore, they used electroshock devices to electrocute him and punched him all over the body. At one point, the officers offered to let him escape, however, Mr. Suhenry stayed since he believed that this was a trick in order to shoot him during what would be later presented as an attempt to flee. The officers also put a plastic bag over his head, but Mr. Suhenry managed to bite a hole in it enabling him to breath. Eventually, Mr. Suhenry confessed in order to end the torture."

"141. After having inspected the cells, the Special Rapporteur ran into Mohammed Tasroni, aged 17, from Jakarta, who was handcuffed to a chair in an office belonging to the drug unit on the fourth floor. Mr. Tasroni was in the process of being interrogated by Mr. Sudartianta (No. 65080313) and had very strong swellings on this face as well as other traces of recent beatings all over his body.

"142. Mr. Tasroni reported that he had been arrested a few hours earlier near the Jatinegara Train Station, East Jakarta. There, he had met an old acquaintance whom he had not seen for a very long time and who asked to provide him with a dose of marijuana. After Mr. Tasroni had arranged for the drugs and handed them over to the former, it turned out that he was actually an undercover police officer working for the pursuit and attack team (“Buser”) of the Criminal Investigation Department. Mr. Tasroni was arrested by several plain-clothes police officers and taken to a private house, which appeared to be an empty office building, in a civilian Kijang car. Once in the house, the officers started to punch and kick Mr. Tasroni all over his body and on his face. He was also heavily beaten on his back. Mr. Tasroni was told the beating would not stop unless he would reveal the identity of his drug dealer. The beating was inflicted in the presence and with the participation of Mr. Bambang (AKP), the chief of Unit III/Baya of the Narcotics
"

For more detailed and up to date coverage of drugs and human rights issues visit the IHRA HR2 blog. The HR2 team will be holding a joint event with HUman Rights Watch at the UN Human Rights Council in Geneva later this month. Details here.

Why we need a cost-benefit analysis part II

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has recently released a report 'Towards a better understanding of drug-related public expenditure' which backs up calls for a cost-benefit analysis of the current drugs laws.

Click on image to read the report

The report argues that,

'Quantifying a government’s drug-related expenditure is a first step in formulating an economic evaluation of drug policy interventions. This evaluation will provide information that can be used to determine whether or not intended outcomes have been achieved.'

The report also recognises that any form of CBA must also look at the alternatives to prohibition in order to fully evaluate the most viable options.

'Public expenditure figures are ultimately intended to enhance policymakers’ decision-making on drug policy. But decisionmakers must be very careful and refrain from taking decisions based on raw public expenditure figures without carefully trading-off the alternatives involved or without a sufficient evaluation of the possible consequences of spending choices. The simple identification of an area of low (or high) expenditure cannot in itself suggest inefficiency. An inefficient allocation of resources exists when the resources concerned could generate greater benefits if used elsewhere, but without an understanding of the benefits gained, it is not possible to assess whether expenditure in a particular area is efficient or not.'

This report is welcomed by Transform who have consistently called for a CBA (see my previous blog on why we need a cost-benefit analysis).

The new report, in conjunction with the Eurobarometer poll (blogged here) that asked young people their opinions about support for the control and regulation of drugs, suggests that within the EU and EC there is a willingness to look at alternatives to the status quo.

Unfortunately the UK goverment has repeatedly rebuffed calls for a CBA. In 2003 at a press conference, Danny asked the then drugs spokesperson at the Home Office, Bob Ainsworth MP, whether the government would support a cost benefit analysis of drug law enforcement. Quick as a flash his reply came back: "Why would we want to do that unless we were going to legalise drugs?"

Well it seems that within Europe those important questions are being asked now with a view to creating an evidence-based policy rather than one based on outdated, and irrational solutions.

Ken Livingstone on drugs

The media circus that is the London mayoral election becomes more and more like a Punch and Judy show and less like a meaningful policy debate each day (and yes, I actually sat through the Question Time debate last night). Still, the outcome will have little impact on drug policy development or implementation in London whoever wins, since the most important policy decisions are still made centrally (or by individual police forces), and anyway, there doesn't seem to be much to choose between Boris and Ken's positions on drugs, or that of the parties the y represent.

The issue has briefly grazed the news media this week with a rather barrel-scraping story in the Telegraph about how Boris had tried to embarrass Ken by associating the incumbent Mayor's apparent links to the Green party with the Green's drug policy (generally very sensible as it happens) - specifically the fact that it calls for the legal regulation of drugs. For some reason ecstasy was alighted on and the headline morphed, in classic lazy-journo style, into Livingstone in row over 'legalise ecstasy' call

I don't care if it's close, you re still both boring me

Challenged on what he is going to do about London's drug problems in the Sun online this week, Ken is quick to note that:

'I am against the legalisation of drugs'

this despite not actually being asked about legalisation in any shape or form. Assuming Ken even penned the Sun online answer, he has arguably changed his tune, or at least his tone on this issue since an interview in 1997 when he said:

“I think all drugs should be decriminalised and addicts could register with their GP for them so organised crime could be driven out of drugs.”

IRC on VirginNet, Nov 12, 1997

His short answer in the Sun seems to differ from this position somewhat and is otherwise rather empty and unhelpful, as indeed have been the answers from all the three main candidates on the drugs issue (see here, page 7, for a deeply uninspiring summary compiled by LDAN).

Whilst Paddick comes out on top from the reformers perspective but this isn't terribly surprising as he came to prominence largely because of his progressive position on drugs in the first place and also because the representative of the 'big three' party with the most forward thinking drug policy by a long stretch. Like his party he has a sound position but doesn't choose to broadcast them, and anyway, he's evidently not in the running anyway with only about 9% on most polls.

yawn

Traditional coca use: caught in the cross fire

Traditional use of coca in the Andes has been an unfortunate casualty of the emergence of widespread powder and crack cocaine use in the West over the past four decades - or, more specifically the increasingly militarised efforts to eradicate cocaine production. Whilst all containing the same drug, powder, and in particularly crack cocaine have presented some serious public health problems (because they involve dramatic increases in the dosage ingested - over a much shorter time frame), that have never been experienced amongst coca leaf chewers or with coca tea consumption. Whilst the international legal framework in the form of the UN drug conventions has made some efforts historically to accommodate the issue of traditional use of certain drugs, traditional coca use has been particularly effected by attempts to eradicate the plant as a way of stopping cocaine production and use.

These attempts have all failed, consistently over a number of decades now (production has more than kept pace with rising demand), despite many billions being spent on crop eradication, various military interventions, and alternative development. The reasons for this systematic failure concern the unforgiving economics of supply and demand in a completely unregulated illegal market - and are not disputed even by the head of the UN agency that nominally oversees the enforcement of eradication efforts, the UN Office on Drugs and Crime (see here and here for example).

There have, however, been a series of unintended consequences of these eradication efforts - not least human rights abuses, violence, environmental destruction, and destabilisation of rural Andean communities that have grown and consumed coca leaf for centuries, but have never had anything to do with illicit cocaine production. Even for those where there has been some cross over into production of coca for non-traditional production, their problems are a direct consequence of externally imposed enforcement of prohibition and the illegal market it creates to serve demand for cocaine in the West.

This new short film produced by the HCLU explores some of the history and recent developments in the clash between traditional coca and cocaine eradication/interdiction efforts.



The interview with the Bolivian minister was filmed at the recent UN Commission on Narcotic Drugs in Vienna where the coca question loomed large following the UN International Narcotics Control Board's recent call for coca chewing and coca tea to be eradicated entirely.

At that CND I remember thinking it ironic how the INCB members had emerged from a closed session discussing this very issue (prohibiting and crimnalising coca leaf and coca tea, mild stimulants associated with no significant health risks, and arguably some benefits) only to adjourn to on the Vienna International Center's numerous coffee bars and enjoy a selection of cappuccino's, espresso's and lattes. Perhaps if we can find some people in another continent who are abusing pro plus caffeine pills we can then arrange to have the INCB arrested and sent one of those charming Bolivian jails?

For a detailed insight into the coca issues this 2006 publication from the Transnational Institute Drugs and Democracy program 'Coca yes, Cocaine, No? legal options for the coca leaf':

UNAIDS and NGO statements shake CND out of its stupor

Amidst the mind numbing tedium of hours of pre-prepared self-congratulatory country presentations at this year's United Nations Commission on Narcotic Drugs (which I am currently attending in Vienna) there were a few rays of light that challenged the consensus that 'everything is fine - let's continue as before'. A few of the non state participants briefly threatened to turn the thematic session in to the 'debate' it was billed as. (a more detailed commentary on the CND to follow)

There were a series of useful contributions from various NGO's (given unprecedented access to the plenary session this year) including this powerful statement from Rick Lines at IHRA, that challenged the CND to fully incorporate human rights into drug control mechanisms, with specific reference to this being the 60th anniversary of the UN universal declaration of human rights.

Below is the complete text of the contribution from the Joint United Nations Program on HIV/AIDS (with references) delivered to yesterday's plenary session by Susan Timberlake. Its pragmatic tone was particularly striking in that it followed series of desperately dry political statements, including notably from the US, that entirely failed to touch on the public health vs criminalisation debate, HIV, or the rights of users, and in the case of the US, actively spoke out against harm reduction. That UNAIDS the statement additionally came with the UN imprimatur - so was impossible for the state representatives to ignore.

Chair, distinguished representatives, ladies and gentlemen, The Joint United Nations Programme on HIV/AIDS (UNAIDS) is pleased to have this opportunity to address the Commission on Narcotic Drugs to seek your support in breaking the dangerous link between injecting drug use and the HIV epidemic. As measures to control drugs and measures to control HIV are critically intertwined, the steps governments take in drug control are likely to have significant impact on progress against HIV.

In most regions of the world, unsafe injecting drug use is a major vector of HIV transmission. It has been estimated that up to 10% of all HIV infections worldwide result from injecting drug use, up to 30% if infections in Sub-Saharan Africa are excluded. Once HIV enters a community of people who inject drugs, it can move to the rest of the population if appropriate steps are not taken.

UNODC, WHO and UNAIDS recommend a comprehensive set of measures for people who use drugs that includes the following: (1) needle and syringe programmes; (2) opioid substitution therapy; (3) voluntary HIV counselling and testing; (4) anti-retroviral therapy; (5) prevention and treatment of sexually transmitted infections; (6) condom programming; (7) targeted information, education and communication; (8) hepatitis diagnosis, treatment and vaccination; and (9) tuberculosis prevention, diagnosis and treatment. The efficacy of these interventions is supported by overwhelming evidence.

Yet in spite of the fact that we know how to address the close links between HIV infection and unsafe injecting drug use, many countries fail to provide this comprehensive set of measures to drug users, who instead continue to face discrimination and other human rights violations. In 2006, fewer than 20% of people who inject drugs received some type of HIV prevention service, with coverage of less than 10% reported in Eastern Europe and Central Asia. Even fewer have access to opioid substitution therapy, needle and syringe programmes, or anti-retroviral therapy, despite the fact that people who use drugs can achieve the same levels of adherence to treatment as other patients with HIV.

In the 3:1 ratio mentioned by Mr. Costa – where enforcement receives three times the resources that prevention and treatment receive – it is clear that many countries take an approach to drug use that focuses on criminalization while neglecting a public health response. A public health response would provide treatment to people who evidence drug dependency and illness and would employ health and social interventions, which have been shown to reduce the harms associated with drug use. Instead, legal and social barriers severely impede access to such health and social interventions. For instance, many countries criminalize possession of syringes without prescriptions and continue to classify methadone and other opioid substitutes as illegal. In many countries, imprisonment and forced treatment with ineffective methods are the primary responses to drug use, with little to nothing being done about HIV. And in some countries, imprisonment is compounded by killings, rape, unwarranted use of force, arbitrary arrests, harassment, extortion, and violation of medical privacy and confidentiality.

Chair, distinguished delegates, UNAIDS supports countries to implement a rights-based response to the HIV epidemic for two reasons: first, because it fulfills obligations under human rights law, and secondly, because it is the most effective way to address HIV. In our efforts against the epidemic, we recognize that all people, even those engaged in activities that are deemed criminal, have human rights, including people who use drugs. Even where drug use is criminalized, people who use drugs have the rights to be free from violence and murder, to benefit from full due process before the law, to be free from discrimination and any forced treatment that violates medical ethics, and to receive comprehensive and voluntary health and social services of good quality, including for drug-related illness and for infections, such as HIV, hepatitis and tuberculosis.

In the Declaration of Commitment on HIV/AIDS (2001) and in the Political Declaration on HIV/AIDS (2006), governments have also committed themselves to an approach to HIV that is based on human rights and the full participation of those affected. In particular, they committed themselves “to intensify efforts to ensure a wide range of prevention programmes, including harm-reduction”, “to overcoming legal...or other barriers that block access to effective HIV prevention, treatment, care and support, medicines, commodities and services”, and “to intensify efforts to enact, strengthen or enforce legislation….to eliminate all forms of discrimination against and to ensure the full enjoyment of all human rights of… members of vulnerable groups”. All this in the context of committing “to scale up efforts…with full and active participation of people living with HIV, vulnerable groups.. towards the goal of universal access to…prevention, treatment, care and support by 2010”.

UNAIDS is working hard to support governments to fulfill these commitments, and much progress is being made. In this context, we ask that those engaged in drug control efforts: (1) respect and protect human rights, including the rights of people who use drugs, (2) ensure access to HIV and health and social services to people who use drugs and remove impediments to such access, and (3) allow people who use drugs or their representatives to participate in the design and delivery of HIV and harm-reduction services so that programmes will be as effective as possible.

Progress towards universal access will be reviewed at the High Level Meeting on HIV/AIDS in June where UNAIDS is also supporting the involvement of civil society as critical partners for accountability. In this regard, a representative of people who use drugs is included in the President of the General Assembly's Civil Society Task Force for the High Level Meeting. In order to provide leadership and guidance to governments in the area of HIV and drug use, UNAIDS urges the consideration by the Commission of measures to:

• Help establish a process by which States’ obligations relating to drug control are clarified to ensure that they conform to human rights obligations, and indeed support the achievement of public health and human rights, including universal access to HIV prevention, treatment, care and support.
  
  
• Support States to enact and implement domestic legislation and policy in the area of drug control that will protect human rights and the public health, including of that of people who use drugs, either vulnerable to HIV or already infected.
  
  
• Finally, encourage States to use the High Level Meeting on HIV/AIDS in June and the current review based on the UNGASS on Drugs (1998) to consider and intensify their efforts to address HIV in the context of drug use, including greatly increasing voluntary and effective HIV prevention, treatment, care and support programmes for people who use drugs.

UNAIDS thanks the Commission and its valuable Cosponsor, the UN Office on Drugs and Crime, and offers its full support in any manner possible.

References

Aceijas, Friedman, Cooper, Wiessing, Stimson, Hickman, Estimates of injecting drug users at the national and local level in developing and transitional countries, and gender and age distribution, Sexually Transmitted Infections, Volume 82, Suppl III, June, 2006.

IPU/UNDP/UNAIDS (2007). Taking action against HIV. A handbook for parliamentarians. Geneva.

Lert F, Kazatchkine M (2007). Antiretroviral HIV treatment and care for injecting drug users: An evidence-based overview. International Journal of Drug Policy 18: 255-261.

Materials produced for UNAIDS Reference Group on HIV and Human Rights, Eighth Meeting, December, 2007.

Office of the United Nations High Commissioner for Human Rights and UNAIDS (2006). International guidelines on HIV/AIDS and human rights (2006 consolidated version). Geneva.

UNAIDS (2005). Intensifying HIV prevention: a UNAIDS policy position paper. Geneva.

UNAIDS (2006). Report on the global HIV/AIDS epidemic. Geneva.

UNAIDS (2007). Practical guidelines for intensifying HIV prevention: Towards universal

access. Geneva.

UNAIDS/WHO AIDS epidemic update, December, 2007

WHO/UNODC Evidence for action series and policy briefs available at http://www.who.int/hiv/pub/idu/en/: Ball et al. (2005)

WHO/UNAIDS/UNICEF (2007). Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report, April 2007. Geneva.

WHO/UNODC/UNAIDS. Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users (IDUs) (in draft)