The WHO cocaine report the US didn't want you to see

Update 18.06.09: This blog post has resulted in mainstream media coverage of this story in the Guardian (by Ben Goldacre and George Monbiot) and an editorial in the Vancouver Sun: Suppressed report raises questions about drug policy. It also appeared on the front page of Reddit attracting 500+ comments and pulling in 60k hits in 24 hours


The largest ever study of cocaine use around the globe was carried out in the early 90's by the UN World Health Organisation (WHO) and funded by the UN Inter-regional Crime and Justice Research Institute (UNICRI), but under pressure from the US its publication was suppressed when it became clear the report's findings were in direct conflict with the myths, stereotypes and propaganda that prop up the war on drugs (read the complete leaked report here).

In March 1995 WHO/UNICRI released a briefing kit summarising the key conclusions, as a curtain raiser to the report's imminent publication.

• "Health problem; from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use.
• Few experts describe cocaine as invariably harmful to health. Cocaine-related problems are widely perceived to be more common and more severe for intensive, high-dosage users and very rare and much less severe for occasional, low-dosage users." (pg. 1)

the coca plant

In a classic example of what happens when public health pragmatism collides with criminal justice dogma, just two months later, at the 48th World Health Assembly, the US representative to the WHO threatened to withdraw US funding for WHO research projects unless they 'would dissociate itself from the conclusions of the study' (read the relevant segment here). He said;

"The United States Government had been surprised to note that the package seemed to make a case for the positive uses of cocaine, claiming that use of the coca leaf did not lead to noticeable damage to mental or physical health, that the positive health effects of coca leaf chewing might be transferable from traditional settings to other countries and cultures, and that coca production provided financial benefits to peasants...


"... it [the US] took the view that the study on cocaine, evidence of WHO's support for harm-reduction programmes and previous WHO association with organizations that supported the legalization of drugs, indicated that its programme on substance abuse was heading in the wrong direction. The press package undermined the efforts of the international community to stamp out the illegal cultivation and production of coca, inter alia through international conventions.


"The United States Government considered that, if WHO activities relating to drugs failed to reinforce proven drug control approaches, funds for the relevant programmes should be curtailed. In view of the gravity of the matter, he asked the Director-General for an assurance that WHO would dissociate itself from the conclusions of the study and that, in substance abuse activities, an approach would not be adopted that could be used to justify the continued production of coca."

It's easy to see why the US would be so opposed to the study being published as it not only challenges a number of myths and stereotypes about cocaine use, but it is highly critical of a number of US-backed policies. The report specifically highlights the criticism that supply reduction and enforcement policies are not working and that alternatives needs to be explored;

"The largest future issue is whether international organisations, such as WHO and the United Nations Drug Control Programme, and national governments will continue to focus on supply reduction approaches such as crop destruction and substitution and law enforcement efforts in the face of mounting criticism and cynicism about the effectiveness of these approaches. Countries such as Australia, Bolivia, Canada and Colombia are now interested in examining a range of options to legalize and decriminalize the personal use and possession of cocaine and other related products. There needs to be more assessment of the adverse effects of current policies and strategies and development of innovative approaches." (pg. 30)


"The studies identified strict limitations to drug control policies which rely almost exclusively on repressive measures. Current national and local approaches which over-emphasize punitive drug control measures may actually contribute to the development of heath-related problems. An increase in the adoption of more humane, compassionate responses such as education, treatment and rehabilitation programmes is seen as a desirable counterbalance to the overreliance on law enforcement measures." (pg. 29)

The study also points out that 'anti-drug' campaigns are not necessarily effective, especially mass media campaigns based on scare tactics;

"Despite a broad range of educational and prevention approaches, most programmes do not prevent myths but perpetuate stereotypes and misinform the general public. Such programmes rely on sensationalized, exaggerated statements about cocaine which misinform about patterns of use, stigmatize users, and destroy the educator's credibility. This has given most education campaigns a naïve image and has reduced confidence in the quality and accuracy of these campaigns…" (pg. 23)

With regards to who uses cocaine, the study says,

"It is not possible to describe an "average cocaine user". An enormous variety was found in the types of people who use cocaine, the amount of drug used, the frequency of use, the duration and intensity of use, the reasons for using and any associated problems they experience.’"(pg. 1)

However it does usefully establish a continuum for use, noting that the majority of harms are accrued by the minority of users at the extreme of the continuum;

• experimental use
• occasional use
• situation-specific use
• intensive use
• compulsive/dysfunctional use

Experimental and occasional use are by far the most common types of use, and compulsive/dysfunctional is far less common." (pg. 28)

The study additionally notes - in direct conflict with the accepted drug war paradigm that all use equals abuse - that:

"occasional cocaine use does not typically lead to severe or even minor physical or social problems ... a minority of people start using cocaine or related products, use casually for a short or long period, and suffer little or no negative consequences, even after years of use. ... Use of coca leaves appears to have no negative health effects and has positive, therapeutic, sacred and social functions for indigenous Andean populations."

In addressing the rise in use, the report posits that key drivers are the drug's illicit status combined with both rising wealth (for cocaine powder) and increased poverty (for crack cocaine).

"The increasing attractiveness of cocaine in the past two decades may be related to:

• the "glamour" of illicit drug use in general;
• increased wealth allowing more people access to what they believe is the most glamorous of all illicit drugs;
• widespread poverty or social disadvantage in countries such as the USA at a time when cheap coca preparations like crack have become widely available." (pg. 14)
  

The report was never officially published and according to the WHO it does not exist, however some of the project advisors are now pushing for it to be formally published. It has only emerged into the public domain because the relevant documents were leaked and found their way into the hands of the Transnational Institute drugs and democracy programme.

The suppression of this detailed, authoritative and independent report is yet more evidence of how certain governments, most conspicuously the US, have willfully refused to develop rational drug policy based on science and evidence - and worse, when evidence emerges that challenges their political prerogatives and drug war ideologies they will resort to bullying, threats and censorship to ensure it is suppressed. This is anti-science drug war posturing of the worst kind, and can only lead to poor policy development with increased social and personal costs the inevitable result.

Transform has passed this report on to the forthcoming Home Affairs Select Committee inquiry on cocaine in the hope that it might usefully be used to inform policy discussions, albeit only at the UK level for now, and some 13 years late.

Also from Transform:

• From soft drink to hard drug; a snapshot of coca, cocaine and crack, By Mike Jay
  
  
• How cocaine markets have been hit by the financial crisis
  
  
• Transform publishes comparative cost benefit analysis of prohibition vs regulation of cocaine and heroin
  
  
• Shoveling water: War on drugs - War on people (film about coca eradication)
  
  
• It is not coca growing per se that fuels the conflict in Colombia, but the fact that cocaine is illegal

Shoveling Water: War on drugs, War on people

Please take a few minutes to watch this excellent short film produced by Witness for Peace, that considers the human and environmental costs of the disastrous ongoing efforts to eradicate coca production in Colombia using aerial fumigation. The film features occasional Transform blogger Sanho Tree, a drug policy analyst from the Washington based Institute for Policy Studies.






The film producers provide the following description;

"Journey to the heart of coca country where United States tax dollars have financed the aerial fumigation of 2.6 million acres of land in Colombia – the world's second most biodiverse country.

See cropdusters target coca plants, the main ingredient of cocaine, with concentrated herbicide as part of the U.S. war on drugs.

Listen to people on the ground, hear about the impacts, and learn new ideas about how to solve this deadly problem."

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':

INCB annual report: even by their standards, this one's a shocker

Below is copied the press release from the Transnational Institute concerning the latest annual report from the International Narcotics Control Board, the quasi-judicial body that oversees state adherence to the UN drug conventions. The INCB has been on the receiving end of sustained NGO criticism for its secrecy, politicisation, and its overzealous approach to some policy areas outside of its remit (objections to established harm reduction initiatives), whilst ignoring key issues that are very much within its remit (notably adherence to human rights in drug enforcement). The TNI have taken issue with the INCB's latest extraordinary call for all coca leaf production to to be prohibited and its use, including indigenous and traditional, to be abolished.

The INCB's annual report is available from the INCB site here

A series of critical reports on the troubling machinations of this anomalous UN entity have been published recently (see below), and for further detailed information on the INCB, and the current UN drug strategy review process see the excellent new TNI website www.ungassondrugs.org

Abolishing Coca Leaf Consumption?

The INCB needs to perform a reality check

The Transnational Institute condemns the decision by the International Narcotics Control Board (INCB) in their 2007 annual report released today, which calls on countries to ‘abolish or prohibit coca leaf chewing and the manufacture of coca tea’. (1)

According to Pien Metaal, researcher specialising in coca issues at the Transnational Institute:

“The Board is displaying both arrogance and blindness by demanding that countries impose criminal sanctions on distribution and possession for traditional uses of the coca leaf, which is a key feature of Andean-Amazon indigenous cultures. Isn’t it time for this UN treaty body to get in touch with reality and show some more cultural sensitivity?”

Coca chewing and drinking of coca tea is carried out daily by millions of people in the Andes as well as considered sacred within indigenous cultures. The INCB’s statement therefore clearly puts it at odds with the UN Declaration on Indigenous Rights approved last year, which promises to uphold and protect indigenous cultural practices.(2)

It also contradicts the 1988 UN drugs convention which recognized traditional uses (3) as well as statements within the current 2007 INCB report which talk about “respect for national sovereignty, for the various constitutional and other fundamental principles of domestic law – practice, judgments and procedures –and for the rich diversity of peoples, cultures, customs and values.” (4)

TNI also condemns the demand within the INCB report that countries should “establish as a criminal offence, when committed intentionally, the possession and purchase of coca leaf for personal consumption”,(5) which if it were implemented would mean the prosecution of several million people in the Andean-Amazon region. It targets not just consumers but also peasants who grow coca: “Governments should establish as criminal offences under its domestic law, when committed intentionally, the cultivation of coca bush for the purpose of the production of narcotic drugs contrary to the provisions of the 1961 Convention”(6), reflecting all uses of the coca leaf.

“Given that the Board in the same report talks about proportionality in sentencing, the Board’s position makes no sense. It would criminalise entire peoples for a popular tradition and custom that has no harm and is even beneficial,” says Pien Metaal.

Earlier reports by the INCB have pointed to the inconsistencies between traditional uses of the coca leaf and the 1961 Single Convention on drugs (which included the coca leaf as “narcotic drug”), but no state has made serious efforts to abolish a habit that has no risk to public health.(7) Moreover, beneficial uses of the plant have growing markets worldwide.

It is understood that the Board was responding to Bolivia’s political decision to give the coca leaf a status as a valuable natural resource, reflected in the new proposed Constitutional text and in its national policy that allows a limited number of farmers to grow a small plot of coca for this traditional use.

According to Martin Jelsma, coordinator of the TNI drugs programme:

“The inclusion of the coca leaf in Schedule I of narcotic drugs of the 1961 Convention was based on an ECOSOC study done back in 1950, inspired by colonial and racist sentiments rather than science. (8) It is time the Board asks the Commission on Narcotic Drugs and the World Health Organisation for guidance on this matter instead of casting its own narrow-minded judgment and retreating to the obsolete thinking of the 1961 Convention.”

Please contact:

Drugs & Democracy Programme (TNI) Tel +31-20-6626608
Pien Metaal +31640798808 pmetaal@tni.org or
Martin Jelsma +31655715893 mjelsma@tni.org
See also TNI’s website www.ungassondrugs.org launched to coincide with the UN Commission on Narcotic Drugs (CND)’s meeting in Vienna to review UN General Assembly Special Session on drugs for more background.

1 “The Board calls on the Governments of Bolivia and Peru to consider amending their national legislation so as to abolish or prohibit activities that are contrary to the 1961 Convention, such as coca leaf chewing and the manufacture of mate de coca (coca tea).” INCB annual report 2007, para 217

2 A/61/L.67, UN Declaration on the Rights of Indigenous Peoples, adopted by the General Assembly on September 13, 2007

3 1988 Convention, article 14, paragraph 2

4 Foreword, INCB report 2007

5 Idem, paragraph 219

6 Idem, paragraph 219

7 http://www.tni.org/docs/200703081409275046.pdf

8 The 1950 ECOSOC Commission of Enquiry on the Coca Leaf claimed that the habit of chewing could be held responsible for malnutrition and immoral behaviour of the ‘Andean man’, while reducing his productive capacity. Report of the findings of the Commission of Enquiry of the Coca Leaf, ECOSOC 1950, now available here

TNI blog commentary on the new INCB report from Martin Jelsma:

INCB & Coca

A colonial attitude unworthy for a UN agency

When the INCB Annual Report for 2007 –under embargo until March 5- started to circulate about a month ago, I was in complete shock after reading the worst ever paragraphs on coca written in UN history for several decades. The position taken by the Board now can be characterized by no more talk about the need to solve 'long-standing ambiguities in the conventions', not a shred of sympathy anymore for traditional customs or rights of indigenous peoples, no trace of cultural sensitivity at all, an all-out attack against coca chewing, drinking of coca tea or any other uses of coca in its natural form in the Andean region and the northern parts of Argentina and Chile. We were warned last year in their report already about this direction of INCB thinking, but still I am outraged by this year’s call to “the Governments of Bolivia and Peru to initiate action without delay with a view to eliminating uses of coca leaf, including coca leaf chewing” and that all countries “should establish as a criminal offence, when committed intentionally, the possession and purchase of coca leaf for personal consumption”.

In what world do these people live in, I wonder. True, the 1961 Single Convention did oblige countries to abolish coca leaf chewing within 25 years. That period has long past and formally all countries who signed that –including Bolivia- are still legally bound by that article. Bolivia and Peru tried to correct that when negotiating the 1988 Convention, which stipulates that drug control measures “should take due account of traditional licit use, where there is historic evidence of such use”. But unfortunately the US at the same negotiations ensured that another article said that the 1988 convention “should not derogate from any obligations under the previous drug control treaties”. Since then, impasse and contradiction.

The INCB has pointed out this contradiction several times (most clearly in its 1994 supplement to their Annual Report) and requested the CND to bring clarity and give policy guidance. Why then do they now take a high-ground position of judge, jury and executioner and arrogantly instruct the world to go back to the 1961 coca abolition dogma, which was based on a colonial and racist ‘study’ published in 1950? I’ve tried to follow dynamics within the Board over the past decade, not an easy task because it operates under a cloud of secrecy totally out-of-line with any accepted UN standards about transparency and accountability. But still, it leaves me puzzled.

Is this the influence of Camilo Uribe Granje, the new Colombian INCB member, previously known for his attempts –paid by the US embassy in Bogota- to deny any harmful impacts of the chemical spraying campaign against coca fields? Or is it due to INCB President Emafo’s influence, a true dinasaur of zero tolerance who also maintains that needle exchange or harm reduction is against the UN drug control conventions, on a moment UNAIDS and WHO declare such interventions to be the only effective answer to the HIV/AIDS epidemic in Asia and Eastern Europe? Or is it an attempt by the Board to show to the US that they are still keeping a hard line on some issues to compensate for the softer line they take in this report on harm reduction and 'proportionality of criminal sanctions'? That could be a point, because there are several positive things to say about this year’s INCB report, positions that probably will not please the current Bush administration. However, even the US has stopped condemning traditional coca uses in the Andes and you can drink coca tea when visiting the US embassy in La Paz.

There must have been disagreement within the INCB on this issue, because not all the members are as ignorant and out-of-touch with reality to support such an extremist position. We may never know, because the Board’s policy is to not mention internal disagreements or minority positions. It is very worrying that the wording on coca in this year’s report apparently had a majority support within the Board and those members who agreed to it should feel ashamed, especially after the recent adoption of the UN Declaration on the Rights of Indigenous Peoples that acknowledges fully the right to the people concerned to continue to chew coca or drink coca tea. Including the WHO has found that coca consumed in its natural form is beneficial. What is the INCB thinking to achieve with this retreat to the obsolete thinking of the 1961 Convention? It merely underlines the need to reform the way the Board is operating. If a majority of the Board does not come to its senses and corrects this mistake, they will only further dig their own grave and confirm their unworthiness to be a UN agency.

Martin Jelsma, TNI

5 March 2008

Four critical reports on the INCB

1. The International Narcotics Control Board: Current Tensions and Options for Reform

IDPC Briefing Paper 7, February 2008

This briefing paper brings together material and analysis from a number of recent reports that raise questions about the role and functioning of the INCB. The IDPC analysis is that the Board mixes a rigid and overzealous approach to some aspects of its mandate, while showing a selective reticence in others. These inconsistencies do not arise automatically from the structure or role of the Board, but from the operational and policy decisions of its officers and members.

Summary:
Beginning with a discussion of its formal powers and self-proclaimed "unique" position in international relations, this IDPC report explores the tensions surrounding various aspects of the current operation of the International Narcotics Control Board (INCB or Board). These tensions are analysed in light of the INCB’s interpretation of the UN drug control conventions and its mandate as laid out within them. It is argued here that in a number of contexts the Board appears prepared to act beyond the limitations which the treaties place upon it and engage in what can be termed mission creep. The report also explores other contexts within which the INCB appears reluctant to meet its mandated obligations and displays what can be described as selective reticence. The report contends that the areas of concern surrounding these mandate issues are further reinforced and complicated by the INCB’s culture of secrecy and the lack of transparency which characterizes all its work. It concludes by outlining "A Way Forward" in reviewing the way the INCB operates: a vital and timely endeavour that should be undertaken during the UN-level process to assess the 1998 UNGASS on drugs and the subsequent period of global reflection leading up to a high-level meeting in 2009 where markers for future UN drug control efforts can be adopted.

Download the Briefing Paper (pdf)

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2. ‘Unique in International Relations’? A Comparison of the International Narcotics Control Board and the UN Human Rights Treaty Bodies, by Damon Barrett, International Harm Reduction Association, February 2008
Download the full report in PDF

a new report released in February 2008 by the International Harm Reduction Association (IHRA), the INCB comes in for some heavy criticism for being overly secretive, closed to external dialogue with civil society, and out of kilter with similar agencies in other UN programmes. IHRA also debunks the INCB’s defence that it is ‘unique in international relations’.
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3. 'Closed to Reason: the International Narcotic Control Board and HIV / AIDS', by Joanne Csete and Daniel Wolfe, Canadian HIV/AIDS Legal Network and International Harm Reduction Development Program (IHRD) of the Open Society Institute, February 2007

A report published in March 2007 by the Canadian HIV/AIDS Legal Network and the Open Society Institute Public Health Program, strongly criticises the INCB. It accuses the Board of becoming 'an obstacle to effective programs to prevent and treat HIV and chemical dependence'. “Nearly one in three HIV infections outside Africa is among people who inject drugs. The International Narcotics Control Board could and should be playing a key role in stopping this injection-driven HIV epidemic — but it’s not,” said Joanne Csete, Executive Director of the Canadian HIV/AIDS Legal Network and co-author of the report.

Download the full report in Pdf

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4. The INCB and the un-scheduling of the coca leaf
TNI Drug Policy Briefing No. 21, March 2007

The 2006 International Narcotics Control Board (INCB) report emitted a clear signal to the governments of Bolivia, Peru and Argentina that growing and using coca leaf is in conflict with international treaties, particularly the 1961 Single Convention. The INCB, rather than making harsh judgements based on a selective choice of outdated treaty articles, should use its mandate more constructively and help draw attention to the inherent contradictions in the current treaty system with regard to how plants, plant-based raw materials and traditional uses are treated.

Download the briefing paper (pdf)

Further reading on coca:

From Soft drink to Hard Drug; A Snapshop History of Coca, Cocaine and Crack
Transform briefing 2005

Coca Yes, Cocaine No? Legal Options for the Coca Leaf
TNI Drugs & Conflict Debate Paper 13 May 2006

For more see the TNI publications page here