Cape Town 160225 Police and Metro Police patrol Manenberg stopping and searching residents loitering in the streets for weapons and drugs. Reporter Caryn Dolley. Photo by Michael Walker

FOR the first time in 20 years, the United Nations 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 (UNGASS) 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 African Union (AU), is gaining traction. Deputy Social Development Minister Hendrietta Bogopane-Zulu has played an important role in promoting harm reduction as chairperson 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 (THCA) 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 UNGASS, 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 – approximately 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 UNGASS 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.

● Exacerbated HIV and hepatitis C transmission.

● Inadequate access to controlled drugs for medical purposes.

● About 187 000 avoidable drug-related deaths each year.

● Violence, corruption and killings perpetuated by criminal drug markets.

● Stigmatisation of people who use drugs.

● 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.

UNGASS 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.