Ghana’s drug policy reform must move beyond law into practice

Ghana has taken significant steps towards rethinking its drug policy. The passage of the Narcotics Control Commission Act, 2020 (Act 1019) marked an important shift away from custodial sentencing as the default response to drug use. By introducing alternatives to incarceration, including fines, the Act created a legal basis for a public health, human rights and evidence-based approach to drug policy.

In a region where criminalisation remains the dominant response, Ghana’s reform represents a significant paradigm shift. It also creates space for further dialogue on how the law can be strengthened, implemented and translated into meaningful improvements for people who use drugs and affected communities. This is where the challenge now lies: ensuring that Act 1019 moves beyond its legal promises and is fully translated into practical systems, accessible services and consistent institutional practice.

To help bridge the gap between legislative reform and practical delivery, the University of Ghana School of Public Health, with support from the Open Society Foundations, convened an ‘Executive Short Course on Drug Policy, Human Rights and Public Health Approaches’ from 13–17 April 2026. Bringing together over 25 senior representatives from the health, law enforcement and justice sectors, as well as civil society participants, the programme created a valuable platform for practical learning, interdisciplinary dialogue and a critical reflection on how Ghana can operationalise its new approach. IDPC was honoured to be invited as one of the expert speakers and facilitators on the course.

Across five days of discussion, field visits and technical engagement, one message emerged clearly: Ghana’s drug policy reform will be judged not by the ambition of its law, but by the strength of its implementation.

Drug use must be treated as a public health issue

The course opened with a fundamental message too often obscured by criminal legal narratives: drug use is a public health issue. Evidence presented by the School of Public Health showed that West Africa is experiencing some of the highest prevalence rates of non-medical synthetic opioid use globally, while the non-medical use of falsified tramadol products among young and vulnerable populations in Ghana continues to be a concern. These are complex health and social challenges that punitive responses have failed to resolve.

Stigma continues to block access to care

Despite the legislative change in Ghana, stigma and discrimination remain among the greatest barriers facing people who use drugs. Fear of judgement, mistreatment and ongoing criminalisation continue to deter many from seeking healthcare and support services. For women who use drugs, these barriers are often intensified by gender-based violence, social exclusion and the absence of tailored services.

A visit to the WAPCAS Plus Drop-in Centre demonstrated the transformative potential of community-led harm reduction services. By offering safe, low-threshold and non-judgemental access to care, such spaces create vital entry points for individuals who are often excluded from mainstream systems. Participants also visited the Pantang Psychiatric Hospital, where the shift from punitive responses towards clinical treatment for drug dependence is beginning to take root in practice.

Act 1019 creates the legal foundation for harm reduction

A central focus of the course was aimed at unpacking the practical significance of Ghana’s Narcotics Control Commission Act. By recognising problematic drug use as a health and social issue, Act 1019 provides legal space for interventions that were once absent from mainstream policy conversations, including needle and syringe programmes, opioid agonist therapy, overdose prevention and management through naloxone, and diversion from arrest and incarceration into treatment and support services.

Technical sessions throughout the week focused on internationally recognised and evidenced harm reduction interventions. A visit to the Iris Place Rehabilitation Centre reinforced the importance of embedding harm reduction within the broader continuum of care one that includes evidence-based and voluntary treatment, psychosocial support, rehabilitation and long-term reintegration.

Participants also explored the need for integrated service delivery, recognising that people who use drugs often face overlapping challenges including HIV, hepatitis, tuberculosis, mental health conditions and social vulnerability. Fragmented systems cannot adequately respond to these intersecting needs. Harm reduction is not a peripheral intervention. It is a practical, evidence-based and rights-affirming response to drug use.

The future of reform depends on meaningful action

The Executive Short Course underscored a vital truth: drug policy reform does not end with legislation. Ghana has created the legal foundations for a more humane, evidence-based and rights-centred drug policy framework. The challenge now is to ensure that this vision is translated into functioning systems, accessible services and institutional practice.

While Act 1019 provides a progressive legal framework, implementation remains Ghana’s greatest test. To translate legal reform into lived reality, participants identified several urgent priorities:

• Reducing stigma through workforce training and sensitisation
• Educating and sensitising judges on the need to apply the new law to ensure that nobody faces a prison sentence merely for drug use
• Establishing operational diversion mechanisms away from the criminal legal system for low-level drug offences to ensure that prisons are used as a means of very last resort
• Securing sustainable domestic financing for harm reduction services
• Expanding gender-responsive and trauma-informed interventions
• Strengthening inter-agency coordination across sectors
• Ensuring meaningful participation of people with lived and living experience in policymaking, in the implementation of the law, and in the provision of services.

Ghana’s reform will succeed only if these commitments are matched by resources, coordination and the meaningful participation of affected communities. With urgency and accountability, Act 1019 can move beyond a progressive legal framework to become a practical route to care, dignity and justice for people who use drugs. This would improve outcomes for affected communities while strengthening Ghana’s role as a regional leader in humane, evidence-based drug policy reform.