This blog post was also published as a feature article by VolteFace

Thailand’s Minister of Justice, General Paiboon Koomchaya, recently ignited a heated debate when he proposed re-scheduling methamphetamine as a ‘medicine’ rather than a ‘narcotic’ drug. But given that one of the Minister’s objectives is to avoid punishing people who use drugs, in particular ensuring they do not end up in prison,’ the proposal to reschedule is essentially a ‘red herring’. To reschedule methamphetamine without other serious policy reforms, such as removing criminal penalties for drug use and possession for personal use and ending compulsory drug detention, those who use methamphetamine without a prescription (and let’s face it, this would be the majority of users) would still end up facing harsh punishment in Thailand.

Over the past year, the failure of Thai drug policies to reduce the use and supply of drugs, particularly methamphetamine, has been the subject of much debate in judicial circles.

This has partly been provoked by the case of a Thai woman caught with one and a half methamphetamine pills after she illegally crossed the Lao border into Thailand, and was subsequently sentenced to 25 years of imprisonment for a “trafficking by importation” offence. This was already a reduced sentence given that the law requires the death penalty or life imprisonment (50 years) for this kind of offence. Several senior judges have since condemned the decision by the Supreme Court to uphold the 25-year sentence, noting the lack of proportionality given the minute amount of drugs involved, while also questioning the effectiveness of harsh punishment in deterring people from using drugs or engaging in the drug trade.

Since the re-naming of methamphetamine in Thai from ‘ya ma’ (literally ‘horse pill’ to symbolise strength) to ‘ya ba’ (crazy pill) by the government as a deterrence measure in 1996, accompanied by harsh penalties and zero tolerance for any drug-related activities, the use and supply of methamphetamine has only increased. Over the same period, Thailand has become home to the world’s sixth largest prison population, as well as having the world’s highest incarceration rate for women; the majority of whom are imprisoned for low-level drug offences, mostly for methamphetamine. Punishment is also imposed for drug use as well as for any quantity of possession, whereby people arrested for drug use could be subject to a fine, forced urine testing, pre-trial detention, and sent to compulsory detention centres for ‘rehabilitation’ (many of which are run by the military and police). The worst case scenario is a prison sentence of between one to five years and it is estimated that about 10% of those in prison for drugs are incarcerated for personal use offences.

Overcrowded prisons are one significant motivation behind the Minister of Justice proposed policy reforms on methamphetamine. But he has also cited the failure of the ‘war on drugs’ to reduce use and supply, and the negative social, health and human rights consequences caused by imposing disproportionately severe punishment for all drug-related activities. As a result, the Minister began calling for consideration of alternative drug policy approaches last year, alongside several government officials from the judiciary, health and human rights sectors, academics and even HRH Princess Bajrakitiyabha. More recently both the President of the Supreme Court and the Minister of Justice have referred to a global shift in the direction of drug control, away from the ‘war on drugs’ following the UNGASS in April 2016, as a reason for Thailand to consider modernising its drug policies to achieve improved health and human rights objectives, thereby aligning its approach with the international community. Minister Paiboon further said that there should no longer be capital punishment, however the Bangkok Post reported on 23 June 2016 the Minister saying that Thailand is not ready to abolish the death penalty for drug offences.

While the Justice Minister has said, with the support of health authorities, that people who use drugs are ‘patients’ and should not be sent to prison (although it is inaccurate to say that all people who use drugs are patients and need treatment, as only a minority do), it is unclear how the proposed re-scheduling of methamphetamine will end their criminalization and incarceration. Scheduling methamphetamine as a medicine may allow a few to access it via a doctor’s prescription, but it is only used in the treatment of certain conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. Given methamphetamine use is largely driven by the need to maintain work performance (e.g. long-distance driving, construction work) and for recreation, it is most likely that only a minority of people who use methamphetamine would be able to access it with a prescription. Going further and legally regulating methamphetamine was clearly ruled out by the Minister and would be unlikely to garner any political or public support given generally conservative views about drug use in Thailand. However, there is genuine, albeit tentative, support across multiple government sectors for a more humane approach to drug use so the climate may be conducive to a serious consideration of removing criminalisation and imprisonment as a punishment for drug consumption and possession for personal use.

Decriminalisation would be a bold step for Thailand, where the brutal 2003 ‘war on drugs’ waged by disgraced ex-Prime Minister Thaksin is still often cited in drug policy debates. Those pushing for positive change in Thailand must push the government further and advocate for decriminalising drug use and possession for personal use, as the weak and somewhat misguided suggestion to re-schedule methamphetamine simply does not address the problems that Thailand faces after years of pursuing a heavily repressive drug control response. Proponents of legal regulation in other parts of the world have argued that decriminalisation does not go far enough and does not address the market dimensions as the supply and trade of drugs would still be illegal. This may be true but the benefits to be gained for the health and human rights of people who use drugs if decriminalisation were achievable in Thailand cannot be ignored.

There is an ongoing process of policy reform in Thailand and new drug laws drafted in 2015 have been approved by the Cabinet and are now subject to approval by the legislature. At present there is no plan to remove criminal penalties for drug use although the draft laws include reduced penalties for both drug use and drug supply activities, and introduce a greater range of alternatives to incarceration as sentencing options including community service and the somewhat problematic proposal to use electronic tracking devices for people who use drugs. Imprisonment and/or compulsory detention for both consumption and possession for personal use remain. The draft law highlights that there is still incoherence between the shifting discourse and the policy response. However, the draft law does show that there is some effort by Thailand to achieve more proportionate penalties and sentencing for drug offences. It is now crucial for Thailand to seriously consider decriminalisation, and to invest in harm reduction and voluntary, evidence-based drug treatment approaches, in order to achieve the health and human rights objectives hoped for by the Justice Minister.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Is drug decriminalisation on the cards for Thailand?

Since it was launched in 2013, the Support Don’t Punish campaign has gone from strength to strength, and activists in more than 100 cities around the world will take part in the Global Day of Action on or around 26th June this year. 2016 has already been a big year for drug policy with the UN General Assembly Special Session on drugs in April, and the UN High-Level Meeting on HIV/AIDS earlier in June.

This month, a huge range of local actions, events, protests and meetings will be held as part of a global show of force calling for drug law reform – including:

A giant mural in the centre of Melbourne, Australia, accompanied by demonstrations and a petition to government.

A music concert in Brussels, Belgium to raise awareness of the need for drug policy reform.

A policy dialogue with politicians, UN officials and community members in Phnom Penh, Cambodia.

Public debates and discussions on the rights of coca, poppy and marijuana farmers in Bogota, Colombia.

A series of debates and workshops in Mauritius.

A football match between people who use drugs and local law enforcement officials, followed by a bicycle rally in Pokhara, Nepal.

A public march in Cape Town and an interfaith healing session with different religious leaders in Durban, South Africa.

“Guerrilla” distribution of naloxone to those in need in London and Liverpool, UK – to highlight the need for better local policies to prevent drug-related deaths.

A large-scale projection in New York depicting people who use drugs under the heading ‘drugs do not define me’ – as well as smaller actions in several other US cities.

The campaign team are working hard to keep the list of actions up-to-date on the campaign website. Please contact campaign@idpc.net if you wish to add a city to the list, or update any information.

The Support Don’t Punish campaign seeks to promote the case for drug policy reform, and to challenge existing laws and policies which impede access to harm reduction interventions – as the harms being caused by the war on drugs can no longer be ignored. The campaign includes the annual Global Day of Action, as well as an Interactive Photo Project – an online photo petition with more than 7,000 supporters from around the world. You can engage with the campaign by following us on Facebook, Twitter or on the campaign website, taking part in the 2016 Thunderclap on social media, watching and sharing our series of videos, sending in your photo for the Interactive Photo Project, taking part in your local event, or organising an action yourself!

For more information on all of this, please visit www.supportdontpunish.org.

Local actions, global voice: The Support Don’t Punish day of action on 26th June 2016

The High Level Meeting on Ending AIDS took place between 8th and 10th June 2016 in New York. On the final day, INCB President Mr Werner Sipp spoke, congratulating Member States on the UN General Assembly’s adoption of the Political Declaration on HIV and AIDS: On the Fast-Track to Accelerate the Fight against HIV and to End the AIDS Epidemic by 2030

Werner Sipp noted that the INCB has used its Annual Reports to draw attention to prevention, treatment and rehabilitation, thereby reducing the ‘negative consequences of drug use’. Such interventions can help to reduce the transmission of the HIV virus resulting from the sharing of infected needles and syringes. Mr Sipp sought to remind the delegates present that the objective of the international drug control treaties is to safeguard individual and public health.

It is worth recalling, nonetheless, that notwithstanding its newfound self-image and its claims that the emphasis on health reaches back decades into the history of the conventions, the Board has at times been remarkably hostile to harm reduction measures such as the distribution of clean needles and syringes. In the words of Mr Philip Emafo, a former occupant of the Presidential role now assumed by Mr Sipp:

‘…to promote drug use illicitly through the giving out of needles…would, it seems to me, amount to inciting people to use drugs, which would be contrary to the provisions of the Conventions’.

The tone of Mr Sipp’s intervention represents a radical change in the Board’s public discourse over the last decade and a half. The Conventions must, he said, be implemented in a comprehensive, balanced and proportionate manner, ‘with full respect for human rights’. Despite this welcome change in the position of the Board, the institution continues to be opposed to the work of safer injection facilities, which were termed ‘opium dens’ by former INCB Secretary Koli Kouame. Safer injection facilities expand on the iconic harm reduction measure of dispensing clean injection equipment, and may be seen as a further health intervention.

Yet the Board expresses its hostility to these facilities. So, alongside the positive and progressive elements of change that are visible in the operation of the INCB, continuity with the old, repressive face of the Board may still be seen. There remains, consequently, a considerable way to go in the INCB’s journey of transformation toward an institution centred on health, human rights and the fundamental goals of the United Nations.

INCB Watch: High Level Meeting on Ending AIDS

Between 31st May and 03rd June 2016, the INCB conducted a country visit to Argentina, led by Professor Francisco Thoumi. The object of the visit was to review developments in the country’s drug control arrangements. More broadly, the INCB is responsible for monitoring governments’ compliance with the three international drug control conventions.

Professor Thoumi, accompanied by Mr Stefano Berterame of the Secretariat, undertook consultations with senior officials at the Ministries of Security, Justice and Foreign Affairs, in addition to meetings with the country’s drug control agency. INCB visited a treatment centre at a federal prison complex, and a community-based therapeutic centre.

The Board will review findings from the visit at its November 2016 Session.

INCB Watch: Board visits the Republic of Argentina

After two weeks of deliberations, the 27th of May 2016 saw the INCB concluding its 116th Session. During this period, the Board began work on its Annual Report for 2016. Among the most significant elements in the 2016 Report will be the thematic chapter, which will address the topic of women and drugs.

Current INCB President Werner Sipp stated that: ‘within drug control policy and practice there are very specific gender considerations, and the thematic chapter of our next Annual Report will be dedicated to precisely this topic – both drug use among women and the impact of drug use on women, but also the policy response of governments to the specific situations of women.’

The INCB focus represents a positive development, since UN drug control agencies have historically directed little attention to women’s involvement in the drug trade, the contexts that provoke it, and the specific impact of the drug control regime on the lives of women. Women are involved in the consumption, distribution and production of drugs in a variety of ways. In Central Asia, women who use drugs are discriminated against when seeking access to healthcare and are often victims of police abuse. In Latin America and some countries in South East Asia, women constitute the fastest growing prison population – and data shows that most of these women are incarcerated for minor drug offences, engaged in the drug trade to cope with a situation of high economic and social vulnerability.

Over recent years, there has been a growing concern with these areas at UN level, with a number of CND resolutions seeking to establish policies, principles and practices that respond to the needs of women. Resolution 59/5 “Mainstreaming a gender perspective in drug-related policies and programmes”, adopted at this year’s CND, no doubt included the strongest wording to date on gender and drugs issues.

Despite these positive developments, the impact of drug control interventions on women continue to receive negligible attention in the policies of many governments.

The author(s) of the thematic chapter is as yet unknown, though it is to be hoped that the focus will move from the harms caused primarily by drugs to those resulting from the international drug control framework itself.

INCB to focus on women and drugs in the thematic chapter of its 2016 Annual Report

Drug trafficking is fast becoming the most serious problem in West Africa. The sub-region has seen an increase in drug trafficking, production and consumption which continues to ruin many lives. There has also been an exponential increase in corruption and impunity which mainly favours drug barons in the region. This also has an adverse effect on citizens who possess or consume very small quantities of drugs.

As a whole, the proliferation of the drug trade in West Africa significantly undermines people’s well being and create a major road block to development efforts.

The yearly value of cocaine transiting through West Africa is estimated by the United Nations to be worth US$ 1.25 billion, which is higher than the national budgets of many West African countries including Liberia, Cape Verde , Sierra Leone, The Gambia, and Guinea-Bissau. This humongous amount which are direct proceeds of drug trafficking, production and consumption within the sub-region has a deadly effect on governance and sustainable development .

According to West Africa Commission Drugs (WACD) 2014 report, West Africa is not only a transit zone of drugs from Latin America to Europe. Synthetic drugs, such as methamphetamine, are increasingly being produced in West Africa for the Asian market. Furthermore, in some countries a strong protection economy for drug kingpins has emerged, allowing them to operate with impunity.

Organised crime syndicates exist at all levels of society in West Africa and pose a threat to good governance, peace and stability, economic growth and public health in West Africa, a region that has only recently emerged from decades of violent conflict. Drug trafficking is becoming a new threat for the “development” of West Africa.

Narcotics narratives are often portrayed as a security issue with more focus on law enforcement through the criminal justice system without a deliberate link to development. The response to drug issues is similar in West Africa, focusing on punishment with the aim of eradicating the supply of illegal drugs and creating a “drugs free world” – this can best be described as an illusion. The criminal justice response has failed.

According to statistics, despite the hundreds of billions of dollars spent in trying to eradicate illicit drugs, the industry is bigger than ever with a growing number of drug users each day. According to the United Nations Office on Drugs and Crime (UNODC) World Drug Report 2015, it is estimated that a total of 246 million people, or 1 out of 20 people between the age of 15 and 64 years, used an illicit drug in 2013. This represents an increase of 3 million over the previous year.

The current drug policy control approaches in West Africa and beyond are negatively affecting public health, economy, the rule of law, human rights, gender and social development.

The primary objective of the international drug control conventions is to protect the health and welfare of mankind. Unfortunately, in practice, the drug free illusion has led to too much focus on criminal justice, law enforcement, instead of public health and the protection of human rights.

In West Africa, the situation is worsening and public health is compromised with an increase prevalence of HIV among people who use drugs and lack of access to essential medicines for palliative care primarily for pain relief and the treatment of cancer patients. Statistics from UNODC’s 2013 World Drug Report state that the prevalence rate of cannabis use in West and Central Africa combined (12.4%) is higher than Africa and the global average, 7.5% and 3.9% respectively.

According to the Ghana’s Minister of Foreign affairs during her statement at the 2016 United General Assembly Specially Session (UNGASS) on drugs, “ it is estimated that nearly 90% of cancer and AIDS patients in Ghana cannot be treated adequately on the current level of morphine supply’’. The current shortage of morphine in the Ghana hospitals has affected treatment given to the majority of cancer and AIDS patients.

The World Health Organization, UNODC and UNAIDS have developed a ‘comprehensive package’ of harm reduction services to reduce the health risks associated with drug use, such as HIV, hepatitis C, tuberculosis and overdose among others. These policy guidelines and programmes have been proven to be cost-effective and have been endorsed by the African Union in its Common Africa Position (CAP) in which the AU called for a commitment to harm reduction programmes, including facilitating access to healthcare in prisons and promoting alternative non-custodial sentencing mechanisms for minor non-violent drug-related offences.

Unfortunately, in West Africa and Africa at large, due to the repressive laws and related law enforcement policies and practices these programmes are yet to take full force. Currently, Senegal is the only country in West Africa implementing a harm reduction programme even though the laws are still very punitive. As a result, less than 1% of people who inject drugs in Africa have little access to needle and syringe programmes or opioid substitution therapy.

Unlike the visible presence of antiretroviral treatment available in the sub-region, hepatitis C remains a great threat in West Africa. The danger of hepatitis C can be seen in potentially serious health problems for those infected, with the possibility of liver failure, liver cancer, and premature death.

In West Africa when a drug user is arrested, under the current regime such a person has to be incarcerated if found guilty without being given the opportunity to seek help for his or her problematic drug use when needed.

Over the years this approach of sending drug users to prison has only exarcerbated their problem because the prisons settings are often characterised by overcrowding, inadequate ventilation and limited medical facilities for treatment, all of which contribute to the spread of diseases such as tuberculosis among prisoners.

According to the UNODC World Drug Report for 2015, the incidence rates of tuberculosis in prisons could be 8-35 times higher than among the general population for some countries. Combined infections of HIV and tuberculosis are particularly serious, with each infection speeding up the progress of the other.

West African countries, as elsewhere all over the world, tend to focus on eradicating supply with little attention to the demand side. Policy makers have failed to appreciate that, demand drives supply. No matter the stringent methods adopted, drug users will always discover new ways of satisfying their cravings for drugs.

An illustration of this is the balloon effect which was the cause of stringent measures put in place by the United States to impede drugs from Latina America to reach their coast. This led to the opening of new routes through West Africa.

West Africa is now a major hub in global drug trafficking. According to the UN, the yearly value of cocaine transiting through West Africa is estimated to be US$ 1.25 billion. For a region with a high rate of youth unemployment, this could lead to the implosion of social cohesion and an increase in crime.

In addition, this huge money can easily fund rebellion or terrorism to overthrow democratic elected government. For example, many analyses have been able to establish an interconnection between terrorist threat in the sub-region (precisely Mali) and drug trafficking.

Furthermore, the drug market encourages money laundering affecting the formal economy, and in turn discourages investment in affected regions.

According to United Nations Development Programme report from June 2015, on ‘

Addressing the Development Dimensions of Drug Policy

, “The existence of a large illicit sector in the economy can also distort economic data and, in turn, macroeconomic and structural analysis and policymaking”.

Societal stigma makes drug users vulnerable to abuse either from law enforcement, their family and society as a whole

These violations include rape, arbitrary detention, unfair trial, torture, ill-treatment, lack of access to basic health care among others. Due to the harsh sentencing policy and fear of being arrested or reported, drug users are discouraged from seeking treatment and other health services, exacerbating their situation of vulnerability and increasing risk behaviour.

Women, in particular, appear to face barriers to treatment. According to the UNODC World Drug Report 2015 while one out of three drug users globally is a woman, only one out of five drug users in treatment is a woman. Women who inject drugs are also often more vulnerable to HIV than their male counterparts. In Senegal, HIV among Female Who Inject Drugs (21.1 percent) is three times higher than among Male Who Inject Drugs (7.5 per cent). In Nigeria HIV among Female Who Inject Drugs (21.0 per cent) is seven times higher than among Male Who Inject Drugs (3.1 per cent). In addition, women who use drugs often fail to access harm reduction services – even when those are available – because of the high stigma associated with their use, and the lack of gender-sensitive services available to address their specific needs.

Drug issues cannot be considered separately from a development paradigm. The international drug control bodies, as well as West African countries, should shift their drug control approach and try as much as possible to embrace a holistic perspective of the issue in light of the debates that took place at and around the UNGASS on drugs in 2016, as well as the Sustainable Development Goals agreed upon in September 2015.

The measurement of success in drug control should no longer rely on the number of people arrested or amounts of drugs seized. The huge amounts of money invested in law enforcements by West African government to operate prisons could be realigned to strengthen the health sector and fund development projects and programmes to address the drug problem.

Governments need to explore and focus on solutions that promote public health, human rights and citizen engagement and participation. West African governments should integrate drug policy and human development in their development programmes.

Sustainable development under threat from drug trafficking in West Africa

The 116th Session of the INCB commenced in Vienna on 17th May. During its first day, it renewed the mandate of Mr Werner Sipp, its President, and elected a new Bureau which will operate for one year.

During the session, which will last until the 27th May, the INCB will review the compliance with the international drug control conventions of over 200 countries.

The INCB’s composition following the elections of the 17th May is:

• Werner Sipp - President of the Board
• Jagjit Pavadia - First Vice-President and Member of the Committee on Finance and Administration
• Viroj Sumyai - Second Vice-President of the Board and Chair of the Standing Committee on Estimates
• Sri Suryawati - Rapporteur and Member of the Standing Committee on Estimates
• Wei Hao - Vice-Chair of the Standing Committee on Estimates

• Raymond Yans - Chair of the Committee on Finance and Administration
• Bernard Leroy - Member of the Standing Committee on Estimates
• Richard P. Mattick - Member of the Standing Committee on Estimates
• Ahmed Kamal Eldin Samak - Member of the Standing Committee on Estimates
• Francisco E. Thoumi - Member of the Standing Committee on Estimates
• Alejandro Mohar Betancourt - Member of the Committee on Finance and Administration
• Jallal Toufiq - Member of the Committee on Finance and Administration

On 19th May, the Board held consultation with the Chair of the CND, Mr. Vladimir Galuska, Permanent Representative of the Czech Republic to the United Nations (Vienna). The opportunity was taken to discuss both the 59th CND in March 2016, and the outcomes of the April UNGASS. Both of these event saw the INCB playing a highly active role.

On the following day, 20th May, the INCB held consultations with the WHO representatives, Dr Vladimir Poznyak, Coordinator of the Management of Substance Use team, Department of Mental Health and Substance Abuse, and Dr Gilles Forte, Coordinator of the Policy, Access and Use team of the Essential Medicines and Health Products Department.

The INCB and the WHO agreed to strengthen cooperation to improve access to controlled medicines.

INCB Watch 116th Session begins in May

At the April 2016 UN General Assembly Special Session on the world drug problem, the INCB held a side-event entitled ‘The drug control conventions: a multi-faceted framework for the promotion of the health and welfare of humankind’.

The INCB President Werner Sipp was accompanied by other Board members: Bernard Leroy, Jagjit Pavadia, Richard Mattick and Sri Suryawati. President opened the event by speaking of the health-oriented and enabling role of the conventions, and expressed a welcome to all those governments who have shifted their drug control policies in this direction. In their presentations, the various Board members went on to emphasis proportionality of sentencing, access to controlled medicines while preventing diversion, NPS, and medically-based drug treatment. There were also wide-ranging discussions in response to questions from civil society dealing with reform of the conventions, cannabis, scheduling and others.

The Canadian SSDP, for example, described the existing drug control paradigm as ‘inherently abusive’, and asked if, in the opinion of the Board, it will ever change. President Sipp replied that it is up to member states to make changes to the international drug control system. For the INCB, he said, the conventions are binding, and they state that drug must be restricted to medical and scientific purposes. Bernard Leroy added that the term ‘medical’ is not defined in the conventions, and is interpreted by member states. Dr Richard Mattick noted that if the conventions do change, such a change is likely to be limited, as governments would have to accept the use of drugs outside the medical and scientific uses stipulated by the current conventions.

A dialogue followed on ensuring access to controlled medicines. Katherine Pettus of the IAHPC complimented the work of the Board in this area, but called for redoubled efforts. Werner Sipp stated that counties must improve the legal situation, to reduce the regulatory boundaries that can block the supplies of controlled medicines to those who need them.

Overall, the INCB engaged in a productive discussion with civil society organisations, and its attitude at this event was highly promising compared with that demonstrated often in recent years.

INCB discusses the international drug control conventions at UNGASS 2016

For the last decade, those of us involved in the field of viral hepatitis have rallied together around a vision; a world where people living with viral hepatitis have access to safe and affordable care and treatment, transmission is halted and people do not face social marginalisation and inequality. This week we may be closer to that goal than we have ever been before.

At the 69th World Health Assembly in Geneva (23 – 28 May), 194 countries will decide whether to adopt or reject WHO’s first ever Global Health Sector Strategy for Viral Hepatitis (GHSS), which sets a goal of eliminating hepatitis B and C by 2030 and includes a set of prevention and treatment targets which, if reached, will reduce annual deaths by 65% and increase treatment to 80%, saving 7.1 million lives globally by 2030.

Claiming the lives of 1.4 million per year (more than HIV/AIDS or malaria), these global killers are affecting more and more people with 10 million new cases each year - and a high-majority of these infections being amongst people who inject drugs. Globally 1 in 2 people who inject drugs (PWID) are living with hepatitis C and they are one of the most vulnerable, discriminated and marginalised groups, experiencing a range of health, socioeconomic and legal challenges, often with poor outcomes. Like the disease itself, they are often ignored and de-prioritised.

With vaccines and effective treatments for hepatitis B and a cure for hepatitis C now available, elimination of viral hepatitis is feasible and achievable, but will require a greater focus on at-risk populations and a dramatic scale up in interventions; at a global level, coverage of harm reduction programmes for PWID, including needle and syringe programmes, which are proven to prevent the transmission of viral hepatitis, is less than 10%.

This Strategy, with its ambitious targets can change that; calling for a major increase in the provision of sterile needles and syringes to people who inject drugs, from a current 20 needles and syringes per person who injects drugs per year to 300 by 2030, it represents a turning point.

Furthermore, the Strategy comes as a follow-up to the Sustainable Development Goals (SDGs), which includes Target 3.3, a commitment to combating hepatitis and Target 3.5 around strengthening the prevention and treatment of substance abuse.This means that all United Nation member states are required to reach these targets in order to meet the obligations of the SDGs. As such, the GHSS represents governments’ best way of achieving these goals.

We are so close but we are not there yet. Some countries still feel uneasy about all the work and scaling up of interventions needed to eliminate viral hepatitis.

We, as a community, must join together to show the adoption of the Strategy really is a no-brainer: reducing mortality rates will not only mean a reduction in personal cost of viral hepatitis, but will also mean reduced financial costs with health systems no longer having to deal with huge numbers of people suffering from the results of untreated viral hepatitis, such as liver cancer and cirrhosis.

Ahead of the Assembly, we and our 230 member organisations are calling on governments to support the adoption of the Strategy and its targets. If governments reject the Strategy, they will be perpetuating the neglect hepatitis has been subject to for years and turning their backs on saving 7.1 million lives. They will also be ignoring one of the key commitments of the SDGs, which is 

, a commitment so apt for people living with viral hepatitis and for those who inject drugs, many of whom are marginalised and discriminated against by society. It’s time we properly address viral hepatitis and rid the world of these cancer causing agents that burden so many people, once and for all.

To find out more about the Strategy, watch our animated video which also introduces NOhep, a global movement to eliminate viral hepatitis, to be launched on World Hepatitis Day this year (July 28 2016).

The World Hepatitis Alliance (WHA) is a patient-led and patient driven non-governmental organisation (NGO), whose membership is comprised of organisations from across the world working in the field of viral hepatitis.

Eliminating a global killer by 2030

The International Narcotics Control Board recently held elections for several new members. In two rounds of secret balloting, the Council elected — from candidates nominated by Governments — Sevil Atasoy (Turkey), David T. Johnson (United States), Galina A. Korchagina (Russian Federation), Luis Alberto Otarola Peñaranda (Peru) and Alejandro Mohar Betancourt (Mexico) to the Board for a five-year term beginning 2 March 2017. The other candidates were Parviz Afshar (Iran), Chafika Bensaoula (Algeria), Wolfgang Artur Goetz (Germany), Amalia Margarita Laborde García (Uruguay), Ana dos Passos da Conceição Mamede Graça (Angola), Maria Lucia Oliveira de Souza Formigoni (Brazil), Ahmed Kamal El Din Samak (Egypt), Sri Suryawati (Indonesia), Luis Yarzabal (Uruguay) and Fadi Mustafa Yousef Alattiat (Jordan).

In a single round of secret balloting, the Council also elected — among candidates nominated by the World Health Organization (WHO) — Cornelius de Joncheere (Netherlands) and Richard Mattick (Australia) for the same term. The other candidates were Mohammed Tamouh Abou-Saleh (Syria), Lukas Radbruch (Germany) and Emran Razaghi (Iran).

In terms of the politics of international drug control, the balance of reformist and conservative elements in the make-up of the Board remain broadly the same. A notable departure, however, will be former President Raymond Yans, who will leave when his term expires in 2017.

Elections at ECOSOC 5th April 2016: INCB

For decades governments have proudly proclaimed a global consensus on drugs. A consensus that reinforced reliance on repression and punishment to deter people from using drugs or from involvement in the drug trade. A consensus that has encouraged hugely expensive drug control polices based in tough law enforcement which have failed to reduce the scale of the drug market but have had a very high human cost. In mid-April the biggest global drugs summit in 18 years took place at the UN and one thing was clear - that out-dated and damaging consensus is no more.

This is not an easy thing for many governments or the UN to admit. Just a few days before this long-awaited UN General Assembly Special Session on Drugs (UNGASS), Yury Fedotov, the Executive Director of the UN's Office on Drugs and Crime, wrote:

"Consensus may not be pretty, but it is the best way of progressing against a global threat that desperately needs unity of action".

He was referring to the fraught negotiations that had taken place in the lead up to the UNGASS which had resulted in a weak 'outcome document' that failed to live up to the expectations for a progressive, forward-looking, "open and wide-ranging debate" on the wicked issue of drug control.

For civil society advocates of reform, the UNGASS process has been marked by "suppressed excitement" and "intense frustration" (to quote from Mr Zeid Ra'ad Al Hussein, the UN High Commissioner for Human Rights). It was hoped that there would be clear acknowledgement in the outcome document of the failure and the damage of punitive drug polices and that the rhetorical shifts signaling a new paradigm of a health and human rights based approach would translate into explicit support for decriminalising drug use, and a genuine and unequivocal recognition ofharm reduction. It was probably too much to expect governments to accept that thelegal regulation of cannabis is actually happening in a number of jurisdictions, although to continue to ignore this rather large elephant in the room risks rendering the very idea of international cooperation on drugs obsolete.

Frustrations also resulted from the political machinations that encumbered the process which meant the debate was neither open nor wide-ranging and essentially ignored the weight of evidence submitted by non-government organisations, UN agencies and much of the progressive language introduced by governmentsthemselves. Civil society participants were also subject to Kafka-esque attempts tolimit access to the actual debates by UN security in New York. A deeply upsetting experience for many NGO colleagues travelling from far and wide to New York that makes a mockery of the fine words spoken by many governments regarding the value of 'civil society participation'.

Fedotov, while admitting it had been "difficult to please everyone", still claimed that the document "promotes cooperation and partnership" and that the "world can benefit from such unanimity". This 'outcome document' was essentially agreed in advance of the UNGASS and was adopted by consensus almost as soon as the session started and before the debate began. The rather quick and seemingly hurried adoption of the document at the start of the session seemed designed to ensure that its contents could not be questioned or subject to renegotiation. Can a consensus so brittle and fragile really be called a consensus at all?

Immediately after the adoption of the document, there were nine statements from governments and regional groups to express dissatisfaction with the outcome document for the issues that could not be included. These ranged from the abolition of the death penalty for drug offences, the decriminalisation of drug use and the lack of reference for allowing traditional uses of drugs.

From the very outset, the UNGASS did not begin in a spirit of 'consensus' - pretty or otherwise. For the next three days, throughout the debates, one after another, government representatives stood up and contradicted one another on the basic premises of drug control. For a number of years now, commentators have increasingly highlighted the fracturing global consensus on drugs that has been heavily rooted in repression and punishment as the means towards eliminating the illicit drug market. At the UNGASS itself, any pretence of a remaining consensus was ripped away.

Russia, now the clear leader of the pack of hardliners since the US softened its war on drugs stance under the Obama administration, stated:

"In the run up to UNGASS, some pessimists argued that we lost the war on drugs. This is not the case. We must continue our fight."

Countries like Singapore, Pakistan, Iran and South Africa brought up the rear with staunch ideological opposition to the 'defeatist' idea that the fight against drugs had been lost. But these regressive views, although perhaps more entrenched than ever, were no longer the dominant voices. President Santos of Colombia, who had in fact led the call for this debate in the first place stated:

"The question we have to ask, looking at the efforts made over years, over decades, over a century is this: After so many lives that have been been destroyed, after so much corruption and so much violence and after so many young people being marched off to jail - can we say that we have won the war? Or could we at least say we are winning it? Unfortunately the answer is no. We have not won the war and we are not winning it now."

His sentiments were echoed by countries as diverse as Tanzania, Jamaica, Costa Rica, Canada, Argentina, Bolivia, Lichtenstein, New Zealand and many others. In addition, the majority of senior UN officials that spoke during the three-day summit pointed out the failure of punitive approaches and the high human cost that has been wrought as a result. Their statements were preceded by several written contributionsmade in advance towards the process which overwhelmingly called for reform and for the decriminalisation of drug use.

Recognising these many progressive calls in his closing remarks, the President of the General Assembly, Mogens Lykketoff, stated:

"With your experience and expertise, you have brought home to us the immense human cost of this problem and indeed, at times, of the approaches we take to address it."

So has the UNGASS been a missed opportunity? Would it have been better had it not happened now and perhaps all the effort been saved for the next 'big moment' of 2019 when governments will have to negotiate a new global action plan on drugs?

The outcome document is mostly disappointing but it is not the only indicator of progress. Apart from the strong dissensus that emerged through government and UN statements, we can look back briefly to the last UNGASS on drugs in 1998. At that time the then President of the General Assembly, the UN Secretary General (who was Kofi Annan, now a strong proponent of reform) and UNODC's Executive Director all made calls for a "drug-free world". This time no self-respecting UN official would openly support the "harmful concept of a 'drug-free world'" (according to the UN human rights experts).

Outside the UN, the momentum created by the UNGASS has helped to strengthen the drug policy reform movement bringing diverse new voices from criminal justice, development, peace building, palliative care, human rights, racial justice and religious groups. Over 1000 prominent and influential leaders, including Hilary Clinton and Bernie Sanders, have also made their voices heard with a strong letter to the UN Secretary General released on the eve of the summit.

The UNGASS was certainly not a success for the defenders of the status quo. The consensus on punitive prohibition has been well and truly ripped apart at the seams. What will rise up in its place? More than likely the trend towards "contentious pluralism" will continue as reforms continue apace at the national level placing further pressure on the global drug to control system to modernize to reflect reality or slide further into irrelevance.

For drug policy reformers, the work is by no means done. Although we should be buoyed by the fact that, by and large, the recent policy changes and shifts in discourse are in response to the numerous and vocal calls made by civil society in the course of the past decade. We can hear our progressive calls and language being reflected back to us by many governments and UN officials. To quote US Vice President Joe Biden:

"No fundamental social change occurs merely because government acts. It's because civil society, the conscience of a country, begins to rise up and demand - demand - demand change."

This UNGASS demonstrates the impact civil society pressure can achieve. The drug policy reform movement will continue to grow into a formidable global social movement towards 2019. The collective demand for change will grow ever louder leading to sustainable and seismic break-throughs at national, regional and ultimately UN levels.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

The drugs consensus is not pretty - It's been ripped apart at the seams

We have come accross an incredible amount of fantastic articles, blog posts and other pieces on the UNGASS 2016. In the following lines, we try to summarise the key takeaway messages emerging from these. Please click on the links to access the original articles. An extensive media coverage list can be found at the bottom of this blog post.

For reform-oriented civil society, UNGASS 2016 has left a bittersweet aftertaste. On the down side, the opaqueness of a process supposed to embrace ‘open, inclusive and wide-ranging discussions‘ was disappointing and frustrating, with most reformist organisations agreeing that it has been ‘difficult to have meaningful impact into both the document and the proceedings‘.

During the preparatory process ‘non-governmental organizations were literally shut out from key meetings‘. Euphemistically called ‘informals’ or even ‘informal informals’, these meetings are the main locus of negotiations, where ‘language is crafted and agreed upon’. For some, this exclusion of civil society and UN agencies alike, and ‘lack of transparency’, only benefited ‘those with a vested interest in maintaining the current state of affairs’, in particular prohibitionist states such as Russia and Egypt.

Yet obstacles to participation in Vienna paled in comparison to ‘the blatant censorship and bureaucratic exclusion that confronted us at New York’s UN headquarters’. Civil society participants were ‘subject to Kafka-esque attempts to limit access to the actual debates’, with ‘the UNGASS leadership [changing] its rules about accessing meetings daily’. Representatives were obliged ‘to stand in line for hours to get in’ or simply be ‘denied entry to the UN on the spurious grounds of “heightened security risks”’.

Despite these formidable hindrances, there is a sense of ‘pride‘ in the reformist camp as it managed to coalesce into an ‘unprecedented mobilisation’ of civil society, ‘powerful and unified over key issues’. Once ignored, the idea that the global drug control regime is failing to deliver was echoed by the majority of declarations from civil society, UN agencies and government delegates alike, who ‘turned their backs on overly repressive approaches’ and recognised the ‘need to experiment with alternatives‘.

Much of the frustration has surrounded the adoption of the UNGASS Outcome Document, which ‘does not represent a real break with the past, but rather business-as-usual, with some shifts in emphasis’. Very limited progressive language survived the ‘strong filter‘ of the UNGASS Board and the fierce opposition of ‘a small but powerful group of member states defending the status quo’, among which China, Egypt, Indonesia and Russia. Despite strong disappointment, however, some wins have been made in the text, for example the ‘well worded recommendations to assist countries in improving access to controlled essential medicines’, as well as other ‘small victories‘ in the form of references to ‘human rights’, ‘some specific harm reduction interventions‘, ‘proportionality of sentencing’ and ‘alternative or additional measures with regard to conviction or punishment’.

While the ‘extreme polarity of [member states] positions explains the absence of any major advances in the adopted text (...) the reality of the discussions is completely different’. As soon as the document was [hastily] approved on the opening session, a series of member states ‘[took] the floor to berate the failings of the [document]’ itself.

The most conspicuous omission became evident as dozens of countries condemned the document’s silence on the death penalty, underscoring the illegality of its use for drug-related offences under international law. But a plethora of statements by member states, UN bodies and civil society organisations also highlighted the lack of explicit mentions to harm reduction, decriminalisation, the failure to call for the creation of an expert group to evaluate global drug control, and the need to recognise and to experiment with the legal regulation of internationally controlled substances. Indeed, while some countries continue to ‘maintain fixed ideas on the well-worn ‘war on drugs’ theme (...), things are evolving’. All in all, the protracted negotiations and debate both within the plenary sessions and in the roundtable discussions laid bare the fault lines of the ‘fragile consensus’ on global drug control.

Member states will meet again in 2019, when a new current Political Declaration and Plan of Action ought to be produced. In the meantime, reform will grow apace at the national and subnational levels, with an increasing number of ‘jurisdictions openly defying the UN treaty system’ by ‘regulat[ing] coca, cannabis, other currently illegal drugs, or new psychoactive substances’. In the next three years, resolving ‘the tensions between the letter of the conventions and [these] ongoing initiatives on the ground’ will be of ‘vital’ importance, and the survival of the international drug control system will depend on its own capacity to engage in a process of meaningful reform. If, once more, it falls prey to ‘inertia’ and ‘immobilism’, it risks continuing its drift into irrelevance and inevitable collapse.

For an extensive list of media coverage on the UNGASS 2016 and its preparatory process, please click here.

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