AMSTERDAM, Sept 15 (Reuters) - Judges at the International Criminal Court on Wednesday approved a formal investigation into possible crimes against humanity allegedly committed under the leadership of Philippine President Rodrigo Duterte in the context of his "war on drugs".

The ICC said in a statement that judges had approved a request by prosecutors to begin the investigation into potential murder as a crime against humanity.

Judges' assessment of material presented by prosecutors, was that "the so-called ‘war on drugs’ campaign cannot be seen as a legitimate law enforcement operation", but rather amounted to a systematic attack on civilians.

Human rights groups accuse Duterte of inciting deadly violence and say police have murdered unarmed drug suspects on a massive scale as part of the campaign. Police deny this, and Duterte says the police are under orders to kill only in self-defence. The government in Manila could not immediately be reached for a reaction late on Wednesday.

International court backs probe into Philippines' 'war on drugs'

The momentum for cannabis regulation is growing around the world. The US is debating federal legalisation. Eighteen states—around a third of the US population—have already legalised non-medical cannabis since 2012. Uruguay legalised recreational use of cannabis in 2013, Canada in 2018, and Mexico is considering following suit. In Europe, Switzerland and Luxembourg have announced formal moves to implement a legally regulated market. The Netherlands is finally establishing a legal supply for its long-tolerated “coffee shop” sales, and Malta is allowing people to grow their own plants while eyeing more formal legalisation.

The arguments for such moves are founded in evidence. Prohibition has proved costly and ineffective—failing to deter use or eradicate supply. By regulating cannabis, governments can regain control of the market, including by managing the quality, potency, and price of available products, and how and where they are licensed to be sold. Governments can take profits away from organized crime groups and generate significant tax revenue, while ending law enforcement practices that have disproportionately criminalised and incarcerated minorities and marginalised populations. But as the debate shifts from questions of 

 to do it responsibly, there are important lessons to be learnt from the successes and failures of regulating other drugs. Not all regulatory frameworks are equal, and the history of the tobacco industry is a testament to that.

In a new report published by the International Drug Policy Consortium (IDPC), in collaboration with other NGOs, we explain how major transnational tobacco companies have been complicit in the illicit tobacco trade—playing an active role in smuggling their own cigarettes to enter protected markets, circumventing effective health regulations, and lobbying governments to decrease taxation or any form of regulation that impacts their bottom line. They have deployed their legal, lobbying, and PR machines to maximise profits, with little concern for the health and social costs of their actions. Many of these schemes were revealed in the late 1990s, thanks to a trove of internal tobacco industry documents released as part of various lawsuits.

Why we can’t let cannabis become the next Big Tobacco

Global outrage regarding human trafficking and sexual slavery has had a major effect upon how women engaged in sex work are represented. No longer publicly imagined as morally corrupt or bad women 

, they are now more likely assumed to be victims of sexual slavery and trafficking. As a result, punishment and discipline have given way to more neoliberal mechanisms of control under the guise of ‘rescue’. Prostitution has been increasingly re-classified as a crime that uniquely victimises women and children, and as this US-led conflation of prostitution with trafficking has spread ‘raid, rescue and rehabilitation’ operations have increased throughout southeast Asia and other Global South contexts. These morality-based agendas make help and support conditional on exiting sex work and/or abstinence rather than prioritising rights, recognition and respect.

This politics of ‘rescue’ has resulted in multiple forms of abuse, and opposition to the approach has galvanised sex workers across the globe. This activism and advocacy, however, has been undercut and ignored. Friends have also been difficult to find. There has been a distinct lack of support from other communities and organisations negatively impacted by discrimination and criminalisation. Instead of taking up calls for decriminalisation and labour rights, potential allies have remained on the side-lines rather than standing in solidarity.

This is true of most anti-trafficking organisations. The image of the feminised sex slave has become so enmeshed in the public imagination that NGOs are afraid to embrace sex workers’ rights amid concerns that backing decriminalisation will potentially erode public and state support for trafficking victims. They are also worried that taking a stand in support of decriminalisation would open up their organisations to attack and put their funding and donations at risk.

Perhaps more perplexing has been the lack of engagement with sex workers’ rights by those spearheading campaigns for the decriminalisation of illicit drugs, including in the UK. Some drug policy reform organisations do see the parallels and are vocal in their support. Yet for others, there is a clear sense of ‘fence-sitting’ when it comes to supporting the full decriminalisation of prostitution. This is hard to understand. Both sex workers’ rights groups and drug reform groups understand the harms created by criminalisation and stigma, and spend their days fighting to reduce them. They also have overlapping constituencies. Yet despite this common ground many refuse to offer their support. Perhaps most concerning are the politicians who champion the right of people to use drugs, yet somehow find it in themselves to also embrace the ‘rescue’ of sex workers.

The common cause of drug reform and sex workers’ rights

By Marie Nougier (IDPC) for Dianova International

2021 marks several drug policy anniversaries: the 60th and 50th anniversaries of the 1961 Single Convention on Narcotic Drugs and of the 1971 UN Convention on Psychotropic Substances, the 5-year anniversary of the 2016 UNGASS on drugs, and last but not least, the 50th anniversary of the ‘war on drugs’ declared by Richard Nixon.

These anniversaries offer a key opportunity for policy makers and advocates alike to take stock of the global state of drug policies. Unfortunately, the political landscape is rather bleak.

Earlier this year, the International Drug Policy Consortium published a report evaluating progress made since the 2016 UNGASS on drugs, in which we assessed moves towards reform in the areas of human rights, health, development, civil society participation, UN system coherence and monitoring and evaluation of drug policies.

Repressive drug policies fuelling human rights abuses

The report puts in stark relief the blatant human rights abuses that communities all over the world continue to face as a result of repressive drug policies. Countries like Brazil, Colombia, the Philippines and others have recently reverted back to a war on drugs approach after several years of progress made towards more humane approaches. The consequence has been a devastating rise in extrajudicial killings, increased levels of violence and a surge in prison overcrowding. These examples also show how fragile any positive move towards more humane drug policies can be.

Over the past year, we have paid particular attention to the issue of prison overcrowding, as punitive drug laws remain a key driver of incarceration all over the world. Addressing prison overcrowding has become all the more critical in the context of the COVID-19 pandemic.

Prison overcrowding and women deprived of liberty

According to the UN, 2.2 million people globally are currently in prison for a drug-related sentence. This represents about 20% of the world prison population. Equally concerning is the fact that those targeted by drug law enforcement belong to the poorest and most marginalised communities, and to ethnic communities. Women are particularly affected, with 35% of the female prison population being incarcerated for a drug offence – a proportion that rises to 50-80% in various Latin American and Asian countries.

Devastating impacts on the health of people who use drugs

The ongoing criminalisation of people who use drugs has also been a major driver of incarceration, with at least 470,000 people incarcerated worldwide for simple possession. Fear of criminalisation, police violence, stigma and discrimination – as well as lack of access to, and funding for, harm reduction and treatment services – have largely contributed to high HIV and hepatitis C prevalence among people who inject drugs and overdose deaths. During 2017 and 2018 alone, the UN recorded a staggering one million drug use-related deaths. This is heart-breaking, when we know that these deaths could have been avoided with drug policies focused on promoting social justice, human rights and public health, and with improved access to services such as sterile needles and syringes, naloxone and drug checking.

How to improve the social justice response: Decriminalisation

Thankfully, several countries have made (small) strides towards policies that seek to address, and redress, the harms of punitive drug control. Removing criminal sanctions for drug use and possession for personal use has been one of the ways in which some countries have sought to improve the lives of people who use drugs.

As of today, 50+ jurisdictions in 31 countries, from Portugal to Czechia, Uruguay, South Africa and Jamaica, have decriminalised drug use and possession for personal use. Not all models of decriminalisation are equal however, and their impacts on the lives of people who use drugs vary greatly. For instance, while Russia has technically decriminalised drug possession, people continue to be targeted by drug law enforcement authorities and imposed harsh administrative sanctions, including detention.

However, when done well, decriminalisation can be instrumental in facilitating access to life-saving health services, reducing stigma and discrimination, and ending police abuse and the overuse of incarceration.

How to improve the health response: harm reduction

Improving access to health services for people who use drugs also remains critical – especially in the context of budget constraints and further social and economic hardship caused by the COVID-19 pandemic and related restrictions. Improved coverage of gender-sensitive services for women who use drugs also remains vital as most services are not adapted to the needs and realities of women. Finally, increased funding for harm reduction is as critical as ever: today, only 5% of funding needs for such services is being met in low- and middle-income countries, and this needs to change.

Pushing back against shrinking civil society space

Most importantly, the meaningful involvement of civil society and affected communities is essential to achieving a human rights, social justice, gender-sensitive and health-focused approach to drug policy. And yet, the rise in authoritarianism, populism and COVID-19 restrictions have severely restricted civil society space at all levels of governance. Crucially, civil society engagement is considered as a ‘ticking the box’ exercise. Rather, we should be considered as critical partners and experts who should be consulted seriously at all stages of the decision making, implementation, monitoring and evaluation processes in the field of drug policy.

There is still hope that drug policies can truly respect, protect and fulfil the human rights of communities worldwide. But policy shifts need to happen now, as we cannot wait for another 60 years for this dire situation to change.

60 years of the war on drugs: What needs to change

UK drug policy is a mess. As Carol Black’s review showed in detail, the UK’s consumption of illegal drugs is growing across all sectors of society and our treatment system is near collapse. Our drug related death rate is one of the highest in Europe, and the availability of drugs remains stubbornly high despite both covid-19 and regular much publicised drug busts.

Current drug policy fails everybody. But it fails black communities in particular. Black people are six times more likely to be stopped and searched than their white counterparts, and nine times more likely when the reason given is suspected drug possession. And this is despite white people reporting higher rates of drug consumption.

Suspicion of drug possession—often merely the claim that an officer can smell cannabis in the vicinity of the target—is the most common reason for searches by far. Black people are also much more likely to be arrested, charged, and imprisoned for drug offences.3 In 2017, black people were eight times more likely to be prosecuted for drug offences and nine times more likely to be sent to prison than white people.

United Kingdom: Our drug laws are racist, and doctors must speak out

By National Institute for Health Research (NIHR)

Scientists have revealed a new method of delivering hepatitis C testing and treatment to people who inject drugs which will help bring the world a step closer to eliminating the virus.

Scientists publish first blueprint for getting hepatitis C treatment out to people who inject drugs in their own communities

New expert guide pioneered in NHS Tayside will help the roll out of treatment across the UK and around the world

Scottish Government hails recommendations a "valuable resource" in eliminating the virus in Scotland.

A team of experts, led by Glasgow Caledonian University (GCU) and the University of Bristol, in collaboration with NHS Tayside and the Scottish Drugs Forum (SDF), have just published a ‘game-changing’ blueprint on how best to get hepatitis C treatment to those who need it most after a successful three-year trial in NHS Tayside.

The breakthrough in getting treatment to those who inject drugs – studied as part of the National Institute for Health Research (NIHR)-funded EPIToPe (Evaluating the population impact of hepatitis C direct-acting antiviral treatment as prevention for PWID (people who inject drugs) project – will help guide efforts in Scotland to eliminate hepatitis C by 2024.

Key recommendations include introducing a nurse-led community service for hepatitis C testing and treatment, recruiting peer workers who know the local drug culture and creating close ties between existing community services for people who inject drugs.

Scientists reveal new method of getting hepatitis C treatment to people who inject drugs

The Global Drug Policy Index (GDPI) is an exciting new project supported by the Robert Carr Fund, and led by the Harm Reduction Consortium. Through this project, we will develop, launch and use a new “composite index” that scores and compares national government policies related to the illegal drug market. The GDPI will initially focus on 30 countries, providing each one with a score or ranking to show how much their drug policies compare to the UN System Common Position on Drugs across four dimensions – criminal justice responses, health and harm reduction, access to controlled medicines, and development (while also exploring key issues such as civil society engagement, decriminalisation, proportionality of sentencing, and funding for harm reduction). The GDPI will track both policies and their implementation.

Complete the GDPI Survey for Civil Society Experts!

A major part of the data collection phase for the Index relies on a civil society survey which will truly enable us to assess how drug policies are actually being implemented on the ground.

For this first iteration, the survey is going to cover 

: Afghanistan, Argentina, Australia, Brazil, Canada, Colombia, Costa Rica, Georgia, Ghana, Hungary, India, Indonesia, Jamaica, Kenya, Kyrgyzstan, Lebanon, Mexico, Morocco, Mozambique, Nepal, New Zealand, North Macedonia, Norway, Portugal, Russia , Senegal, South Africa, Thailand, Uganda, United Kingdom.

If your country is included in the list, please help us by filling in the survey and share it widely with your civil society colleagues! The deadline for filling in the survey is Friday, 1 October Wednesday, 6 October 2021.

English: https://survey.sogosurvey.com/r/uxeFhy

Portuguese: https://survey.sogosurvey.com/r/ZqIYzk

Russian: https://survey.sogosurvey.com/r/9ZToWf

Arabic: https://survey.sogosurvey.com/r/UrmVaS

French: https://survey.sogosurvey.com/r/F8TUg5

Spanish: https://survey.sogosurvey.com/r/kygi7w

The Harm Reduction Consortium behind the Global Drug Policy Index is comprised of: International Drug Policy Consortium (IDPC); Harm Reduction International (HRI); Youth RISE; Women and Harm Reduction International Network (WHRIN); Middle East and North Africa Harm Reduction Association (MENAHRA); European Network of People who Use Drugs (EuroNPUD); Global Drug Policy Observatory / Swansea University (GDPO); Eurasian Network of People who Use Drugs (ENPUD); Eurasian Harm Reduction Association (EHRA); West Africa Drug Policy Network (WADPN).

Global Drug Policy Index (GDPI) survey for civil society experts!

Following the official launch of the Drug Decriminalisation [e]Course on 30th of June 2021, as a result of our collaborative project together with the International Drug Policy Consortium (IDPC), Mainline Foundation, and Frontline AIDS to end the punishment and stigmatisation of people who use drugs, a total of 240 participants from over 55 countries have started their online learning journey. Seven highly interactive, engaging e-modules enriched with videos, exercises, and key information equip participants with knowledge and tools to move the world towards decriminalisation and away from the war on drugs.

Expanding on this initial success and to engage with a broad and global audience, the course will be translated into French with funding support from the AIDS and Rights Alliance for Southern Africa (ARASA). By providing this free online course in multiple languages IDPC, Mainline Foundation, Frontline AIDS, and Health[e]Foundation aim to support partners worldwide on ending the criminalising approaches to drug use and personal possession.

Join for free and learn how to become an impactful advocate and influencer via the IDPC / Health[e]Foundation e-learning platform: https://idpc.healthefoundation.eu.

The Drug Decriminalisation [e]Course is soon available in French! 

By Ricky Gunawan, Global Drug Policy Program, Open Society Foundations

In the recent 47th session of the Human Rights Council, the UN Working Group on Arbitrary Detention released a study relating to drug policies. In this report, the Working Group examines how punitive drug policies have resulted in a large and disproportionate increase in detention and imprisonment for drug-related offences worldwide. The Working Group further observed that drug law enforcement often targets poor people and vulnerable groups, such as women, and people of African descent. They call for the decriminalization of drug use and possession, acquisition, or cultivation of drugs for personal use.

In the same Human Rights Council’s session, the UN High Commissioner published a seminal report that analyzes systemic racism against Africans and people of African descent by law enforcement agencies globally. She identifies that the conduct of special police operations in the context of the war on drugs is a driver to police-related fatalities that have occurred most frequently. In this report, the High Commissioner calls for removing laws and practices that incentivize racial discrimination in law enforcement, including reforming drug-related laws and policies.

These reports are important and opportune for contemporary human rights and drug policy reform movements, for at least two reasons. First, in times of long overdue racial awakening, it affirms that the war on drugs is a major building block that continues to sustain racist and abusive policing globally. In Indonesia, in its three rounds of execution in 2015-2016, nine of eighteen people executed for drug offences were all African nationals. In the US, Black people are almost four times as likely as their white counterparts to get arrested for marijuana possession, despite similar rates of consumption. Reading the two reports, one may infer that comprehensive efforts to uproot racial injustice and discrimination in law enforcement entails dismantling the punitive drug policies that are historically and intrinsically racist.

How the global human rights community can further push drug policy reform

Access to controlled medicines in humanitarian emergencies remains constrained

Recognizing World Humanitarian Day 2021, the International Narcotics Control Board (INCB), the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization (WHO) once again call on governments to facilitate access to medicines containing controlled substances in emergency settings, including during pandemics and the increasing number of climate-related disasters.

The theme of World Humanitarian Day 2021 acknowledged the impact of climate-related emergencies. Over 7,348 disasters have been reporting in the last two decades of which 40% are now estimated to be climate-related according to United Nations reports. The impact of their increasing number combined with the persistent COVID-19 pandemic creates a complex landscape for ensuring access to controlled medicines in emergencies.

A year after an earlier joint statement, unprecedented trade restrictions, shortages of medicines, surges in infections, and new variants of SARS-CoV-2 compound the problems related to maintaining a supply of controlled medicines, according to WHO and the World Trade Organization.

The problem of access to controlled medicines in emergencies

There is an increase in demand for controlled medicines in emergency responses. Since the beginning of the COVID-19 pandemic, WHO has identified over 20 medicines with global-level shortages, including four that contain controlled substances that are used in intensive care units for the treatment of severe cases of COVID-19. Internationally controlled medicines such as morphine, diazepam, and midazolam listed as WHO essential medicines, are vital for the management of pain, palliative care, surgical care and anesthesia, and treatment of drug-use disorders, mental health, and neurological conditions.

Shortages impact countries of all income levels. Low- and middle-income countries (LMIC) are often disproportionately impacted by shortages--partly related to their relative purchasing power in international medicines markets and partly because specialized systems to manage controlled medicines do not always accommodate sufficient exceptions for emergencies.

Urgent action is needed to ensure that national systems improve access to controlled medicines for people affected by emergencies, including pandemics, and climate-related disasters.

INCB, UNODC and WHO joint statement on access to controlled medicines in emergencies

By Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Palliative Care Medicines

July was a quiet month for palliative care advocacy, as many UN staff and colleagues in the northern hemisphere take well-deserved summer holidays. We are using this time to develop our new advocacy course to be released in September, catch up on reading, writing, and correspondence, and prepare for upcoming regional meetings of the World Health Organization. The WHO 71st Regional Committee meeting for Europe will be held September 13-15, and our final list of delegates includes myself, our Board Chair Dr. Lukas Radbruch, IAHPC research advisor Dr. Tania Pastrana, Italian primary care physician and geriatrician Dr. Simone Cernesi, our Advocacy Focal Point for the Russian Federation Dr. Galina Khemlina, a palliative care physician in San Diego, and IAHPC board member Ms. Gulnara Kunirova, founder of the Kazakhstan Association for Palliative Care.

News from the Inter-American Drug Abuse Control Commission

In its capacity as a civil society organization in official relations with the Organization of American States, the IAHPC fielded a delegation at the virtual 71st meeting of the Inter-American Drug Abuse Control Commission, or CICAD, on July 30. Our delegation—whose spokesperson was María Adelaida Córdoba, representing the Colombian Association of Palliative Care (ASOCUPAC)—called on CICAD to develop more programmatic support for members in the region wishing to improve access to controlled medicines. Although CICAD’s Hemispheric Drug Strategy and Plan of Action on Drugs have some paragraphs calling for improving access, , as the member state interventions at the meeting clearly demonstrated, much more advocacy by palliative care partners in the region is needed to translate these priority actions that still exist only on paper/PDF into policies that support patients and families. Dr. Cordoba’s intervention can be found here.

Our CICAD delegation included myself, Colombia Advocacy Focal Points María Adelaida Córdoba and Paola Ruiz, El Salvador Focal Point Marvin Colorado, and Argentina Focal Point Sofia Bunge. IAHPC Research Advisor Tania Pastrana assisted with Dr. Córdoba’s statement, and Universidad de la Sabana professor Marta Ximena León completed our institutional list of observers. We will be organizing our advocacy with CICAD around their next meeting, in Costa Rica in November. Anyone who wishes to join, please contact me, and stay tuned for more notices on this new campaign.

Policies fixated on abuse aren’t working

So much of the global, regional, and national drug control strategies—including CICAD’s—are still fixated on the 20th-century model of “supply control” as a solution to public health problems of harmful use of controlled substances, although according to the UN’s own data, harmful use and overdose is more prevalent than ever. Clumsy supply control policies and criminal justice-based approaches to illicit “drug” use have systematically restricted access to controlled medicines for pain control and palliative care, particularly in lower- and middle-income countries, resulting in what the European Association for Medical Oncology called the global pandemic of untreated pain, and what the 

 Commission on Palliative Care more recently named the “access abyss.”

Tell us about your situation
so that we can help

Dismantling harmful drug control narratives that restrict access to essential palliative care medicines is a key pillar of IAHPC advocacy. We rely on our members to send us information about the situation regarding access in their countries so that we can help them with advocacy and pass on this information to the relevant UN agencies.

treated pain as a side effect of almost a century of drug control, exacerbated by the COVID-19 pandemic, has created a secondary public health crisis—suicides, heart attacks, and chronic conditions associated with serious health-related suffering. As clinicians and patients know too well, untreated pain decreases mobility, impairs immunity, decreases concentration, accelerates anorexia, and worsens sleep disturbances, eviscerating quality of life. Pharmaceutical opioids, which should be inexpensive and accessible for rational medical use, are still unavailable in more than 80% of the non-industrialized world.

Illicit use is thriving but
patients are deprived

Recent evidence shows that the US is now sliding into the abyss: the pathological public policies spawned by the original—and much misinterpreted—UN “drug control system” are proliferating in a swamp of ideological contradictions that have simultaneously supercharged trends of illicit substance use worldwide while depriving patients even in countries such as the US of essential pain medicine, as shown in this study. Only clear and consistent advocacy can turn this around.

'Drug control' and pain management: The truth of the matter

On International Overdose Awareness Day 2021, the Women and Harm Reduction International Network (WHRIN) calls attention to the gender specific needs of women who use drugs and the need for immediate responses to address the ever rising number of drug overdoses.

Women who use drugs face unique challenges to prevent and manage overdose. This includes accessing lifesaving information, support to develop personal prevention strategies and the tools to effectively manage overdose.

Where harm reduction services exist, they are generally established without a gender lens and cater best for male clients. These services lack relevance and are not freely accessed by women and gender non-conforming people. This is accentuated for those with children, who have been subject to violence and for sex workers. Women with children, especially single mothers, are often reluctant to attend drug services for fear of being identified as a drug user and losing child custody. As a result of this women may use drugs secretly and alone, compounding the risk of fatal outcomes. Studies suggest that older women (45-64 years) are at particular risk of overdose, requiring targeted attention from harm reduction providers.

The COVID 19 pandemic has disproportionately affected women and gender non-conforming people who use drugs. Prevention of drug overdose — particularly through harm reduction services and commodities (including naloxone) as well as in-person peer support — has been restricted. Gender based violence (GBV) has increased. Demonstrated linkages between overdose and intimate partner violence indicate the urgent need for integration of GBV and harm reduction services. Fortunately, there is some progress, such as the gender sensitive service, Sisterspace, a women-only safe injecting facility in Vancouver. However, such services are exceptional and in no way proportionate to the scale of need.

To reduce these preventable deaths, it is vital that women who use drugs are meaningfully engaged in planning and delivering harm reduction and other lifesaving services. Peer to peer naloxone distribution, safe injecting spaces and overdose management training must become a feature of harm reduction services and other organisations engaging with women who use drugs. In addition, providers should make all efforts to reach women with low threshold approaches, particularly given COVID19 lockdown measures (where peer support and linkages, including through virtual means, are critical). Womensensitive harm reduction services must be urgently expanded.

On Overdose Awareness Day, WHRIN grieves for the women who have lost their lives to this war on drug users. The losses are harder to bear given the preventability and injustice surrounding the murderous failure of prohibition. The damaging ideology attached to the war on drugs acts as a core barrier to preventing and managing overdose - it is killing people and must end.