Since the 1960s, the “War on Drugs” had started to take shape, not just in the US, but globally. By 1988, the United Nations Member States had ratified 3 major conventions that have fuelled criminal and repressive approaches to many forms of drug use. The War on Drugs has become a conflict of enforcing prohibitionist policies on the manufacture, distribution, and consumption of “illegal drugs.” However, now, after more than forty years of a militaristic approach to a public health problem, there continues to be an increase in narcotics production in the so-called “global south” and rising rates of consumption particularly in northern economies. Even more importantly, in recent years, there have been grave concerns about the global response to drugs; it has become more than clear that the War on Drugs not only perpetuated, but fuelled, severe human rights abuses towards people who use drugs, was not effective in its stated goals to curb drug use, and only worsened public health issues, especially in the context of HIV.

In the past decade a growing movement for reform of the outdated punitive approach has started to gain traction. Not only local, regional, and global civil society organisations, but also UN agencies are speaking out more and more in favour of drug policy reform and the need to provide people centred and rightsbased harm reduction services to people who use drugs. The harms of a continuing punitive approach that effectively criminalises people who use drugs are inconsistent with basic human right principles. In 2019 the UN System Task Team’s published a report entitled “What we have learned over the last ten years” speaks out strongly against the violent consequences of the War on Drugs.

Unexpectedly, global drug policy has influenced the African region significantly. Criminalisation of the possession of drugs for personal use remains across the southern African region and in many places harm reduction policies are not available; in places where policies are available to provide harm reduction services, implementation is often still lacking. In 5 countries where this report has done focus groups with people who use drugs it shows clearly that repressive policies lead to an environment of impunity of violence by the police, government stakeholders, and the wider community. Extreme levels of stigma are fuelled by criminalisation f drug use and possession within the communities that people who use drugs live. Even more worrying is the added burden of people who use drugs who live with HIV, who struggle to access ART, and of women who use drugs who face added issues of gender-based violence. Through linking the prevailing laws and policies with the lived experiences of people who use drugs this report provides clear evidence of the dehumanising effects of the continuing repression.