Por Maria-Goretti Ane-Loglo (IDPC) e Charity Monareng (TB/HIV Care)

Em 2015, os estados membros das Nações Unidas adotaram a Agenda 2030 para o Desenvolvimento Sustentável, que fornece uma proposta compartilhada de paz e prosperidade para as pessoas e o mundo em geral. No centro estão 17 Objetivos de Desenvolvimento Sustentável (ODS) que exigem ações urgentes de todos os países em uma cooperação global. Os governos do mundo reconheceram que a erradicação da pobreza e outras privações deve ser acompanhada de estratégias que melhorem a saúde e a educação, reduzam a desigualdade, protejam o planeta e estimulem o crescimento econômico.

Com menos de uma década restante até a data-alvo de 2030, é imperativo fazer um balanço do quanto a África avançou para alcançar os ODS e o que ainda precisa ser feito. No entanto, muito pouca atenção está sendo dada à reforma das políticas de drogas na África, que é de particular importância considerando como o controle global de drogas é uma questão transversal de desenvolvimento que impacta e impede muitos dos ODS. Estados membros devem, no mínimo, apresentar relatórios sobre a Meta 3.5 do ODS e seus indicadores, que estão diretamente relacionados ao uso e tratamento de drogas. No entanto, nos últimos cinco anos, governos africanos não incluíram quaisquer indicadores ou metas relacionadas com drogas nos seus relatórios.

Este artigo é composto por três partes.

A Parte 1 demonstra como a reforma das políticas de drogas é uma questão de desenvolvimento sustentável. A

Parte 2 fornece os resultados de uma análise documental das declarações dos países africanos nos Fóruns Políticos de Alto Nível sobre Desenvolvimento Sustentável (HLPF na sigla em inglês) em Nova York: de 7 a 16 de julho de 2020 e de 6 a 15 de julho de 2021.

Finalmente, a Parte 3 contrasta a omissão dos governos em mencionar sobre drogas nessas declarações, ao contrário do que realmente está acontecendo em nível nacional, a partir de uma rápida revisão da rede do IDPC na região.

Política de drogas e os Objetivos de desenvolvimento sustentável (ODSs): A África não pode alcançar as metas dos ODSs sem reformar as políticas de droga

Civil society engagement at the UN Commission on Narcotic Drugs (CND) and related meetings has improved dramatically over the past decade – in terms of the numbers attending, the opportunities to interact and participate, and the levels of experience and professionalism of nongovernmental organizations (NGOs) themselves. These changes are very important given that the contribution of NGOs and civil society organisations make policymaking more responsive to the needs of society.

Moreover, youth involvement specifically makes the voice of those who are normally excluded from policymaking but are disproportionately affected by the results heard. In their efforts to promote an inclusive and evidence-based debate, SSDPers have been organizing side events and have even been elected on the board of the Vienna NGO Committee on Drugs (VNGOC) and the New York NGO Committee on Drugs (NYNGOC) which advocate for and oversee civil society involvement with the UN.

In order to encourage youth engagement with international policymaking, this Advocacy Handbook gives an overview of the main UN institutions involved with the making of global drug policy, as well as highlights the ins and outs of advocacy. We hope that such an overview will help you make valuable contributions to the work of the CND and related processes, this way advocating for evidence-based drug policy embedded in the protection of human rights.

Drug policy reform at the United Nations: A youth advocacy handbook (2nd edition)

UNITE Global Parliamentarians Network to End Infectious Diseases

 All-Party Parliamentary Group for Drug Policy Reform

Zimbabwe Civil Liberties and Drug Network (ZCLDN)

Aiming to engage Honourable Members of Parliament in Zimbabwe into the discussion regarding drug policy reform, UNITE Global Parliamentarians Network to End Infectious Diseases, the All-Party Parliamentary Group for Drug Policy Reform and the Zimbabwe Civil Liberties and Drug Network (ZCLDN) held a virtual Evidence-Based Drug Policy workshop on 24 September 2021. The workshop sought to equip members of parliament with necessary tools for debating responsible and effective drug policy interventions to directly support their efforts in promoting a positive future for Zimbabwe. The discussion was moderated by Tendai Mhaka (Key Population Coordinator at National AIDS Council).

Evidence-based drug policy - Workshop with parliamentarians in Zimbabwe

By Marie Nougier and Adria Cots Fernandez (IDPC) / Harm Reduction Consortium

The Global Drug Policy Index is a unique tool that documents, measures and compares national-level drug policies, providing each country with a score and ranking that shows how much their drug policies and their implementation align with the UN principles of human rights, health and development. As such, the Index provides an essential accountability and evaluation mechanism in the field of drug policy. It is composed of 75 indicators running across 5 broad dimensions of drug policy. This first iteration evaluates the performance of 30 countries covering all regions of the world.

Key takeaways from the Global Drug Policy Index

The global dominance of drug policies based on repression and punishment has led to low scores overall, with a median score of just 48/100, and the top-ranking country (Norway) only reaching 74/100.

Standards and expectations from civil society experts on drug policy implementation vary from country to country.

Inequality is deeply seated in global drug policies, with the top-ranking 5 countries scoring 3 times as much as the lowest-ranking 5 countries. This is in part due to the colonial legacy of the ‘war on drugs’ approach.

Drug policies are inherently complex: a country’s performance in the Index can only be fully understood by looking across and within each of the dimensions.

Drug policies disproportionately affect people marginalised on the basis of their gender, ethnicity, sexual orientation and socio-economic status.

There are wide disparities between state policies and how they are implemented on the ground.

With a few exceptions, the meaningful participation of civil society and affected communities in drug policy processes remains severely limited.

The Global Drug Policy Index is a project of the Harm Reduction Consortium, which includes the following partners: the European Network of People Who Use Drugs (EuroNPUD), the Eurasian Harm Reduction Association (EHRA), the Eurasian Network of People who Use Drugs (ENPUD), the Global Drug Policy Observatory (GDPO) / Swansea University, Harm Reduction International (HRI), the International Drug Policy Consortium (IDPC), the Middle East and North Africa Harm Reduction Association (MENAHRA), the West African Drug Policy Network (WADPN), the Women and Harm Reduction International Network (WHRIN), and Youth RISE.

The Global Drug Policy Index 2021 - Analytical report

The Key Principles of Harm Reduction are an innovative set of tools developed through the HR4Homelessness Project. The innovation lies in their capacity to translate existing experiences and knowledge on Harm Reduction into actionable guidance through an open, iterative and evolving framework.

The Key Principles aim to contribute to improving and transforming the services that shape access to and the quality of care that people experiencing homelessness who use drugs or alcohol receive. Further, they aim to support these services to respond to conditions that negatively influence marginalised and underserved communities’ social and health outcomes.

Key Principle 1: Human Rights
Key Principle 2: Meaningful Engagement
Key Principle 3: Target Risks & Harms
Key Principle 4: Pragmatism
Key Principle 5: Person Centred
Key Principle 6: Evidence-Informed
Key Principle 7: Accountability

In response, the Key Principles of Harm Reduction in Homeless Services aims to support service providers to implement activities that respect the rights of people experiencing homelessness who use drugs or alcohol, which are informed by evidence. It also intends to advance social justice transformations, respect service user decisions and priorities, and contribute to eliminating stigma and discrimination of the communities they work for and with.

Harm Reduction Key Principles in Homeless Services

By Daan van der Gouwe (Trimbos Institute) / EHRA

This report draws on a study conducted by the School of Law, Swansea University, in collaboration with the Eurasian Harm Reduction Association (EHRA).1 Within the framework of this project, 8 country reports were drafted, targeting the use of new psychoactive substances (NPS) in Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Moldova, and Serbia. The assignment was undertaken to generate a more accurate picture of the use of NPS in these countries. For this study, two sources were used: (1) desk research of available literature and (2) additional structured interviews and focus groups with key respondents.

Throughout the Eastern Europe and Central Asia (EECA) region, the use and variety of NPS are relevant issues, although the nature and extent differ among the EECA countries and subregions, with better awareness of their presence among health professionals and people who use drugs. Synthetic cannabinoids and synthetic cathinones are predominant groups of NPS and widely available, whereas synthetic opioids seem to be more present in Estonia and Lithuania. Among people who use NPS, there are two key populations: those who have more experience with use of drugs, who have shifted to the use of NPS for a variety of reasons, and young people with no previous history of drug use. Drivers for use of NPS include the unavailability of drugs of choice, context-driven motives, as many NPS are not detected in blood and urine, and the aggressive marketing of NPS throughout the EECA region. NPS are marketed on social media channels, but also on public walls in many cities. A main risk of NPS is the absence of (chemical) analysis: that is, you do not know what you are actually consuming. Other health-related risks include mental health issues and increased risk of transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) caused by unsafe use (mainly by injections), often combined with unsafe sex. So far, in the EECA region, no specific treatments are available for people with NPS dependency issues, as the focus has remained on traditional drugs, in particular opioid use. Similarly, harm reduction services are mostly not equipped to address the need of people who use NPS. In the EECA region, data-driven and science-based publications on NPS are almost non-existent.

To better address the phenomenon of NPS in the EECA region, recommendations include the following:

implement a pilot program to check consumer drug samples (drug checking);

establish a regional Early Warning System (EWS) for NPS, similar to the EWS for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA);

develop and disseminate evidence-based, comprehensive information on NPS, including their risks and a suggested action for those overdosing on NPS;

scale-up harm reduction services to meet the needs of people who use NPS, to address the emerging and potentially very risky unsafe drug use and unsafe sexual practices in various chemsex scenes (for example, men having sex with men and young people communities); and,

implement measures to address the aggressive marketing of NPS in public spheres and via social media

The time of governments to bury their heads in the sand, hoping this phenomenon would disappear one day, is behind us. NPS are here to stay, and immediate action is urged to address NPS, in particular the needs of people who use NPS.

New psychoactive substance use in Eastern Europe and Central Asia: Regional report

 This is a zine about death, overdose, grief, and drugs.

The Harm Reduction community observes International Overdose Awareness Day on August 31 each year. This year, The DOPE Project worked with artist Gaia Wxyz to create a single-page zine as an act of care for a community that experiences too much preventable loss. You can read the zine below, print, and fold your own at home on 8.5″ by 11″ paper and distribute them to friends, family, program participants, and direct service workers in your community.

Learn how to use naloxone: https://bit.ly/UseNaloxone

Find naloxone near you: https://bit.ly/NaloxoneFinder

 you experience related to a painful loss, like the death of a loved one, and it is normal. Grief is a reflection of love.

When you lose someone you care about, your love for them remains. This love is precious, and so is your grieving process.

When you lose a loved one to overdose, your grief can feel both ambiguous and disenfranchised, which can feel isolating and like your grief doesn’t matter.

Ambiguous grief: Loss that occurs without closure or understanding

Disenfranchised grief: Loss that isn’t acknowledged or validated because of societal norms

Acknowledge your grief and your loved one in ways that feel good to you. Take care of yourself. Let yourself be taken care of. You are not alone.

Grief and death can teach us to celebrate a person’s life while they are still alive, and to be present for each moment we have with people we love.

Remember the person you are grieving lives on in many ways.

It’s okay to continue to hold space for them.

Common feelings in response to overdose loss:

Sadness over not having the chance to say “goodbye”

Helpless that you could not protect your loved one

Anger at your loved one, yourself or others who played a part in their addiction

Guilt, “should haves,” “could haves,” and “if onlys”

Disappointment in yourself for not having a sixth sense or picking up clues

Struggling with unanswered questions and a need to understand

Impatience waiting for toxicology or police reports, if initiated

Difficulty concentrating, forgetfulness, fear you are “going crazy”

Frustration over the lack of support and understanding from others about addiction

Need to have your loved one remembered for their lives and not their deaths

Difficulty sleeping, having intense dreams, intrusive thoughts or flashbacks about the deceased or circumstances at time of death

Feeling isolated from supports and possibly lacking places to talk about your grief

Fear of this happening to others you care about

Relief that you are no longer waiting for bad news

This zine was created for Overdose Awareness Day 2021 for The DOPE Project, San Francisco. Art and design by Gaia Wxyz

 Gaia WXYZ @gaiaw.xyz (pronounced “wize”) is a multimedia creator who specializes in visual art, specifically comics. Last year they earned an MFA in Comics from California College of the Arts, and appeared in the award-winning documentary 

No Straight Lines: The Rise of Queer Comics. 

They write & draw autobiographical comics about being Black and gender non-conforming. Art has been the major motivating force in their life, concocting characters and storylines in sketchbooks from an early age. Though they have skills in a variety of media, including printmaking, painting, design, sculpture, photography, installation and performance art, Gaia has focused their talent to pursue a lifelong dream of becoming a published comic artist.

Grieving overdose zine: Your grief matters and so do you

In 2018, the West African Commission on Drugs (WACD) published a ground-breaking ‘Model Drug Law for West Africa: A tool for policymakers' to assist policy makers in (re)formulating national drug laws in line with the UN drug control conventions and human rights obligations. The Model Drug Law was a follow-up to the Commission’s 2014 publication ‘Not Just in Transit: Drugs, the State and Society in West Africa’. By design, the Model Drug Law is a technical document – but it can be one of many highly useful tools for civil society to help advance drug policy reform and harm reduction programmes based on public health and human rights, including and especially for people who use drugs. This ‘explainer’ is one of two advocacy documents related to the West Africa Model Drug Law – the other explaining and breaking down the main contents of the Model Drug Law itself.

This short document serves as a practical guide for civil society on possible ways to use the Model Drug Law in advancing drug policy reform in West Africa and beyond. Despite its focus on the drug law and its legislative provisions, the Model Drug Law can be used by a wide variety of civil society organisations (including networks of people who use drugs) working on drug policy, harm reduction and related issues.

How to use the West Africa Model Drug Law: ‘Explainer’ 2: Guide for civil society advocacy

In 2018, the West African Commission on Drugs (WACD) published a ground-breaking ‘Model Drug Law for West Africa: A tool for policymakers’ to assist West African policymakers in (re)formulating national drug laws. The Model Drug Law was a follow-up to the Commission’s 2014 publication ‘Not Just in Transit: Drugs, the State and Society in West Africa’.

The Model Drug Law contains the four key parts of a drug law (general provisions, penal provisions, authorised activities, and schedules and annexes), each of which consists of model legislative provisions and commentary, in line with the UN drug control conventions.

By its design the Model Drug Law is a technical document, so this ‘explainer’ aims to provide a more accessible summary of the key elements.

How to use the West Africa Model Drug Law: ‘Explainer’ 1: Summary of key elements

Since 2013, a number of countries and local jurisdictions around the world have legalised and regulated their cannabis supply chains for non-medical use. Lawmakers, regulators, researchers, and advocates continue to design, enact, implement and revise regulatory frameworks for medical and recreational cannabis. And yet lessons from regulating other psychoactive substances, including tobacco products, are not always fully considered.

The experience of the illicit tobacco trade is particularly relevant for cannabis regulation. There are of course significant differences between the two substances. Cigarettes kill over 7 million people worldwide annually, and between one half and two thirds of their users. Non-combustible cannabis products, in contrast, present very low levels of harm, and some medical benefits. Cannabis and tobacco distribution also differ in nature. The global tobacco market is heavily concentrated. China, Brazil, and India accounted for 63% of all tobacco leaf cultivation in 2019 as part of a global cigarette market dominated by a small number of companies. China National Tobacco Corporation (CNTC) accounted for 43.9% of global cigarette retail volume in 2019 – the large majority of it is destined for domestic consumption, though the company has been developing a global expansion strategy. Beyond CNTC, Philip Morris International (PMI) (13.4% of global retail volume in 2019), British American Tobacco (BAT) (12.7%), Japan Tobacco International (JTI) (9.1%) and Imperial Brands (4.2%) accounted for 70% of the rest of the world’s market share in 2019. In contrast, cannabis can be grown indoors and therefore almost anywhere across the world. The illicit cannabis market has been characterised by a high number of small-scale growers, including for personal consumption and local distribution. Moreover, cigarettes are light, compact, distributed in small packs, and easy to smuggle – in part because they can be disguised as legal products through false invoicing and/or when hidden within a shipment containing other commodities. One 20-foot shipping container alone can hold almost five million cigarettes.

Yet tobacco and cannabis are both plants with psychoactive substances, with some similar characteristics including with regard to production (cultivation and processing) and consumption (tobacco and cannabis products can be smoked, consumed with a vaporiser, or used orally), and to some extent converging industries.

In any jurisdiction that regulates a psychoactive drug like tobacco or cannabis, a portion of it will remain on the illicit market. In Canada for instance, approximately half of the total cannabis market was illicit in the third quarter of 2020, almost two years after cannabis legalisation was introduced, according to expenditure data. Across the 10 Canadian provinces, legal recreational cannabis shares varied from 13% to 70% in September 2019. An estimated 10-12% of cigarettes consumed worldwide are illicit – this includes both illicit production and distribution.

Given those similarities and while the legal cannabis industry is still nascent, now is the time to explore lessons from tobacco control in order to inform cannabis regime design decisions. By tackling these questions early, governments are more likely to be able to prevent the emergence of an industry capable of preventing, deflecting and undermining policies centred on public health, social justice, inclusive and equitable trade, and human rights. The tobacco experience is arguably not a reason to refrain from regulating cannabis at all. Rather it serves as a cautionary tale of the difficulties to restrain private actors once they have become too powerful. The history of the illicit tobacco trade, and the role of the tobacco industry in both driving it and shaping responses to it, is particularly relevant in that regard. It will be the focus of this report.

Cannabis regulation: Lessons from the illicit tobacco trade

Australia’s Annual Overdose Report 2021

 reveals that there have been 34,728 overdose deaths in Australia since the turn of the century.

That figure includes 2,227 overdose deaths in 2019, 1,644 of which were unintentional.

We stand at a unique moment in history. We have a once in a lifetime opportunity to create an unprecedented legal framework that reconfigures one of the world’s major illegal trades – to make it work for social justice rather than against it.

We have identified 15 key priorities to be included in legal regulation policy that will directly impact and strengthen sustainable development and global equity.

This paper is an invitation for organisations and advocates to get involved in the process of developing legal regulation and by doing so begin to address the harms caused by years of prohibition.

Publications from IDPC Members