A law at war with itself: How Ghana’s drug policy is failing its public health mission

South Africa enters the new year still absorbing the revelations of the Madlanga Commission and the uncomfortable clarity it provided about criminal networks, policing failures and the erosion of public trust. And while our own institutions grapple with questions of accountability, the world has been jolted by the US’ military intervention in Venezuela and the capture of President Nicolás Maduro, under the guise of the War on Drugs.

We are justifiably shocked and scandalised and the public conversation has landed on a familiar and deeply misleading place: “drugs” are the problem, and harsher criminal justice responses are posed as the solution. Provocatively, we are asked to reconsider this popular, simplistic narrative: cartels are not infiltrating the state because drugs exist, they are infiltrating the state because prohibition creates a lucrative, unregulated economy, which criminal networks exploit.

South Africa is home to an estimated half a million people who use illicit drugs (such as methamphetamine and heroin), the majority of whom use occasionally, in a non-problematic pattern and in ways that pose little to no threat to the public. Yet our law continues to treat them as criminals, corralling people who use drugs and low-level drug sellers into the same punitive framework designed for large-scale traffickers and cartel operatives.

The Madlanga Commission’s hearings have exposed what research has shown repeatedly, that criminalisation of drug use creates enormous illicit markets, and illicit markets in turn create incentives for corruption. When a product is illegal but widely used, its regulation shifts from the state to whoever is willing to use violence and bribery to control the trade.

Decriminalising personal possession of drugs will not end drug use. But it has the potential to help end the criminalisation of poverty, free up our courts and alleviate our overcrowded prisons. It also has the potential to redirect resources towards prevention, treatment and harm reduction and, importantly, it has the potential to starve criminal networks of the low-level arrests they rely on to distract the public from high-level corruption.

South Africa: Crime, cartels and corruption — The drug policy debate we refuse to have

People who smoke crack cocaine face significant health risks, including communicable diseases and damage to respiratory health, particularly when using shared or homemade equipment. Despite this, there are currently no targeted harm reduction interventions in Wales for this population.

This study presents a rapid Health Impact Assessment (HIA) of a pilot safer inhalation device intervention, exploring its potential impacts on health, wellbeing and health inequalities among people who smoke crack cocaine.

Safer inhalation devices: a rapid Health Impact Assessment of a harm reduction pilot for people who smoke crack cocaine

A growing body of research has focused on the critical analysis of drug policy narratives. Lacking in this literature is research from Africa, especially analysis of narratives around cannabis policy, which is changing across the continent as in the rest of the world. We analysed contrasting accounts of cannabis policy, seeking to highlight the diversity of narratives and the role of hegemonic narratives that reinforce policy stasis through containment of existing alternatives.

We drew upon qualitative interviews with cannabis market insiders (e.g. farmers, transporters, traders), drug advocacy NGOs and policy officials in South-West and South-South Nigeria, focusing on how these actors constructed cannabis as a policy problem. Analysis was thematic and aimed to identify the core narratives in the data and to explore their meanings and functions in policy debates.

We found contrasting representations of cannabis – e.g. ‘cannabis as dangerous drug’, common in policy officials’ narratives, and ‘cannabis as cash crop’, often found in market insiders’ narratives. The latter actors, driven by the realities of poverty and deprivation, emphasised socioeconomic and medical benefits of cannabis and supported equity-based policy reforms to secure cannabis-based livelihoods. Conversely, the former emphasised the negative social and health consequences of cannabis consumption. Their more hegemonic narratives, reflecting ideological and institutional concerns, accommodated piecemeal policy adjustments based on a framing of ‘global best practices’, thus containing reform impetus and reinforcing resistance to substantive policy change.

The article highlights how hegemonic cannabis policy narratives, especially espoused by policy officials, contribute to maintaining cannabis policy stasis.

Drug policy stasis and hegemonic narratives of cannabis in Nigeria

Cocaine trafficking through West Africa fuels local addiction

Two of Zimbabwe’s leading drug rehabilitation hubs, Matrix Rehabilitation Centre and Angel of Hope Foundation, are among a plethora of sprouting correctional centres that are increasingly taking the limelight for human rights abuses and corruption. .

This emerged during an investigation supported by Information for Development Trust, a non-profit outfit promoting accountability journalism in Zimbabwe and Southern Africa.

The investigation established that some of the victims at such detention centres who are being arbitrarily rounded up are as young as nine.



Human rights abuses, corruption rampant at Zimbabwe’s shady drug rehabilitation centres

The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Tlaleng Mofokeng, today welcomed reports of a directive by the South African Police Service to end the unnecessary confiscation of syringes and needles.

“This development supports recommendations I have previously made in my reports with regards to harm reduction policy tools, to include Needle and syringe programmes as an essential component to the right to health and the right to benefit from scientific progress and its applications,” Mofokeng said.

The Special Rapporteur encouraged all states to desist from law enforcement practices that hamper the right to health, including the seizure or destruction of injection equipment and the prosecution of healthcare and harm reduction service providers.

South Africa: UN expert welcomes report of police directive supporting harm reduction programmes

The human rights related risks and barriers faced by key populations are well-recognised, and addressing these is understood to be an essential component of a comprehensive HIV key population programme. A related, but less well understood challenge is the security of those involved in implementing HIV key population programmes and delivering services to these groups. Implementing organisations – which are often themselves key population-led – are often on the receiving end of threats and violent attacks which are directly related to their work. This insecurity has a heavy toll on the physical and mental health of those working in programmes. It reduces the effectiveness of those programmes as they deal with staff arrests, damage to organisational reputation, limited mobility, and hacked data, along with other issues that direct attention away from programming, that limit programme reach, and that can cause programme beneficiaries to decide to avoid these services.

While human rights programmes take a long-term approach to address the root causes of violence, stigma, discrimination and human rights abuses, including working at a policy and legislative level, it is also vital to implement day-to-day actions to reduce the risk of security threats and incidents faced by programmes, and to respond to those when they occur. Systematically tracking and assessing risks and putting in place resources and measures to reduce those risks and to respond to incidents is integral to any HIV key population programme, is essential to achieving and sustaining results in HIV and human rights programming. It is also part of the duty of care towards front line organisations, workers, and volunteers, and is essential to make community-led programming a safe and sustainable option. 

The Global Fund to fight AIDS, Tuberculosis and Malaria is collaborating with FHI 360, and with the Civil Society Institute for Health in West and Central Africa (CSIH-WCA), to adapt tools that programmes can use to anticipate security risks, to plan ahead to reduce these risks, and to respond to incidents and threats. This document introduces the tools available to Global Fund programme implementers. They can be used to systematically build security measures into existing programmes, and as a basis for allocating resources to security as part of reprogramming or country dialogue processes.

Security toolkit: Protecting implementers and improving programme outcomes

This briefing paper provides an overview of the harm reduction response in Nigeria in relation to the drug law and policy landscape. The aim is to support stakeholders—including civil society organisations, advocates, and policymakers—in identifying opportunities to improve the health and rights of people who use drugs.

The paper highlights major gaps in the legal and policy environment that restrict access to harm reduction services in Nigeria, such as needle and syringe programmes (NSPs) and opioid substitution therapy (OST), despite their recognition in national guidelines. It also outlines the roles of key institutions and actors in shaping the national response to drug use and harm reduction, and provides recommendations for ensuring a more enabling environment.

Harm reduction landscape and drug laws in Nigeria

In July 2022, the Supreme Court of Ghana ruled in a 4-3 majority decision that the inclusion of Section 43 in the Act was unconstitutional, citing procedural flaws in its passage. However, experts believe that the successful implementation of these cannabis regulations could unlock significant economic benefits for Ghana.

The Minister for Finance, Hon. Ato Forson has revealed that the Ministry of the Interior has initiated processes to implement Section 43 of the Narcotics Control Commission Act, 2020 (Act 1019) and the Narcotics Control Commission Regulation 2023 (L.I. 2475).

He announced this in his presentation of the 2025 Budget Statement to Parliament on March 11, 2025.

Hon. Ato Forson stated that this initiative is aimed at regulating the cultivation and management of cannabis with a tetrahydrocannabinol (THC) content not exceeding 0.3% on a dry weight basis in Ghana.

According to the Minister, Comprehensive Guidelines for the cultivation and management of cannabis have already been drafted, and the associated charges and fees will be laid before Parliament for approval in 2025. This is contained paragraph 734, page 119 of the THE 2025 BUDGET STATEMENT AND ECONOMIC POLICY OF GOVERNMENT referred to as 

“Resetting The Economy For The Ghana We Want”.

This development comes after years of legal back-and-forth regarding cannabis legislation in Ghana. The passage of Act 1019 in 2020 was initially celebrated as a progressive move toward the regulation of industrial hemp and medicinal cannabis. However, in July 2022, the Supreme Court of Ghana ruled in a 4-3 majority decision that the inclusion of Section 43 in the Act was unconstitutional, citing procedural flaws in its passage.

Following a review application by the Attorney General, the Supreme Court reaffirmed its decision in May 2023, maintaining that the legislative process leading to the law's approval was flawed. This ruling temporarily halted efforts to regulate the cultivation and management of industrial hemp in Ghana. This necessitated Parliament to reconvene and pass amendment of the Act to let same be inline with the parameters set by the Supreme Court.

The decision to finalize regulatory guidelines and present them before Parliament for approval signals a renewed push toward creating a structured legal framework for industrial hemp cultivation.

Ghana: Government to lay guidelines for cultivation and management of cannabis for approval in 2025

 Accra International Conference Centre(AICC)

 Catalysing Integrated Sustainable Responses to end AIDS, TB & Malaria.

Catalysing Africa’s progress towards triple elimination and sustainable resilient health systems through innovation and digital technologies.

Promote cooperation among governments, communities, the private sector, and international organizations to enhance health security and improve pandemic preparedness and response.

Strengthen capacity and facilitate knowledge exchange for healthcare professionals, researchers, and policymakers.

Empower communities and promote human rights and gender equality in the context of HIV/AIDS and emerging and reemerging diseases.

Mobilize domestic resources and political commitment to sustain Africa's progress towards achieving the UNAIDS 95-95-95 targets and global health security goals.

23rd International Conference on AIDS and STIs in Africa (ICASA)

In January 30, employees at TB HIV Care received a letter informing them that they’d soon get their last paychecks. The nonprofit organization, working directly with people who use drugs in South Africa, has been forced to halt operations—part of a global freeze imposed on groups receiving United States humanitarian aid. 

Some 5,000 people were being served by TB HIV CARE at two harm reduction sites in eastern South Africa—depending on them for access to resources including sterile syringes and medications for opioid use disorder (MOUD).

“I owe my HIV-negative status to their efforts.”

Barend Beukes, 42, who lives in the city of Tshwane in Gauteng province, has relied on groups like TB HIV Care, and others funded by US aid programs, for years. “I owe my HIV-negative status to their efforts,” he told 

He got his first dose of methadone right before the COVID lockdowns. “It has progressively been changing my life ever since. Programs like opioid support therapy have allowed me the semblance of a normal life.”

The two sites include one in Tshwane, which has been serving about 4,000 people, and another in the Ehlanzeni district of Mpumalanga province, serving around 1,000.

“Both sites are now closed, leaving these clients without access to critical harm reduction services,” Klaus Mtshweni,a national leader with the SANAC Civil Society Forum PWUD Sub-sector, told 

Sub-Saharan Africa