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Drug crime and criminalisation threaten progress on MDGs

 

Interview with Antonio Maria Costa

 

·       International drug crime and the policies intended to tackle it are both threats to progress on health, human rights, and the Millennium Development Goals

 

Kelly Morris reports.

 

In preparation for the UN Millennium Development Goal (MDG) Summit, secretary-general Ban Ki-moon, declared on this year’s International Day against Drug Abuse and Illicit Trafficking that “we must recognise the major impediment to development posed by drug abuse and illicit trafficking”, and urged that: “our

work to achieve the MDGs and fight drugs must go hand-in-hand”.  

Antonio Maria Costa, executive-director of the UN Office on Drugs and Crime (UNODC), told The Lancet that if the many cross-cutting, multidimensional issues about drugs and crime are not addressed, many MDGs will not be met in various countries. The effect of the illicit drug trade, which constitutes the major

part of global organised crime “is high on the international agenda”, Costa notes, and a fundamental concern is the “vicious cycle” of drug production and trafficking, poverty, and instability.“22 of the 34 countries least likely to achieve the MDGs are in the midst—or emerging from—confl icts, located in regions that are magnets for crime and violence.”

 

In the report The Globalization of Organized Crime, UNODC notes that cocaine trafficking from Central America through west Africa, and heroin corridors from Afghanistan through central and west Asia are linked with violence, corruption, and increased local drug-use problems. Central and west Asia are experiencing an “increasing presence of insurgents and terrorists funded mainly by the drug trade”, Costa explains, while in west Africa, drug cartel soldiers are paid in drugs, which tend to be sold locally. Thus, addiction is spreading to developing countries, and there are fears that this will further threaten health-related MDGs, especially in Africa, he says.

 

To respond, Ban spoke of the need

to promote development in regions

where drug crops are grown, and

increase efforts against corruption

and organised crime. Costa urges

that “the MDGs are the most

effective antidote to crime, while

crime prevention helps to reach

the MDGs”. But voices from many

quarters, including more than 17 000

signatories of the Vienna Declaration,

 

“‘The enrichment of organised

crime, corruption, and violent

conflict stem directly from drug

prohibition’.”  say that drug prohibition and drug

policies based around criminal justice

efforts are not only failing to achieve

their goals, but are also a major

driving force behind the crime and

violence that threaten health, human

rights, and development. The central

issue for Robin Room, Turning Point

Alcohol and Drug Centre (Fitzroy, VIC,

Australia), is that UN policy defines the

problems in terms of crime and not

public health. Ban’s message, he says,

“is basically a call to redouble a policy

which has failed practically, and which

in my view is immoral”.

 

“MDG and drug problems do need

to be addressed together”, comments

Wayne Hall, professor of public health

policy, University of Queensland,

Herston, Australia. But, he says,

“we know that crop substitution

programmes and military operations

against illicit producers in source

countries have had limited impact on

drug supply”. Room continues that “the

drug-war strategy of source-country

containment has failed, and is likely

to continue to fail. If we could forget

about drug crop eradication and crop

substitution, and get on with workable

strategies for development, that would

 

be all to the good”. But if development

strategies are “held hostage to drug

war considerations, that would be a

very bad outcome”. Hall asserts that

“demand reduction via treatment and

more intelligent law enforcement

approaches is probably a better

response in developed countries that

are the destination for these drugs”.

 

The illicit drug trade is estimated at

US$320 billion—driven by a market

mostly based in richer countries

supplied by and through poorer

countries. Evan Wood, fi rst author of

the Vienna Declaration (International

Centre for Science in Drug Policy,

Vancouver, BC, Canada), told The Lancet

“the enrichment of organised crime,

corruption, and violent confl ict stem

directly from drug prohibition”, and , he

says, development goals are unlikely to

be reached without a new approach.

 

The overarching adverse eff ect of

drug prohibition is policy displacement,

Wood says. “If nations continue to put

such incredible resources into drug law

enforcement and incarceration of petty

drug offenders, this simply cripples

development eff orts by draining

opportunities for evidence-based

modalities to meaningfully reduce

drug-related harms.” $2·5 trillion has

been spent in the USA in the past 40

years on the war on drugs, which Wood

says is an approach that “basically

prohibits innovation” in methods of

reducing drug-related harms.

 

In addition, punitive policies

towards drug users are linked strongly

with human rights violations and

adverse public health consequences,

especially the spread of HIV/AIDS.

Hall cites as examples the high

rates of imprisonment for drug use

and possession; widespread use of

compulsory treatment (often enforced

detoxification and forced labour

rather than recognised treatment);

and prohibitions on harm-reduction

measures such as needle and syringe

programmes and opioid agonist

maintenance treatment.

 

The recent UNODC discussion paper,

From Coercion to Cohesion, details

evidence-based and ethical treatment

as an alternative to criminal justice.

But the health damage and human-

rights abuses surrounding current

drug controls are much wider, and

include the intergenerational eff ects

of incarceration, “which no one is

speaking about”, says Wood. Another

is the report of law enforcement

supported financially by Europe and the

UNODC, leading to executions for drug

offences, released by the International

Harm Reduction Association (IHRA).

 

What is needed as a priority, says

Wood, is acknowledgment by the

UN of the failure and unintended

consequences of the global drug

control system and the evaluation and

investigation of alternatives. In recent

months, similar calls have come from

increasingly diverse sources. Mexico’s

president Felipe Calderón became the

latest Latin American leader to call for

a debate on drugs legalisation as part

of a review on tackling security issues,

although CalderÓn personally opposes

legalisation. Official figures estimate

28 000 killings in the past 4 years due to

drug-related violence in Mexico. In the

US, Drug Czar Gil Kerlikowske declared:

 

“The term ‘War on Drugs’ is outdated

and drug addiction is a complex

problem. We do not like to use the term

‘war’ because it gives you limited tools”.

And, the outgoing president of the UK

Royal College of Physicians, Ian Gilmore,

announced his personal backing for

calls to reconsider drug laws with a view

to decriminalising use, which, he wrote,

“could drastically reduce crime and

improve health”.

 

Costa, who ended an unprecedented

two terms as UNODC executive director

in August, has repeatedly emphasised

a perspective to drug control that

focuses on the rights to health,

development, and security. He reported

his convictions to the Commission

on Narcotic Drugs earlier this year in

a personal note: Drug control, crime

prevention and criminal justice: a Human

Rights perspective. Tackling prevention

and treatment of drug-use problems is

the first priority, says Costa, since law

enforcement activities will not halt

illicit activities if underlying markets

remain unaddressed. Member states

spend much more on containing supply

rather than demand reduction, he

explains, but International Drug Control

Conventions give states the flexibility to

adopt approaches to treatment of users

based on health and human rights.

 

On taking up office as the new

UNODC executive director, Yuri

Fedotov of the Russian Federation

spoke of advancing the UNODC agenda

“to give public health and human

rights the pride of place they deserve

in drug control, crime prevention, and

criminal justice”. In his opening address,

Fedotov said he will shortly launch a

major consultation with member states

and other partners to chart UNODC’s

future course of action, but emphasised

international legal instruments and the

current criminal justice system as his

initial thoughts for the positioning and

priorities of UNODC.

 

In a statement to the media, Fedotov

noted that “drug dependence is a

health disorder, and drug users need

humane and effective treatment—

not punishment”, adding that drug

 

treatment should also promote the

prevention of HIV. However, the IHRA

has criticised the appointment of a

Russian official, given the negative

impact of Russia’s drug control regime,

which continues to ban the use of

methadone, despite estimates by

UNAIDS that one in 100 Russian adults

are now infected with HIV largely

because of a heroin use epidemic.

 

In November, in a potential test

for one alternative to prohibition,

the US state of California will vote on

whether to regulate and tax cannabis,

going beyond the decriminalisation

policy that operates in some European

countries. In September, at the British

Science Festival, cannabinoid expert

Roger Pertwee (University of Aberdeen

and GW Pharmaceuticals, UK) called for

a UK expert group to discuss licensing

the recreational use of cannabis,

perhaps in a manner akin to driving

licences. Wood says that regulation can

mean various approaches but ideally

involves strict control by governments

in a medical model, the aim being to

break the current cycle of violence and

corruption by channelling money away

from organised crime groups “and into

the hands of those who do not have a

vested interest in marketing drugs to

young people”.

 

Legalisation concerns Costa, because

it is mainly called for by the rich but

“will open the floodgates of a public

health disaster in the third world”, he

says. Wood counters that the disaster

has already arrived in places like Mexico

and Afghanistan and that “continuing

to ignore this reality will simply cripple

development efforts”. Instead, he

says that “health models and drug

law reform are not incompatible with

reducing both drug use and crime. If

the UN system continues to ignore the

failure of the ‘War on Drugs’, countries

should break ranks with the UN

system and seek to apply and evaluate

evidence-based health models in the

same way we would tackle any other

health and social problem.”

 

Kelly Morris

 

www.thelancet.com Vol 376 October 2, 2010

 

Last Updated on Sunday, 04 May 2014 16:59