Side event – Getting better results: Aligning drug policy objectives within the wider UN system

Side event organised by New Zealand, Brazil, Canada, Switzerland, the Global Drug Policy Observatory, the International Centre for Science in Drug Policy, IDPC and Transform

Hon. Peter Dunne, Associate Minister of Health, New Zealand. Over the past few years, we have shifted drug policies towards a health approach. Most of us have come to the conclusion that we need more robust and effective systems that demonstrate the consequences of drug policies. A new report in New Zealand assesses the costs of drugs on people, health, etc. We will more today on initiatives being done all over the world.

Indicators event

Dr. Mandeep Dhaliwal, UNDP. I will focus on the SDGs. Drug control and SDGs share the common aim of reducing harms and improving health, well-being, gender equality, justice and strong institutions. We know we must address organised crime to improve the SDGs. Insufficient attention has been paid to poverty and inequality as the root causes of crop cultivation. We know now the unintended consequences of drug control. Despite the evidence linking development and drug policy, world leaders have not paid sufficient attention to the development dimensions of drug policy. The 2030 agenda for SDGs offers a comprehensive human rights based framework for addressing drugs issues. We need to go from the standing point of leaving no one behind, including people who use drugs. The SDGs create opportunities to better develop and implement drug policies. It includes a set of indicators that could be used to evaluate drug policies. We can then strengthen system-wide coherence in development. If we don’t address HIV among PWID, then we will miss our HIV targets, for instance. In terms of UNDP’s work, our work intersects with eradicating poverty and reducing exclusion. We have developed a paper on the intersect between drug policy and development. Today, we released a pragmatic set of recommendations on how to move forward. I want to leave you with two messages – drug control that prevents crime, poverty and exclusion is critical to development. Likewise, success in achieving the SDGs can support drug control efforts. The global community can address the welfare of individuals and improve the welfare of mankind, without leaving anyone behind.

Nazlee Maghsoudi, ICSDP. In January, we held an event to release an open letter on indicators and metrics to measure drug policies. This has been published in the Lancet. It uses decades of research to show that the mtrics and indicators used by member states (arrests, seizures, price, purity) have failed to capture the complex ways in which drug policy impacts on our communities. We propose a new set of indicators based on health, reductions in violence, human rights, and development. This commitment to revise indicators should be an official outcome of the UNGASS process. We also call for the creation of an advisory group as an official outcome of the UNGASS. We were happy to see the inclusion of metrics in the first draft, which was then watered down and removed from the final draft. The absence of a meaningful commitment to revising indicators is a critical missed opportunity to address the 3 UN pillars, and the SDGs. As it stands, the status quo in drug policy will act as a barrier to the achievement of the SDGs. This exercise can be undertaken regionally and nationally. International cooperation is also critical – revising indicators should be also undertaken at international level – we need academic and technical work to be done for 2019. The CND has not taken up this challenge. New York may need to step in to work towards the achievement of the SDGs and align with the concerns of systemwide coherence.  I urge member states to recognise the role of academics in this work. The ICSDP letter provides preliminary indicators that have already been adopted by some member states. It is only when we start measuring the ways in which our drug policies impact in our communities that we can have a real impact around the world.

Mike Trace, IDPC. This issue is often seen as less glamourous or technical. But for me this is a crucial systemic issue which we have to get right. Otherwise you are likely to miss the key issues and objectives. The analysis I am providing today is from IDPC but is drawn from 3 other documents – the GDPO and Transform’s alternative world drug report. There are many NGO voices that say the same thing. I have always been concerned that we don’t give enough attention to how to measure our drug policies. Reducing demand and supply is a good thing, but these are not good objectives for the whole UN system. They are process indicators. These are not just symbolic however, they provide the rationale that if you eradicate and interdict, you will achieve your ultimate objective. I have been disappointed that we haven’t spent a lot of time in Vienna on the UNGASS on this. In 1998, the slogan was “a drug free world, we can do it” – this was not official but is important in this context and can lead us to the wrong track. They are not aligned with our objectives of development, health and human rights. We need to articulate a set of outcome objectives. For example: my experience in the UK government was that the priority should be to tackle petty crime. What was the best way to reduce the problem? Offer social care and support to people involved to prevent their involvement. This worked well in the UK. Another example was HIV prevention – a large number of countries decided that the best way to respond to this was harm reduction and care for people living with HIV. You analyse your objective, identify best evidence and implement the policy. Mexico is another example – it had a clear problem of drug-related violence. The objective there is not to defeat the market, but to reduce violence. They stated the right objective – they are now trying to identify the best way to do this. It is the responsibility of multilateral agencies to think that way. Is it now the time for New York to take the lead?

Secretary of State for Health, Switzerland. For more than  decades, the Swiss drug policy has been based on 4 pillars: prevention, treatment, law enforcement and harm reduction. The 4 pillars have areas of action complementing one another. We have put strong emphasis on coordination across these pillars. Sometimes, measuring impact is straightforward. For HIV, we saw a drastic reduction of HIV infection. But for other interventions, it is unclear. The best example is harm reduction and law enforcement. There is tension between these two sets of action – reduce harms with drug consumption rooms could be undermined by repressive measures. So we put strong emphasis on coordination between harm reduction and law enforcement. The success is quality of relationship between actors working on both fields – how do you compare quality? Do you rely on anecdotal evidence? There is no simple recipe for this. As one way to address this problem, we have developed a new set of indicators. This will help us understand what drug use looks like, how it evolves over time and how to adapt interventions to reduce harms. One key lesson from our experience is that we have to look at policy outcomes in a holistic way – some outcomes can only be measured in a holistic way. Good policy indicators are critical to measure the effectiveness of our drug policies.

Luis Paiva, SENAD, Brazil. We have already participated in similar side events in Vienna and I had the opportunity to present what s happening in Brazil. In 2016-2019 we will have governmental planning to define drug policy but also other guidelines for the administration. We had to develop specific metrics for policy to be included as part of the plan. When it comes to translating indicators to national policy, it’s not helpful – there are a lot of cross-sectional topics that have to be considered: crop reduction/supply reduction will help you establish cooperation between different agencies. This exercise was difficult to ensure coherence between different agencies inside Brazil and their distinct evaluation methodologies. Drug policy is integrated in several ministerial agendas in Brazil, so we had to take those into account. From now on, the large portion of metrics in drug policy will be integrated in our new governmental plan. It will include: infectious diseases, access to harm reduction services, aligned with development indicators. We can start consideration of the SDGs as part of the evaluation of the whole plan. We strongly believe that this exercise to establish global metrics and indicators in drug policy can lead to interesting results. We have interesting materials being drafted by NGOs and agencies. We are disappointed that this topic was not included in the outcome document, but we now have a window to start discussing the topic of metrics to set out what we want to achieve in 2019. The 2030 agenda is essential to avoid the isolation of drug policy indicators on security issues, and develop other priorities for drug policy: such as harm reduction – it is recognise as a priority in many UN agencies and we had a hard time establishing this as a objective of drug policy – this is a clear example of how we have a double standard in the way our policies work and are established.

Questions from the floor:

Angela Me, UNODC. The relation drugs/development is complex. We need to have a look at the impact that drugs have on development, not just drug policy.

Mandeep, UNDP. Absolutely – we must look at the impact of drugs, the two are related – drugs and drug policy. There has been an inclusive process to look at indicators for the SDGs. There are clever ways in which we can get development indicators to fit with drug policy.

Dan Werb, ICSDP. I was interested by the Westbourne analysis – how do you use the data you have at your disposal in relation with other data?

Christian Schneider, Switzerland. I am not directly involved on this issue, but to give you an example: a study by the University of Lausanne analysed the trends in drug use and evolutions on the weekend, which showed that cocaine use increased over the weekend. This was something we didn’t know and we compared this with other studies in other cities and found a similar trend. This is one of the ways we can use data to adapt our strategies.

Steve Rolles, Transform. This is a question to Mandeep. In terms of UN contributions in the UNGASS process, there was a lot of discussion on the issue of metrics and indicators. In terms of improving systemwide coherence, could the role of these agencies be formalised in developing a set of metrics and indicators and add those into the World Drug Problem?

Mandeep, UNDP. Let me get back to the SDGs here which are the perfect example of how that would work.

Mike Trace, IDPC. The statistical commission could be a tool to bring about that coherence. This is where this discussion should be linked. There is great work being done by all these UN agencies to ensure that this debate is aligned with the overall UN agenda.

Russia. I want to repeat my position on harm reduction – it is not universally recognised. My question is about indicators – can you show some country examples of indicators for how to measue drug policy?

Nazlee, ICSDP. Please look at the appendix in our letter which shows how these indicators are being used by countries. This can be used as a starting point.

Mike, IDPC. we are not just talking about one indicators – if that were so, we’d be in trouble! We need to discuss headline indicators, have a clear process in differentiating process indicators/stepping stones and outcome indicators, to achieve the ultimate outcome.

Russia. Can you tell us a little bit more, at least one example?

Nazlee, ICSDP. For example the incidence of opioid overdose – this is a crucial issue in my part of the world, in particular Canada.

???. How realistic is it to think we can set up a new set of objectives and metrics?

Mike, IDPC. It’s a lot more realistic if we address this as a technical issue, not a political one. If you take this as a political process, countries will not agree. If this is a technical process, you take the SDG indicators, and an articulation of what comes below that.

Nazlee, ICSDP. I agree. Proceeding at national and regional level could be a way forward in this regard.

???. A lot of indicators are top-down – it would be important t use the drug user voice when establishing these indicators.

Mike, IDPC. This is a very good point. On supply reduction, one of the important measure we failed to achieve was around whether these efforts had an impact on drug users’ access to these drugs.

Dunnes. We discussed the balance between the health/harm reduction and the law enforcement approach. We also discussed the impact on individuals, on communities and on the international community. It is a point that is consistent with the underlying theme of the UNGASS – baalnce between the traditional approach that has not been succeeding, and a new approach which we are discussing here. I hope this will be a critical issue for 2019.

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