Side Event – A 10-year review of successes and failures of global drug control: A civil society shadow report

Event co-sponsored by the Permanent Mission of Norway to the International Organisations in Vienna, the Permanent Mission of Mexico to the International Organisations based in Vienna and the International Drug Policy Consortium.

Ambassador Kjersti E. Andersen (Norway). I welcome our four speakers to this side event to welcome the Civil Society Shadow Report. I want to say a few words about the report. It evaluates the impacts of drug policy using data from the UN and academia and civil society. This side event is an opportunity to hear more about the report and its recommendations on the next decade in drug policy. Member states have different views on drug policy. Norway supports CSOs working on drug issues, they have showed professionalism in their work. We have moved away from punishment towards health support and follow up. As we undertake this reform, we want to review what has been done in other countries. But we are not considering legalisation. I am confident the report will be read by our policy makers.

UNGASS was a key moment in global drug policy and we should continue to reach the SDGs. Human rights are also a key framework for drug policy.

In light of the 2019 MS, we should evaluate the impact of our drug policies.

Ambassador Alicia Buenrostro Massieux (Mexico): Thank you very much for your kind words. I want to commend the IDPC for the initiative of this civil society shadow report which will become an invaluable asset for evaluation which we will make at the Ministerial Segment. Thank you for this because it is a very professional report, and will help us to delineate the global drug strategy for the coming decade, bearing in mind the UNGASS outcome document and to reach the agenda for sustainable development.

Ann Fordham, IDPC Executive Director, please convey our appreciation to all those involved in the initiative. I also want to recognise my dear colleague the Norwegian Ambassador, and highlight the energy and dedication for true multilateralism. I thank you for having an open, honest and inclusive discussion like this one. This discussion is even more helpful when it is based on knowledge. This is why it is an honour for us to have Ms. Carpentier from UNODC. I also want to salute Judy Chang from INPUD, a network that works to expose and challenge stigma, discrimination and criminalisation of people who use drugs. I will recall the powerful presentation on the suffering of drug users and their families and communities to recall that this discussion is first about human beings.

I also want to highlight the role of civil society for improving national policies and standards. Our work should be to the benefit of our people. I am confident that this session of the CND will become a key moment to renew international commitments in a holistic fashion, while taking stock of progress made. We will benefit from a better understanding of effective drug policies, with due consideration to human rights, health and development, as highlighted in the UNGASS. We should also focus on the SDGs, and how drug policy affects the SDGs, and how the adoption of the 2030 agenda is relevant to create a new operational environment to which the UNODC, CND and member states need to adhere.

I look forward to our discussions. I welcome the focus in the report on the need to develop new indicators on measuring what is working or not.

Ann Fordham, IDPC. It is a pleasure to be here with you today for the launch of the Shadow Report. Many thanks to Mexico and Norway for being with us today and for recognising civil society engagement in this space. I thank my co-panellists: Chloe and Judy. This report has been one year in the making: Marie Nougier, the broader IDPC team and the network, as well as many other reviewers from governments and UN entities.

Why did we produce the Shadow Report? We are at an important moment as we reach the end of the 2009 Political Declaration. In Resolution 60/1, member states agreed to take stock of the implementation of commitments agreed in 2009. As this deadline is fast approaching, there is no comprehensive review, unlike in 2008-9. As CSOs, we felt it was important to take stock of what has happened, there have been main changes, there is more complexity in the international drug market. This is with this that we put the shadow report on the table. We want to look at and whether the political declaration has contributed to the broader UN priorities of human rights, security, development, and assess progress against targets set in 2009. Finally, the report offers recommendations for the next decade on drug control, focusing on UNGASS implementation and the SDGs.

In terms of our methodology, it is not a comprehensive review, not all 234 actions were reviewed, not all of them are actionable and measurable. We selected a few. We looked at key achievements between March 2009 and July 2018. It is desk-based research, using UNODC, other UN data, academic research and CSO reports.

There is a lot of data in the report, but we looked specifically at para 36. There has been an increase in opium cultivation, a large increase in NPS on the market, and of use for all substances. There has also been an average increase by 31% in demand for drugs.

On the health and social risks, we have not seen a reduction in HIV, hep C and TB prevalence, overall infection rates have remained stable. But there has been a massive increase in drug-related deaths, which has been a massive area of concern. Around 1/3 to ½ are related to overdoses.

We looked at the impact of drug policies on the right to health. Only 1/100 of people who use drugs who have access to both NSPs and OST. But in terms of good news, 26 governments have adopted a model of decriminalisation.

In parallel, 75% of people remain without access to pain relief, mainly in the global south.

We also see a continued use of the death penalty, an increase in extrajudicial killings, the over-incarceration of people for low-level non-violent offences. There is also a rise in crypto drug markets, with limited impact of drug law enforcement interventions.

In terms of development impacts, alternative development has not been sustainable or effective because of the lack of broader development focus.

What next? There is more research needed on the impacts of drug policy on human rights, health, security and development. We need to consider how and what to measure, with new targets and indicators aligned with the UNGASS and SDGs, which we highlight in the report.

Finally, I want to show you a final slide showing the difference between the 2009 Political Declaration and the 2016 UNGASS outcome document, which highlights the broader issues focused on the UN priorities.

Slide set

Chloe Carpentier, UNODC. I cannot comment on the shadow report because I didn’t get the time to read it at such short notice. But what I want to highlight is the complexity of the drug problem. The range of substances and combinations of substances has never been wider. Cultivation has reached an overall high and synthetic substances are more diverse. Fentanyl is affecting particularly North America, and there is also an issue here of the non-medical use of prescription drugs. This is becoming a threat, especially in developing countries. The massive increase in cocaine manufacture is another issue of concern, shipments of opiates in neighbouring countries via non-traditional routes will likely also have a spiralling effect, with increased consumption and related harms. In Latin America, the increased cultivation of coca has had knock-on effects in North America and Europe, but also new markets in large middle class economies in Asia. There is a possible spill over in Africa. In terms of synthetic drugs, trafficking has increased in East and South East Asia. The increased use of amphetamines has also risks. There has been a lot of attention to the opioid crisis in North America with an increase in overdoses, associated with the non-medical use of opioids. We need new efforts on this, as well as on tramadol in many countries. We need to see how non-medical use impacts on health.

One in three women is a drug user, but only one in five are in treatment – this shows the stigma of drug users in seeking treatment. Women who initiate drug use progress more rapidly than men. Children and youth are a particularly vulnerable group for drug use but also in drug supply. This is a window of opportunity for evidence based interventions.

I want to make a plea to produce more analyses of trends based on data that is reliable, unbiased, from scientific literature and evidence.

Judy Chang, INPUD. Thanks to IDPC. The role of communities is to hold people into account, and this shadow report is a key opportunity to take stock of what progress has been made for communities on the ground in terms of human rights.

Drug free world targets have failed, the market has diversified and expanded as never before, while disproportionately targeting people who use drugs. Some of this data has been mentioned before:

  • 1 in 5 people incarcerated worldwide for drug offences, most of them people who use drugs. And most people in detention are people of colour. This increases social inequality.
  • We know that state sanction violence is rationalised due to the war on drugs, with the application of the death penalty and extrajudicial killings, this is despite being against international law.
  • The war on drugs also undermines the right to health: only 1% of PWUD live in countries with adequate coverage of NSPs and OST. 1 in 10 live with HIV, 51% with hepatitis C. In 2017, there were an estimated 71,000 drug overdose deaths in the USA alone. This is entirely preventable.
  • Torture and inhumane treatment and punishment are carried out in the name of treatment including forced labour, sexual assault and denied access to treatment.

There has been some progress in the past 10 years too. Some countries have scaled up harm reduction since 2009, including in Africa. There are 26 countries that have decriminalised drug use. And in terms of stigma and discrimination, Canada led on the first resolution on the issue in healthcare settings. But these successes are limited compared to the scale of the issue. In this context, people who use drugs are demonised.

Every year that countries fail to address this, this results in countless lives lost.

In response, people who use drugs have organised. There is a long history of mobilising and organising to initiate debates and discussions, providing a different viewpoint from doctors and medical professionals. When networks of PWUD are mobilised, we produce demand for health services, demands for policy making that is effective in practice. The achievements of mobilising is seen all over the world. In Australia, this has led to people being early implementers of NSPs, with significant health benefits. PKNI in Indonesia has also been instrumental, and currently seats in a national task force on HIV for PWUD. In Canada, in the midst of the overdose epidemic, the country opened 25 new drug consumption rooms.

All these highlight the need for better objectives and better metrics. The principle of community involvement was underlined by the WHO, but also UNAIDS. Drug policy in the next decade must learn from these other sectors to stop this destructive cycle.

Slide set

Amb. Andersen (Norway): We now open the floor for comments and questions.

Spain: It seems that the situation has worsened. The previous biennial report which took stock of the 2009-2019 process called for stabilisation.

Chloe Carpentier, UNODC: We have more and more substances on the market. These substances have the same group of effects. This is something we will discuss more in depth in the next world drug report.

Esbjorn, IOGT. The first two slides from INPUD, I totally agree on this, and on much of what has been said. Coming from the civil society sector which believes that less drugs are better than more, this is about legal and illegal drugs. We need to see what regulation can do. But tobacco today kills millions of people a year. It would kill many more if there was no regulation. Same for alcohol. This is a bad example of how society deals with legal drugs. When it comes to human rights and health, we will need to look at what kind of evidence we are looking at. We should not legalise cannabis. I would really look at what is happening. One question to IDPC: why did you send this now? Why didn’t you wait for the CSTF evaluation of what happened after UNGASS?

Ann Fordham, IDPC: We felt it was important to get this document on the table, given that the discussions are starting now, providing some guidance on what is happening. To wait until December would be too late. We will feed into this in the broader CSTF contribution, but we felt the time was right to have an impact on the discussion.

We agree on many things Esbjorn, as you identify. We also have concerns about corporate capture on the move to legal regulation. We are advocating for limitations of corporate power, social justice (especially for small farmers so that they are not left behind in the medical and regulated markets). Cannabis is harmful, as are all other drugs, but prohibition fails to protect those people from those harms. Punitive policies have created far more harms than the drugs themselves. We can learn from alcohol and tobacco. There would be limits on advertising, reducing access, etc. But in an unregulated market, who can control that? Only law enforcement, and this has its whole new range of problems.

Judy Chang, INPUD: In terms of the overdose epidemic, the unregulated illicit market is causing more harms, entire communities are being decimated. People are incarcerated for putting something in their body. I am glad we can agree that we need a new strategy as this current strategy is not working.

Daniel Joloy, Amnesty International: It is great to see the efforts from Norway and Mexico about civil society engagement. What do you see as the main challenges for those advocating for drug policy reform going forward?

Judy Chang, INPUD: There are a number of challenges on shrinking civil society space. We need resources to organise properly. There is a lot of attacks against civil society. We see this when people who use drugs have come out and advocated. We need more links with bigger organisations focusing on protecting human rights advocates. There is increasing conservatism and populism, it is a real concern. In terms of drug policy, what we would like to see at global level is more drug users being included in national delegations to give inputs. Last year this happened with the Canadian delegation, they fed in the stigma resolution. We feel that in the lead up to the Ministerial Segment more delegations will include PWUD to learn more about what is happening on the ground, and devise policies that fit with the needs of communities.

Ann Fordham, IDPC: The first thing to say in response to this is that there has been huge progress in civil society engagement in Vienna. This is really important, many member states have opened and protected that space. This is to be commended and protected. The UNGASS process took civil society participation to a high standard. As the CSTF we take the UNGASS as a baseline. However, this space should be protected because many human rights defenders, affected communities (PWUD and cultivators) speak about the abuses they face and face fear of reprisals. This is something we need to talk about more, especially in countries where drug policies are incredibly repressive. This is something we should acknowledge more in CND discussions given the current global climate towards civil society.

Netherlands: Thanks to IDPC for providing us with a toolbox on evidence-based materials. We can use this evidence for the debate at home. We can safely conclude that supply reduction alone is not the solution. What is not in the report is the financial implications of supply reduction measures in a country. This can be used as an argument to use money in a better way than supply reduction alone. You need to make sure that young people will not be seduced to getting involved in drug trafficking. We must find ways to hit organised crime where it hurts most. What arguments can we figure to convince the more ideological, moralistic governments that we need to look at the factual arguments, the evidence?

Ann Fordham, IDPC: Thank you for the question. It’s a very difficult challenge we are facing, particularly as a network. The cost argument is being made by some partners and colleagues. There is an ideological argument here. What we tried to do with the report is to put as much of the data on the table as possible. The data is compelling: 60-70% of the data is coming from UNODC, the rest is from other UN agencies. We tried to take as much data as possible and put it in a format that is useful. If the goal is to eradicate the market, is it working? What is the data? And there are some serious negative consequences here that undermine the lives of people worldwide. Human lives are at stake here and we have to keep bringing attention to this. Drug policies urgently need to change.

Amb. Buenrostro-Massieu (Mexico): This is my personal take of what I have seen, rather than speaking as the chair of the CND. In the end, it’s a matter of evolving maturity. The realities of our societies are evolving. I think that it is important to have a good recollection of data, with policies that are really working. I can understand the positions of all countries, but the numbers and reality are critical. We are dealing with the lives of people, and we are not always as close to this reality. This is why it is important to keep doing our homework so that we can get the most reliable data. There is no unique formula on how to deal with the issue. Statistics and data are important in order to move forward.

Judy Chang, INPUD: Sometimes what we fail to ask is – what is this evidence for? Evidence is not politically neutral. Evidence we are collecting is about reducing drug supply and demand, rather than how to protect human rights. We need to start with what is our end goal and this should align with human rights.

Chloe Carpentier, UNODC: I hear a lot about good quality data. But I want to highlight the difficulty of assessing causal relationships. This is particularly the case in drug policy, because there are a number of factors to take into account. Here we are also talking about hidden behaviours and data is missing. I would like to end on this, and be cautious. Also a point on trend analysis – we have tried to make the report lighter, and we don’t always focus on methodological caveats, and caution should be exerted on this.

Amb. Andersen (Norway): I want to thank our panellists, this is the beginning of this report, I saw the headlines of CNN today. There are copies of the report at the back.

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