Side Event: Comprehensive and evidence-based approach in tackling the world drug problem.

Mario Horvatić (Croatian Ambassador to the UN): [Welcoming remarks] The slogan of the Croatian (EU) presidency points out a strong Europe in a challenging world. We believe the tackling the world the drug problem is one of the most important challenges, not only on the EU level but globally. Moreover, we believe that the implementation of balanced, integrated, multidisciplinary and evidence based approach based on the UNGASS 2016 outcome documents and the 2019 ministerial declaration. The world drug problem is a common responsibility of all MS that it has to be solved in joint actions of enhanced international cooperation. In this regard, I would also like to commend EMCDDA, UNODC, INCB, WHO and other international and European organisations who had invested and who continually take significant efforts to ensure a balanced, multidisciplinary, evidence based approach in drug policymaking.

One of the contributions in promoting this approach is the European Union resolution under the name “the collection of reliable and comparable data to strengthen the balanced, integrated, comprehensive, multidisciplinary and evidence based responses to the world drug problem” presented by the Netherlands. Croatia, as a member of the European family that is based on the principles of democracy and human rights, strongly advocates the universal implementation of all international legal instruments which consuetude the fundaments or international drug control system. In this context we fully support the work of the CND and its MS. 

Witnessing an even more diverse struggle for and rapid development of illegal drug markets we must strengthen our emphasis on law enforcement and increase the necessary resources for addressing drug related crimes, and especially its new forms such as drug supply through internet and social networks. Croatia is continuously working to improve its national policies and approaches in addressing drug issues, especially given the shift of global policies towards a more balanced and evidence based approach, including issues such as prevention programmes, social reintegration programmes, harm reduction and treatment programmes that are tailored to the needs of users.

Ghada Fathi Waly (UNODC Executive Director): Pleased to be here and thankful for Croatian Presidency. I have experience in designing and implementing a national programme on drug abuse; one that encompasses outreach to young people and to the vulnerable like women, children, addresses access to prevention and treatment services and pathways to rehabilitation and reintegration in society. Balanced drug responses seek to curve criminal activity and trafficking, while ensuring that essential medicines are available to those who need them. Such support needs to be targeted and effective, and must be based on evidence and science. We need reliable data collection to identify and understand the mechanisms and substances that threaten and harm the most vulnerable. We need the latest scientific research so we can design treatment interventions that offer the best chance of recovery. We need to understand the pull and push factors of illicit cultivation to help people trapped by poverty into growing opium poppy and cocaine. We need to enable them to find sustainable alternative livelihoods. We need to share intelligence and studies; study the dynamics of markets, the profile of traffickers, routes and shipments. 

Drug markets are in a continuous state of flux which requires flexible research tools and innovative data collection instruments. In order to improve the evidence base countries need to development methodological standards, strengthen national coordination across all relevant agencies and national drug observatories, and access technical support to elaborate new methods, such as drug use surveys, while improving existing sources such as administrative data. Such measures require significant resources and support. Moreover, effective policy design and implementation require a formidable array of capacities and a high level of coordination. They require adequate legislative frameworks, education, specialised training and equipment, as well as operational cooperation between law enforcement and criminal justice institutions in consideration of health and social factors. Both quality data and analysis are helping governments in targeting available resources with the most efficient way and they represent essentially an investment that pays off in the long term. This is especially important for developing countries. Moreover, technological and scientific advances can lead to more cost effective solutions; wastewater analysis, the use of some big data and artificial intelligence, for example, can be employed to fill in information gaps. With this in mind UNODC is testing innovative methodologies to improve coverage of drug data. We will keep you updated on our progress. As requested by the CND and the 2019 ministerial declaration UNODC has developed a new questionnaire providing information reflecting on the reality of drug markets today and informing our flagship WDR.

Over the past 30 months UNODC has designed a new ARQ through a comprehensive expert level consultation. The process has included 2 global expert group meetings, 3 online consultations and 1 pilot exercise for 35 volunteer countries. Overall, experts from more than 80 countries took part, along with colleagues from international organisations of experts from academia and civil society. Close coordination was maintained throughout the process in particular with EMCDDA, AU, CICAD, OHCHR and WHO. UNODC has kept the CND well briefed on progress, and the ARQ is before the commission this week. Countries need to be willing to share information and help build technical capacities to make this an effective tool. It is especially critical that donors as well as regional international organisations scale up their support to countries to develop and maintain high quality national drug information systems. We know that there are many countries with underreported drug challenges, unaccounted therefore unaddressed. We cannot allow people in need to continues being unassisted. UNODC remains committed to working with MS to improve the knowledge regarding on drugs, with devotion to scientific rigour and the highest standards of evidence in partnership with UN-family, national, regional and international organisations, academia and civil society. 

Tomislav Dulibić (Croatian Health Minister): Evidence based approach emphasises on the importance of persistent and cost effective decision making, while moving away from policies based on anecdotal evidence or intuitive assumptions. Also, this approach has supported the introduction of important treatment and harm reduction policies such as OST and NSP for PWID. Both in 2019 ministerial declaration 2019 and 2016 UNGASS outcome document we recognise that the world drug problem remains a common and shared responsibility. That should be addressed in the multilateral setting through effective and increased international cooperation and demands an integrated, multidisciplinary, mutually reinforcing, balanced, evidence based and comprehensive approach. Other relevant documents such as operational recommendations, joint ministerial statements, political declaration and plans of action, as well as 2013-2020 EU Drug Strategy emphasise on the importance of developing evidence based policies and best practices, supported by objective monitoring and evaluation system; a key for better delivering of our activities at national, regional and international levels. The role of information, research, monitoring and evaluation is to contribute to a better understanding of all aspects

of the drug phenomenon. Many EU country guidelines and quality standards represent an important mechanism for knowledge transfer into policy and practice. they support the implementation of evidence based recommendations for practice. 

In Croatia we continuously work on evolving national policies and approaches to address those issues towards a more a more balanced and evidence based approach, including issues of prevention, treatment, harm reduction, and social integration and implementing programmes tailored to the needs of the users. Also we incorporate in our penal policy alternative measures aimed at rehabilitation and recovery. In recent years, Croatia has invested heavily in increasing the standards and quality of preventive intervention and has taken concrete steps towards the full implementation of recommended standards. We also cooperate continuously with the academic community and conduct research and evaluations. We have created an online database of the programmes implemented in the area of reducing drug demand. We associate quality criteria with the financing of NGO projects and we provide training for prevention practitioners. We have increase the availability, accessibility and coverage of diverse drug treatment to problem drug users, including non opiate users, so that all those who wish to enter drug treatment can do so according to relevant deeds. [..] Our challenges are translating research findings into drug policy and practice. Our responsibility is on focusing financial resources on evidence based approaches and intervention, as well as, elevating resources to strategically set needs and priorities. Finally, all approaches should be based not only on evidence supported by scientific research and the exchange of best practices but also on objective monitoring and evaluation systems which would create the preconditions and basis for the creation of all national and international drug related measures, and policies.

Alexis Goosdeel (Executive Director EMCDDA): EMCDDA was created because of the HIV epidemic of the 80s followed a bit later by a new HCV that was discovered as well as of a very important number of drug related deaths in the main big cities which lead among others to the Frankfurt declaration. In October 89 President Mitterrand proposed the creation of a European drugs observatory since there was a huge lack of information regarding the drug situation. Our mandate is to contribute to a healthier and to a more secure Europe through better informed drug policy and action. Our primary customers are EU institutions, the national decision makers, but also professionals working in the drug field. We have developed a comprehensive data collection system over the two pillars of public health and public safety and security. We are encompassing standard indicators both for epidemiology and law enforcement but also all new complimentary sources of information; a constellation of networks of data providers and groups of experts that jointly are creating the EMCDDA system that provide this added value both for national decision makers and for practitioners at a European level. 

One key asset that is unique in the world is an early warning system operating between all the EU member states plus Norway and Turkey. This is working on 24hours/7days basis, covering all emerging threats associated to NPS. Over the last 20 years we have discovered 780 of them and for the moment we detect one per every week. What is our contribution to policies and responses? We are collecting data with a purpose. We provide support together with Europol to all the interventions for drug supply. We also provide support to the partnerships between the EU and international and national partners. We also contribute and provide support to the EU drug related programmes with a the strategic dimension and we help the EU speak with one voice, and we also contribute to the evaluation of the European strategy. I think the main conclusion to share with you is first, we don’t do stats, or data collection just for the sake of data collection. So all work aims to reduce the burden of drugs on society and on those who are more vulnerable. This implies that today we are working to change our business model because the question today is not anymore how many but what is happening, why, how, when and how can we address it, because the scope and the importance of the phenomenon the nature of the phenomenon has change over the last 25 years. It’s time for us to build on the achievements but change the business model.

Victor Sannes (Dutch National Coordinator): In the Netherlands we believe in learning therefore we tabled a resolution on monitoring and analysing data as well as evidence based policymaking. Let me illustrate the rationale behind the resolution and the importance of using data and evidence based policymaking by some examples of our experience. One of the main sources is our National Drug monitor. It provides the current picture of the drug situation in the Netherlands to us policymakers at the national level but also to municipalities, researchers and professionals in addition care. Our Secretary of State then uses these data to make new prevention policy. Last year there was an increase in the use of nitric oxide for recreational purposed. We ordered a risk assessment with resulted in the decision of placing it under the national narcotics Act. An other example of evidence based approach in our policy is the Persona Research Project purposed to identify different subgroups of users and non users based on lifestyle, social environment, experience etc; specifically within 18 to 25 young people. Based on the analysis of a lot of scientific data we created personas to be used in prevention practice. Also, monitoring and evaluating interventions is more important, perhaps, when the approach is not successful. Let me give an example of our Healthy School prevention programme. That run for 30 years now and offers an integrated approach for schools to raise awareness of the consequences of drug use. One of the interventions was aimed at preventing cannabis use targeting young people and kids at the elementary school. Through its evaluation we figured out that this was a good intervention produced on the wrong moment; we provided the prevention information too early.

We are committed to strengthening and streamlining data collection within our domestic capacities. The preparation of data and statistics on various elements of a local problem in now needed also globally to get a realistic picture that will underpin our discussions and policy decisions like our interventions. That is why we tabled the resolution on data analysing, monitoring, scientific evidence based research and with this resolution we want to support the work of UNODC and MS to improve collecting data and monitoring. Also, improving the strengthening the ARQ is important to collect more data and gain more insight and worldwide trends on drug use and drug markets. Only with solid data we will be able to examine the effectiveness of approaches and the consequences for human health and human rights. We should know what works and what doesn’t work.

Abel Basutu (AU): There is an obvious problem and everybody is aware of it but nobody wants to talk about it openly. In many countries drug use is approached from a moral angle and therefore open debates are a taboo issue and people are stigmatised. So the extent of drug use at the AU is rather unknown and drug use is an hidden phenomenon. When you look at Africa’s high unemployment rate you can assume that many risk in falling into problematic drug use. But that in itself is a new phenomenon. Our grandparents know how to take care of a person living with HIV but not somebody on drug withdrawals.

The AU’s response has been the formulation of projects in establishing a continental drug surveillance system; the panAfrican epidemiology network on drug use. The mechanism for establishment of that continental network is the creation of sustainable national community networks that would seed into the bigger network by providing data and assisting policymakers in making progressive drug policy. This is integral part of our revised policy on drug control 2019 – 2023; 29 out 55 AU MS have already established operational national networks. However, research and record keeping is still very weak in most of our countries and often these data are not integrated into health information systems. Also, there is the issue of lack of funding for research as well as issues regarding reliability and validity of data. There’s no quality assurance or validation of data that is collected. One country that was not keen on starting harm reduction programmes underreported falsely the number of PWID. Also, we face issues regarding the lack of qualified personnel, the lack of standardised definition for data collection tools. Civil Society is not willing to share with governments of data so the capacity is often limited.

Angela Me (UNODC): As my concluding remark I was thinking of a sentence often used; an argument, without evidence is just an opinion. This is particularly true at the drug sphere. As our AU colleagues mentioned the drug issue is a morally charged issue that we hear a lot of opinions, probably not many arguments. What we need to face that is technical capacity and the implementation of programmes as well as the collection of data that can be analysed to improve policies. We have learned also what is important is the transnationally dimension of that effort; how to bring together the evidence rather at a global level and the role of UNODC. If we say a single country alone cannot address a drug problem, I would add that a single country alone cannot understand that problem right. 

Let me add one dimension for the development of evidence and that is political will. We have also seen that often maybe the evidence is there but there is also reluctance in sharing in the fear of judgement. So the political will is also very important in sharing the data but also the commitment to the scientific evidence. I also want to add another key word; innovation. Today we live in a world where there is no scarcity of information. So the challenge is not on the quantity but on the quality of information. And for this we need to innovate. Perhaps in the way we communicate evidence and on the tools we use such as the application of AI in monitoring.

Gilberto Gerra (UNODC): My role tonight is to make an appeal to the EU to help UNODC and WHO and lead in the implementation of the UNGASS 2016 and the implementation of the international standards for treatment and cooperation. For instance 60% of the countries globally have still their drug prevention and drug treatment programmes under the Minister of Interior or Minister of Justice and rehabilitation by the police. In around 60% of the counties public health is just not there (for PWUD). For instance if your wife suffers from depression she goes to a free clinic but if its cocaine related depression she is excluded from the public health system and she is sent in isolation. Another point is on the dissemination of evidence in combating ignorance. Science based means also to stop the ideology debate on supply reduction and demand reduction as well as in understanding the continuum of care as that should be put in place for each country. Also, regarding human rights, we must end the moralistic and punitive approach for PWUD. Any sort of punishment should be abolished.

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