Candice Welsh, UNODC. Drug use conditions are health issues. Scientific evidence based treatment improves health outcomes and benefits communities in multiple ways. Alternatives to incarceration are in line to international drug conventions and improve health, wellbeing and public safety. In 2015, UNODC launched its first handbook on the subject. This is where the implementation principles come in. They are in line with CND resolution 58/5, support more cooperation between health and criminal justice officials, ensure that alternatives are available and accessible, pre-trial, post-trial and post-sentencing. Today we will share practical information on implementation. UNODC has implemented care and treatment alternatives across settings. We stand ready to support member states to ensure that drug use issues are dealt with as a health issue. When I started my career in Canada, I was a prosecutor. And drug courts were an incredible experience there, they were just starting. When they graduated, it saved lives, enabled them to participate in jobs, etc. This shaped my career since then.

Yvonne Olando, NACADA, Kenya. I will be sharing Kenya’s experience. We are currently implementing the CND resolution 58/5 to support the development of alternative measures across criminal justice for PWUD. We have gone a step ahead to form a national ATI steering committee with UNODC’s support. NACADA, under the MoH is the chair. We have MoH involved. For civil society and other associations in the mental health field, we involve them too to ensure that people who need support can access it too. We have targeted measures, including trainings for policy makers since 2021. A few months later, we held a series of workshops, and then identified what challenges remained. We have developed a national action plan with goals in all criminal proceeding stages: pre-trial, during and post-trial. We have held case care management trainings as well as overdose management trainings. We are piloting the programme in Mombasa, and have held Africa Leaders Deflection Summits in 2024 and 2025 to share our experience. The Ministry of Interior, via NACADA, is working on continuing the programme, so that it can continue to work without external funding. We currently have a diversion guideline for magistrates and the prosecutors, but the police doesn’t have such guidelines and so it’s not implemented the same way across the country. We are also rolling out the training to Mombasa County Steering Committee members, so that they can understand drug use as a health issue and the need for alternatives to incarceration. We hope the courts will be willing to divert people with substance use disorders towards a community-based programme we’re starting to implement now.

Hadiza Sabuza Balarabe, Deputy Governor of Kaduna State, Nigeria. There is a growing partnership between UNODC and Kaduna State to confront the complex challenges of substance use with clarity, compassion and courage. For many years, the global response has relied heavily on punishment, filling our prisons. Kaduna state recognises the cycle of incarceration for drug use is not a moral failure, it is a health issue. We have developed the Kaduna Model. We focus on removing restrictive colonial laws with a new approach focusing on health and human rights and anti-discrimination. We transformed the approach with a new institution focusing on health and human rights, including mental health, for PWUD. A system built on dignity and care. The element of the model is our alternatives to incarceration programme. Through technical partnership with UNODC, we became the first jurisdiction in Sub-Saharan Africa to do so, via judicial readiness and judicial technical knowledge. We move from punishment to treatment, stigma to healing. We focus on knowledge, neutrality and strength, improvement of quality of life. Partnership is one of principle, progress. I thank our judiciary to support this model. This practice is now firmly grounded in law. The Practice Direction is not just a guideline. It is a judicial mandate and requires all courts to divert eligible non-violent individuals towards treatment. This is a legal bridge between health and justice and it has changed lives. It shows that treatment works. 271 individuals have now been diverted into supervised treatment programmes. This approach is also financially wise. Prison costs more than 8 times the cost of treatment, it improves safety. We remain open to discussing and sharing our experience with other member states. Let us continue to work with compassion, let us prioritise recovery, hope and human dignity.

Sven Pfeiffer, UNODC. I want to highlight how important alternatives to conviction are important in all contexts, not just that of drug use. I want to highlight three reasons why alternatives make sense. First, they address systemic challenges such as overcrowding, allowing to focus on those who would cause most harm. Second, alternatives are cost-effective, and by reducing the cost of criminal justice we free up funding for treatment and other alternatives. Third, alternatives allow for more tailored approaches for individuals who come into contact with the criminal justice system. This is why we partner with our health section, looking at the entire package of UN standards. We also work to increase access to justice and legal aid to ensure fair trial and access to essential services. We look forward to using the new implementation principles. We look forward to working with our partners and ensure stronger coordination and improve treatment and social reintegration of people in contact with the criminal legal system.

Subhan Hamonangan, advocate of effective drug use disorder treatment, Indonesia. I want to share first information about our current regulation. Forst, there is an issue with the definition of drug treatment. Any person who uses drugs gets arrested, and goes to rehab. Our legal perspective is that drug users are arrested. The police considers the minimum requirement on whether they should be considered as drug users. Family member or lawyer of the defender submit the application to get a comprehensive assessment by a team. The team then decide on whether they go to prison or rehab centre. The MoH has released the new decree on integrated primary health services. Indonesia has more than 300,000 healthcare centres across 38 provinces. The main stakeholders in drug treatment: BNN (drugs agency), Ministry of Health and Ministry of Social Affairs. In 2017, we shared our recommendations to the government on alternatives to coercive sanctions. We updated our recommendations in 2022. The advocacy is a long process, we will still continue it.

Giovanna Campello, UNODC. Today we are here to launch this publication you Will find before you. I will be the last one to speak because we wanted you to hear examples of reality, some with UNODC involvement, others not. But things that can happen. We need to build on good practices and work together to expand them. I want to bring things together. You have heard it too, regarding the number and complexity of use around the world and how this is connected to morbidities such as HIV, hepatitis C, mental health disorders, and there is little coverage of services for PWUD. We start from the point of view that drug use disorders are multifactorial disorders best addressed through a health approach. We are best placed to make this a reality. We have heard it today, but I want to share some graphs with you today showing that evidence based treatment decreases drug use, infectious diseases, reincarceration and arrest, and involvement in criminal behaviour. Evidence-based treatment improves the quality of life and costs less that prison or doing nothing. This has been recognised by member states of the UN in different ways, including the conventions, the instruments connected to the work on criminal justice. We have recently come up with a policy note on alternatives. The idea is now to focus on how to make this a reality. We found it would be useful to create a practical guide, which is why we are launching this guide today. We had wide consultations with 160 participants from 65 countries, we had series of consultations as each stage of the criminal justice system has different considerations. We consulted experts, civil society and people with lived experience for a mega-consultation where we distilled all the results from the formal consultation. The final product delineates what needs to be there to provide successful alternatives. 1- we need existing health responses that could be used as alternatives. It is useful to start small as a pilot like we say with the Kenya experience, ensuring quality, monitoring and evaluation. 2- build partnerships and bridges, sensitizing leadership and the public. We need the support of the general public. No pilot, no experience will succeed unless there is a lot of trust among the different sectors. 3-Building that trust between health, social partnerships, criminal justice, law enforcement, etc. is a big part of the preparatory work. 4- It is important to have alternatives throughout the stages of the criminal justice pathway. For each stage, we look at which are the best actors to be involved, the best health and social approaches, etc. We then provide a checklist for assessment, preparation, implementation and learning. I hope you will find this tool of use and interest and inspire you. We heard from Kenyan colleagues the wonderful collaboration we sustained with funding which is now finished. We are looking for more funding but we can still meet and discuss what would be the best way forward for alternatives to punishment for PWUD in contact with the criminal justice system. We believe that this means better health and welfare for people who use drugs. We are at your disposal.

Q&A:

International Drug Policy Consortium. I would like to make three points/questions. First, could you say a few words about the gendered aspects. Women continue to be overrepresented in prison for drug offences and, when alternatives exist, women rarely have access to alternatives to coercive sanctions. Second, how can we ensure quality of treatment services grounded in international standards, evidence and human rights and ensure that treatment is always voluntary? Thirdly, we didn’t hear about decriminalisation today for drug use and related activities. 60 jurisdictions in 40 countries have decriminalised, this has proven to be effective to remove stigma, reduce incarceration, and ensure better health and rights outcomes, does not increase drug use. What is the UNODC position on decriminalisation and how are you working with member states to promote this approach?

Giovanna, UNODC. There is some information in the implementation principles. I am not pretending that it will get you all the way, but it will be relevant as a tool if you want to develop treatment and care as alternatives for women who use drugs caught in the criminal justice system. A specific tool for that is next on our list. Sven already has tools addressing alternatives for women.

Sven, UNODC. We published a toolkit for practitioners for gender-responsive non-custodial measures including a chapter on drugs. It is not only for WWUD. We also have complicated cases of women who are involved in micro-trafficking. There are examples of laws and policy practices for practitioners to consider how to use our own laws to address these issues and ensure more proportionate sanctions.

Giovanna, UNODC. Regarding the quality of services, this also has a gender component, ensuring services are tailored to their needs. This requires some particular consideration. It is true what you mention: the first implementation principle we have in the document is the need to offer treatment and care aligned with the standards of quality and voluntary. Offering compulsory treatment as an alternative doesn’t count as an alternative. This is why I showed the data on treatment earlier. We want interventions that are safe and effective for people. Moving on to your last question on decriminalisation: the branch has published a policy note on this on how we engage with member states on decriminalisation. This particular publication is about showing the great flexibility that the conventions have on alternatives, which are not used enough.

Shuban. We have the same vision, and the same objective of our advocacy between IDPC and what we are trying to do in Indonesia. I won’t deny your question on standards for treatment. In Indonesia, UNODC has already shared the study on standards of drug treatment. We have already moved towards this. Together with the Ministry of Health we are trying to formalise the drug treatment standards in Indonesia, we are trying to certify the institutions. This is the efforts we have made. We have just submitted our judicial review with the police department for people who use drugs, we are waiting for the verdict.

Yvonne. On Kenya, there is free treatment for women. When there is a women-only programme, women are not coming because of stigma and because their husbands don’t want to pay for it. This is why we ensure they are free of charge. We are making standards for treatment, we go around different rehabs each year to see what they are doing. We used to shut down the rehabs, but we are now supporting them for the first time. Then the third time we close them down. On decriminalisation: this should be handled from country to country. Look at alcohol, it is legal and there is so much use!