Contribution to the Annual Report 2016 of the MMI Network

Around the world, punitive drug control policies continue to restrict the health and rights of poor and marginalised populations. Since it began over 5 decades ago, the global ‘war on drugs’ has not only failed in its efforts to create a ‘drug free world’ but has undermined efforts to tackle poverty, improve access to health, and protect the rights of some of the most marginalised communities and fragile environments in the world. Health Poverty Action is challenging this harmful policy paradigm as part of its OSF funded drug policy reform project, by advocating for and raising awareness both within the sector and at the UN level of the need for development focused drug policies..

It is striking the many ways in which repressive drug policies impact on poor and marginalised communities. (1) For people living in poverty in marginalised rural and urban areas, involvement in illicit drug markets is often a strategy to mitigate hunger and food insecurity where viable or sustainable livelihood opportunities in licit markets do not exist. There is also a strong link between poverty and problematic drug use, and yet punitive drug control policies such as crop eradication and imprisonment push those who are already vulnerable further into poverty and food insecurity. The right to health is significantly limited by policies which prioritise demand reduction over the provision of evidence based treatment and harm reduction services for people who use drugs. The criminalisation of people who use drugs and possession of associated paraphernalia in particular has a negative impact on incidents of HIV and hepatitis amongst the injecting drug community. Heavy restrictions on controlled medicines in many countries in the global south mean that 80% of the world’s population live in countries with either insufficient or no access to essential medicines for pain relief, such as morphine.

Existing inequalities, which for many are a significant factor in engagement with the drugs trade, are strongly reinforced by the stigma and social exclusion associated with these policies. For women this impact is felt most acutely. Gender inequality intersects with, and is reinforced by, prohibition and criminalisation, which disproportionately impact women in many ways, perhaps most evident in the increasingly high percentages of women incarcerated for drug offenses in the Americas, or the lack of gender specific care for females who use drugs.

There are also the environmental and other social impacts of the war on drugs to consider, particularly the effects of a militarised response to the drugs trade, which has actually fuelled rather than reduced violence in many places, as well as the illicit nature of the trade which continues to stimulate vast profits that facilitate bribery and corruption.

Health Poverty Action began advocating for development sensitive drug policy reform 3 years ago in order to address these harms associated with the current war on drugs approach, including since 2015 drawing attention to the impacts of this policy approach on the new Sustainable Development Goals (2).

Given the multiple ways in which punitive drug control policies impact the health and rights of marginalised communities, it is surprising that many development and health organisations have been historically absent from the drug policy debate and have often overlooked drug affected communities in their efforts to address poverty and poor health through their programming work. For this reason, Health Poverty Action has set up the UK based Bond Working Group on Drug Policy to bring together development INGOs interested in addressing these issues through collaborative policy innovation and collective advocacy, in order to challenge the current war on drugs from a development perspective.

In April 2016 this group led the call for greater coherence with the SDGs in global drug policy objectives at the UN General Assembly Special Session on Drugs (3). Since then members of this working group have contributed to UN level discussions on the implementation of the UNGASS Outcome Document and we recently attended the annual session of the Commission on Narcotic Drugs to ensure that achieving the SDGs and leaving no one behind remains high on the drug policy agenda. Health Poverty Action is also currently working to address the evidence gap in this area, through a research project which will capture the impacts of punitive approaches to drug policy as experienced by individuals and communities who depend on the illicit drugs trade for their livelihoods and for those who lack access to essential pain medicines.

Through advocating for a development first approach and greater alignment of drug policies with the SDGs, Health Poverty Action, and the Bond Working Group on Drug Policy, aim to achieve an end to the ‘war on drugs’ and policies and practices that champion development, access to health and rights over punitive approaches which undermine all of the above.