Drugs at the UN: The needle inches forward

In a little corner of the United Nations each year in March, governments get together to debate drug policies at the "Commission on Narcotic Drugs", or "CND". In many respects, these annual gatherings in Vienna are routine and seemingly unremarkable. However, upon closer inspection, it becomes apparent that the needle is inching forward in the global drug policy debate.

The pretence of a consensus on how to deal with the illicit drug market has long been stripped away, and the space that has been created allows different priorities, approaches and ideas to emerge. It is still a difficult environment, with divergent views that result in tense negotiations at times, but the progress that is being made towards putting health, human rights and development at the centre of drug policies should not be underestimated.

This momentum has been spurred on by last year's UN General Assembly Special Session (UNGASS) in New York, the first global drugs summit in eighteen years and the highest level of political debate possible on the topic. The UNGASS had been urgently called for by Colombia, Mexico and Guatemala - all countries that have suffered huge collateral damage in their fight to end the drug trade - a fight that has been futile in achieving its stated objectives, while instead fuels violence, corruption, mass incarceration and devastating abuses of human rights. The summit's declaration, while unfortunately failing to explicitly acknowledge the damage wreaked by misguided policies, calls for greater attention than ever before to the human rights dimensions of the response to drugs. It specifically calls for proportionate sentences for drug-related crimes and the provision of alternatives to conviction or punishment, as well as adherence to due process and the rule of law. In addition, the declaration's strong focus on health calls for action on the global epidemic of pain created by overly strict controls on opiate painkillers like morphine and outlines specific harm reduction measures to prevent HIV, overdose deaths and other harms. Finally, a strong link is made to the Sustainable Development Goals, in recognition that the pursuit of drug control targets must not undermine the global commitment to human development.

It is clear that the rhetoric on drugs is changing at the UN, although the reality on the ground in many countries still falls short of these emerging aspirations. So it is crucial to leverage the gains made at the UN to push for governments to re-think bad and misguided drug policies.

Following on from the UNGASS last year, ensuring commitments to human rights, development and public health were strands that ran throughout the Vienna debates last month more prominently than ever before. Here are five significant moments from last month's CND meeting:

1. "We must not forget that the ultimate objective of drug control policies is to save lives" Margaret Chan, Director-General of the World Health Organisation, addressed the delegates at the opening of the 60th Session of the CND

Vienna is home to the UN Office of Drugs and Crime (UNODC) and is where the CND meetings are held. In this setting, the law enforcement response to drug use has traditionally prevailed, trumping considerations of the health and rights of people who use drugs. Dr Chan's personal appearance in the opening session (alongside the Executive Director of UNODC, Yury Fedotov) - and her strong support for harm reduction as central to drug policies based on evidence rather than ideology - underlines the paradigm shift that has taken place. It is no longer acceptable to singularly pursue draconian and disastrous drug policies based on repression and punishment, and those countries that continue to do so can expect to be called out.

The new UN Secretary General, António Guterres, who sent a video address for the opening, called for reinforcing the links between drug policies, health and human rights. He reminded the CND that when he was the Prime Minister of Portugal, the government had decriminalised the use of drugs as part of a comprehensive approach, before encouraging the CND to 'deepen reflection' on the future of drug policies.

2. Stop the killings!

Since President Duterte took power in the Philippines in June 2016, there have been more than 8,000 extrajudicial killings of people suspected of using, dealing or trafficking drugs. This year in Vienna, many governments, UN officials and NGO representatives called for an end to the death penalty for drug offences and an end to extrajudicial killings - even if they could not diplomatically single out the Philippines in their public statements. Stark violations of human rights committed in the name of drug control are increasingly being highlighted and condemned in the UN drug policy debates, and bodies such as the International Narcotics Control Board (INCB) now speak out strongly against these violations, whereas only a few years ago they did not deign to intervene or even acknowledge such violations. Since the UNGASS last year, human rights have become more embedded in the Vienna discourse on drugs than ever before.

3. Committing to ending the HIV/AIDS epidemic

The CND meeting broke new ground this year by passing a resolution that directly calls for increased funding for the harm reduction response for people who inject drugs. This funding is urgently needed given the devastating increase of 33% in new HIV infections among people who inject drugs between 2011 and 2015 - over the same period during which the global community had committed to reduce such infections by half. There is a huge global funding gap for harm reduction measures, partly due to a decline in HIV funding, but also related to an ideological resistance to harm reduction. Globally, most of the available funding for drug policies continues to be channelled towards law enforcement to deter drug use, rather than towards proven health interventions that save lives. This imbalance has resulted in a burgeoning HIV epidemic among people who inject drugs. This call for funding from governments within a drug control setting is unprecedented and will have far reaching implications.

4. Drug consumption rooms and drug checking

Drug consumption rooms, or safer injecting facilities, have long remained controversial even in countries that have accepted other harm reduction measures, such as distributing sterile needles and syringes or providing substitution therapy for people who use heroin (which are explicitly mentioned in the declaration from last year's UNGASS). No one has ever died from a drug overdose in a drug consumption room - a facility set up for the safe consumption of drugs under the supervision of medical personnel. This is particularly important in contexts like the USA, Canada and the UK, countries that are facing alarming increases in preventable deaths from opioid overdose. There are approximately 90 of these facilities around the world, mostly in Europe, but also in Canada and Australia. This year, for the first time, the INCB deemed that drug consumption rooms could be justified providing that they are offered within a broader health continuum that also encourages drug treatment and social support - which is generally the way these facilities work anyway. In addition, another innovative harm reduction measure, drug checking (sometimes called pill testing or adulterant screening) was discussed for the first time at CND in a prominent side event during the CND meeting for the first time, and is receiving increasing attention as a way to reduce the risks associated with drug use. The side event was organised by NGOs and underlines the crucial role that civil society advocates have in continuing to push the debate on drugs forward.

5. Cannabis is coming...

Canada announced its intention to legally regulate cannabis in a bland and matter-of-fact statement. Having undertaken a lengthy study to assess how best to do this in the Canadian context, the government has recently announced that it will happen by 1st July 2018. As more and more jurisdictions move to regulate cannabis, it is becoming harder for the UN to ignore. Many hardline countries, however, still staunchly oppose these moves, and the general view is that the legal regulation of cannabis is outside of the limits of the UN conventions on drugs. Meanwhile, cannabis will soon be reviewed for the first time ever by the WHO's Expert Committee on Drug Dependence, who in examining the evidence, may recommend less restrictive cannabis policies. Watch this space!

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