On 26th June 2012, the United Nations (UN) General Assembly held an 'informal' debate on Drugs and Crime as a Threat to Development. The debate was moderated by Yuri Fedotov, and the UN Secretary General gave an (unfortunately very bland) opening speech.

As is to be expected with events dominated by diplomatic niceties, there was very little real debate and a lot of hollow prepared statements from member states, as we have become accustomed to at CND. That said, there were a few meaningful interventions, and we could observe a continuing trend of normalisation of references to decriminalisation, legalisation, and drug policy reform. The German delegation also called for a strong focus on long-term strategies of sustainable development.

Many delegations emphasised the importance of civil society, which of course didn't change the fact that NGO statements were relegated to the last few minutes of the day, which limited the number of such statements because of time constraints.

The Guatemalan Minister of Foreign Affairs gave a robust argument in favour of his country's call for fundamental review of drug strategies, the US repeated its CND call to focus more on treatment than punishment, and the Luxembourg Ambassador stated that the UN should be giving serious consideration to the recommendations of the Global Commission, and asked the panel for their views.

The Chairman of INCB, Raymond Yans, in response gave a garbled explanation of his reasons for opposing legal reform, in a few short minutes contradicting himself repeatedly ('this is a matter for member states, but here is the INCB's position'), and aiming a dig at Uruguay for weakening the international consensus, thereby breaking the convention of not criticising individual countries.

IDPC gave an NGO statement that called on the UN to lead the debate on reform, and to give a greater role to the health, development and human rights agencies. We also ran a side event on the previous day, organised in conjunction with the Guatemalan Mission, and with presentations from their foreign Minister Harold Caballeros, UNDP Latin America Director Heraldo Munoz, and Coletta Youngers of WOLA. We laid out the case for reform to an audience of 80 participants from New York missions and UN offices.

This debate will not have any direct result, but it is a good sign that the wider United Nations structures are discussing the drug policy issue beyond Vienna, and we took the opportunity to distribute our papers and key messages to a broad new audience.

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UN debates on drug policy

The third the World Federation Against Drugs was held in May 2012 in Stockholm, Sweden, a country which has become the symbolic home of those 'restrictive' drug policies the Forum celebrates. An IDPC representative joined the curious mix of people who gravitated to the event: a sprinkling of those making a career out of fortifying the drug prohibition industry; a selection of familiar drug war zealots; and some individuals, probably very well-intentioned, there to support treatment and prevention.

The prevailing mood was one of bewilderment, anger and resentment, summed up by Victor Ivanov as he railed against the 'locomotive of the global drug legalisation movement’ whose objective is to 'legalise transnational organised crime' (sic). Russia’s treatment system is notoriously harsh and patently ineffective, but Ivanov was, philosophically speaking, on home territory here, and nobody was going to interfere, even in the name of basic conceptual coherence. The attendees were characterised by a kind of bunker mentality, being quite convinced that they face a shadowy network of well-armed billionaires determined to distort the evidence and lead the public pied-piper style into a maelstrom of addiction and misery.

Nonetheless, the organisation’s own attitude toward evidence is ambivalent at best. ‘Drug policies are too important to be left to drug experts,’ opined WFAD president Sven Olov Carlsson, who also announced that the Russian representation was ‘especially welcome’.

Maria Larsson, Sweden’s Minister of Health, rose to confirm that every time she goes to the Commission on Narcotic Drugs in Vienna, she encounters ‘a co-ordinated campaign to liberalise drug laws’. The bloated coffers and highly organised cadres of a ruthless and conspiratorial opposition was a theme repeatedly invoked throughout the event. Robert Dupont, a former Whitehouse drug tsar, then attempted to underpin the proceedings with a platform of pseudo-science, describing drug addiction as a ‘chemical slavery’ grounded in the hijacking of the ‘mammalian brain’ (this part of the brain, he expounded helpfully, ‘is not the human brain’). Dupont crowned his intervention by proudly characterising the assembled crusaders as ‘modern Vikings’. There was a press conference given by representatives of the US, UK, Russia, Italy and Sweden, at which the press was prohibited from asking questions. The tone of the proceedings was eccentric, and at times frankly bizarre. It was deeply disturbing to witness Gus Jaspert, the Home Office representative, aligning the UK with this movement.

Four overall themes emerged as the weapons with which the WFAD plans to counter the machinations of George Soros and his fellow super villains.

Use the language of human rights, which has up to now been commandeered by the harm reduction lobby.

Talk to the public about children, especially the Convention on the Rights of the Child.

There was no new research, no examples, other than the Swedish, in which repressive prohibition has succeeded; the sole argument made was that 'drug legalisation' would make things even worse. The IDPC representative left with the impression that these people were obsessed with harm reductionists and legalisers, whom they believe are actively seeking to increase drug use. It was difficult to credit, listening in to the discussions of this angry and confused subculture, that almost all the world's governments agree with them.

Tales from the World Forum Against Drugs 2012

In recent months we have seen several Latin American initiatives to promote alternatives to drug control based in prohibition, while Europe has remained fairly silent on the issue. This may be because of difficulties posed by the diversity of views among European Union (EU) member states or perhaps it is because the EU has become a little complacent about public health and harm reduction. Either way, Europe is failing to lead the global debate on drug policy reform and in several EU member states pragmatic approaches towards the issue of drugs are under threat from political, ideological and financial pressures.

The Global Commission on Drug Policy and the International Drug Policy Consortium took this discussion to Brussels last month. On May 29, we co-organised a seminar “Modernising the global drug control system – Can Europe lead?” at the European Parliament. During the event, co-hosted by the Member of Parliament (MEP) Nikos Chrysogelos, we called on the EU to break the taboo on drug policy reform, and for EU institutions to show true leadership in global drug policy debates.

Michel Kazatchkine and Pavel Bem, the two Commissioners who participated in the panel discussion, highlighted the fact that a drug policy rationale that is based on zero-tolerance and the harsh punishment of people who use drugs has failed to curb the global drug market. Instead, we have seen a raft of serious negative consequences as a result of the over-reliance on policies that prioritise supply reduction, incarceration and tough law enforcement, these include an increase in the reach and power of organised crime, deepening the marginalisation of vulnerable communities and an HIV epidemic among people who inject drugs.

It was a positive experience to be facing a room full of MEPs who did not shy away from discussing the difficult issues during our joint meeting with the Global Commission. MEP Sir Graham Watson (UK), for example, declared, “I would like to plead for moving away from prohibition”. Mr Chrysogelos (Greece) added, “Since prohibitive policies have failed in their primary objectives and they have proven ineffective, with a clear overweight of cost over benefits, there is an urgent need to reform them towards better regulation that would reduce the harms to users, society and the economy”. The remarks of Pierre Vimont, the Secretary General of the European External Action Service (EEAS), were also positive. While acknowledging the difficulties faced by the EU in holding a unified view on drug policy, he did make it clear that it was necessary for EU representatives and EU focal point diplomats from around the world to achieve a coherent and agreed discourse on drug policy.

On the afternoon of May 29, IDPC and the Global Commission held a civil society seminar on similar issues. Participants at the seminar shared a belief that it is important for the new EU Drugs Strategy to be based on evidence, and that regional leadership is important for many member states. At the same time, the role of civil society and grassroots activism at country level should not be neglected, as it is to a large extent the member states that are shaping the future European strategy. Balanced and well-functioning national drug policies, which respect human rights and public health principles, backed by civil society and general public support form a strong argument for policymakers who represent their societies at international forums. The discussions also touched upon issues related to the willingness of the EU to engage in meaningful debate around drug policy reform and harm reduction, and strategies that could be implemented to encourage more leadership among EU institutions.

These two seminars clearly reflect the fact that a number of MEPs and the EEAS are interested in engaging in meaningful drug policy reform debates, whereas the European Commission and the DG-Justice seem to be more reluctant to show leadership on the drugs issue, at a time when the EU is reviewing its Drugs Strategy. Nevertheless, we were encouraged by the European Council’s conclusions on the EU Drugs Strategy released last week, which explicitly call for a balanced drug policy based on public health and human rights. We hope that the new EU Drug Strategy will follow this direction and that better leadership will be shown by all EU institutions to engage in a much needed debate on drug policy reform.

Can Europe lead the way to global drug policy reform?

Today in Australia, politicians hailing from different parties called on the government to task the Productivity Commission to investigate the adequacy of the country’s drug laws, including the economic and social costs of law enforcement measures on illicit drugs. They reason that the entry of the Productivity Commission will help to depoliticise and inject evidence into the debate on drug law reform—a debate that is timely given the widespread (though sometimes merely private) acknowledgement amongst policymakers, experts and the public that current approaches are not working.

The call for an official review of Australia’s drug laws rides on a wave of national debate on the need for drug law reform stimulated by the media, and the Australia 21 report The prohibition of illicit drugs is killing and criminalising our children and we are all letting it happen released in April this year. The Australia 21 report was based on a roundtable discussion involving former high level politicians and policymakers, and community representatives. It considers the costs and benefits of Australia’s existing policies, and concludes that they have failed in their fundamental objective of protecting Australians from the harms of drug use and markets. It points out the alternative options to prohibition that other parts of the globe are starting to consider—including de-penalisation, decriminalisation, legalisation, regulation and taxation—and declares that “[i]t is time to reopen the national debate about drug use, its regulation and control.”

It appears that a national debate on the need for drug policy reform has indeed opened in Australia. However it is sobering to note that the prospect for reform remains a serious political challenge, given Prime Minister Julia Gillard shut down any discussion of a change in drug policy upon the release of the Australia 21 report, and public debate on the topic appears to remain deeply divided. Nevertheless the initiative taken by parliamentarians today to ensure a rational evaluation of Australia’s existing policies is an exciting development. There is hope yet that Australia may become a regional, even global, leader on the reform of drug policies to confront the damaging impacts caused by existing prohibition-based measures.

Growing support for rational evaluation of drug policies in Australia

Along with several colleagues from IDPC and Release, I attended the conference of the ISSDP last month. Set in the rather beautiful, historic city of Canterbury (it was in fact right next to the cathedral), the theme for this year’s event was the exploration of the ways that empirical research studies influence drug policies. There were numerous interesting presentations, and it would be impossible to mention more than a fraction of them here.

Of most significance to IDPC, however, was the plenary session featuring critical discussion of the Report of the Global Commission on Drug Policy. Mike Trace, IDPC Chair, opened the session with a defence of the Report. He reminded the audience, that this publication was always intended as a political intervention, yet despite that, he stood by the general thrust of the data on which the report was based.

Eminent US academic Professor Peter Reuter then spoke critically of the Global Commission Report, outlining briefly the shortcomings of some of the data it contained. ‘Nonetheless,’ he went on, ‘I come to praise Caesar, not to bury him.’ He listed the high calibre public figures who made up the Commission, and suggested that the real importance of the Report was that such well-respected individuals had very publically aligned themselves with the failure of the present drug control system and the need for open discussion of reform. The Report had done its job, he said, by drawing the attention of mainstream media and politics to the drug policy question, and the Commission should now quietly retire. He added that the Commission might have been more radical in its recommendations, a point echoed by (the equally eminent) Robin Room.

As an observer with, as it were, one foot in each camp of the academic research/policy activist divide, I found many of the discussions stimulating, one or two soporific, and some positively useful.

However, my impression is that the conference was not entirely successful in fulfilling its brief. On the ISSDP’s web site, the organisation’s stated objectives include ‘to improve the interface between researchers and policy makers’. If we broaden this a little to include not just policy-makers but the policy community (NGOs, civil servants, etc), there were times when academic researchers and the wider policy community appeared to exist in parallel universes. To a large extent, this is due to the differing institutional frameworks and cultures involved, which do not always share the same languages or possess equivalent types of formal social status. It is to be hoped that the conference will continue as an interface, and attempt to more effectively bridge this divide, with both sides viewing the conference as a learning process.

The attempt made by the ISSDP to be more geographically inclusive and broaden out the discussion to include a few presentations from Latin America and South East Asia should be noted. There is still further work to be done to stimulate academic discussion and research on drug policy in countries other than those in Western Europe, North America and Australasia. The next conference will take place in Bogota, Colombia and will be the first time the conference has been held outside Europe or the US.

The 6th Conference of the International Society for the Study of Drug Policy (ISSDP)

Nanna W. Gotfredsen and Emil Kiørboe, The Street Lawyers

In June 2012, the Danish Parliament approved a new law on drug consumption rooms.

In September 2011, during the Danish national election campaign, Gadejuristen, The Danish Street Lawyers, published a legal paper and a press release, 

“The Emperor’s New Groove – No Legal Obstacles for Drug Consumption Rooms – only Political”

. The title of the paper is explicit regarding its contents, but for those interested, a summary of the document is available on the Street Lawyers’ website in English.

On the 12th of September 2011, just three days before the national election – at which point it was impossible to tell whether left or right wings would come first – a NGO led by the social entrepreneur Michael Lodberg Olsen opened a mobile drug consumption room (DCR) in Copenhagen. According to media coverage, it was clear that no matter which political wing won the elections, Denmark would, for the first time ever, have a majority in Parliament which supports the establishing of DCRs in Denmark, as the “Liberal Alliance” party announced that they would support this important progress no matter which party the voters chose to elect.

Unfortunately, once the new left-wing minority government was established, and despite its concerns about the high death rates among Danish people who use drugs, no mention was made of the possibility of establishing DCRs. In October 2011 a motion for a resolution on DCRs was put forward by Liberal Alliance. A few days later, the government finally delivered their promise to establish DCRs in Denmark. We all awaited the promised bill for almost 6 months, when Liberal Alliance decided to ask the Minister of Health for a status on the process. In the end of April 2011, the law proposal was finally put into the hearing process. Civil society was only given 4 days to submit their remarks on the proposal. The Street Lawyers refused to support the proposal and submitted an 18 pages harsh critique of the document.

On the 9th May 2012, an amended and more acceptable bill was introduced in Parliament, and was followed by a hotheaded political debate during all of the three mandatory parliamentary readings. However, it must be stressed that the political debate was a lot more user- and drug policy reform-friendly than was ever seen in this country. On the 13th June 2012, the third and final reading was completed, with Joachim B. Olsen (MP, Liberal Alliance) had the Minister of Health promise that the coming DCR-guidelines being drafted by the Danish Health and Medicines Authority would not include instructions that would make DCR staff obliged to inform the police about the whereabouts of DCR clients.

This is how a majority of the Danish Parliament ended up voting in favour of DCRs (63 MPs in favour, 43 against, 1 abstention), including instructions to police and the prosecutors not to search, seize and prosecute users in possession of ‘small quantities’ of controlled drugs for personal use ‘in and nearby’ DCRs. However, ‘small quantities’ remains a matter of legal interpretation. According to the guidelines outlined by the highest General Attorney, this usually relates to less than 0.2 g (= 200 mg.) of heroin or cocaine. However, in a ruling from the Supreme District Court, the possession of 1.37 g. of heroin was considered as personal use.

The new law, which will come in force on 1st July 2012, also allows for Danish municipalities to establish DCRs for smoking or inhaling heroin or crack.

Now it is about time for us to acknowledge and show or appreciation to the current Danish government for their continuous support for DCRs, heroin treatment and general harm reduction services, and for putting forward the bill on DCRs. Because of the support of the Liberal Alliance, the law will be able to survive future shifts in political power.

The new law will finally enable us to welcome people who use drugs so that they can use in much safer conditions. We are hopeful that this new step will contribute to a much needed decrease in mortality among people who use drugs, and an increase in users’ social inclusion and dignity.

Watch the HCLU's 2009 movie about the Street Lawyers of Denmark

Danish Parliament paves the way towards increased safety and dignity for people who use drugs

Emily Crick, MPhil student, Swansea University

At different points in history, drug production, supply and use have all been presented as threats to human, national or international security. The international relations theory of securitization can be used as a way of explaining how and why the ‘drugs as a threat’ narrative holds so much power, even today. The UN drug control conventions clearly illustrate the ‘drugs as a threat’ discourse and more recently Russia has attempted to identify Afghan opium production as a threat to international security.

 constitutes a serious evil for the individual and is fraught with 

UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988 - 

illicit production of, demand for, and traffic in

 [drugs] adversely affect[s] the economic, cultural and political foundations of society… [and ] links between illicit traffic and other related organized criminal activities… undermine the legitimate economies and 

threaten the stability, security and sovereignty

“Raising through the UN Security Council the status of the problem of 

Securitization is defined as a specific grammatical process that involves a ‘speech act’ whereby an issue is presented as an ‘existential threat’ to a designated ‘referent object’ and finally, ‘extraordinary measures’ are justified in order to combat this threat.

Of course, ‘extraordinary measures’ do not automatically have to equal war; they are more likely to result in a range of law enforcement activities. Though the UN drug control conventions allow national governments a certain degree of flexibility which accounts for the spectrum of policies that includes de-penalization (e.g. Portugal and the Netherlands), strict law enforcement (e.g. the USA) and the militarization of enforcement and eradication (e.g. Plan Colombia), all these policies can be seen as examples of the ‘extraordinary measures’ of global drug control.

Whilst the speech acts mentioned here are not the only examples of drugs having been securitized, they highlight the power of the ‘drugs as a threat’ narrative. Global prohibition consistently relies on the portrayal of drug users, drug producers and drug traffickers as the ‘existential threat’. Initially the threat was identified as drug use (Single Convention), however gradually drug trafficking organisations and then ‘narco-terrorists’ have become identified as the most dangerous threats to national and international security (the 1988 Convention and ‘Rainbow-2’).

Securitizations define which values and behaviours are acceptable, and which are not. In the case of global drug policy it sets out which drugs are acceptable (alcohol and tobacco) and which are not (e.g. coca/cocaine, opiates and cannabis).

The securitization of an issue can create ‘Frankenstein’s Monster’ in that it is no longer subject to the scrutiny of normal policy making because it has been framed either as ‘security politics’ or as above politics. In some cases the ‘emergency measures’ themselves create severe ‘unintended consequences’, nowhere is this more evident than with global prohibition (Costa, 2008). The idea of ‘Frankenstein’s Monster’ partly explains the ‘bureaucratic inertia’ that has characterised the regime and reinforces the argument that political and security professionals portray themselves as managers of security in order to compete for budgets, develop technologies, and justify their own authority. Furthermore, once the monster has been created, limiting or challenging it becomes extremely difficult.

The development of the ‘drugs as a threat’ narrative

I attended a high level seminar, convened by the Kofi Annan Foundation, on Drugs and Security in West Africa last month. As someone new to the region, this trip to Dakar was a real eye-opener on several levels, but from the IDPC drug policy perspective, there were several aspects of what is happening in West Africa that were worryingly familiar, and it is not easy to see how the emerging problems in that region are going to be avoided.

There is no doubt that the scale and breadth of drug trafficking (primarily, but not exclusively, Cocaine from South America on its way to the lucrative European markets) is fast increasing in the region, and that it is controlled by organised crime groups with the ability to engage in widespread corruption of officials, and provide financial support to the many political and territorial rebel groups in the region.

Unsurprisingly, the domestic consumption of 'Western' drugs such as cocaine and cannabis seems to be increasing accordingly, although in the absence of widespread surveys, we are only likely to see convincing data when it is too late to react. On the positive side, there is little sign (yet) of the sorts of market related violence that we see in Central America for example. This may be due to the less widespread availability of small arms (a situation that may be changing since the fall of the Gaddafi regime in Libya) or, ironically, due to the efficiency and clear dominance of particular trafficking groups.

However, if I am reading history correctly, all the conditions exist for the fragmentation and diversification of trafficking groups and routes, which usually leads to massive violence, with many innocent victims. Which brings us to the government responses – it is quite right that national governments and the international agencies have identified the security threats associated with drug trafficking through West Africa, but it is hard to see how current agreements and strategies will succeed, and indeed, avoid making things worse for the affected communities.

The level of law enforcement resources within the region, even bolstered by international aid agreements and technical support, stand little chance of achieving anything more than the occasional arrest of minor players, or the temporary disruption of particular trafficking groups or routes. We have seen this before – the scale and the nature of the markets remain unchecked, while some of the pieces move around. And this 'balloon effect' usually results in more violence and disruption in more areas. If enforcement is effective in Guinea Bissau, where will the traffickers move next (Mali seems already to be moving that way)?

Fortunately, there is a growing community of analysts and drug control experts in the region who are starting to think more widely than the simple law enforcement approaches that have failed to stem the tide in Asia and Latin America, and are looking more closely at innovative approaches to managing drug markets to minimise the violence and corruption, and also at effective treatment and public health strategies to protect their own citizens. It will be important that these wider drug policy debates are given the chance to flourish in Africa, through initiatives such as that of the Kofi Annan Foundation, and that experts from the region can learn from what has worked, and not worked, in parts of the world that have previously faced similar challenges.

Drugs and security in West Africa – An inevitable tragedy? 

The lasting legacy of the sixth presidential summit held in Cartagena, Colombia on 14th and 15th April will likely be the beginning of a serious regional debate on international drug control policies. With the adept leadership of Colombia’s President Juan Manuel Santos, the issue was discussed at a private, closed-door meeting of the presidents. Santos later announced that, as a result, the Organisation of American States (OAS) would be tasked with analyzing the results of present policy and exploring alternative approaches that could prove to be more effective. A topic long considered taboo, the U.S. “war on drugs,” is now being seriously questioned and debate on new strategies – including legal, regulated markets – is officially on the regional agenda.

While making it clear that no change in U.S. policy is in the offing, Washington has reluctantly agreed to participate in a debate. The United States is no doubt pleased that the OAS was tasked to study the issue. The Secretariat of its Inter-American Drug Abuse Control Commission (CICAD) is traditionally led by someone appointed by the U.S. government (presently it is former U.S. diplomat, Amb. Paul Simons) and it is widely perceived across the region as a U.S.-driven agency. However, ultimately, CICAD’s agenda and focus is dictated by member states. The burden is now on those member states advocating reform to ensure that the OAS effectively carries out its mandate to explore all alternative policies and to include in the discussion relevant experts and organizations.

Present international drug control policies are deeply-rooted and change will no doubt come slowly. However, an opportunity for meaningful drug policy reform has emerged in Latin America.

Drug policy takes centre stage at Cartagena Summit 

Most of us predicted a dull Commission on Narcotic Drugs (CND) this year, but it turned out to be surprisingly eventful – a pleasant surprise for veterans, if still frustratingly opaque for those looking for open and vibrant debate.

There was the usual procession of countries that listed their national policies in excruciating detail – primarily numbers of arrests and seizures – but it was notable that a growing number gave prominence to showing off their efforts in the field of demand and harm reduction. Also routine was the vocal resistance of the Russian delegation to anything related to harm reduction or tolerance towards people who use drugs (including the clearly incorrect claim that methadone is not a medicine), and the efforts of some member states and officials to stifle debates – in particular the right of NGOs to speak in the official proceedings.

On the other hand, I think I detected a definite change of tone in much of the discourse – many Asian and Latin American delegations issued statements that signalled a move away from repressive policies to more health promotion and social development, and significant positions were taken by:

The USA, whose statement expressed regret at previous administrations' overuse of punishment to reduce demand, and emphasised treatment and support for drug users.

The International Federation of the Red Cross and Red Crescent Societies, who moved beyond their long stated support for harm reduction, to make a clear call for an end to criminalisation and punishment of drug users.

The Czech Republic, whose statement clearly called for a fundamental review of global policy, and supported the conclusions of the Global Commission on Drug Policy.

We at IDPC also noticed a much greater level of interest from government delegations (including many from Asia and Latin America) in attending NGO events, and receiving materials on alternative strategies. There is clearly an increasing momentum for at least considering more humane and effective approaches – many powerful interests will continue to resist this process, but the taboo is clearly broken, even in the dusty corridors of Vienna.

The 2012 CND – Change or inertia?

For many years under the Berlusconi government, Italian drug policy has been directed by ideology. The government passed a legislative amendment to increase penalties for all categories of drug possession and use, treating cannabis with the same severity as heroin and cocaine. It has also been consistently hostile towards harm reduction services in domestic and international drug policy forums. However the departure of the minister primarily responsible for spearheading ‘tough on drugs’ policies hopefully heralds a corresponding change in Italy’s approach to drugs. It was in this promising context that a group of judges, magistrates, politicians, NGOs and academics met to discuss the problems they are inheriting from the outgoing administration, and the emerging opportunities for reform.

We met last week on 23 – 25 February 2012 in Syracuse, Sicily at an international expert seminar co-convened by the International Drug Policy Consortium, Societa della Ragione, and Forum Droghe. Our discussions focused on two key themes: decriminalization and diversion schemes, and harm reduction. We heard from experts on the experiences and lessons learned by countries in Europe, Asia and South America, in order to get a sense of the challenges to tackle and opportunities to grasp in implementing decriminalization, diversion and harm reduction measures. Experts from the UN and academia also shared advice on ensuring effective harm reduction interventions and cultivating supportive environments to sustain those interventions, especially building a positive relationship between law enforcement and people who use drugs.

We all shared a hope that Italy could gradually overcome significant barriers to its implementation of decriminalization, effective diversion and up-scaled harm reduction measures: rising rates of prosecution of drug offences (due partly to inconsistent prosecution practices), and declining investment in needle exchange schemes and opiate substitution treatment. Overcoming these barriers will only be possible with continuing open debate, informed by evidence and international best practice, and increasing investment in the reforms that are appropriate for Italy.

A promising time to open debate on reform in Italy

Last week in Bangkok (6th to 8th February 2012), delegates from governments, UN agencies and civil society organisations (CSOs) based in the Asia-Pacific region gathered in the UN Conference Centre to discuss the progress they have made in taking action on problems related to HIV/AIDS. But it is perhaps fair to say that for some countries, the preference was to not discuss the progress made (suggesting that there was no real progress) but to simply deliver prepared statements on aspects of their country’s national policies that revealed little about the reality for people living with HIV/AIDS (PLWHIV). Procedure was followed but substance was disappointingly lacking.

After the two and a half day meeting, and significant organisational efforts by the UN, country representatives and CSO delegates, it is reasonable to expect that a good understanding of the progress made and ongoing challenges for governments could be achieved. There were certainly moments that met this expectation. China spoke about the challenge of implementing methadone maintenance treatment and needle/syringe exchange programmes because of resistance from law enforcement agencies and conflicts between laws that are yet to be resolved. Tajikistan reported that their main challenge at the moment is to change social attitudes, where it is commonly believed that HIV is a Western disease that did not affect Muslims. The CSO representative in the Vietnamese delegation talked of the need to build the capacity of CSOs, especially those that are willing to be critical of responses to HIV/AIDS-related problems. But I thought these moments were too few and far between.

In spite of the shortfall in meaningful discussion on progress and challenges, we should not neglect some of the positive features of this UN meeting. Such as the fact that this was the first time that CSOs could participate, and not only observe, a UNESCAP meeting. ‘Participate’ in the UN sense, meaning that a CSO could only attend by invitation (given in accordance with strict criteria), make statements during formal plenary sessions (if representing a CSO with ECOSOC status, and at the discretion of the Chair) and provide comments during the interactive session.

I was therefore delighted and grateful that I could deliver a statement on behalf of IDPC. But you might ask: why ‘grateful’ when CSOs have the right to participate (even if only in the UN sense)? In short, it is because the UN system’s focus on procedure over substance makes it incredibly difficult for CSOs to participate in a meaningful way. There is certainly value in UN activities such as this UNESCAP meeting, yet I can’t help thinking that there is potential for these forums to be so much more effective, impactful and inclusive.

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