More than 3,000 health experts, advocates and activists from over 60 countries gathered in Bali, Indonesia in August 2009 for the 9th International Congress on AIDS in Asia and the Pacific (ICAAP). The event aimed to discuss efforts towards universal access to HIV/AIDS treatment, care and support – including for people who use drugs – and called for a strengthened commitment from governments and donors despite the pressures of the global economic crisis. The theme for ICAAP9 was ‘Empowering People, Strengthening Networks’.

The goal of universal access was set in the ‘Declaration of Commitment’ adopted at the UN General Assembly Special Session on AIDS in 2001, and reaffirmed by a ‘Political Declaration’ in 2006. Mr JVR Prasada Rao, Director, UNAIDS Regional Support Team, Asia and the Pacific, delivered a speech on behalf of UNAIDS Executive Director, Mr Michel Sidibé, calling for the establishment of enabling environments and supportive social norms necessary to deliver a future generation free of HIV. He told delegates that “more than 1,000 people become infected with HIV in Asia each day”, and urged that “We must transform the AIDS response in Asia so that it works for people, and especially for people who have been marginalised and without a voice” – including sex workers, men who have sex with men, and injecting drug users. He added that “most infections could have been averted if only we had invested in reaching populations at higher risk and their partners – at a cost of less than half a US dollar per person”.

The Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Professor Michel Kazatchkine, also addressed delegates and said “it is time for the G20 – which is 85 percent of the world’s economy – to come into the circle of donors” in order to help expand the global AIDS funding. He pointed to countries such as Brazil, China, Mexico and South Africa, who “play more political leadership roles [and] have to enter into the global solidarity effort when it comes to health”.

The ICAAP event also featured discussions on key topics such as the decriminalisation of drug use, the high rates HIV and hepatitis C co-infection, compulsory treatment in Asia, and youth leadership on HIV issues. There was also a meeting of AIDS Ambassadors to discuss the mobilisation of funds and commitments, and accountability in the global responses to HIV. A pre-congress forum was also held for people who use drugs to discuss issues such as the decriminalisation of drugs, the human rights of people who use drugs, and issues around drug policy reforms.

Read articles from the Key Correspondents who were reporting from the conference:

Hepatitis C: A challenge among injecting drug users who are living with HIV

Criminalization of drug use: Is it a solution to end the war on drugs?

ICAAP Calls for Stronger Commitment to Universal Access

The Drug War has failed. After more than 20 years of tirelessly pushing for the same policy, the efforts have not been able to bring the expanding illicit drug markets under control and instead have led to an unmanageable crisis in the judicial and penitentiary systems, human rights violations, the consolidation of criminal networks and the marginalization of drug users who are pushed out of reach of health care services. For these reasons, some Latin American countries are starting to explore a more effective and honest drug policy.

In Argentina, soon a legislative proposal to decriminalize the possession of small quantities of drugs for personal consumption will be discussed, and next week the Supreme Court could determine that the imposition of criminal sanctions for the possession for personal consumption is unconstitutional.

The prospect of decriminalization in Argentina has encountered strong support as well as condemnation. The discussion about drug policy is often hampered by polarized positions of prohibition versus legalization, too often erroneously translated into having to make the choice between either 'zero-tolerance to protect our youth' or a 'free-for-all with rising drug use'. This dichotomy obscures the fact that much experience already exists with less repressive approaches in the fields of decriminalization, harm reduction, and more tolerant policies towards cannabis.

The lessons learned in practice can help to overcome the fear that stepping away from punitive approaches is a leap into the dark. In fact, countries that have decriminalized drugs have not suffered explosions in drugs use. And less punitive approaches may well be more effective in protecting our youth and reducing levels of drug-related crime. Not to mention that punishing users for the mere fact of consumption or mandating heavy prison sentences against small traders are clear examples of punishments that are disproportionate to the offense.

Across Europe nowadays, it is unlikely to be imprisoned for possession of small quantities almost anywhere, even though legal definitions vary from place to place. Spain, Italy or Portugal, for example, do not consider possession of drugs for personal use a punishable offence, while in The Netherlands or Germany, possession for personal use remains de jure unlawful, but guidelines are established for police and prosecution to avoid imposing any punishment. Other countries impose administrative sanctions only, and very few countries (Sweden, Cyprus) still maintain the option to impose prison sentences for possession of small amounts.

Three recent impact evaluations of the impact of decriminalization in Portugal concluded that no significant rise in drug use occurred since passing the law in 2001 and that heroin use even had gone down substantially. The one by the US-based Cato Institute, concluded that "the Portuguese decriminalization framework has been a resounding success. Within this success lie self-evident lessons that should guide drug policy debates around the world."

In the case of cannabis, quite a few countries and US states have introduced more tolerant approaches. In none of these cases, there appears to have been any large increase in cannabis use. Even in the case of The Netherlands, despite the open sales through the 'coffeeshops', the levels of cannabis consumption are similar to those of the neighboring countries like Germany and Belgium, and much lower than in the UK, France or Spain.

In Latin America, a more rational drug policy to address the main concerns in the region, while avoiding the negative consequences of the US model, has taken more time to develop. There are good signs, however, that the tide is turning and that a wave of legislative reforms is starting to humanize drug policy in the region. Brazil decriminalized possession for personal use in 2004 and Mexico earlier this year. Both models, however, have clearly flaws in their legal reach and implementation, not least because both new laws introduced harsher sentences for small trafficking.

In contrast, last year Ecuador issued a pardon for drug mules, singling out a specific group of prisoners as victims of indiscriminate and disproportionate legislation. More than two thousand offenders arrested with a maximum quantity of two kilograms of any drug, who had no prior conviction under the drug law, and who had completed ten percent of their sentence or a minimum of one year, were released from prison. Soon, the Ecuadorian government will present a fully reworked drugs law, including the decriminalization of possession.

The debate on more far-reaching reforms in cannabis policy, including the option of a regulated market to take this source of income away from criminal groups is starting to open up in Brazil, Mexico and Paraguay. And Bolivia this year initiated formal procedures at the UN level to correct the historical error of prohibiting coca leaf consumption.

Let's hope that the decriminalization proposal in Argentina can add another positive example, strengthening the turning tide in Latin America. It is not a leap into the dark, but a first significant step away from the darkness of the past.

Martin Jelsma is a political scientist and an expert on drugs, also a research fellow at the Transnational Institute (TNI), in Amsterdam.

Source: Newsweek Argentina, August 19, 2009

Stepping away from the darkness - Argentina to discuss decriminalisation for personal use

Mexico enacted a controversial law on Thursday 20th August, decriminalising possession of small amounts of marijuana, cocaine, heroin and other drugs while encouraging government-financed treatment for drug dependency free of charge.

The law sets out maximum “personal use” amounts for drugs, also including LSD and methamphetamine. People detained with those quantities will no longer face criminal prosecution; the law goes into effect on Friday.

Anyone caught with drug amounts under the personal-use limit will be encouraged to seek treatment, and for those caught a third time treatment is mandatory — although no penalties for noncompliance are specified.

Mexican authorities said the change only recognized the longstanding practice here of not prosecuting people caught with small amounts of drugs.

The maximum amount of marijuana considered to be for “personal use” under the new law is 5 grams — the equivalent of about four marijuana cigarettes. Other limits are half a gram of cocaine, 50 milligrams of heroin, 40 milligrams for methamphetamine and 0.015 milligrams of LSD.

President Felipe Calderón waited months before approving the law.

Mexico Decriminalises Drug Possession

The European Network Correlation has started a new period of activities 2009 - 2012. The overall aim of the project is to tackle health inequalities, and to improve prevention, care and treatment services, targeting blood borne infection deseases (BBID), in particular HIV/AIDS and Hepatitis C among vulnerable and high risk populations (e.g. drug users, young people at risk, sex workers).

The project will approach the issue from different angles and with interventions which have been identified as effective such as Outreach / Early Intervention, E-Health, Peer Support, Hepatis C and HIV/AIDS Policy. In 2010, the project organises seminars on theses issues. For more information, please check the website www.correlation-net.org

New period of activities for European Network Correlation

In November of this year, Transform will be publishing 'After the war on Drugs: Blueprint for a Regulated Drug Market'. It is a groundbreaking document that will provide a fulsome answer to the questions and concerns that many people raise in response to our calls for change. It will shed significant light into the area that so many describe as a step into the dark.

Transform have a rough first draft that they are working on now. A more finished draft will be available in the coming months. Transform are seeking international partner organisations to assist with the launch and dissemination of this document. The plan is to see 'Blueprint' launched simultaneously on five continents, making it the major international breakthrough report of the year, in terms of moving the debate further toward the centre of the political agenda.

If your organisation would like to be a part of this exciting venture please contact Transform. Your organisation's involvement could be as little as helping to get out a press release, through to holding some kind of launch event, putting up spokespeople and associated activities, such as debates and workshops.

Launch of 'After the war on Drugs: Blueprint for a Regulated Drug Market'

The first Latin American Conference on Drug Policy took place in Buenos Aires on August 6-7 and brought together regional experts, policymakers and civil society representatives. Legislative reforms in several countries share a common denominator: decriminalization of drug users, proportional sentences for small dealers, and harm reduction policies to bring drug users closer to the healthcare. More information available at www.conferenciadrogas.com.

I Latin American Conference on Drug Policy 

During the V Latin Conference on Harm Reduction held in Porto (Portugal) last July 1- 4, judges from Argentina, Brazil, Italy, Portugal and Spain gave a joint statement on drug policy and human rights. Among other issues, they stated: "Public drug policies have failed as they haven´t achieved the expected goals of reducing drug use nor have punished big criminal organisations (...) International co-operation in criminal matters is one of the weakest areas in Criminal Law, with a lot of bilateral, multilateral, international instruments that show general fragility and that must be improved within a global framework to achieve the goals they were conceived for".

Latin judges denounce drug policy as a failure

At the Substantive Session of the Economic and Social Council on Thursday, 30th July 2009 in Geneva, it was decided that, starting in 2010, CND and the Commission on Crime Prevention and Criminal Justice will hold reconvened sessions on an annual basis in the second half of the year, back to back, with a duration of one day each.

Read the draft decision below (E/2009/L.38).

Reconvened Sessions of CND formally scheduled

At the Substantive Session of the Economic and Social Council on Thursday, 30th July 2009 in Geneva, Bolivia commenced the formal process by which they hope to delete article 49, paragraphs 1(c) and 2(e) of the Single Convention on Narcotic Drugs, 1961, as amended by the Protocol amending the Single convention on Narcotic Drugs, 1961.

Article 49, paragraph 2(e) states that ‘coca leaf chewing must be abolished within twenty-five years from the coming into force of this Convention as provided in paragraph 1 of article 41’; paragraph 1(c) states that a Party to the Convention may reserve the right to permit coca leaf chewing temporarily in any one of its territories, subject to the restrictions established in paragraph 2(e), that is, for a period of no more than 25years.

The Bolivian proposal was supported by a letter from the President of Bolivia, Evo Morales, which explains that coca leaf chewing is a non-harmful and ancient socio-cultural practice and ritual of the Andean indigenous peoples closely linked to their history and cultural identity practised today by millions of people in Bolivia, Peru, northern Argentina and Chile, Ecuador, and Colombia. The Bolivian delegate to ECOSOC assured other delegates that ‘we are not talking about free growing of coca so as not to feed the narco trade’ and explained that the proposed amendment to the Convention would allow countries to ‘make up their own minds’ on coca-leaf chewing and would not require any change in the domestic law of other countries, she said ‘this is a full application of the principle for non-intervention and non-meddling in the sovereignty of states’. The delegate further stated that the Bolivian government plans to hold a seminar for interested parties on coca leaf chewing in October of this year. Read the Bolivian proposal below.

The United States of America and Sweden both raised their flags on this agenda item but the resulting dramatic tension was quickly abated by a procedural question with regards to the consultation process. The question was answered as follows: if the proposed amendment is not rejected by any Party within eighteen months of 30th July 2009, it shall enter into force. If any rejection is forthcoming, however, a conference shall be called to consider the amendment.

Bolivia commences process to allow coca-leaf chewing under international drug control scheme

At the Substantive Session of the Economic and Social Council on Thursday, 30th July 2009 in Geneva, the report of the International Narcotics Control Board was presented by the President of the INCB, Professor Sevil Atasoy. He declared that multilateral drug control was ‘one of the 20th century’s greatest achievements’ . Professor Atasoy also highlighted a number of challenges, however, in particular, the ‘important issue of public health…low licit consumption of opioid-based medications’ and stated, ‘The Board calls on Governments to establish policies to make these substances available for medical purposes and to support the Access to Controlled Medications Programme, which is being implemented by the World Health Organisation’. Read the statment below. The INCB report can be accessed here.

The INCB report was either welcomed or passed without comment by all delegates except the Iranian delegate, who drew attention to the difficulties that Iran faces in ‘being situated in the neighbourhood of the biggest producer of drugs in the world’ but for the assistance provided by the involvement of the private sector and NGOs and called for further allocation of funds by the international community to the fight against drugs.

INCB Report adopted at ECOSOC substantive session

The Substantive session of the Economic and Social Council on Thursday, 30th July 2009 in Geneva embedded the Vienna outcomes deep into international drug policy. However, the efforts of the United Kingdom delegation and the chair of IDPC, ensured that that the door is not closed to further debates.

Under Item 14(d) of the ECOSOC Agenda, the Report of the Commission on Narcotic Drugs on its fifty-second session (E/2009/28) was proposed for adoption. The report, which buries mention of the most controversial aspect of the negotiation of the declaration (the ‘interpretive statement from 26 countries on harm reduction) deep in the narrative at pp. 119-120, would have been adopted without any recognition of the deep divisions of perspective between member states were it not for the speeches of the United Kingdom Delegate and of Mike Trace, Chair of IDPC. Indeed, the representative of Namibia (the country that Chaired this year’s CND) introduced the report in glowing terms , stating ‘the time is now for us to tackle the world drug problem and to actively promote a society free of drugs’. Bizarrely, Namibia also congratulated the CND on the strong role played by civil society in the CND process – despite repeatedly ignoring repeated civil society requests for more meaningful access to the debates. Read the full address below

Considering that twenty-six countries had been so concerned by the Vienna process in March as to formally state that they would interpret harm reduction into the political declaration, it was disappointing that only the United Kingdom and IDPC formally intervened at this stage to point out the fractured consensus and the system wide incoherence that is demonstrated by the political declaration.

The United Kingdom drew particular attention to the fact that during the negotiations to agree the political declaration ‘many areas of agreement existed, and equally there were a significant number of differences in approach and understanding that in the end were not wholly resolved.’ Read the UK's speech.

Mike Trace, on behalf of the IDPC, detailed for ECOSOC how ‘efforts to reduce the scale of drug markets have had very little impact… these efforts incur a large public expenditure cost for limited returns… [and] can lead to negative consequences for the health and social wellbeing of communities… [whereas] there are programmes and activities that governments can pursue that have been proven to be effective in reducing some of the harms associated with drug markets and use, while not necessarily reducing their scale’. Mr Trace also gave a compelling example of the inconsistency riven within high level policy on drugs that had many delegates taking note, specifically that this same ECOSOC meeting had only last week passed a resolution on the UNAIDS programme that explicitly supported harm reduction approaches to HIV prevention amongst drug users (E/2009/L.23) at paragraph 19, whereas the CND, equally explicitly, had rejected this approach. The IDPC briefing note ‘The 10 year review of the United Nations Drug Control System: Difficult Questions Remain for member states and UN system wide coherence’ was also distributed to delegates.

Otherwise, very few national delegations commented on the report; even the USA, who took the floor during this agenda item, were silent on the drugs issue. Of those who spoke, Russia expressed their support of the political declaration but regretted that the Afghan threat had not been sufficiently reflected and called for the creation of zones of narcotic security around Afghanistan; St Lucia highlighted the magnitude of the drug problem in their region, and called for a move away from punitive measures to preventative measures. Sweden, on behalf of the European Union, welcomed the report but called, in strong terms for UNODC to adopt a comprehensive and integrated approach that addresses the drugs issue in a balanced way and highlighted the issue of data collection stating that ‘may countries lack the most basic knowledge on their own drug situation’.

The CND report will now go to Committee Stage in New York.

IDPC addresses the Substantive Session of ECOSOC on the adoption of the CND report

The US House of Representatives have voted in favour of lifting the ban on the use of US federal funds for needle exchange by a vote of 218 - 211. There are still some challenges ahead in this process but this is an important step in US government policy towards the endorsement of evidence-based harm reduction measures. Speaker Nancy Pelosi made the following statement:

"Sound science is an essential component of good public health policy, and the scientific support for needle exchange could not be more clear.

The Centers for Disease Control, the National Institutes for Health, the World Health Organization, and former Surgeon General David Satcher have all confirmed the scientific evidence in support of needle exchange programs. These initiatives are an effective public health intervention that reduces the number of new HIV infections without increasing the use of illegal drugs.

By lifting the ban on federal funding for needle exchange, the language in the Labor-HHS-Education appropriations bill reflects this sound science. Today's defeat of an amendment that would have reinstated the ban was a victory for science, for public health, for people living with HIV/AIDS, and for people at risk for HIV infection. As this bill moves forward, we must continue to ensure science comes first in our public health policy.

We simply cannot rest until we have done everything we can to prevent new HIV infections, including ensuring access to effective interventions such as needle exchange. We cannot rest until every person living with HIV has access to the care and medications they need to stay healthy. And we cannot rest until we have a cure."