The UN Drug Control Debate
The 48th session of the UN Commission on Narcotic Drugs (CND), 7-11 March 2005 in Vienna, was plagued by controversy about the legitimacy of harm reduction policies. Ending in stalemate, guidance for UNODC to operate in this field remains ambiguous. In June, at the Programme Coordinating Board (PCB), a consensus was reached regarding a mandate for UNAIDS to be involved in needle exchange programmes and other harm reduction activities among injecting drug users. What options are available to clarify UNODC’s mandate in this area and more in general to achieve a breakthrough in policy dilemmas that surfaced recent years at the UN level.
Worldwide trends seem to indicate a growing divergence between zero tolerance ideology and pragmatic approaches, leading to tensions between the letter and spirit of the UN conventions on the one hand and daily practices in an increasing number of countries on the other hand. How can UNODC, but also UNAIDS and WHO, operate efficiently and coherently amidst these tensions? A well prepared procedure for the 2008 review of the 1998 General Assembly Special Session on drugs will be required to address these dilemmas in a serious way.
Looking at how the drugs issue is being dealt with within the UN system, it is clear that many things happened over the past decade, both in terms of policy developments and in terms of the UN structure and its main agencies.
Let me start with characterising the drugs policy debate itself. In the media and in politics often an easy breakdown is made into two supposed opposite poles in the discourse, as if the debate can be simplified between prohibition and legalisation. In my view, that is a rather unhelpful distinction leading to an unnecessary and invalid polarisation. I would rather put the different positions of multilateral agencies, governments or NGOs on a variety of overlapping and gliding scales, with relatively few players occupying a place at the extreme end of any of the scales.
The first of these is the scale between repression and protection, between law enforcement and social policy, between punishment and assistance. Regarding the consumption of drugs, on the one end of the scale you find criminalisation with high penalties, towards the other end alternative sentences or decriminalisation of use and possession for personal use. Either crime or health concerns are more emphasized, placing more responsibility in the hands of either the police or the medical profession. For production, whether crop eradication or development is prioritised determines whether the military or a development agency is given more of a leading role.
A second divide is that between dogma and pragma, between the philosophies of "zero tolerance" and "harm reduction", between those who believe that the problem can be eliminated and those trying to learn how best to cope with it, between those reconfirming the status quo and those willing to reassess it.
As with so many other issues, the divide between the powerful and the dependent is present – between North and South, between donors and recipients, between those with political room for manoeuver and those whose tap may be turned off if their words or actions displease their funders.
Finally, there is balance between demand and supply, that is, whether it is consumption or production that should be considered most to blame for the expansion of the illicit drug market. Some believe it is more effective to concentrate resources on demand reduction because supply tends to accommodate demand, while others hold that the levels of demand can best be influenced by cutting off the flow of drugs, thereby reducing availability, driving up prices and stifling demand.
Most of the current policy debates are rooted in differences in emphasis and priorities, moving back and forth along these scales. Motives behind such differences also vary and can have a religious, philosophical or legalistic background, can be prompted by differences between regions and countries in the nature of drug-related problems they are confronted with, and can be driven by scientific evidence about what works and what doesn't, based on evaluation of policies and practices.
Having said that, what I want to do is first give a quick overview of the main policy trends over the past decade and then go into some more detail about how the various UN entities are operating within that changing policy environment, with emphasis on UNODC as the lead agency, and end with some recommendations on how to improve UN performance in this field looking towards the moment of the UNGASS review in 2008.
Looking at trends in the three main areas of drug policies, those addressing drug use, cultivation and interdiction, some conclusions can be drawn.
Drug use: a clear trend is underway towards acceptance of harm reduction measures. Across the globe we find examples of policy shifts taking place in the direction of decriminalisation of drug use, introduction of needle exchange and substitution programmes, expansion of drug consumption rooms and heroin prescription, and incorporation of harm reduction language in policy documents. There is no question about the direction policy trends are taking in this field.
Cultivation: here trends seem to be contradictive. This is the field where progress is measured most easily (crop monitoring), and many governments are trying to reach goals set for 2008, applying repressive measures like opium bans and forced eradication. Policy discourse meanwhile has developed in the opposite direction, acknowledging that forced eradication is not justifiable and reductions not sustainable as long as alternative livelihoods are not secured, and placing the issue of illicit crops more and more in the broader context of conflict resolution, human rights and development. However, while discourse moves on the scale from punishment towards assistance, on the ground an escalation of repressive approaches seems to be the reality.
Interdiction: the law enforcement side of supply reduction efforts seems to be simply continuing without anyone really bothering about its effectiveness. Seizures, judicial cooperation to disrupt trafficking rings, precursor and money laundering control operations, all just go on unbothered by any serious evaluations about their real impact in terms of disrupting the illicit market. Hardly no example has ever been documented that those efforts have ever led to scarcity on the international drug markets which they are supposed to do. The only trend visible, especially within law enforcement agencies themselves, is a growing acknowledgement and frustration about the lack of impact on the market, slowly shifting policy priorities in this field away from drug supply reduction towards reduction of drug-related crime where impact of certain best practices has been demonstrated.
A paradigmatic distinction that runs through all these areas, is between on the one hand the ones who believe in the possibility of a drug-free world and for whom zero-tolerance towards illicit drugs can be the only answer, and on the other hand the ones who try to find the most pragmatic and humane ways to deal with the reality of continuing drug use and a supply market that has proven to be resistant to policy interventions.
In summary one can observe a clear paradigm shift from zero-tolerance to pragmatism. The reducing numbers of zero-tolerance proponents, in view of disappointing impact vis-à-vis the realisation of their dream of a drug-free world, tend to become more aggressive in their methods, resorting to radical approaches to production (spraying crops, military eradication units, opium bans etc), merging the fight against drugs, crime and terror, and introducing radical measures to curb drug use such as mass incarceration and random drug testing.
Meanwhile the growing numbers of proponents of pragmatic approaches run into two kinds of obstacles. Firstly, a lack of resources necessary to scale up the programmes to a level where longer-term impact could be achieved. It is not easy to convince politicians of the need for huge investments in development and health care which will only gradually and slowly reduce drug-related problems, they tend to prefer the illusion of quick-impact measures and prefer to talk in terms of 'solutions' for problems rather than managing or containing them. Secondly, the room for manoeuvre for pragmatic policy trends and experiments is limited by legal obstacles in national legislation or in international treaties, obstacles that are not easily removed.
Turning to the question how the various UN entities are operating within this changing policy environment, it is perhaps needless to say that these trends trigger tensions within the UN drug control machinery. The UN is the arena where arguments for less punitive policies must be defended within the strictures of the conventions and against the doctrines of the past, and are only slowly making headway. The core triangle, consisting of the UN Commission on Narcotic Drugs (CND), UNODC and the International Narcotics Control Board (INCB), is resisting to adapt to the paradigm shift taking place.
There are three clear reasons for that:
- The conventions
The triangle operates on the basis of the three UN drug control conventions, negotiated at a time when zero-tolerance was still the prevailing paradigm. Their intention was to limit the use of drugs to medical and scientific purposes only and they prohibit the possession, trade and production of drugs for any other purposes. The 1961 Single Convention was tied to deadlines to eliminate the use of coca, opium, cannabis and their derivatives in 15-25 years. No distinction is made between recreational drug use and problem drug use and even the concept of traditional use only entered the 1988 convention is a very ambiguous and contradictory manner. The accepted language within the triangle therefore is restricted, terms like 'controlled drug use' or harm reduction interventions such as consumption rooms or heroin prescription are difficult to defend under the treaties. The Conventions are in a sense the embodiment of the dream of a drug-free world. The fact that most countries have learned by now that 'a drug-free world, we cannot do it' doesn't annul the fact that they all signed the treaties at the time. And the mandate for the INCB and UNODC is to derive their wisdom from the treaties, not from reality, or only as far as the reality is compatible with the conventions. And on some issues that is no longer the case. That was confirmed by a confidential memorandum to the INCB by UNODC legal experts, who argued that most harm reduction measures are acceptable under the conventions, and that where harm reduction practices are on a tense legal footing with some articles of the conventions, and I quote: "It could even be argued that the drug control treaties, as they stand, have been rendered out of synch with reality".
- UNODC under donor influence
UNODC is under heavy influence from its major donors and particularly under pressure from US side. We've all seen a gruesome example of that this year with the US threat to withdraw funding unless UNODC would distance itself from harm reduction in word and practice. Given the precarious financial situation of the office, not giving in to such pressures would practically amount to institutional suicide, confronting the Executive Director with painful and difficult choices, easily resulting in capitulation to such demands. Other examples of this are Mr Costa's pleas regarding aid conditionality in the case of Afghanistan, adding to the pressure on the Karzai administration to apply harsh measures against poppy farmers because otherwise he might lose the generosity of the international community to supply funding for reconstruction, and Mr Costa's support for the controversial introduction of random drug testing at schools etc.
- CND functioning
The CND operates on the basis of consensus, enabling even a small minority to block progress relatively easily. Officially, the CND is the UN body providing policy guidance to UNODC. Looking at the examples mentioned about harm reduction, aid conditionality and drug testing, it is clear the procedure does not work well. This year's CND and especially the thematic debate about HIV/AIDS prevention in the context of drug control, was a massive and inspiring demonstration of support for harm reduction from a far majority of member states, including the full EU and GRULAC blocks, Canada, Australia, and most Asian and African nations, including the ones who two years ago were still strongly opposed to them. In fact, the only country siding with the US in this debate was Japan, and only on specific topics and moments also Malaysia and Russia. An overwhelming majority supported needle exchange and other harm reduction measures, but because no consensus could be agreed, UNODC did not get a mandate to support such policies. The examples of aid conditionality in the case of Afghanistan and the issue of drug testing are equally worrying. Alternative Development has been discussed many times at the CND, there was a thematic evaluation and a resolution. There is no way you could mis-interpret the guidance given on that issue in such a way that would support the idea of conditioning development aid to Afghanistan to drug control achievements, to the contrary, the recommendations on that issue are quite clear. Still, Mr Costa is actively campaigning for conditionality. Same with drug testing, there is no CND resolution that expresses any support for that idea, still Mr Costa is campaigning in favour of it. These are clear examples of the fact that the US has a stranglehold on the office that is totally unacceptable. The only reason UNODC is pushed in this direction is because they need to secure continued US funding. This contradicts the governing role the CND has been given within the UN system and it contradicts the spirit of multilateralism that was behind the founding of a UN drug control agency.
Merging Drugs and Crime
There is yet another concern about the direction UNODC is taking, which has to do with merging the drugs, crime and terrorism agendas.
In his very first address to the staff after being appointed, Mr Costa emphasized the connections between "drugs, crime and terrorism, the evils of our time". By 1998, steps were already taken to bring together the UNDCP and the Centre for International Crime Prevention (CICP) under a single umbrella. Mr Costa simplified the name of the merged agencies into what is now known as the UN Office on Drugs and Crime (UNODC). He has also taken this process further by re-organizing the still-separated entities into a single, unified UNODC structure. Already now, the office is operating on the basis of a consolidated budget that integrates drugs, crime and terrorism. This step has significant implications because the dual structure is governed by two separate ECOSOC commissions: the Commission on Narcotic Drugs (CND) for the drugs side, and the Commission on Crime Prevention and Criminal Justice for the crime side. Ultimately, the structure foreseen would imply a merger between the two commissions and the conversion of the Major Donors Fund for UNDCP into a fund for UNODC.
Now, no one will deny the relationship between the drugs and crime issues. However, there is concern that this re-organization threatens to shift the balance regarding how the drugs issue is being treated within the UN system. The current trend risks to over-emphasize the drugs-crime connection at the expense of other connections. The drugs issue cuts across many policy areas, and is as closely related to health or development as it is to crime. The priority given now to the relationship between drugs and crime appears to be pushing UNODC drug control policy to focus more on a law enforcement approach than one geared toward health or development. Quite a few member states have opted to mandate the health ministry to be the lead agency for drug policy. Just try to imagine what the difference would be if the UN would decide to merge UNDCP with WHO and merge the CND with the World Health Assembly.
The decision to merge drugs with crime might not be so much of a worry if good coordinating structures within the UN would be in place with the agencies dealing with health and development allowing them to play a significant role in UN drug policy making. However, this merger between drugs, crime and terrorism is pushed through at a time when in fact agencies such as WHO, UNAIDS and UNDP seem to be more and more marginalised in the broader UN drug policy debate.
The WHO's Department of Substance Abuse, the section specializing in drugs issues, has been nearly disbanded. It was merged in 2000 with the Department of Mental Health, "reflecting the many common approaches of management of mental health disorders and substance dependence." That was the formal justification, but closer to the truth might be to say that evidence-based approaches to drug consumption by WHO led to a conflict of interest with the drug control paradigm dominant in the triangle, and the WHO specialists basically 'lost the battle'. During the 1990s the WHO drugs programme was expanded and its research challenged certain drug control dogmas.
The WHO has been at odds with the established drug control system and the illicit-licit distinction from the beginning -its mandate to look at impacts on public health led it to give more weight to alcohol and tobacco abuse. WHO therefore consistently uses language such as "psychoactive substances, including alcohol and tobacco", or " psychoactive substances, regardless of their legal status."
Reports from the Expert Committee and the outcomes of WHO research projects on cocaine, cannabis and heroin prescription, led to serious tensions with the triangle. After a WHO report concluded that the "use of coca leaves appears to have no negative health effects" the US government accused the WHO of "undermining the efforts of the international community to stamp out the illegal cultivation and production of coca". The US delegation to the World Health Assembly also threatened that "If WHO activities relating to drugs fail to reinforce proven drug-control approaches, funds for the relevant programs should be curtailed."
Down-grading the role of WHO in UN drug policy decision making at a time UNODC tends to concentrate more on the links between drugs, crime and terrorism, is in my opinion highly problematic. Let me give three concrete examples. WHO recently included methadone and buprenorphine in its list of essential medicines, and advised that their current scheduling under the 1961 and 1971 Conventions needs to be reviewed because it raises contradictions. Many CND delegates would not even know about this and no one raises the obvious question that it's weird that WHO essential medicines are included in outdated schedules that lack any logic or consistency. The WHO Expert Committee also recommended to re-schedule THC, the active ingredient of cannabis, from its nonsensical inclusion in the list of severely controlled substances under the 1971 convention, but that recommendation did not even reach the CND. Third example is that WHO produced a thorough paper on the effectiveness of needle exchange programmes for HIV prevention, well timed to be ready for the tense CND session this year on the subject, but the paper never got an official status for the CND deliberations, so was not taken seriously into account while UNODC was forced to abandon open support for such programmes.
I could go on with examples of ambiguities within the UN drug control system, including contradictions pointed out by the INCB itself, and with the 2001 UNGASS Declaration on HIV/AIDS, and with the Declaration of Human Rights and the Millennium Goals. In short, I wouldn't hesitate to say it's rather a mess...
UNGASS Review 2008
Turning to the propositive part of how to deal with all these dilemmas, contradictions and tensions, it's a good moment to draw attention to the upcoming moment of global reflection on these issues in 2008. It's still to be decided what form that review will take, whether it will be another Special Session or another kind of forum. But as you will remember, in 1998 in New York the international community agreed upon several targets for 2008 and elaborated action plans to achieve them, so in one form or another those will have to be reviewed. Regarding production, the Political Declaration agreed to "eliminate or significantly reduce the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by 2008". Significant reduction was also predicted for ATS production and for the demand side a commitment was made to "achieve significant and measurable results". You don't have to be an expert in evaluation methodology to predict that in 2008 there will be a certain tension between those goals and the achievements.
So let me conclude by offering five suggestions for how to go about it:
- Establish clear procedure for the 2008 preparations
A transparent procedure for the 2008 review needs to be agreed upon soon, at the next CND meeting in March 2006 otherwise no serious review will be possible two years down the line;
- Assess possible consequences of drugs & crime merger
Definitive decisions about the restructuring of UNODC, the merger of drugs and crime, and the governing structure of the ECOSOC Commissions should not be made before a good assessment is made about the possible consequences, which requires looking at the embedding of the drugs issue within the UN system as a whole, including coordination mechanisms with other expert agencies such as WHO, UNAIDS, UNDP etc.. If such an assessment can be organised before 2008, fine, but proposals coming from UNODC should not be rubber-stamped without a genuine discussion and it might be good to consider postponing the decision until a more comprehensive review takes place in 2008.
- Establish system-wide commission for 2008 preparations
The mandate to prepare the 2008 review should under current circumstances not simply be handed over to UNODC. It would be wiser to consider the establishment of a special commission or steering group -which can operate under UNODC coordination- but which includes participation from other UN agencies like WHO, UNAIDS and UNDP, regional bodies with experience in evaluation mechanisms such as CICAD and EMCDDA, etc.
- Include civil society
The inclusion of civil society in the process should be guaranteed from the outset, including representation in the preparatory commission. As this ICAA Conference as well as other network gatherings have demonstrated over the years, there is a wealth of sophisticated knowledge and experience from the field readily available which should not be excluded from the process. A concrete step would be the appointment by a preparatory commission of a person with a special mandate to organise and facilitate civil society participation in the process from the start.
- Reclaim UNODC multilateralism
Finally, and coming back to the role of UNODC, preparations for 2008 should somehow include a strategy to reclaim the multilateral character of the office, to relieve it of its dependence on US funding, broadening its funding base, enabling it to perform its role as a neutral centre of expertise that all of us would want to see to help guide the international community in the search for more effective and humane policies capable to alleviate drug-related problems and to bring the agency fully in line with the realities of today. This is not meant to just criticize the agency for its performance today, many good things are happening under the UNODC umbrella as well, it is meant to be a constructive contribution to strengthen and improve the role the agency can play within the UN system as a whole.
These five points for me would be the essential points for an urgent discussion, without which I fear the international community will simply hang on until 2008, paralysed by the contradictions mentioned, in the vain hope that somehow reality will fall into line with the wishful thinking of the Political Declaration of 1998.
Budapest, October 24, 2005
Presentation at the 48th ICAA Conference on Dependencies