A call for prioritizing health and harm reduction in reforming drug policies Drug policy special session AIDS 2014 Melbourne July Dr Alex Wodak AM 1

Basis current global drug policy? Three international drug treaties Multiple UN agencies Almost every countries participates Participating countries pass laws criminalising all aspects certain drugs Politicians use harsh language refer people who use drugs Majority govt expenditure to supply control 2

Has it worked? Academic debate now over: drug prohibition abject failure* Drug market soared, more dangerous Much harder to protect public health e.g. control HIV among people who inject drugs Increase: deaths, disease, crime, corruption, violence, threats national security Bad policy = good politics * Wodak A, ANZ J Criminology August

‘In addition to criminalizing HIV transmission, many countries impose criminal sanctions for same-sex sex, commercial sex and drug injection. Such laws constitute major barriers to reaching key populations with HIV services. Those behaviours should be decriminalized, and people addicted to drugs should receive health services for the treatment of their addiction’ UN Secretary-General Ban Ki-Moon 4

What needs to change? Threshold question: re-define drugs as predominantly health, social issue Funding implications Base policy on evidence Respect human rights of all Allocate government spending according to return on investment More demand reduction, harm reduction 5

When will it start to change? Change already started First phase: - Netherlands (1970s) -Switzerland (1990s) -Portugal (2001) Current phase: Bolivia left, rejoined 1961 Convention (2011, 2013) Global Commission Drug Policy (2011) UNDP Global Commission on HIV and the Law (2012) 6

When will it start to change? 2 Summit of the Americas (2012), OAS (2013) CO, WA states USA voted 55: 45 % tax, regulate cannabis (2012) Uruguay legislature passed bill legalise cannabis (2013) NZ began regulating new psychoactive substances (2013) Jamaica decriminalised personal ganga (2014) 7

Harm reduction: Initially marginalised 1980s, 1990s Now mainstream global drug policy UN system though still some opposition Evidence now compelling: scientific debate over re needle syringe programs, opioid substitution treatment Concept well defined* # countries supporting, implementing increasing But still too little, too late, only 3% funding needed: impeded drug prohibition * 8

Conclusions: Academic debates now over, political debates continue Harm reduction effective, safe, cost-effective Drug prohibition failed, huge collateral damage, very costly Redefining drugs as predominantly health, social issue the critical step More demand reduction, harm reduction 9