The global war on drugs, including the repressive law enforcement tactics, are helping to drive the world's continuing HIV/AIDS pandemic, according to a new report released today by the Global Commission on Drug Policy. Harsh policies, argues the report, "force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated."
The commission — which includes six former presidents, British business magnate Richard Branson and former Supreme Court of Canada Justice and UN High Commissioner for Human Rights Louise Arbour — is releasing their report (pdf) in advance of the International AIDS Conference, the world’s largest gathering of HIV/AIDS experts. It will be held in the US for the first time in 22 years this July 22-27, in Washington DC.
Mass incarceration, another mainstay of the drug war, also plays a role, says the report, noting that as many as 25 percent of Americans infected with HIV may pass every year through correctional facilities, where prevention and treatment measures leave a lot to be desired.
The report's authors praise countries where "addiction is treated as a health issue" such as Australia, Portugal and Switzerland, where newly diagnosed HIV infections have been nearly eliminated among drug users, but condemned the dominance of failed drug policies which have seen the availability of illegal drugs only grow. According the report, the worldwide supply of illicit opiates, such as heroin, has increased by more than 380 percent in recent decades .
The Commissioners also stress the drug war’s contribution to the growth of organized crime and violence, and urge countries that under-utilize proven addiction treatment and public health measures to immediately scale up evidence-based strategies to reduce HIV infection and protect community health and safety. These measures include sterile syringe distribution, safer injecting facilities, and prescription heroin programs. “Failure to take these steps is criminal,” the report states.
"This war is not slowing drug use," Branson said, calling it "perhaps the greatest failure" of public policy in the past 40 years."
This is the second report published by the Global Commission. Its first report, released in June 2011, generated unprecedented media coverage and catalyzed international debate about the urgent need for fundamental reforms of the global drug prohibition regime. The Global Commission is the most distinguished group of high-level leaders to ever call for such far-reaching changes – including alternatives to incarceration, greater emphasis on public health approaches to drug use, decriminalization, and experiments in legal regulation.
The Commission’s recommendations are summarized here. They include:
- Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.
- Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.
- Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.
- Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.
How the drug war fuels the HIV pandemic:
- Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.
- Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.
- Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.
- Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.
- Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.
- Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.
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