Diego Cánepa. Credit: Office of the Presidency of Uruguay

By Pavol Stracansky
VIENNA, Apr 17 2014 (IPS)

The Uruguayan government has made a controversial move to regulate the production and sale of cannabis. The government believes that this will help in the fight against drug-related crime and in dealing with public health issues.

The move has been condemned by the UN’s International Narcotics Control Board (INCB), whose president Raymond Yans accused the country’s government of having a “pirate attitude” for going against the UN’s conventions on drugs."It is not our aim that anyone follow us or do what we have done."

Diego Cánepa, secretary of the office of Uruguayan President José Mujica, tells IPS that he believes a regulated marijuana market was the right decision for his country.

Q. How do you feel about your country being labelled “pirates” by the INCB for legalising the marijuana market?

A. Well, the INCB is just one UN body and it is just one opinion. They have a special mandate and that mandate is not to decide what approach each individual country should follow. We have had a discussion over the correct interpretation of the UN drugs conventions. We believe, and we have the evidence to show this, that our interpretation is correct. We followed the original spirit of the convention and we hope that the step which we have taken is the right one to create better control of the marijuana market in our country.

Prohibition was a big mistake in the last 40 years, so we believe that a strictly regulated marijuana market is the best way to fulfil the spirit of the UN drugs conventions.

Q. Do you get frustrated when you hear people from other countries talking about how what you are doing is wrong, for example from countries which have a much more conservative, hard line approach to drugs?

A. We very much respect every opinion. It’s an open discussion. We do not think that we have the whole truth in our hands. We listen very carefully to the opinions of other countries but we defend our sovereign right to do what we think is right for our own country and our people. And we believe that in terms of our health policies this is the best option for Uruguay.

We don’t want to be a model for other countries over this, we just think that this is the best way for our country and we will defend our right to take this option. But we are open to discussion. We think that prohibition is not the answer and overwhelming evidence has shown that it is a mistake. We don’t want to have this kind of policy. We need to have the right to explore a different approach to drugs.

Q. If you find that after a couple of years things are not going well with the legalisation or that you are not seeing the kind of results you want with regards to public health, would you be prepared to go back to a ban on drugs?

A. I think the question is different. First of all, a few years is not enough. You need at least eight, nine or ten years before you can draw any conclusions. We need to have a lot of evidence over a long time period to really understand what effects this policy is having.

Looking at public health, violence, drug consumption – all the evidence shows us so far that by regulating the market and making visible what has until now been an invisible market means that you can control that market better, and control trafficking and then you have less violence. But I think that if that doesn’t happen in ten years then we will have another debate on this. But I do not think we would go back to banning [marijuana]. We would need to find another answer.

Q. Are you happy when you see other countries doing things which are similar to what you have done? For example states in the U.S. which have legalised commercial marijuana sales.

A. Actually, what they have done in Colorado is much more than what we have done. There you are free to buy and sell what you want. They have a different model to us. But there are 18 states in the U.S. where marijuana can be bought for medical purposes. But that is just an euphemism because we know that the majority of people use marijuana not with a medical purpose but with a medical excuse.

We see that an individual state in the U.S. is operating this way with no federal overrule on it so it is impossible to not accept that there is a big, open debate on this when you have different countries around the world taking different approaches to the problem.

Q. Could you see other countries following your lead and regulating their marijuana markets?

A. I really don’t know and it is not our aim that anyone follow us or do what we have done. We do not want to be a model for any other country. We respect everyone else’s policies but we think that this is the best model for our country.

An addict injecting heroin on the outskirts of Peshawar. Credit: Ashfaq Yusufzai/IPS.

By Ashfaq Yusufzai
PESHAWAR, Mar 22 2014 (IPS)

Pakistan may have low prevalence of HIV/AIDS, with only about 9,000 officially confirmed cases, but the country is at high risk, particularly due to a growing number of injecting drug users (IDUs), say experts.

Of the country’s 180 million people, 420,000 are IDUs according to the Drug Use in Pakistan survey conducted last year.“In 2007, Pakistan had an estimated 90,000 IDUs and the number has now risen to around 500,000."

“IDUs contract HIV by sharing infected syringes. We are afraid that HIV/AIDS can spread to the general population through them,” Syed Mohammad Javid, manager of the National AIDS Control Programme (NACP) told IPS.

He said the easy availability of heroin from nearby Afghanistan, where large swathes of land are under poppy cultivation, has become a pressing problem for Pakistani cities. Peshawar, capital of the northern Khyber Pakhtunkhwa province, is one such place.

“Twenty percent of IDUs have tested positive for HIV/AIDS in Peshawar, which is alarming,” he said, citing a study conducted by the Canadian International Development Agency (CIDA) in collaboration with the NACP in 2010.

A similar study in 2008 had put the figure at 13 percent, Javid said, pointing out that HIV/AIDS prevalence is increasing.

He said Pakistan has officially declared 9,000 confirmed cases of HIV/AIDS. But the World Health Organisation (WHO) estimates that the actual number could well be more than 100,000.

Javid said in 2010 the World Bank had stopped funding free services for HIV infected drug addicts as the money had to be diverted for use in flood-hit areas. This compounded the problem, he said.

Dr Abdul Hameed, a WHO medical officer, is deeply concerned over the sharp rise in HIV/AIDS cases among IDUs because there is no official detoxification and rehabilitation programme in the country.

Hameed said the health department and donor agencies used to believe earlier that HIV/AIDS had no local source in Pakistan, and blamed an HIV positive immigrant population deported from the United Arab Emirates and other countries.

“A WHO study has proved that the infection has potential local source, namely IDUs, which warrants administrative support to addicts at antiretroviral therapy (ART) centres,” Hameed said.

Pakistan has set up 13 ART centres in collaboration with the WHO where around 5,000 patients have received treatment so far.

Oussama Tawil, UNAIDS country coordinator for Pakistan and Afghanistan, told IPS that a high incidence of HIV/AIDS among IDUs in Peshawar had alarmed UN agencies.

“The number of IDUs who share syringes has increased from 500 to 1,800 in the city over the last three years,” he said. The situation is also dismal in other Pakistani cities such as Karachi, Faisalabad, Sukkur, Larkana, Lahore and Rawalpindi, he said.

“In 2007, Pakistan had an estimated 90,000 IDUs and the number has now risen to around 500,000,” Tawil said.

UNAIDS is in the process of establishing 20 wards for detoxification and rehabilitation of IDUs. NGOs will locate IDUs and bring them to the wards for detoxification. Those with HIV will be taken to ART centres for treatment, Tawil said.

NGOs have also been tasked with implementing the UN’s needle exchange programme under which IDUs will be given sterilised needles to end the use of contaminated ones and prevent the human immunodeficiency virus (HIV) from spreading, he said.

This is a pilot programme for Peshawar and will be launched in other cities later.

After detoxification, the IDUs will be counselled and tested at ART centres so that they don’t go back to narcotics, Tawil said.

The 2013 survey, Drug Use in Pakistan, jointly conducted by the Narcotics Control Division, Pakistan Bureau of Statistics and UN Office on Drug and Crime (UNODC), shows that around 4.25 million people in the country are drug dependent.

Mian Zulqernain Amir, joint secretary of the Narcotics Control Division, told IPS that in the last 12 months only 30,000 adult drug users had access to treatment, mostly at private centres run by NGOs.

“However, we now have baseline information on the prevalence and pattern of drug use among the population and we are taking steps, in collaboration with the UN and NGOs,” he said.

The survey on Drug Use in Pakistan showed that cannabis was the most commonly used drug in Pakistan, with four million people listed as users. Opium and heroin were used by about one percent of drugs users. The highest levels of heroin use was seen in provinces bordering poppy cultivating areas in Afghanistan.