A new analysis of global drug policies looks at how countries’ drug policies and implementation align with the UN principles of human rights, health and development. Credit: Michael Longmire/Unsplash

By Ed Holt
BRATISLAVA, Nov 9 2021 (IPS)

A “radically innovative” new analysis of global drug policies has laid bare the full impact repressive drug laws and their implementation have on millions of people worldwide, civil society groups behind its creation have said.

The inaugural Global Drug Policy Index (GDPI) www.globaldrugpolicyindex.net, developed by the Harm Reduction Consortium (HRC) – a collaboration of civil society groups – ranks countries on their drug policies against a series of indicators related to health, development, and human rights.

Groups in the HRC say it is the first tool of its kind to document, measure, and compare countries’ drug policies, and their implementation, across the world.

And the results of the first index have underlined how even the best-ranked countries are falling dramatically short in aligning policies and their implementation with UN principles of human rights, health, and development.

Ann Fordham, Director at the International Drug Policy Consortium (IDPC), which was involved in creating the index, told IPS: “The message is that no country is doing well. They all have huge room for improvement.”

HRC organisations say that for decades, tracking how well – or badly – governments are doing in drug policy has been difficult.

Until now, many governments have measured the ‘success’ of drug policies not against health, development, and human rights outcomes, but instead by prioritising indicators such as the numbers of people imprisoned for drug offences, the volume of drugs seized, or the number of hectares of drug crops eradicated.

The net result, drug law reform groups argue, is a severe lack of accountability when it comes to the repressive approaches to drugs favoured by many governments and which blight the lives of millions of people, invariably among the most vulnerable and marginalised populations.

But they believe the GDPI will change that.

It uses 75 indicators running across five broad dimensions of drug policy: criminal justice, extreme responses, health and harm reduction, access to internationally controlled medicines, and development.

Thirty countries – the HRC plans to expand the project to include more states in future – are given a score in each of these five areas and ranked according to an overall score out of 100.

The scores are decided on not just extant data but, crucially, expert local perspectives on policy implementation.

This, the team behind the index’s methodology says, helped create a more accurate picture of how people were being affected by a given state’s drug policies, and objectively quantifying the effects of their implementation.

Professor David Bewley-Taylor, of Swansea University told IPS: “Our work was a deliberate effort to include affected communities at the heart of the index. It allows lazy assumptions about countries’ drug policies to be challenged and adds nuance to the debate about drug policy.”

His colleague, Dr Matthew Wall, added: “Even with the best data records there can be gaps. Because we were working with civil society, we could get extra data, get an on the ground evaluation of policy implementation.

“Without civil society perspectives, there would have been something missing, especially in measuring equity of implementation in some areas, for instance, access to harm reduction treatment.”

Some of the findings in the index highlighted the dire impact of policy implementation on communities.

It showed that a militarised and law enforcement approach to drug control remains prevalent globally, with lethal force by military or police reported in half of the countries surveyed. Drug law enforcement is also predominantly targeted at non-violent offences, especially people who use drugs.

Meanwhile, to some extent, in all countries, there is a disproportionate impact of drug control on marginalised people based on gender, ethnicity, and socio-economic status.

The index also pointed out sometimes large gaps between policy and its implementation, and how some countries are doing well in some areas but poorly in others.

For instance, in ensuring access to controlled medicines, countries like India, Indonesia, Mexico, and Senegal score high on policy but get 0/100 for actual availability for those in need.

It also found that inequality is deeply seated in global drug policies, with the five top-ranking countries scoring three times as much as the lowest-ranking five countries. According to the report, this is partly due to the colonial legacy of the ‘war on drugs’ approach.

While Norway topped the index, even it did not perform well in all areas and gained an overall score of 74/100. The median score across all 30 countries in the index was just 48/100.

Campaigners believe that by framing the ‘success’ of countries’ drug policies in terms of indicators of human rights, health, and development, and especially because it involves data gathered from on the ground experience of implementation, the index can be a powerful tool in trying to persuade governments to change their approach to drugs.

“The Global Drug Policy Index is nothing short of a radical innovation,” said Helen Clark, Chair of the Global Commission on Drug Policy and former Prime Minister of New Zealand.

“Good, accurate data is power, and it can help us end the `war on drugs´ sooner rather than later.”

Writing in the report’s foreword, she added: “For decision-makers wishing to understand the consequences of drug control, as well as for those who seek to hold governments accountable, the index sheds light on critical aspects of drug policies that have been historically neglected, such as the intersection of drug policy and development, or the differentiated impacts of drug law enforcement on ethnic groups, Indigenous peoples, women and the poorest members of society.”

The index’s accompanying report illustrates the effects of drug policies on communities, including real-life stories of people who use drugs, often documenting the stigma, violence, and persecution drug users face because of repressive drug policies and their implementation.

It also has a series of recommendations for governments, including calls for an end to violence, arbitrary detention, extreme sentencing and disproportionate penalties, and the promotion of access to health, medicines, and harm reduction services and a long-term development approach for marginalised communities worldwide.

However, it is unclear to what extent the GDPI would sway policymakers in countries where repressive drugs policies have been the norm for decades and where regimes have repeatedly resisted calls for reform.

Groups campaigning for drug law reform in Belarus, for instance, which has some of the most repressive drug legislation globally and notoriously harsh implementation of it, told IPS the index is unlikely to change the regime’s legislation, nor its hard-line approach to drug use.

Piotr Markielau of Legalize Belarus told IPS: “This index is a great idea, but it has very little chance of influencing drug policy in Belarus or any other non-democratic country.”

But Fordham said even if the index was ignored by policymakers in some states, it does not diminish its worth.

“We appreciate that there are some countries which will remain impervious to our efforts, but we hope that the index will at least ignite conversation about the metrics used to measure drug policies.

“We have to keep banging the drum and shining a light on repressive drug policies and the harm they are doing.”

She added: “Governments don’t like accountability on this, so we expect some pushback on the index. But one thing I am proud of with the index is the incredibly robust methodology that has been used. It is a very considered piece of work, and it will put us on solid ground when we talk to governments.”

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Coca leaf growers from the traditional region of Yungas, in northwest Bolivia, surround the legislature in the city of La Paz, demanding an expansion of the legal cultivation area by the new law. Credit: Franz Chávez.

By Franz Chávez
LA PAZ, Mar 9 2017 (IPS)

A new bill in Bolivia, which will allow the amount of land allocated to producing coca to be increased from 12,000 to 22,000 hectares, modifying a nearly three-decade coca production policy, has led to warnings from independent voices and the opposition that the measure could fuel drug trafficking.

Since 1988, the amount of land authorised for growing coca has been 12,000 hectares, according to Law 1,008 of the Regulation of Coca and Controlled Substances, which is line with the 1961 Single Convention on Narcotic Drugs.

This United Nations Convention pointed the way to a phasing-out of the traditional practice among indigenous peoples in the Andean region of chewing coca leaves, which was encouraged during the Spanish colonial period, when the native population depended heavily on coca leaves for energy as they were forced to extract minerals from deep mine pits.

But the traditional use of coca leaves instead grew in Bolivia. According to the president of the lower house of Congress, Gabriela Montaño, some 3.3 million of the country’s 11 million people currently use coca in traditional fashion.

Citing these figures, lawmakers passed the new General Law on Coca on Feb. 24. The bill is now awaiting President Evo Morales’ signature.“This law is making available to the drug trafficking trade more than 11,000 metric tons of coca leaves per year, the average yield from the 8,000 hectares which the law grants to producers.” – Public letter signed by local intellectuals.

Morales originally rose to prominence as the leader of the seven unions of coca leaf growers in the central region of Chapare, in the department of Cochabamba, fighting against several conservative governments that wanted to eradicate coca cultivation, in accordance with Law 1,008 and the U.N. Convention.

The law had enabled the anti-drug forces, financed by the U.S. Drug Enforcement Administration (DEA), to wage an all-out war against coca cultivation. The struggle against the law catapulted Morales as a popular figure and later as a politician and the country’s first indigenous president, in January 2006.

Montaño estimates that annual production amounts to 30,900 metric tons, 24,785 of which are used for medicinal purposes, in infusions or rituals, she said.

The remaining 6,115 tons are processed into products, or used for research and export, she said.

Assessing compliance with the 1961 Convention, medical doctor and researcher Franklin Alcaraz told IPS that in South America, only Ecuador has managed to eradicate the practice of chewing coca leaves.

On Feb. 28, some fifty intellectuals signed a public letter titled: “Public Rejection of the General Law on Coca”, which stated that “this law is making available to the drug trafficking trade more than 11,000 metric tons of coca leaves per year, the average yield from the 8,000 hectares which the law grants to producers.”

Bolivia was one of the 73 signatory countries to the 1961 Convention where clause “e” of article 49 declared that the practice of chewing coca leaves would be banned within 25 years of the (1964) implementation of the accord.

In January 2013, Bolivia recovered the right to practice traditional coca chewing, when it won a special exemption to the 1961 Convention. Its request was only voted against by 15 of the 183 members of the U.N., including Germany, Japan, Mexico, Russia, the United States and the United Kingdom.

Wives of coca leaf farmers from Yungas during a vigil at the gates of the La Paz police station, where dozens of leaders were taken, accused of inciting disturbance during the demonstrations held to demand an expansion of the legal cultivation area in their region in northwest Bolivia. Credit: Franz Chávez.

In a January 2014 communique, the representative of the United Nations Office On Drugs and Crime (UNODC), Antonino De Leo, stated that the exemption “only applies to the national territory.”

The new bill repeals the first 31 articles of the 1988 law and legalises 22,000 hectares for cultivation – 10,000 more than before.

In practice, the new legal growing area is just slightly larger than the 20,200 hectares of coca which UNODC counted in 2015, according to its July 2016 report on the country.

President Morales has defended the increase in the legal cultivation area and reiterated his interest in carrying out an old project for the industrialisation of coca leaves.

On Feb. 28, Morales expressed his support for the new bill and accused conservative governments of supporting the demonisation and criminalisation of coca leaf chewing at an international level.

Montaño said that in 2006, when Morales first took office, 17,000 hectares of coca were grown in the Chapare region. Ten years later, UNODC registered only 6,000 hectares devoted to coca production.

She said that under Morales, the reduction of coca crops has been negotiated and without violence, in contrast to the repression by conservative governments that generated “blood and mourning”.

Before Congress passed the law, coca producers from the semitropical region of Yungas, in the department of La Paz, held violent protests in the capital.

Between Feb. 17 and Feb. 23, hundreds of demonstrators surrounded Murillo square in La Paz, where the main buildings of the executive and legislative branches are located, demanding 300 additional hectares, on top of the 14,000 presently dedicated to coca in Yungas.

There are an estimated 33,000 coca farmers in Yungas, and 45,000 in Chapare.

In the midst of clashes with the police, destruction of public property and the arrest of at least 143 organisers, talks were held with the government, which ended up giving in to the demands.

The settlement also granted growers in the Chapare region an additional 1,700 hectares, on top of the 6,000 currently registered and monitored by UNODC.

Political analyst Julio Aliaga told IPS that traditional use of coca leaves only requires 6,000 hectares, rather than the 22,000 hectares that the government of the leftist Movement Towards Socialism (MAS) is about to legalise.

This figure of 6,000 hectares is drawn from a European Union study on demand for coca leaves in Bolivia for infusions, chewing or in rituals. This study was not mentioned by the authorities or MAS legislators.

“Bolivia has a large surplus of coca which goes toward drug trafficking. The cocaine ends up in Africa, Europe and Russia, and the new colossal market of China,” Aliaga said.

Samuel Doria Medina, the leader of the opposition centre-left National Unity (UN), questioned the 80 per cent expansion of the lawful cultivation area and told IPS that the measure is “a clear sign of an interest in increasing the production of narcotic drugs.“

“The new policy will be indefensible before multilateral drug control agencies,“ since the UNODC certified that “94 per cent of the coca production from Chapare goes toward the production of cocaine,” he said.

In his opinion, the new law provides an incentive for the drug trafficking mafias to sell drugs in Bolivia, “with the well-known violence that this business entails.”

By Jomo Kwame Sundaram
ROME, Dec 11 2015 (IPS)

The latest estimates are that over two billion people in the world suffer some micronutrient deficiencies, often referred to as “hidden hunger.” The main sustainable solution is to ensure adequate public health interventions, including clean water, sanitation and hygiene as well as healthy, diverse diets for all.

Jomo Kwame Sundaram. Credit: FAO

In the short term, however, it will be necessary to provide supplements of vitamins, minerals and trace elements to those especially vulnerable, e.g. due to displacement and emergency situations. There is a general consensus that such needs of pregnant and lactating mothers should be especially prioritized due to the intergenerational consequences of child stunting for such reasons.

Developing countries should be able to affordably access locally produced or imported generics of the vitamin and mineral supplements they require. Many current options associated with public-private partnership will instead strengthen the vested interests of the lucrative, large and fast-growing industry for nutrition supplements.

The need for supplementation to address urgent, short-term micronutrient deficiencies should qualify as part of the public health exception to the Trade-Related Aspects of Intellectual Property Rights (TRIPs) rules of the World Trade Organization (WTO). This has not been fully recognized ostensibly because people do not drop dead immediately due to “hidden hunger.”

TRIPS and generics production for developing countries

Under the TRIPS agreement, intellectual property rights (IPRs) — for copyright, trademark, geographical indication, industrial designs and patents — are extended to all signatory countries. Patents, most relevant to public health and access to medicines, give twenty years of protection to inventions.

In the current language, there are no explicit provisions for generic production of patented nutrition supplements. However, there is supposed to be a great deal of flexibility on the basis of public health needs, which could be extended to minerals and vitamins for supplementation.

The TRIPS Agreement provides space for countries taking measures to protect public health. Under Article 31, countries can issue compulsory licenses allowing firms or individuals to produce generic copies of patented products or processes for the domestic market without the owner’s consent in “case of a national emergency or other circumstances of extreme urgency or in cases of public non-commercial use.” The government can also determine adequate payment to the IPR holder.

At the Doha WTO conference in 2001 launching the Doha Development Round of trade negotiations, the Declaration on the TRIPS Agreement and Public Health affirmed the right of countries to protect public health, enable access to medicines, and determine the criteria for issuing a compulsory license. It emphasized that each country “has the right to grant compulsory licenses” and “the right to determine what constitutes a national health emergency or other circumstances of extreme urgency.”

This new text corrected the false impression that some health emergency was needed to justify compulsory licensing. It also spelt out that “public health crises, including those relating to HIV/AIDS, tuberculosis, malaria and other epidemics, can represent a national emergency or other circumstances of extreme urgency.”

Technology transfer

Under Article 66.2 of TRIPS, developed country governments are obliged to actively promote technology transfer in establishing manufacturing capabilities for patented processes in developing countries. The 2001 Declaration also reaffirmed the developed countries’ commitment to provide incentives to their corporations to enable technology transfer to the least developed countries. This was part of the original bargain for developing countries to provide protection of IPRs.

Developing countries also have the right to import generics if they lack manufacturing capabilities. A 2003 waiver allows countries unable to domestically produce pharmaceuticals to import them instead. Hence, under compulsory licensing, such countries can import externally produced patented drugs. Thus, while compulsory licensing allows countries to import cheaper generics from countries already producing them, to take advantage of TRIPS Agreement flexibility, countries need to legislate accordingly.

However, exemptions to pharmaceutical patent protection to the least developed countries, enabling them to import without issuing a compulsory license, were only extended until 2016. The upcoming Nairobi WTO ministerial should extend this exemption beyond next year.

While there appears to be legal space under TRIPS for developing countries to use compulsory licensing, they have effectively be prevented from doing this by complicated rules and procedural requirements. Consequently, use of compulsory licensing by developing countries has been largely limited to HIV/AIDS medicines, and almost exclusively used by middle-income countries. LDCs have not issued any compulsory licenses while the total number of applications has declined significantly in the last decade.

Needed actions

Existing TRIPS texts do not preclude compulsory licensing for local generic production in developing countries. However, extension of the right to use compulsory licensing and other such flexibilities to vitamin and mineral supplements is not explicit. While explicit permission is given to AIDs, malaria, tuberculosis and epidemics, even this is rarely used.

In light of the foregoing, the following revisions to WTO provisions to protect developing countries’ right to produce generic vitamin and mineral supplements should be introduced. This will also be in line with the July 2015 Addis Ababa Action Agenda’s commitment to facilitate technology transfer:

• Developing appropriate model legislation to facilitate development of the national legislation needed for compulsory licensing, etc.
• Provide free legal services to developing country governments interested in accessing TRIPS facilities.
• Identify and investigate relevant national vitamin and mineral supplement production needs in partnership with other governments to enable developed countries to meet their technology transfer obligations.

Developing countries need to act to overcome three major constraints to issuing compulsory licenses and bypassing patent legislation for public health. First, the governments must be strong enough to withstand business and political pressures. Second, it is necessary to have enabling legislation in place. Third, these countries need to have production capacity and distribution arrangements in place.
Also, the UN system should offer appropriate technical expertise to advance progress.

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Excerpt:

By Germán Velásquez
GENEVA, Nov 10 2015 (IPS)

The important relationship between the examination of patents carried out by national patent offices and the right of citizens to access to medicines hasn’t always been well-understood. Too often these are viewed as unrelated functions or responsibilities of the state. And the reason is clear: patentability requirements are not defined by patent offices, but frequently by the courts, tribunals, legislation or treaty negotiators.

Germán Velásquez

Given the impact of pharmaceutical patents on access to medicines, patent offices should continue to align their work in support of national health and medicine policies, using the freedom permitted by the Trade Related Aspects of Intellectual Property Rights Agreement (TRIPS) to define patentability requirements.

The TRIPS Agreement requires all World Trade Organization (WTO) member states to incorporate into their legislation universal minimum standards for almost all rights in this domain: copyright, patents and trademarks.

A patent is a title granted by the public authorities conferring a temporary monopoly for the exploitation of an invention upon the person who reveals it, furnishes a sufficiently clear and full description of it, and claims this monopoly.

As with any monopoly, it may lead to high prices that in turn may restrict access. The problem is compounded in the case of medicines, when patents confer a monopoly for a public good and essential products needed to prevent illness or death and improve health.

According to the TRIPS Agreement, the patentability requirements used by national intellectual property offices require a product or manufacturing process to meet the conditions necessary to grant patent protection, namely: novelty, inventive step and industrial applicability (utility).

These three elements, however, are not defined in the TRIPS agreement and WTO Member States are free to define these three criteria in a manner consistent with the public health objectives defined by each country.

It is widely held that patents are granted to protect new medicines to reward the innovation effort. However, the number of patents obtained annually to protect truly new pharmaceutical products is very low and falling. Moreover, of the thousands of patents that are granted for pharmaceutical products each year, a few are for new medicines – e..g. new molecular entities (NMEs).

All of the above led the World Health Organization (WHO), in collaboration with the United Nations Conference on Trade and Development (UNCTAD), the United Nations Development Programme (UNDP) and the International Centre for Trade and Sustainable Development (ICTSD), to develop, in 2007, guidelines for the examination of pharmaceutical patents from a public health perspective.

The guidelines were intended to contribute to improving the transparency and efficacy of the patent system for pharmaceutical products, so that countries could pay more attention to patent examination and granting procedures in order to avoid the negative effects of non-inventive developments on access to medicines. The major problems can be identified in the current use of the patent system to protect pharmaceutical innovation: reduction in innovation, high prices of medicines, lack of transparency in research and development costs, and proliferation of patents.

A study carried out by the journal Prescrire analysed the medicines that were introduced to the French market between 2006 and 2011, arriving at the conclusion that the number of molecules that produced significant therapeutic progress reduced drastically: 22 in 2006; 15, 10, 7, 4 in the following years up to 2011, which was a year in which Prescrire declared that only one medicine of significant therapeutic interest was brought to the market. Given that France is one of the largest pharmaceutical markets in the world, the reduction in innovation confirmed France is a good indicator of the global situation.

Oncologists from fifteen countries recently denounced the excessive prices of cancer treatments, which are necessary to save the lives of the patients, and urged that moral implications should prevail; according to them, of the 12 cancer treatments approved in 2012 by the United States Food and Drug Administration, 11 cost more than 100,000 dollars per patient per year.

Since the 1950s, there have been some references to the costs of Research and Development (R&D) for pharmaceutical products. According to some sources the average cost of research for a new pharmaceutical product these figures have increased from 1 million dollars in 1950 to 2.5 billion dollars for the development of a single product.

During the summer of 2014, a number of European countries, including France and Spain, spent many months negotiating with the company Gilead on the price of a new medicine for hepatitis C known as Solvaldi. The price fixed by Gilead was 56,000 Euros per patient for a twelve-week treatment, or 666 Euros per tablet. According the newspaper Le Monde the price of each tablet was 280 times more than the production cost. In France, it is calculated that 250,000 patients should receive this medicine, the cost of which would represent 7 per cent of the annual state medicine budget.

The application of patentability requirements for medicines, given their public health dimension, should be considered with even more care than in the case of regular merchandise or luxury items. The first and most important step is to use the freedom permitted by the TRIPs Agreement to define the patentability requirements: novelty, inventive step and industrial applicability (utility) in a way that keeps sight of public interest in the wide dissemination of knowledge.

(End)

Excerpt:

Yury Fedotov, Executive Director of the U.N. Office on Drugs and Crime (UNODC) with U.N. Secretary-General Ban Ki-moon. "The magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, 'It always seems impossible until it is done'. We must keep working together, until it is done" – Yury Fedotov. Credit: Courtesy of UNODC

By Yury Fedotov
VIENNA, May 27 2015 (IPS)

With terrorism, migrant smuggling and trafficking in cultural property some of the world’s most daunting challenges, “the magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, ‘It always seems impossible until it is done’. We must keep working together, until it is done.”

The words are those of U.N. Office on Drugs and Crime (UNODC) Executive Director Yury Fedotov, who was speaking at the closing of the 24th Session of the Commission on Crime Prevention and Criminal Justice (Crime Commission) held in the Austrian capital from May 18-22.

Earlier this month, IPS Editor-in-Chief Ramesh Jaura interviewed Fedotov on how the challenges facing the United Nations’ drugs and crime agency translate into challenges on the sustainable development front.“The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development” – UNODC Executive Director Yury Fedotov

Q. The United Nations Office on Drugs and Crime (UNODC), established in 1997, understands itself as “a global leader in the fight against illicit drugs and international crime”. At the same time, you have taken up the cudgels on behalf of sustainable development. What role does the UNODC envisage for itself in achieving sustainable development goals to be agreed at the U.N. summit to adopt the post-2015 development agenda in September?

A. Crime steals from countries, families and communities and hampers development while exacerbating inequality and violence, especially in vulnerable countries. Trafficking in diamonds and precious metals, for instance, diverts resources from countries that desperately need the income.

The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development. These are just some of the many challenges that the international community faces around the world that are related to crime.

UNODC’s broad mandate includes stopping human traffickers and migrant smugglers, as well as tackling illicit drugs. It encompasses promoting health and alternative livelihoods and involves battling corruption, illicit financial flows, money laundering and terrorist financing. Our work confronts emerging and re-emerging crimes, including wildlife and forest crime, and cybercrime, among others, all of which hinder sustainable development.

Currently the United Nations is making the transition from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). In Goal 16, the Open Working Group, responsible for identifying the development goals stressed the need to promote peaceful and inclusive societies for sustainable development, and to provide access to justice for all, as well as building effective, accountable and inclusive institutions. Justice is also one of the six essential elements identified by the Secretary-General in his own Synthesis Report on this subject.

Goal 3, which focuses on “ensuring healthy lives”, underlines the importance of strengthening prevention and treatment of substance abuse. These goals – justice and health – go to the very heart of UNODC’s mission. I am hopeful that when the U.N. Heads of State Summit on Sustainable Development in September 2015 takes place these goals will remain.

Q. UNODC organised its Thirteenth Congress on Crime Prevention and Criminal Justice from Apr. 12 to 19 in Doha, Qatar. The 13-page Doha Declaration contains recommendations on how the rule of law can protect and promote sustainable development. Is that the reason that you described Doha as a “point of departure”?

A. The Doha Declaration was passed by acclamation at the 13th Congress on Crime Prevention and Criminal Justice, and contains crucial recommendations on how the rule of law can protect and promote sustainable development. The declaration is driven by the principle that these issues are mutually reinforcing and that crime prevention and criminal justice should be integrated into the wider U.N. system.

At the 24th Session of the Commission on Crime Prevention and Criminal Justice (May 18-22), there were nine resolutions before the Commission and they pave the way for the Doha Declaration to go before the U.N. General Assembly and ECOSOC for approval. The other resolutions, for instance on cultural property and standard rules on the treatment of prisoners, seek to implement the principles of the Doha Declaration.

It is for this reason that I described the 13th Crime Congress in Doha as a significant “point of departure”. Doha is the first, but not the last step in the process of implementing the Declaration and ensuring that we turn fine words into spirited and dedicated action in the areas of crime prevention and criminal justice – action that can benefit the millions of victims of crime, illicit drugs, corruption and terrorism.

If we do this, we have an opportunity to energise the 60-year legacy of Crime Congresses and give it the power to shape how we tackle crime and promote development for many years to come. Indeed, I see a strong, visible thread between the recent Crime Congress, September’s UN Summit on Sustainable Development and the 14^th Crime Congress in Japan in five years’ time.

Q. The Doha Declaration also pleads for integrating crime prevention and criminal justice into the wider United Nations agenda. This suggestion comes at a point in time when the United Nations is turning 70. Are there some issues which the United Nations has ignored until now or is there a range of issues that have emerged over previous decades?

A. Member States are increasingly affected by organised crime, corruption, violence and terrorism. These challenges undercut good governance and the rule of law, threatening security, development and people’s lives.

Sustainable development can be safeguarded through fair, human and effective crime prevention and criminal justice systems as a central component of the rule of law. As stated by U.N. Secretary-General Ban Ki-moon: “There is no peace without development; there is no development without peace; and there is no lasting peace and sustainable development without respect for human rights.”  We need to break down the walls between these activities and integrate the various approaches.

UNODC is well placed to assist. We work closely with regional entities, partner countries, multilateral and bilateral bodies, civil society, academia and the private sector to support the work on development. We can also offer our support at the global, regional, and local levels, through our headquarters and network of field offices.

Q. Do you find willingness on the part of all countries around the world to agree on national, regional and international legal instruments, to combat all forms of crime, and their willingness to pull on the same string when it comes to implementation?

A. Our work is founded on the U.N. Convention against Transnational Organised Crime and its three protocols, the Convention against Corruption, international drug control conventions, universal legal instruments against terrorism and U.N. standards and norms on crime prevention and criminal justice.

Almost all of these international instruments have been universally ratified by the international community. Why? Because countries recognise that crime today is too big, too powerful, too profitable for any one country to handle alone. Countries recognise that, today, crime not only crosses country borders, but regional borders. It is a global problem that warrants comprehensive, integrated global solutions.

The UNODC approach to this unique challenge is threefold. First, we are building political commitment among Member States. Second, we deliver our activities through our integrated regional programmes across the world. Third, we are working with partners, both within and outside the United Nations, to ensure that our delivery is strongly connected to other activities at the field level.

In support of this action, and to give just one example, UNODC is networking the networks. Today’s criminals have widespread networks and vast resources; if we are to successfully confront them, we need to ensure greater cross-border cooperation, information sharing and tracking of criminal proceeds.  The initiative is part of an interregional drug control approach developed by UNODC to stem illicit drug trafficking from Afghanistan and focuses on promoting closer cooperation between existing law enforcement coordination centres and platforms.

Q. UNODC has assigned itself a wide range of tasks. Which are your priorities in the biennium ending this year, during which you have 760.1 million dollars at your disposal?

A. I would mention two matters that are of international importance. First, smuggling of migrants not just in the Mediterranean or the Andaman seas, but also elsewhere. We are witnessing unprecedented movements of people across the globe, the largest since the Second World War. People are leaving because of conflict, insecurity and the desire for a better life. They are falling into the arms of unscrupulous smugglers and many of them are dying, while trying to make the dangerous journey across deserts and seas.

Second, the nexus of transnational organised crime and terrorism is a major threat to global peace and security, and has been recognised as such in recent Security Council resolutions. Every extremist and terrorist group requires sustainable funding. The most reliable, and sometimes the only, means of achieving this is through illicit funds gained from transnational organised crime, including cybercrime, drug trafficking, people smuggling and many other crimes.

Information on the magnitude and exact nature of such relationships remains incomplete, and more research is needed. Based on data and analysis, however, for some regions, we can follow the funding in support of violent extremism and terrorism. In Afghanistan, for example, the Taliban could be receiving as much as 200 million dollars annually as a tax on the drug lords.

Edited by Phil Harris    

Excerpt:

A crowd gathers to watch an intoxicated youth as a police officer comes to his rescue in Nyeri town, Central Kenya. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
NAIROBI, Mar 27 2015 (IPS)

Despite legislative attempts to curb drinking, Kenya is still facing its greatest threat from alcohol abuse. Calamities associated with excessive intoxication – dementia, seizures, liver disease and early death – have done little to deter users.

Not even confirmed reports by the Ministry of Health and government agencies such as the National Authority for Campaign against Alcohol and Drug Abuse (NACADA) that illicit brewers have been turning to lethal embalming fluid used in mortuaries have cut the rate of abuse.

“Patrons want to spend as little as possible but drink as much as they can, so they opt for cheap illicit brews, especially spirits,” says Nduta Kamau, who brews home-made alcohol in the sprawling Mathare slums in Nairobi.The [Kenyan] Alcoholic Drinks Control Act was substantially weakened in 2013 with the introduction of “devolved government”. This system of ‘home rule’ means that each county government must ratify the act – an uphill battle because some county leaders are also the owners of bars.

According to Kamau, those who brew illicit alcohol also spend as little as possible “in time and money but produce as much alcohol as they can”, while chemicals used in the mortuary speed up the production process, “so we are able to produce a lot of alcohol in a very short time.”

Kamau adds that illicit brews from dens in the slums are bottled, labelled and sold in pubs across the country. A series of police raids in these dens have found women’s underwear and dead rats in the brew.

The Alcoholic Drinks Control Act of 2010 restricts the sale of alcohol to between 5 pm and 11 pm, but drinkers are finding their way around the curfew.

Data collected by Euromonitor International, a market research firm, revealed that alcohol bought in shops or off trade beer sale during the curfew in December 2012 rose by 4.35 percent to 26.4 million litres.

“They [patrons] lock themselves up in pubs and drink during curfews or they buy the alcohol and drink in their homes exposing their children to alcohol from a very young age,” says Dave Kinyanjui, a bar owner in Nairobi’s downtown area.

The Alcoholic Drinks Control Act was substantially weakened in 2013 with the introduction of “devolved government”. This system of ‘home rule’ means that each county government must ratify the act – an uphill battle because some county leaders are also the owners of bars.

Increased drinking has meant higher profits for commercial brewers. A report last month by the East African Breweries Limited (EABL) noted an average 11 percent increase in profit from beer sales.

According to EABL, the highest growth in sales – at 67 percent – was in spirits, mainly targeting the lower income earners, who are also the target for the many brands from informal sources.

Another report released by Euromonitor International confirmed the steady growth in alcohol consumption, which could rise as the economy improves further, saying that “the alcoholic drinks market is set to expand over the forecast period as the economy is expected to grow tremendously during this time due to bright prospects of oil in Kenya and political stability.”

With the availability of non-returnable bottles and cans, it has never been easier to carry alcohol to the house.

A 2012 national survey by NACADA showed that alcohol is now the most abused substance in the country and of the different types of alcoholic drink, traditional liquor is the most easily accessible, followed by wines and spirits and last but not least Chang’aa (which literally means ‘kill me quick’).

According to an “Alcohol Situation Analysis” for 2012 by the regional office of IOGT-NTO, a global temperance movement: “out of the number of people interviewed, 63 percent had used alcohol and 30 percent had more than five alcoholic beverages per sitting, which is heavy episodic use. Teenagers between 14-17 years of age are having two alcoholic beverages per sitting.”

Government statistics also show that alcohol and drug abuse is highest among young adults aged 15 to 29 years and lowest among adults of 65 years and older.

Under-age and rural children have not been spared. According to NACADA, rural children are more likely to have consumed traditional liquor and Chang’aa than urban children.

David Ogot, national coordinator of Alcohol Awareness in Kenya and a recovered alcoholic, told IPS that “excessive drinking is often viewed as a passing problem until it really gets out of hand, at which point most families hide the issue due to shame.”

He said that there is now a great need to address “alcoholism and to stop justifying the behaviour of an alcoholic.”

Alcoholics wanting to end their addictions have little recourse, according to Dr William Sinkele, Executive Director of Support for Addictions Prevention and Treatment in Africa (SAPTA). While Kenya has over 70 in-patient treatment centres, only three are government-run, he told IPS – Mathare Hospital (with an addiction unit), Coast General Hospital and Portreitz Hospital. The rest are privately owned.

“While is it is good that we have this many treatment centres, most are concentrated around the Nairobi area.  We do not have many centres outside Nairobi.  The average Kenyan with an alcohol or drug problem cannot afford treatment,” he said.

Meanwhile, many of those fighting alcohol abuse in Kenya point an accusing finger at the global alcohol industry which has a big foothold in Kenya and has undermined proper implementation of the Alcoholic Drinks Control Act with aggressive advertising and promotion through musical and artsy events.

A press release from financial advisors KPMG, titled “Incredible Growth of Kenya’s Beer Market“ noted: “Driven by strong population growth, a growing middle class and a dynamic private sector, the beer industry in Kenya has taken off in impressive ways, and is promising of even further developments in the coming decade.” Only inflation and tax increases could diminish this rise, it said.

“To expand its customer base, “the company has accordingly invested in marketing and sales capabilities in this area.”

Meanwhile, in a blog on the IOGT International temperance website,  Brenda Mkwesha wrote: “The odds seem to be against us, but we have heart-driven teams who aren’t willing to stand by while we flush our lives down the toilet. Here’s to a Life Set Free!”

Edited by Lisa Vives/Phil Harris   

One of the empty streets in the town of Santa Ana del Águila, in the Mexican municipality of Ajuchitlán del Progreso, where there is almost no one left and homes and businesses are shuttered and many have bullet marks. Credit: Daniela Pastrana/IPS

By Daniela Pastrana
AJUCHITLÁN, Mexico, Feb 7 2015 (IPS)

Cerro del Águila, which two centuries ago was a refuge for independence fighters in Mexico, is now a stronghold of organised crime groups engaged in turf wars for control of the prosperous poppy trade and trafficking routes, which have left a string of ghost towns in their wake.

From Águila mountain – “cerro” means hill in Spanish – it’s possible to see who is coming and going from a number of villages down below in this region known as Tierra Caliente, which is in the Balsas river basin in the impoverished southern state of Guerrero, and in neighbouring municipalities in the states of Michoacán and México.

These states are hotbeds of organised crime and drug trafficking, and made the headlines in 2014: Michoacán, as the state that armed paramilitary forces known as “self-defence” groups; México, where the army killed at least 15 civilians; and Guerrero, where municipal police ambushed and forcibly disappeared 43 students from a rural teachers college.

In Santa Ana del Águila, a town of 748 people at the foot of the hill which belongs to the municipality of Ajuchitlán del Progreso, over half of the population has fled in the last few weeks. There is no longer a sheriff, a priest, or anyone to run the shop where people buy food at subsidised prices as part of the government’s National Crusade Against Hunger anti-poverty programme.

The windows of the houses are closed and barred and local businesses are shuttered. The doors to the health clinic and schools have chains and padlocks. Only the middle school dared open after the year-end vacations, but at a high cost: on Jan. 12, the second day of classes, the teacher was kidnapped, and his family has not been able to scrape up the ransom money yet.

“I’m not afraid to die, but the way these people are going to die makes me sad,” one local resident who is still here told IPS.

Ajuchitlán del Progreso and the adjacent San Miguel Totolapan are the municipalities that have been hit by the highest levels of violence in Guerrero. Several organised crime groups, including the notoriously violent La Familia Michoacana and Guerreros Unidos drug cartels, are fighting for control of this region, which is key for the trafficking of poppies, used to produce heroin.

In an interview with IPS, the mayor of Ajuchitlán, José Carmen Higuera, said that since 2007, the most frequent crimes in the municipality are kidnapping and extortion. “What happened here is the usual: the town fills up with police and the army, but nothing happens, no major arrests are made. I have said it before: we don’t want them here, in the municipal seat; they should go out and protect the villages and communities, where they are really needed.” -- Mayor José Carmen Higuera

“I try to do the best I can, but we need a more efficient and operative strategy, with real intelligence work,” said the mayor, who does not have bodyguards even though two of his predecessors, Raymundo Flores and Esteban Vergara, have been missing since 2013.

As in many similar cases of missing local officials and priests, no investigation has been carried out.

The federal authorities “do a lot of pretending,” Higuera said. “What happened here is the usual: the town fills up with police and the army, but nothing happens, no major arrests are made. I have said it before: we don’t want them here, in the municipal seat; they should go out and protect the villages and communities, where they are really needed.”

The municipality includes the main town of the same name and 127 villages spread over nearly 2,000 sq km, with a total population that before the forced displacement stood at nearly 140,000.

Heroin for the United States

Mexico produces nearly half of the heroin consumed in the United States, and in recent years has become the main supplier of illegal opium derivatives in that country, according to the U.S. Drug Enforcement Administration’s (DEA) 2014 National Drug Threat Assessment.

In the annual report on the major drug transit or producing countries that President Barack Obama sent to Congress in September, the DEA reported a 324 percent increase in heroin seizures at the Mexican border between 2009 and 2013.

“The United States is particularly concerned about poppy cultivation in Mexico, the primary supplier of illegal opium derivatives to the United States,” Obama said in the presidential memorandum.

The poppy-producing areas in Mexico are in the Pacific coastal states, from Oaxaca in the south to Sinaloa in the north, and in mountainous areas in the neighbouring Chihuahua.

Guerrero, one of the country’s three poorest states, has been the leading producer over the last three decades. Some experts estimate that the state accounts for 40 percent of the opiates produced in Mexico.

Control of Tierra Caliente, which has two ports, is key. And because of that, Santa Ana del Águila and other communities in Ajuchitlán and Totolapan have become ghost towns, as more and more people flee the violence.

The last wave of armed clashes began shortly after Christmas, local residents of Santa Ana and the nearby village of Garzas told IPS.

But the problem is not new. Massive forced displacements in this area began in July 2013, when battles between organised crime groups forced 631 people to flee Villa Hidalgo, a village in Totolapan.

At that time at least 1,300 people fled seven villages, Totolapan Mayor Saúl Beltrán Orozco told IPS.

The National Human Rights Commission, an independent government agency, launched an investigation, and in its special report on self-defence groups and rising crime and violence in Guerrero, presented in December, it documented 2,393 cases of forced displacement from mid-2013 to mid-2014.

The second wave occurred from March to July 2014. In March, 136 people from the town of Linda Vista, which is also in Totolapan, hiked through the mountains for nearly 24 hours without food, to reach another town before heading to Chipalcingo, the capital of Guerrero, where they sought shelter and were housed in centres used to evacuate people during heavy rains and flooding.

Three months later, armed civilians attacked villages, setting houses on fire and kidnapping or killing local residents. In one community, Atlayolapa, only an older couple was left.

Local press reports estimate the number of people displaced by the violence in the area at 4,000 from mid-2013 to mid-2014. But a national lawmaker puts the total at over 7,000. None of these figures have been verified.

In January, after the kidnapping of seven people, the commander of the military zone 35, Juan Manuel Rico, officially confirmed that a camp would be set up in the county seat in Ajuchitlán, to protect the local communities, which over 1,000 people have fled in the last few weeks.

But the federal forces – military and police – rarely leave the main town and can be seen walking around the central square, while every day people comment about new murders, homes burnt down, and armed clashes in communities just 20 minutes away.

“They do a lot of pretending. They don’t even inform us about what they’re doing,” said Mayor Higuera, complaining that the military and police forces don’t patrol the communities and villages, where the violent clashes take place. To sum up the lack of support he feels in his fight against organised crime, he said “better alone than in bad company.”

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

Young boy sitting on a wall outside 'Way Home', a UNICEF-assisted shelter providing food, accommodation, literacy trainings and HIV/AIDS-awareness lessons to street children in Odessa, Ukraine. Because of unsafe sex and injecting drug use, street adolescents are one of the groups most at risk of contracting HIV. Credit: UNICEF/G. Pirozzi

By Pavol Stracansky
KIEV, Dec 9 2014 (IPS)

Marginalised communities and civil society groups helping them are warning of a “tragedy” in Eastern Europe and Central Asia (EECA) as international funding for HIV/AIDS and tuberculosis (TB) programmes in the regions is cut back.

The EECA is home to the world’s only growing HIV/AIDS epidemic and is the single most-affected region by the spread of multi-drug resistant TB (MDR-TB). For years, HIV/AIDS and TB programmes in many of its countries have been heavily, or exclusively, reliant on funding from theGlobal Fund to Fight AIDS, TB and Malaria.

But this year has seen the Global Fund move to a new financing model based on national income statistics, under which funding in many EECA countries has already been – or will soon be – heavily cut.“This [reduction in Global Fund financing] could lead to tragedy because governments are not yet ready to take on the responsibility for addressing the HIV/AIDS epidemic. I would like decision-makers to understand that this is not just [about] epidemiological statistics but that our lives and health are at stake” – Viktoria Lintsova of the Eurasian Network of People Who Use Drugs (ENPUD)

Some of those likely to be most heavily affected by the cuts say that the reduction in Global Fund financing is putting essential HIV/AIDS and TB services, and with it lives, at risk.

Viktoria Lintsova of the Eurasian Network of People Who Use Drugs (ENPUD) told IPS: “This could lead to tragedy because governments are not yet ready to take on the responsibility for addressing the HIV/AIDS epidemic. I would like decision-makers to understand that this is not just [about] epidemiological statistics but that our lives and health are at stake.”

At the heart of their concerns are worries over funding for not just medical treatment for existing patients but prevention and other services for at risk and marginalised communities.

Injection drug use has been identified as the main driver of the HIV/AIDS epidemic in the EECA but HIV/AIDS is also being increasingly spread among men who have sex with men and sex workers – groups which are heavily marginalised because of political and societal attitudes to homosexuality and women.

TB, an equally severe health problem in the EECA, is closely linked to the HIV/AIDS epidemic because co-infection rates are often high.

Throughout the region, prevention and harm reduction services for marginalised groups are provided by civil society groups which rely almost exclusively on international funding.

Sveta McGill, health advocacy officer at international advocacy NGO Results UK, told IPS that the withdrawal of Global Fund funding could see many sick people slip under the health care radar.

She said: “It is affecting services provided by NGOs covering at-risk groups. These ‘low threshold entry’ services, while not necessarily medical interventions, are crucial to keep people from risk groups coming to centres where they get referred to medical institutions to get treatment and can access medical services as well.

“Often, they would not feel comfortable going straight to state health care institutions, and closing down these venues would mean that less people would be referred to state health care institutions.”

Critics point to rising HIV/AIDS infections in Romania in recent years as a sign of what could happen in other EECA countries when the Global Fund cuts back its financing.

The Global Fund ended financing for programmes in the country in 2010. According to data from the Romanian government, since then there has been a dramatic rise in HIV infections among people who use drugs: in 2013, about 30 percent of new HIV cases were linked to injection drug use compared with just three percent in 2010.

Under the Global Fund’s New Financing Model (NFM), the major change is a reduction in financing to middle income countries. Many EECA countries are now classified as middle income and critics say that while the organisation’s goal of looking to prioritise use of finite resources is sensible, national income data does not always accurately reflect the ability of people to access health care services, nor whether a country has the funds for an adequate disease response.

They point to studies showing disease burdens shifting from low income countries to middle income states, and poverty being greatest in middle income countries. Also, most people living with HIV live in middle income countries.

But some have also dismissed as naive the notion that, as the Global Fund wants, national governments will automatically fill the gap in funding left as the Global Fund cuts back its financing.

Many point to the situation in Ukraine as an example highlighting the problems of the NFM.

According to a report from the Open Society Foundations, Global Fund spending on HIV will drop by more than 50 percent for Ukraine between 2014 and 2015. This includes reductions in unit cost spending for people who use drugs by 37 percent, for sex workers by 24 percent and for men who have sex with men by 50 percent.

Meanwhile, the national HIV prevention budget was slashed by 71 percent in 2014 amid political and economic upheaval.

Lintsova, who lives in central Ukraine, told IPS of the problems drug users are currently facing.

She said that not only are there shortages of the right drugs to treat TB in some parts of the country, but that very few drug users have access to them. Places on opiate substitution treatment (OST) programmes are very limited and waiting times to join them long, sometimes fatally so.

“I know two people who died waiting to get on an OST programme,” she told IPS. “And there are other problems like a lack of needle exchange centres in rural areas, in fact a lack of any harm reduction services in small towns, which leads to high rates of HIV in those places.”

She added that without proper funding, the situation would not improve. “The only solution to these problems is financing,” she said.

But other stakeholders have also privately raised fears that a greater government role in fields such as drug procurement could see authorities looking to save money and procuring larger quantities of cheaper TB drugs of worse quality. Meanwhile, local legislation also makes procurement tenders long and difficult, leading, some health care experts predict, to governments running out of stocks of some essential medicines.

It is unclear how governments will deal with the reduction of Global Fund financing. The transition from Global Fund to domestic funding, although widely announced and anticipated, is not going smoothly in all countries.

Many are often unclear when the Global Fund will actually leave because no straightforward timing plan has been set. There are also specific problems in individual states. In Ukraine, in particular, domestic TB funding has been severely affected by the military conflict, struggling economy and currency fluctuation.

Late last month, these growing fears prompted 24 prominent NGOs in the region to send an open letter to the Global Fund warning of their ‘grave concerns’ over the allocation of funding in the region and calling for it to work with local groups and affected communities.

They specifically asked it to look at each country individually, rather than adopt a “one size fits all” approach.

The Global Fund declined to respond when contacted by IPS.

However, drug users who spoke to IPS said there was little hope of an improvement in the region’s HIV/AIDS and TB epidemics if the Global Fund fails to heed NGOs’ warnings.

Lintsova told IPS: “A lack of reaction to our calls could lead to problems accessing prevention and treatment programmes and a deepening of the EECA’s HIV/AIDS and TB epidemics.”

(Edited by Phil Harris)

By Carlos M. Correa
GENEVA, Sep 29 2014 (IPS)

The steady increase in patent applications and grants that is taking place in developed and some developing countries (notably in China) is sometimes hailed as evidence of the strength of global innovation and of the role of the patent system in encouraging it. 

Carlos M. Correa

However, such an increase does not correspond to a genuine rise in innovation. It points instead to a major deviation of the patent system away from its intended objective: to reward those who contribute to technological progress by creating new and inventive products and processes.

The increase in the number of patents reflects, to a large extent, the low requirements of patentability applied by patent offices and courts. Patents granted despite the absence of a genuine invention detract knowledge from the public domain and can unduly restrain legitimate competition.

Low standards of patentability encourage a large number of applications that would not otherwise be made, leading to a world backlog estimated at over 10 million unexaminedpatents.

This problem affects various sectors. For instance, Nokia is reported to hold around 30,000 patents relating to mobile phones, a large part of which are likely to be invalid, while Samsung holds more than 31,000 patent families. A study covering various fields of clean energy technologies, including solar photovoltaic, geothermal, wind and carbon capture, found nearly 400,000 patent documents.“The steady increase in patent applications and grants … does not correspond to a genuine rise in innovation. It points instead to a major deviation of the patent system away from its intended objective: to reward those who contribute to technological progress by creating new and inventive products and processes”

The proliferation of patents is particularly high and problematic in the pharmaceutical sector, where large companies actively seek to acquire broad portfolios of patents in order to extend patent protection beyond the expiry of the original patents on new compounds. These ever-greening strategies allow them to keep generic producers out of the market and charge prices higher than those that would otherwise exist in a competitive scenario.

For example, the basic patent for paroxetine, an antidepressant, expired in the late 1990s, whereas ‘secondary’ patents will extend up to 2018.

Ever-greening strategies by one company often force others to follow the same pattern as a defensive approach.  The proliferation of ‘secondary’ or ‘spurious’ patents can impose significant costs on patients and public health systems.

Several measures can be applied at the national level to avoid the proliferation of patents on trivial developments in full consistency with the Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS), because they fall within the policy space that World Trade Organisation (WTO) members have retained to design and apply their patent laws.

The most important policy that governments may implement is the rigorous application of the requirements of patentability, based on a thorough examination of patent applications. The TRIPS agreement neither defines the concept of ‘invention’ nor how such requirements need to be interpreted.

Thus, national laws may differentiate inventions and discoveries, and require that the former result from an inventive activity, thereby excluding pre-existing subject matter that is merely found, such as natural substances.

While some patent offices grant patents on the basis of legal fictions on novelty, there is no reason to follow such practices in other jurisdictions.

An example of this practice by some patent offices is to admit what are known as ‘selection patents’, whereby one of more items that were previously disclosed are independently claimed. This type of patents provide an effective means of ever-greening, because protection can be extended for the full length of a new patent, i.e. normally twenty additional years, despite the fact that novelty was actually lost when such items were first disclosed.

While some large patent offices, such as the U.S. Patent and Trademark Office, the European Patent Office and the Chinese Patent Office, seem to apply a lax inventive step standard thereby allowing for the granting of a large number of ‘low quality’ patents, there are strong public interest arguments to follow a different approach, particularly in developing countries.

A strict application of the industrial applicability/usefulness requirement, when provided for by the national law, may also contribute to prevent the grant of unwarranted patent rights.

This is the case, in particular, for claims on new medical uses, which are equivalent to claims over methods of treatment that have no industrial application or technical effect. The lack of industrial applicability may be a sufficient ground to reject such claims.

Given the policy space left by the TRIPS agreement to adopt their own definitions of the patentability standards, and to do so consistently with their legal systems and practices, governments can follow different methods to ensure that patents are granted only when there are sufficient merits under the applicable law.

Governments may introduce specific standards in the patent laws themselves. A notable case is the Indian Patent Act, as amended in 2005, which incorporated in section 3(d) specific standards to assess patent applications in the field of chemicals and pharmaceuticals.

In a case brought by Novartis (a Swiss pharmaceutical company) against the rejection of its patent application relating to a beta crystalline form of imatinib mesylate, the Indian Supreme Court held that the claimed invention failed in both the tests of invention and patentability.

The definition of the standards of patentability can also be made through regulations, including patent offices’ guidelines. A good example is provided by the guidelines on the patentability of pharmaceutical products and processes adopted by the Argentine government in 2012 to limit the ever-greening of pharmaceutical patents.

Finally, it is worth noting that in applying patentability standards, patent offices can differentiate, in line with the TRIPS agreement, among fields of technology in order to take into account particular features of specific sectors and public policies objectives, for instance in relation to the promotion of generic drugs.

Measures to accommodate these differences constitute a necessary response to the diversity of technologies and, consequently, a condition sine qua non for an intrinsically balanced system of protection that remains neutral in its effects on competition. (END/IPS COLUMNIST SERVICE)

(Edited by Phil Harris)

This column is taken from the author’s research paper on ‘Tackling the Proliferation of Patents: How to Avoid Undue Limitations to Competition and the Public Domain’, published by the South Centre (http://www.southcentre.int/research-paper-52-august-2014/).

Excerpt:

Irina was 21 when she first started using drugs. More than 30 years later, having lost her husband, her home and her business to drugs, she is still battling her addiction.

But, like almost all female drug addicts in this former Soviet state, she has faced a desperate struggle not only with her drug problem, but with accessing help in the face of institutionalised and systematic discrimination because of her gender.

“Georgia’s society is very male-dominated,” she told IPS. “And this is reflected in the attitudes to drugs. It’s as if it’s OK for men to use drugs but not women. For women, the stigma of drug use is massive. There are many women who do not join programmes helping them as they would rather not be seen there.”

Women make up 10 per cent of the estimated 40,000 drug users in Georgia, according to research by local NGOs working with drug users.“Georgia’s society is very male-dominated and this is reflected in the attitudes to drugs. It’s as if it’s OK for men to use drugs but not women. For women, the stigma of drug use is massive. There are many women who do not join programmes helping them as they would rather not be seen there” – Irina, now in her 50s, who has been taking drugs for 30 years

However, because of very strong gender stereotyping, women users have very low access to harm reduction services – only 4 percent of needle exchange programme clients are women and the figure is even less for methadone treatment.

Local activists say this startling discrepancy is down to the massive social stigma faced by women drug users.

Dasha Ocheret, Deputy Director for Advocacy at the Eurasian Harm Reduction Network (EHRN) told IPS: “In traditional societies, like Georgia’s, there is a much stronger negative attitude to women who use drugs than to men who use drugs. Women are supposed to be wives and mothers, not drug users.”

Many female addicts are scared to access needle exchanges or other harm reduction services because they fear their addiction will become known to their families or the police. Many have found themselves the victims of violence as their own families try to exert control over them once their drug use has been revealed. Others fear their drug use will be reported to the authorities by health workers.

Registered women drug users can have their children taken away while they routinely face violence – over 80 percent of women who use drugs in Georgia experience violence, according to the Georgian Harm Reduction Network– and extortion at the hands of police helping to enforce some of the world’s harshest drug laws. Possession of cannabis, for example, can result in an 11-year jail sentence.

Irina, who admits that she arranges anonymous attendance at an opioid substitution therapy (OST) programme so that as few people as possible can see her there, told IPS that she had herself been assaulted by a police officer and that police automatically viewed all female drug users as “criminals”.

But those who do want to access such services face further barriers because of their gender.

Free methadone substitution programmes in the country are extremely limited and because levels of financial autonomy among women in Georgia are low, other similar programmes are too expensive for many female addicts.

Discrimination is not uncommon among health service workers. Although some say that they have been treated by very sympathetic doctors, other female drug users have complained of abuse and denigration by medical staff and in some cases being denied health care because of their drug use.

Pregnant women are discouraged from accessing OST, despite it being shown to be safe in pregnancy and resulting in better health outcomes for both mother and child.

Eka Iakobishvili, EHRN’s Human Rights Programme Manager, told IPS: “Pregnant women don’t have access to certain services – they are strongly advised by doctors and health care workers to abort a baby rather than get methadone substitution treatment because they are told the treatment will harm the baby.”

While some may then undergo abortions, others will not, instead continuing dangerous drug use and the potential risk of contracting HIV/AIDS which could then be passed on to their child.

Meanwhile, those harm reduction services accessible by women are not gender-sensitive, according to campaigners, who say that female drug users need access to centres and programmes run and attended only by women.

Irina told IPS: “On some [harm reduction] programmes, the male drug users there will abuse the women drug users for taking drugs. This puts a lot of women off attending these programmes.”

She said that she had asked for a women-only service to be set up at the OST centre she attends but that it had been rejected on the grounds that only a few women were enrolled in it.

Together, these factors mean that many women are unable to access health services and continue dangerous drug-taking behaviour, sharing needles and injecting home-made drug cocktails made up of anything, including disinfectants and petrol mixed with over the counter medicines.

But there is hope that the situation may be about to change, at least to some degree, as local and international groups press to have the problem addressed.

At the end of July, CEDAW (UN Commission on Elimination of Discrimination against Women) released a set of recommendations for the Georgian government to ensure that women obtain proper access to harm reduction services after local NGOs submitted reports on the levels of discrimination they face.

These include, among others, specific calls for the government to carry out nationwide studies to establish the exact number of women who use drugs, including while pregnant, to help draw up a strategic plan to tackle the problem, and to provide gender-sensitive and evidence-based harm reduction services for women who use drugs.

The government has yet to react publicly to the recommendations but local campaigners have said they are speaking to government departments about them and are preparing to follow up with them on the recommendations.

Tea Kordzadze, Project Manager at the Georgian Harm Reduction Network in Tibilisi, told IPS: “We are hoping that at least some of the recommendations will be implemented.”

The Georgian government has been keen to show the country is ready to embrace Western values and bring its legislation and standards into line with European nations in recent years as it looks to create closer ties to the European Union. Rights activists say that this could come into play when the government considers the recommendations.

Iakobishvili said: “These are of course just recommendations and the government is not obliged at all to accept or implement any of them. But, having said that, Georgia does care what other countries and big international rights organisations like Amnesty International and so on say about the country.”

Irina told IPS that only outside pressure would bring any real change. “The European Union, the Council of Europe and other international bodies need to put pressure on the Georgian government to make sure that the recommendations don’t remain on paper only.”

But, she added, “in any case, the recommendations alone won’t be enough. The whole attitude in society to women drug users is very negative. It has to be changed.”

(Edited by Phil Harris)

Rosa Julia Leyva, to the left, with other participants in the Drugs and Social Inclusion panel at the Fifth Latin American Conference on Drug Policies, held in San José, Costa Rica. She spent 12 years in prison for smuggling a small stash of heroin in a bag that a friend gave her to carry. Credit: Diego Arguedas Ortiz/IPS

By Diego Arguedas Ortiz
SAN JOSE, Sep 5 2014 (IPS)

Poor young men, slumdwellers and single mothers are hurt the most by anti-drug policies in Latin America, according to representatives of governments, social organisations and multilateral bodies meeting at the Fifth Latin American Conference on Drug Policies.

During the Sept. 3-4 conference held in San José, Costa Rica, activists, experts and decision-makers from throughout the region demanded reforms of these policies, to ease the pressure on vulnerable groups and shift the focus of law enforcement measures to those who benefit the most from the drug trade.

Today things are backwards – the focus is on “the small fish” rather than “the big fish”, Paul Simons, the executive secretary of the Inter-American Drug Abuse Control Commission (CICAD), told IPS.

The proposals set forth during the meeting recommended an overhaul of the legal systems in Latin America, to reduce incarceration and establish sentences proportionate to minor crimes. The participants argued that laws and the justice systems should focus on cracking down on the big interests involved in drug trafficking.

They also recommended that amounts for legal personal possession should be established, along with measures such as the decriminalisation of some drugs or the creation of markets controlled by the state, along the lines of what Uruguay is doing in the case of marijuana.

The current policies give rise to cases like that of Rosa Julia Leyva, an indigenous Mexican woman who now works in the Mexican interior ministry’s National Commission on Security.

Leyva was imprisoned in 1993 for carrying a woven bag with a small package of heroin, which was given to her by a friend who paid her plane ticket in exchange for help with her baggage. It was the first time she had ever left the Petatlán mountains in the southwest state of Guerrero. Until her arrest, she told IPS, she thought she was carrying money or clothes.

At the time, she was the prototype of the women who are constantly thrown into Latin American prisons for drug smuggling: an illiterate 29-year-old, the mother of a five-year-old daughter, sentenced to a quarter century in prison for possession of heroin.“I’m just a poor woman who went through something very difficult. I had nothing to do with drugs and I never could have imagined that they would give me 25 years for drug trafficking. They made out like I was a big drug smuggler and I didn’t even speak Spanish.” --Rosa Julia Leyva

The Organisation of American States (OAS) reports that 70 percent of the female prison population in the region was incarcerated for drug possession.

“I’m just a poor woman who went through something very difficult,” Leyva says. “I had nothing to do with drugs and I never could have imagined that they would give me 25 years for drug trafficking. They made out like I was a big drug smuggler and I didn’t even speak Spanish.”

“I think the law should be more specific in these things,” said Leyva, who also makes crafts. She managed to get her sentence reduced to 13 years, of which she served just over 12. Now she gives theatre classes in Mexican prisons.

In the world’s most unequal region, the prisons are packed full of poor people, while white collar criminals are much less likely to be brought to justice, said experts participating in the “Drugs and Social Inclusion” panel during the conference.

This imbalance and overcrowding of the prisons could change, they said, if the courts and prison systems made the effort.

“We want to see who is brought before the courts, and look into options for people who are not violent and who have committed minor crimes, as consumers, drug mules [who smuggle small quantities] or people who committed the crime to feed themselves and their families,” Simons told IPS.

“They are the small fish, like bus drivers or mules, who smuggle small quantities without any violence in a region full of contrasts,” said the head of CICAD, which forms part of the OAS. “We want to see if there is a way for these people not to be caught up in the prison cycle.”

In a region where 10 of the most unequal countries in the world are located, “drug policies must be reformulated,” said Yoriko Yasukawa, resident coordinator of the United Nations Development Programme (UNDP) in Costa Rica.

The proportionality of sentences in cases like Leyva’s was a recurrent theme among the experts, who called for a “more just” legal system in line with the real damage caused by people convicted of drug-related crimes.

“Sometimes the punishment is comparable to the penalties for homicide or other serious crimes,” Argentine social worker Graciela Touzé told IPS.

“It is not similar to the damage caused, and the punishment can’t be similar either, although that does not mean that they shouldn’t be held accountable,” added the president of the Intercambios Asociación Civil, an organisation based in Buenos Aires.

Social cost

During the regional conference, speakers were adamant in their criticism of the social costs of repressive anti-drug policies.

Costa Rica’s minister of public security, Celso Gamboa, explained that the people arrested in his country in the first eight months of 2014 included fishermen, flight attendants and drivers who were drawn into drug smuggling by poverty.

“The blows to drug trafficking structures have focused on the most vulnerable parts, which leads us to conclude that much of the fight against drugs in Costa Rica and the rest of Latin America fuels the criminalisation of poverty,” he said.

“The question is: where are the investigations enabling us to reach the white collar structures and those who hold the real power?” said Gamboa, a former prosecutor from the Caribbean province of Limón, where he was involved in hundreds of drug trafficking cases.

Above and beyond the complicated situation in the prisons, civil society organisations insisted that anti-drug policies are marked by inequality. For that reason, activists said, drug consumers and young people are punished more harshly.

But the different proposals for redressing the imbalance sometimes clash.

Gamboa believes in tackling the drug problem with an economics-based approach that goes after the big fish who hold the real money, while Zara Snapp, of the Mexican Movement for Peace with Justice and Dignity, says the best way to reduce the number of civilian victims of the drug trade is by creating a market in Mexico regulated by the state.

“The inequality does not mean that there isn’t a lot that we can do, because we still have many resources, it’s just that we channel them into the militarisation of the struggle and into law enforcement, rather than towards creating opportunities for the vulnerable populations,” the Mexican activist, who also forms part of the non-governmental Mexican Commission for the Promotion of Human Right, told IPS.

“The only thing that approach does is to create fertile ground for recruitment by organised crime,” she said.

It is poor young men and women who pay the cost. According to the OAS, the prevalence of consumption of “pasta base” or cocaine paste is 1.8 percent overall, but 8.0 percent among young people in poverty.

The stigma surrounding the use of pasta base accentuates their marginalisation and further limits their opportunities, according to the Report on the Drug Problem in the Americas.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

When Veronika Sintsova was diagnosed with tuberculosis in 2009, she spent six months in hospital before being discharged and allowed to continue treatment as an outpatient.

Today clear of the disease, the 35-year-old former drug user from Kaliningrad says the fact that she beat tuberculosis (TB) is not because of, but rather in spite of, the way many people with tuberculosis are treated in Russia.

“I think it would be fair to say that Russian authorities don’t take the problem of tuberculosis seriously,” she told IPS.

Tuberculosis is a major health threat in Russia, where it is the leading infectious disease killer.The country has the highest rates of multi-drug resistant (MDR) and extremely drug resistant (XDR) tuberculosis in Europe and the third highest in the world. And those rates are climbing.Tuberculosis exploded in Russia after the collapse of the Soviet Union as health care infrastructure crumbled, the country was thrown into economic crisis and crime and poverty soared, leading to overcrowded penal institutions.

It also has the 11th highest burden of all TB in the world, according to the World Health Organisation (WHO), which just last week said that parts of the country were “disaster areas” for the disease.

Tuberculosis exploded in Russia after the collapse of the Soviet Union as health care infrastructure crumbled, the country was thrown into economic crisis and crime and poverty soared, leading to overcrowded penal institutions.

But, say NGOs in Russia and international groups working to combat the disease, the continued use of outdated and inefficient approaches to the disease are still fuelling its spread.

Long stays in health facilities filled with people with TB were a cornerstone of the Soviet health care system’s approach to the disease, and have remained, even though they were abandoned years ago in the West because they were seen as contributing to the spread of the disease.

But it is not just in health care facilities where people with TB are being failed. The disease is rife in Russian jails. Overcrowding, poor conditions and bad nutrition all contribute to high infection rates with one in seven prisoners having active TB, according to the Russian Federal Penitentiary Service.

The way prisoners with TB are treated typifies the general approach to the disease by authorities. Sintsova said that although she was treated well by doctors, it was during a sixth month spell in prison for a drug offence that she had what she says was “the worst experience” of all the time she had the disease because fellow inmates and wardens took no pity on her when she left her cell.

“They would shout out ‘tuberculosis sufferer on a walk’ as I went along. That really hurt me. It was probably the worst thing I experienced in all the time I had tuberculosis,” she told IPS.

And this abuse is typical, she said, of the way many people with the disease are viewed in Russia. TB is common among those at the margins of society – drug users, alcoholics, people with HIV and those in dire poverty. “In our society, a drug user is not a person and their death from tuberculosis is seen as something they deserve,” Sintsova, who herself has HIV, told IPS.

Third sector groups working with TB sufferers say approaches towards such people need to be changed. Anya Sarang, president of the Andrei Rylkov Foundation for Health and Social Justice, has previously told local media that the “unjustified imprisonment of Russian people, especially drug users, leads to prison overcrowding” which in turn fuels continued TB infection.

Others point to the need to provide integrated care for people with co-infections, such as HIV and hepatitis C. Oksana Ponomarenko, Russia country director for the U.S. organisation Partners in Health (PIH) which works with TB patients in Russia, said on the group’s website: “The biggest problem lies in the fact that each health system in Russia is vertical and operates separately –TB, drug addiction services, HIV care, psychiatric services, among other health programs.

“At federal level and in individual regions these programs are not connected. Often, clinicians in one programme will not have complete information on other nearby services and programmes.”

PIH and other local organisations have started programmes to try and provide integrated treatment to people with TB in some cities, including a mobile clinic.

Some success has been reported in a scheme in the city of Tomsk where prisoners with TB are all housed in one facility. If released before their treatment has finished, they are placed straight into hospital to prevent infecting others when they return to wider society.

PIH says that its methods have been adopted as official state policy on TB and legislation was recently brought in to emphasise the importance of ambulatory, rather than institutional, care in TB treatment. The government has also increased spending on TB in recent years, modernised diagnostic equipment and overhauled research institutes specialising in TB.

But what worries many working with TB patients is the Kremlin’s approach to some of the biggest international funders of TB projects. It recently decided to reject money from the Global Fund for Aids/TB and Malaria, justifying the move by saying that Russia is now a donor to the Global Fund and that it would be wrong for it to continue to take money from it.

Some see the move as entirely political and part of attempts by the Kremlin to crack down on foreign NGOs operating in Russia. Another major funder of groups working on TB programmes, USAID, was expelled from the country in 2012 and forced to stop operating, on the grounds that it was interfering in Russian politics.

Some projects, including a few run by PIH, have already been affected.

Nadezdha Tolokonnikova and Maria Alyokhina (fourth and fifth from the right) with activists from the Andrei Rylkov Foundation for Health and Social Justice in Moscow marking the United Nations International Day Against Drug Abuse and Illicit Trafficking with calls for reform of Russia's hard-line drug policies. Credit: Andrei Rylkov Foundation

By Pavol Stracansky
MOSCOW, Jun 26 2014 (IPS)

A protest in Moscow Thursday marking the U.N. International Day Against Drug Abuse and Illicit Trafficking has highlighted the ‘torture’ drug users are put through in the Russian criminal justice system.

Nadezhda Tolokonnikova and Maria Alyokhina, members of the Pussy Riot Group who were controversially jailed for performing in a Moscow cathedral in 2012, spoke in the Russian capital to highlight the plight of drug users in Russia.

Joining protestors in more than 80 cities around the world demanding drug policy reforms, they attacked what they said was their country’s “cruel and inhuman” treatment of drug users.

Describing a litany of rights abuses against drug users, including torture and beatings by police and prison warders, they said Russian authorities viewed imprisonment as a “cure for drug dependency”.“Similar to xenophobia and homophobia, narcophobia has become a protective cloak for the authorities .... Creating an image of the enemy, the subhuman, the zombie, and reinforcing that image in the public consciousness justifies the inhuman treatment of drug dependent people in our country” – Nadezhda Tolokonnikova and Maria Alyokhina, members of the Pussy Riot punk rock group

“People who use drugs are outcasts – they are despised, hated, accused of all problems, and criminalised. Similar to xenophobia and homophobia, narcophobia has become a protective cloak for the authorities…. Creating an image of the enemy, the subhuman, the zombie, and reinforcing that image in the public consciousness justifies the inhuman treatment of drug dependent people in our country,” they said.

“Russia’s drug policy is built on torture. Humiliation and violation of human dignity – thisis what drug dependent people face everywhere, from hospitals to prisons and other state facilities,” they added.

Russia takes a hard-line approach to drug use, implementing repressive drugs legislation, including lengthy jail terms for possession of even tiny amounts of hard drugs.

Drug users say they are also targeted by police: official figures show that one in six of the Russian prison population is a drug user and, according to other surveys, just under 30 percent of drug users have been arrested at some point since they started using drugs.

They say they also regularly have confessions extracted from them or are coerced into helping officers as they go into withdrawal in detention – a charge police deny.

There is a complete lack of relevant medical services for drug users in temporary holding facilities and pre-trial detention centres and even painkillers are rarely given to addicts going into withdrawal.

Drug users in prison face particular hardship. Conditions for all prisoners are poor with hygiene often bad, cells massively overcrowded and brutality and disease rife. But drug users are especially vulnerable.

Anya Sarang, head of the Moscow-based Andrei Rylkov Foundation for Health and Social Justice, which works to raise awareness of drug problems, told IPS: “Russian prison is torture in itself with prisoners not given basic medical infection control, nutrition etc., and general human rights violations. But drug users are more vulnerable than other prisoners.

“For instance many are HIV positive, but not only are there problems getting their medicine or starting them on treatment because they are not given necessary immune system checks in some cases, but their diet is poor and there is always the risk of infections, such as tuberculosis.”

Tuberculosis (TB) is a major problem in Russian prisons, according to the World Health Organisation (WHO) and other bodies. Studies have shown that a person with HIV is 25 times more likely to contract TB in a Russian prison than outside one.

But the risk of potentially deadly infections is only one problem facing drug users in prisons. As in many jails across the world, drugs are smuggled in and traded between inmates, giving users, some of whom may never have tried hard drugs, access to substances like heroin and experience of dangerous drug-taking methods.

Campaigners say that this is further evidence of how the criminalisation of drug use only perpetuates and worsens drug problems.

Michel Kazatchkine, UN Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, told IPS: “We know from studies that contact with the criminal justice system is associated with increased injection drug use and other similar behaviour, among other problems. Putting drug users in prisons …. is making things worse not just in prisons but also for communities when they are released from prison.”

Activists point to how opioid substituition therapy (OST) for people in custody or prison has been successfully implemented in some Western states.

But the practice is completely banned in Russia, despite being widely implemented in many countries around the world, recommended by the World Health Organisation (WHO), and having been proved to be successful in helping halt the spread of HIV/AIDS.

Russia has one of the world’s fastest growing HIV/AIDS epidemics – there were 78,000 new HIV cases registered last year, up from 69,000 in 2012 and 62,000 in 2011 – which the Joint United Nations Programme on HIV and AIDS (UNAIDS) and other bodies say has been historically driven by injection drug use.

Drug use in the country is growing equally rapidly. According to figures from the country’s Federal Drug Control Service (FSKN) there were an estimated 8.5 million drug addicts in 2013 – up from 2.5 million since 2010. The service says up to 100,000 people die each year in Russia from drug abuse. It is also the world’s largest heroin consumer.

Tolokonnikova and Alyokhina said only a reform of drug policy including decriminalisation would improve the situation in prisons.

But Russian authorities show no sign of lifting the OST ban nor improving the very limited harm reduction services which exist in the country and FSKN officials have made a number of public statements in recent months reaffirming their commitment to hard-line drugs policies.

Kazatchine told IPS: “I don’t see any sign of Russia’s approach to drugs softening. What I am seeing is a toughening of the way Russian society looks at marginalised groups, such as drug users, men who have sex with men, LGBT people, etc. The climate has toughened and Russia is de facto criminalising drug use and recession.”

This, critics say, has left Russian drug users in a terrible position in society. Sergey Votyagov Executive Director of the Eurasian HRM Reduction Network (EHRN), told IPS that they were “one of the most stigmatised and under-served populations” in the country.

Meanwhile, the devastation wrought by Russia’s drugs policies has been seen clearly in its newest territory. Just days before Thursday’s protest in Moscow, campaigners in Ukraine had raised the alarm over the fate of drug users in Crimea following its recent annexation.

OST is available in Ukraine and had been provided to 800 people in Crimea. But as part of Russia, Moscow ordered OST programmes there shut down at the start of May.

A mission by the Council of Europe to Crimea which ended last month reported that at least 20 people had died following the cessation of the programmes and at least 50 more had migrated to the Ukrainian mainland, while a few had gone to Russia for detoxification and rehabilitation treatment.

Those who remained spoke of having to deal with intimidation by new authorities and, in some cases, losing their jobs because of either worsening health or their status as former OST patients being made public.

Some who have fled the peninsula described the fear and desperation among drug users still there.

Speaking at an event organised by the International HIV/AIDS Alliance in Ukraine in Kiev earlier this month, one woman, Oksana, who left the day after her OST treatment had stopped, said:  “I might have died if I had stayed in Crimea.

“I am disabled, I have had a stroke and I know very well how it feels to be left without therapy and help. Those who could not leave Crimea are in terrible conditions. Some of them are already dead, others have chosen suicide.”

There is little hope that things in Crimea will change any time in the foreseeable future. Earlier this month, Sergei Donich, deputy prime minister in the Crimean government, told local media that OST was ineffective and was being pushed by pharmaceutical firms who stood to gain from it.

Kazatchine described the situation on the peninsula as a “tragedy”, adding that it was unlikely there would not be more deaths among drug users.

He told IPS: “Evidence shows that OST reduces mortality, it prevents overdoses among drug users. I think it is inevitable that [with no more OST] more drug users will die.”

Unmarked graves of victims of Colombia’s half-century civil war, like this one in La Macarena in central Colombia, are scattered across the country. Credit: Constanza Vieira/IPS

By Adam Schaffer and Gimena Sanchez
WASHINGTON , Jun 3 2014 (IPS)

After half a century, Colombia may put an end to its conflict—if the U.S. will allow it.

Colombia has been the host of some of the most extreme and brutal violence in Latin America’s history. The country’s half-century long conflict has taken the lives of almost a quarter million women, men, and children, and displaced nearly six million more.

The United States has financed much of the conflict in recent years, investing nine billion dollars since 2000 – much of it to bolster Colombia’s security forces.

Yet peace may be near. On May 16, the Colombian government and the Revolutionary Armed Forces of Colombia (FARC), the country’s largest guerrilla group, signed a preliminary accord on the third of five negotiating points in their ongoing peace talks in Havana, Cuba: illicit drugs.

The agreement offers a viable plan for the FARC to end its involvement in the Colombian drug trade, alternatives for small-scale cultivators of crops destined for illicit drug markets, and meaningful policy reforms at the national level for addressing issues of drug consumption and public health.

Hope too lies with an announcement that came earlier the same day. Following national and international pressure – including an inter-parliamentary letter signed by 245 representatives from the United States, United Kingdom, and Ireland – the FARC announced a unilateral ceasefire.

While the government maintains that it will not end military operations until an agreement is signed, and though the FARC’s temporary ceasefire ended on May 28, this act is encouraging because it significantly decreased violence and will likely increase confidence at the negotiating table.

According to the International Committee of the Red Cross, hundreds of thousands of Colombians continue to be affected by the conflict every year. Ensuring that all parties respect international humanitarian law is essential and will likely help to advance the peace talks.

Domestic political shake-ups, though, threaten to disrupt this progress. In the first round of Colombia’s presidential elections on May 25, sitting President Juan Manuel Santos, who began the talks to the dismay of many former political allies, came in second to conservative hardliner Oscar Ivan Zuluaga.

Zuluaga, who is allied with former president (and current senator-elect) Alvaro Uribe, has made clear his scepticism towards the talks.

While he has now softened his stance in advance of the runoff election, his long-time opposition to the process remains concerning. Santos and Zuluaga will face off in a second-round vote on Jun. 15.

A step closer toward meaningful drug policy reform

The accord on the drug issue – declared a “partial agreement,” as no individual agreements are final until all points on the agenda have been agreed upon – is little short of historic.

The language, which was agreed upon by both parties, reflects a significant shift away from the prohibitionist approach to drug policy.

Adopting some of the proposals of the growing community calling for drug policy reform, the accord acknowledges that “evidence-based alternatives” to current policies are needed to address problems that may be associated with drug consumption, and distinguishes between the cultivation of crops for the illicit market and drug trafficking.

Furthermore, it calls for the expansion of crop substitution programmes, recognising that many rural communities rely on coca and opium poppy cultivation for their economic livelihoods.

However, it stipulates that “supportive measures…will be conditioned to…agreements on substitution and no-replanting,” implying that cultivators would be required to cede their earnings from crop cultivation before they see the benefits of alternative crops.

Experience in Latin America has shown that conditioning assistance on total eradication harms the chance of developing lasting alternatives, as cultivators lack a successful bridge between when the cultivation of crops for the illicit market ends and alternative livelihoods become sustainable.

Not surprisingly in these circumstances, many growers return to the cultivation of coca and poppy crops. A more effective model would be to offer a phasing out period and/or subsidies to cultivators until meaningful alternative livelihoods are actually in place.

Yet while proper sequencing on reducing crops for the illicit market will need to be reviewed, the parties get it right on local involvement. Opting for what one Colombian analyst described as “building the state from below,” the development programme would rely heavily on, and actively engage with, local communities to ensure their participation – and hence the programme’s sustainability.

The most monumental point came with the government’s concession to de-prioritise -though not entirely retire – the destructive and ineffective aerial herbicide spraying of coca crops, opting first for alternative development and manual eradication before spraying crops.

In more than a decade of its use in Colombia, aerial spraying has served only to disperse coca crops, destroy poor farmers’ livelihoods, and engender local distrust for government authorities, as the only contact many communities have had with the state has been the occasional visit of a plane spraying crops.

The agreement also addresses drug consumption, an issue generally thought to be outside the purview of the peace talks. While details here are scant, linking this issue to the peace talks will help continue regional debates on drug policy reform. Recognising that drug policy should be based on respect for human rights and public health is a valuable contribution.

But a full agreement, if eventually signed, will not be a panacea. Taking the FARC out of the cultivation and trafficking business will not independently solve the drug issue or the associated violence.

As long as there is worldwide – and particularly U.S. – demand for drugs, criminal organisations will find a way to supply them. Furthermore, an accord will likely leave a power vacuum in rural regions of the country as the FARC demobilises and cedes those territories.

There is a good chance that right-wing paramilitary successor groups and criminal gangs will try to fill it. Establishing a positive state presence and providing basic services will be a major challenge, especially in regions where the armed forces have been the primary face of the state.

Supporting peace from Washington

Because of these continued challenges, the United States has an important role to play in the implementation phase, both in supporting Colombia financially and in granting the Colombian government political space to implement the accords – even when they contradict U.S. policy priorities.

A State Department communiqué on the drug policy agreement, which highlights the continuation of forced eradication, raises questions about whether the United States will help or hinder the advancement of the peace process.
Nearly two of every three aid dollars destined for Colombia goes to the public security forces. Will the U.S. government be willing to shift aid to build peace rather than continue war?

Achieving durable reductions in poppy and coca crop cultivation for illicit drug production will require implementing alternative livelihoods and connecting long-forgotten rural areas with the national infrastructure.

After decades of waging a largely ineffective “war on drugs” in Colombia, will the United States allow its long-time ally to break with the prohibition-focused model and explore alternatives to the current militarised approach? Some of the most revolutionary agreements in the accord, such as all but ending aerial spraying, would challenge the existing U.S. approach.

These questions, and the many more that will be raised as the talks progress, will likely dismay hardliners in the U.S. government who are not ready to shift drug control tactics.

But with little progress to show after decades of violence and billions of dollars spent, the Colombian and FARC negotiators have made an important step toward ending decades of violence. The United States should stand ready to support Colombia, both financially and politically, in the coming months and years – and it should know when to stand down.

Adam Schaffer is an analyst with the Drug Policy and Colombia programme at the Washington Office on Latin America (WOLA), which promotes human rights, democracy, and social justice by working with partners in Latin America and the Caribbean to shape policies in the United States and abroad.  Gimena Sanchez is a Senior Associate for the Andes at WOLA. This article was originally published by Foreign Policy in Focus.

An OST patient in Simferopol, Crimea. OST programmes are to finish soon following annexation of the region by Russia. Credit: HIV/AIDS Alliance Ukraine.

By Pavol Stracansky
KIEV, Apr 16 2014 (IPS)

As local authorities prepare to put an end to opioid substitution treatment (OST) programmes in the newly annexed Crimean peninsula, drug users there say they are being forced to choose between a return to addiction and becoming refugees.

OST – where methadone and buprenorphine are given to opioid addicts under medical supervision – has been available in Ukraine for almost a decade.

But Russian law forbids its provision, and Russian government officials have said they intend to close OST services in the region by the end of this month."We don’t know what the future holds. Without substitution therapy, I will die."

Organisations working to provide services to drug users on the peninsula say this has put the future health of more than 800 people receiving OST in the region in doubt.

They say that distances to the nearest facilities in Ukraine offering the treatment mean it would be impossible for drug users to access OST services without leaving Crimea permanently.

Without this lifeline treatment, they warn, many users will turn back to dangerous drug habits, reverting to crime or prostitution to support their addiction, and sharing contaminated needles.

Anton Basenko, a member of the All Ukrainian Association of OST Participants, told IPS: “Many of these people, just like me, have HIV, hepatitis C and other chronic diseases complementing their drug dependence. Stopping substitution therapy for the majority of them is the same as denying them oxygen to breathe. They are being thrown back to crime and despair.”

Drug users in Crimea who spoke to IPS said they were dreading their futures without OST.

One 32-year-old drug user from Sevastopol, a mother of one who gave her name only as Ludmila, told IPS: “I am hoping to start a full-time job in a few weeks but this will be impossible for me if I cannot receive OST. My husband, who also receives OST, currently has a job but he will lose it if he stops getting his treatment. Ending these programmes will be a disaster for this whole family.”

Another, who gave his name only as Vitaliy, told IPS he had been helped by the OST he had been receiving for the last four years. He said he did not want to leave his home in Sevastopol but was afraid of what might happen to him if he did not.

The 27-year-old said: “I don’t want to go but at the same time I don’t want to return to injection drug use.”

A 37-year-old man who asked to be called ‘Yevgeny Kovalenko’ (not his real name), who has been receiving OST in Simferopol since 2008, said he faced a stark choice.

He told IPS: “I am scared, my friends are scared. We don’t know what the future holds. Without substitution therapy, I will die. And that is not me just being dramatic or using a figure of speech, I will literally die.  So will many others.”

Groups such as the HIV/AIDS Alliance in Ukraine say some drug users have already left Crimea to ensure they can continue to access OST. The Alliance is preparing for hundreds to arrive in Kiev looking for help when the programmes close in Crimea.

But while those who make it to Kiev will be able to get help, those that cannot, or choose not to leave their homes in Crimea, will be left to deal with their addiction in a region where local authorities will be enforcing repressive Russian policies on drugs.

Under Russian legislation, minor drug offences are punished severely with, for example, convictions for possession of even the smallest amounts of heroin – including residue in a syringe. Such offences carry lengthy jail sentences.

Russia has one of the world’s fastest growing HIV/AIDS epidemics, which UNAIDS and other bodies say has been historically driven by injection drug use.

Ukraine, which also has a serious HIV/AIDS epidemic, has recently reduced the rate of new HIV infections – a success put down to the widespread implementation of harm reduction programmes.

It is unclear at the moment what effect Crimea becoming part of Russia will have on the provision of harm reduction services other than the OST programmes.

Ukrainian groups working with drug users say there are more than 14,000 people in Crimea who access such services, and that any threat to their provision could have devastating consequences for their health and create a serious public health threat in Crimea.

Meanwhile, drug users in Kiev are calling on the Ukrainian Ministry of Health to act.

They say that, even if they cannot persuade authorities in Crimea to allow the extension of OST programmes at least until January next year, when all legislation in the peninsula should be brought fully into line with that of the rest of Russia, the ministry should be setting up facilities for OST programmes in other parts of Ukraine.

Basenko told IPS: “Practical steps need to be taken to organise the accommodation of these refugees, these patients from Crimea, so they can continue their treatment in Ukraine.

“Drugs available in Ukraine must be redistributed and additional OST facilities need to be set up to meet the needs of these patients.”

A top level United Nations conference on drugs has highlighted growing divisions between member states on how to move forward in dealing with global drug problems as calls grow for major reforms in approaches to international drug policy.

The High-Level Review at the latest annual session of the U.N. Commission on Narcotic Drugs (CND) – the chief policymaking body for international drug control – in Vienna assessed last week how the organisation is meeting goals for dealing with the global drug problem ahead of the U.N. General Assembly Special Session on Drugs in 2016."We have been taking a certain approach for 50 years and it hasn’t worked. It’s time to experiment with alternatives.”-- Ann Fordham, executive director of NGO, International Drug Policy Consortium

But it ended with a joint ministerial statement that was only agreed at the very last minute after months of fractious debate, with states failing to agree on a common approach to key points, and proposed paragraphs on issues such as the death penalty absent from the final text.

This, say civil society groups promoting global drug policy debate, underlines a growing split in attitudes towards drugs in U.N. member states between those pushing for liberal reforms and those continuing to follow conservative and repressive approaches which evidence is increasingly showing is failing.

Ann Fordham, executive director of the International Drug Policy Consortium NGO, told IPS at the conference: “The joint ministerial statement always comes out, even if individual member states disagree over some fundamental things. But this year things were much harder, it was much more difficult for countries to agree, and for a while it looked like the unthinkable might happen and they wouldn’t agree and there would be no statement.

“But while there was one in the end, and although it was full of watered-down language, it shows there are growing fractures between states on how to approach drug problems and just how big those differences are.”

A number of U.N. member states have recently either undertaken or are planning fundamental reforms to their drugs policies.

In December last year Uruguay became the first country to legalise commercial sales of marijuana and regulate its production. Commercial sales of marijuana began in the U.S. state Colorado in January while sales of marijuana will begin in Washington state in June.

These developments came just months after Latin American leaders used U.N. platforms to deride the body’s approach to drugs. The president of Guatemala told the U.N. General Assembly that the regulated supply of illicit drugs should be considered while his Colombian counterpart told the same body that the U.N.’s conventions “gave birth to the war on drugs …. that war has not been won.”

These reforms have been praised by many third sector organisations working with drug users and pushing for debate on drug policy. They say reform is desperately needed and a traditional punitive criminal approach to dealing with global drug problems has been shown to have failed.

But the U.N. has slammed drug legalisation. United Nations Office on Drugs and Crime (UNODC) executive director Yury Fedotov told journalists just days before the start of the Vienna Conference that Uruguay’s decision to legalise cannabis sales was “not a solution to dealing with world drug problems.”

The U.N.’s International Narcotics Control Board has labelled the country’s government “pirates” for going against the U.N.’s conventions on drugs.

The apparent distance between U.N. drugs policy bodies’ thinking on drugs and that of individual member states was further evidenced at the conference itself.

Individual country representatives – particularly those from Latin America which has seen decades of horrific violence connected with the drugs trade – spoke vociferously of the need to move away from criminalisation of drug use to a health-based approach to drugs problems.

Colombian minister of justice Gomez Mendez told delegates: “…people have been sacrificed in our actions to tackle the drug problem….we call for more effective ways to achieve the objectives stated in international agreements.”

Meanwhile, representatives of the Ecuadorian government spoke of “the failure of present drug policies” and said “many voices are calling for a change in paradigm in the understanding and approach to the drug phenomenon.”

This was backed up by civil society representatives who spoke in special sessions and meetings during the conference.

Senior U.N. officials too emphasised the importance of preventive measures, rather than punitive criminal justice legislation, in helping deal with problems caused by drugs.

Michel Kazatchkine, U.N. Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, said at the conference that “ciminalisation of drug use, restrictive drug policies and aggressive law enforcement practices are key drivers” of serious public health threats such as of HIV and hepatitis C epidemics among people who inject drugs.”

However, despite these warnings, the joint ministerial statement was released without the use of the term ‘harm reduction’ as such language is still deemed unacceptable by countries like Russia which stringently enforce severely punitive anti-drug policies.

This, argued civil society groups at the conference, shows that the U.N.’s drug policy bodies have abrogated their responsibility as leaders in dealing with the global drug problem, focusing on punitive measures rather than a health-based approach.

Joanne Ceste, deputy director of the Open Society Global Drug Policy Programme told IPS: “For a long time, UNODC has abdicated its responsibility as the global leader for HIV prevention, treatment and care among drug users because it has had such a hard time getting serious about real advocacy on decriminalisation of minor offences.”

However, there is hope that the current divisions between member states’ views on drug policy could end up providing the impetus for important debate ahead of the U.N. General Assembly special session on drugs in 2016.

Fordham told IPS: “What was interesting about watching negotiations on the joint ministerial statement is that usually when they can’t agree, member states just say, ‘OK, let’s just reaffirm what we said last time’, which was in 2009.

“But this time, even though the eventual statement is much weaker than we would have liked, there were many states that said, ‘no we can’t go back to that. Things have changed, we need to come to new agreements on drugs policy’.”

She added: “There are some governments now, ahead of 2016, that are really pushing for global drugs policy to be debated. We have been taking a certain approach for 50 years and it hasn’t worked. It’s time to experiment with alternatives.”

Police raid on a greenhouse where marijuana and opium poppies were grown in La Cumbre, in the Honduran municipality of La Iguala. Credit: Courtesy of Policía Nacional.

By Thelma Mejía
LA IGUALA, Honduras, Mar 15 2014 (IPS)

Discovery and destruction of an elaborate greenhouse for growing opium poppy and marijuana on a western hill, La Cumbre, has alerted the Honduran authorities to the fact that this is no longer just a transit country for illicit drugs, but also a producer and processor.

This is the first time that opium poppies have been found in this country. Previously, the only place in Central America where they had been recorded was in the Guatemalan region of El Petén. Opium paste is the raw material for making heroin, which is highly addictive and is re-emerging as a drug of choice.

On Jan. 31, the authorities announced the discovery of the high-tech greenhouse on the steep mountain, 1,600 metres above sea level and 400 kilometres from Tegucigalpa, in the hamlet of La Cumbre in the municipality of La Iguala. IPS visited the place, which is reached by tracks that are barely passable by rural vehicle and on horseback.

On the way up the trail went through five hamlets, and wound between wild flowers and coffee plantations, typical for the department (province) of Lempira. The roads were creviced and narrow, wet and muddy; they become impassable in the rainy season that begins in May.

At the end of the trail, the remains of the greenhouse came into view. It was 100 metres long and 40 metres wide, and 1,800 opium poppy plants and 800 of the Dutch variety of marijuana (cannabis) were found there.

The enclosed area was air-conditioned, with a large generator, a modern irrigation system and high-efficiency equipment.

Carlos Mejía, deputy superintendent of the National Police in Lempira, who headed the seizure raid, told IPS “we suspect there are many more plantations in these enormous western mountains, so we are combing the entire region.”

Two people were captured during the operation, Rubén Darío Pinilla, a Colombian, and Orlando Jacinto Miranda, a Honduran. Miranda worked for Pinilla, and grew vegetables on his farm as a “front” for his illegal activities at the greenhouse, Mejía said.

Another police officer present during the raid told IPS that the registered owner of the land, a local person, is being investigated, and that he himself might be fronting for someone else. It is assumed that crops of opium and marijuana have already been harvested here.

A teacher in the community of El Matazano, at the foot of the large hill, told IPS in confidence that “it was high time they caught those people.”

“For some time now, we have seen four-wheel-drive vehicles on these bridle paths at night, loaded with plastic barrels, and people have been saying that marijuana was being grown on that hill, but this opium poppy business is news to us,” the teacher said.

The mayor of La Iguala, Marcio Orlando Miranda, told IPS that Pinilla had been arrested in July 2013 for illegal logging in the forest close to the greenhouse, but strangely, he was freed. “There was collusion with the authorities,” he insisted.

Pinilla is in prison awaiting trial for drug trafficking, while those responsible for freeing him last year are under investigation, and a prosecutor has already been suspended.

Mayor Miranda said that for some time,“strangers have been appearing around here, and it is said that many local farms are being used to grow marijuana and this opium poppy that I never heard of before.”

La Iguala is a municipality of 27,000 people, where maize, beans and particularly coffee are grown. There is only one police post, with five poorly-equipped officers, to serve its 26 villages and 86 hamlets.

The operation that dismantled the greenhouse was organised from Tegucigalpa by the National Police anti-drug squad and was headed by the Lempira branch, which is also very short of manpower, equipment and vehicles in the fight against powerful drug traffickers.

The authorities suspect that in adjacent provinces like Ocotepeque and Copán, which border on Guatemala and El Salvador, there may be more opium poppy plantations. Lempira also shares its southern border with El Salvador.

In February the police found what appeared to be a clandestine laboratory in the Nueva Arcadia region of Copán, that was suspected of being used for cocaine processing, together with underground tunnels, heavy machinery and a helipad.

Nueva Arcadia and La Iguala are both economically depressed zones located among tree-covered mountains.

But they are not the only indications that the drug trade is changing its spots in Honduras, which has been a transit zone since the 1970s and is now a country where drugs are grown, processed and even, to a lesser extent, sold.

Eugenio Sosa, a sociologist and university professor, told IPS that Honduras “has for a long time ceased to be a transit country. There are indications that drug trade penetration is much deeper than that, and growing opium poppies only reflects one of the forms of organised crime.

“The authorities seek to present these discoveries as a success, but one has to ask: are more drugs seized because more are being trafficked, because they are being produced and processed, or because the authorities are more efficient?” he said.

“I have my doubts about the last of these possible answers,” he said.

Mirna Flores, an expert on security issues, attributes the expansion of drug-related crimes to displacement of the trafficking routes due to the war against drugs in Mexico, which has prompted the cartels to dispute territories in Central America.

“Honduras’s geographical location appeals to the cartels and they have become more sophisticated in their expansion strategies, based on corruption and impunity,” she told IPS.

In her view, “that is why these plantations and processing laboratories have arisen.”

The Atlantic cartel, on the northern Caribbean coast, and the Valle cartel in the west are the main drug organisations operating in this country of 8.5 million people.

Analysts say the opium discovery will compel the government to crack down more effectively on the smaller cartels operating in the country, and on their political and economic bosses.

Official reports say that 80 percent of illegal drugs en route towards the lucrative United States market through Central America pass through Honduras, and connect this with the country’s having one of the world’s highest levels of violence, with an average of 19 violent deaths a day.

According to the United Nations Office on Drugs and Crime (UNODC), in 2012 Honduras had the highest homicide rate in Latin America, at 81.9 per 100,000 population.

Most of those who meet violent deaths are young people, and although criminal investigation is fragile, the nature of most of these murders leads criminal experts to believe that they are the result of cartel turf wars and score settling.

Caden Clark has Lennox-Gastaut syndrome, a catastrophic form of epilepsy that causes him to have seizures from 10 to 20 times a day. Courtesy of the Clark Family.

By Matthew Charles Cardinale
SPOKANE, Washington, Mar 14 2014 (IPS)

Beth Collins recently picked up and moved from Virginia to Colorado, but it wasn’t for the typical reasons: new job, better schools, nicer weather. Collins’ 14-year-old daughter, Jennifer, has intractable epilepsy. Medical cannibis eases her frequent seizures. But it’s illegal in their home state.

“We got here the first week in December [2013]. She has been on THCA [a strain of cannabis],” Collins told IPS. “She takes it three times a day. We are seeing a 70 to 90 percent decrease in seizures. She’s been on the medication now for close to two months.”"It's just a huge gift and a trauma. Coming here and sort of ripping away, it was horrible and it was so hard." -- Kim Clark

Prior to the THCA, Jennifer tried a variety of drugs and diets, but they all had bad side effects, her mother says.

“She’s feeling better but she misses her dad, she misses her sister, she misses her friends. When you have a sick kid, we have a network of people it takes a long time to [build]. You have to start over again finding that support system when you move,” she said.

“Just she and I came. We want to make sure it works before we sell the house,” Collins said, adding that her family will probably be forced to permanently relocate to Colorado.

“I can’t leave with the medicine – we’ll be criminals if we do. They have pretty harsh fines [in Virginia]. I’d rather not be a criminal – it’s not how I want my daughter to see things, that if things don’t go your way, you’d commit a crime. I’d rather have her see us fighting,” Collins said, crying. “It’s emotional, it’s a hard thing. My family’s split.”

The Collins family is just one of hundreds that have migrated to the states of Colorado and Washington to access medical cannabis, or marijuana, to treat their children or other relatives, since voters in those states legalised the drug in the November 2012 elections.

An estimated 36,284 people moved to Colorado in 2013, almost 8,000 more than the year before, according to the Daily Beast. A good part of this increase is believed to be due to families migrating for medical cannabis, legal recreational cannabis, and cannabis-related business opportunities.

Caden and his mother, Kim Clark. The 10-year-old has been through numerous surgeries, including a partial lobotomy, which failed to stop his seizures. Courtesy of the Clark Family.

At least 200 families moved after cannibis oil was featured in a documentary called “Weed” by Dr. Sanjay Gupta of the cable television news station CNN.

One is the Clarks, whose 10-year-old son Caden has Lennox-Gastaut syndrome, a catastrophic form of epilepsy that causes him to have seizures from 10 to 20 times a day.

“He’s never had a seizure-free day in his life, ever,” said Caden’s mother, Kim Clark.

Kim moved with Caden from Georgia to Colorado after trying everything the legal medical community had to offer: prescription medications with severe side effects; a starvation diet; severing the brain hemispheres; even a partial lobotomy.

“We are not anti-science people. We are very pro-science people. Our child has had a lobotomy per science. It just didn’t work for him,” she told IPS.

The Clarks are on a waiting list for cannabis oil and said they had just received a phone call that their medicine might be ready as early as next week.

“We saw the special that Sanjay Gupta did on CNN about Charlotte Figi [a child whose epilepsy was cured by cannabis oil]. I took it to my husband, who is a narcotics officer in Atlanta, Georgia,” Clark said. “He’s the guardian of the drug vault, so there’s a bit of a conflict of interest there.

“When I approached him, my husband is highly anti-drug. He was like ‘not happening, anywhere’. I had to bring the science hard and heavy, with of course our son dying in front of us. It had to be really convincing,” she recalled. “We packed up everything. It’s very hard.”

Clark’s husband and other son stayed in Georgia. “We’re living in separate states. It’s what we have to do. Our older son actually said it. He looked at us, and he said, how can we not do it if we love him [Caden]? That became our mantra, our resounding call to Colorado,” Clark said.

Caden (right) and his brother, Jackson, who stayed in Georgia with their father. HB 885 is a bill currently pending in the state that would allow for medical cannabis to be administered to patients like Caden suffering from seizure disorders. Courtesy of the Clark Family.

An eighth-generation Georgian, she is bitter that her home state has not yet legalised medical cannabis and considers her and Caden to be “refugees”.

“My grandma taught me to grow vegetables and love God. I knew what county I’d raise my children in when I was 10 years old,” she said. “Do I feel disenfranchised and unwelcome [in Georgia]? Yes, you bet your ass I do,” she said.

“This is such a huge emotional screw. It’s a trauma. It’s just a huge gift and a trauma. Coming here and sort of ripping away, it was horrible and it was so hard,” Clark said.

Clark said eventually her family will run out of savings and will have to sell their house in Georgia in order to support a split household that is half living in Colorado.

Helping with the huge expenses involved in uprooting a family from one state to another are grassroots organisations like the Undergreen Railroad (a twist on the historic “Underground Railroad,” which during the 1800s helped slaves escape the U.S. South).

Another charity, Ride to Give, has raised 12,000 dollars for one family, the Coxes, who relocated from Georgia to Colorado to access medical cannabis for an ailing child, Haleigh, who also suffers from Lennox-Gastaut.

Nicole Mattison tells a similar story. “We moved in January from Tennessee to Colorado for our two-year-old daughter,” she told IPS.

“It’s been a bit of an undertaking, but so far it’s been well worth it,” she said. “Our daughter is diagnosed with intractable infantile spasms.”

Like other parents, Mattison had tried everything, including the starvation diet, which had the side effect of causing kidney failure in her daughter, Millie.

Mattison has been giving Millie THCA, with amazing results. “She’s been on it for six weeks now. We’ve seen a 75 to 90 percent decrease. She hasn’t had any infantile spasms.”

Mattison’s whole family made the move. “My husband owned a landscape company in Tennessee. We sold that to help fund the move. Currently, neither one of us have a job. It’s been really tough. We have two other children,” she said. “We left our church, our established support group.”

But Mattison does not regret her decision. “I would take the hardships any day for the possibility that Millie could one day have an improved quality of life.”

A MDR-TB patient at a Médecins Sans Frontières clinic in Manipur in north-eastern India. Credit: Bijoyeta Das/IPS.

By Bijoyeta Das
NEW DELHI, Mar 5 2014 (IPS)

For years Joba Hemron, 50, prayed that her cough would go away. She was diagnosed with Tuberculosis (TB) in 2011. She was put on a Directly Observed Treatment Short-course (DOTS), provided free at a public health clinic in Bongaigaon district in Assam.

But soon she began missing too many doses. “My sons work in the fields, I was too weak to go on my own to get the pills,” she says. She went to a private clinic, hoping to collect all the medicines at once. That was expensive, which meant she could again not complete the course."Each time the patient moves from one doctor to another, physicians tinker around with the drug combination, further worsening the drug resistance."

Three years and five doctors later, she kept losing weight. “I took medicines whenever convenient but I was only getting worse.” Her family sold a goat and with the money traveled to the state’s capital, Guwahati.

She was diagnosed with multi-drug resistant TB (MDR-TB). “I don’t know what this means, no one explains anything. Will I get well?” she asks. Her frail body shakes as cough rakes her lungs.

For many like Hemron, lack of proper diagnosis and interrupted dosages are increasing their resistance to available drugs. Drug resistance is human-made – an iatrogenic disease resulting from mismanagement of TB, experts say.

Drug resistant TB can occur as a primary infection or develop during a patient’s treatment. India accounted for the greatest increase in MDR-TB in 2012 with an estimated 64,000 new cases.

India provides free TB treatment through the Revised National Tuberculosis Control Programme (RNTCP), which reaches 1.5 million patients. TB remains the deadliest infectious disease in the country with two deaths every three minutes. India has more than a quarter of TB cases globally.

Ramanan Laxminarayan, vice-president of the Public Health Foundation of India says the national TB programme is “stuck in the 1990s.” It is yet to rope in all available tools and involve the private sector.

“Every case of MDR-TB can be 20 times more expensive to treat than a sensitive strain and cause much greater inconvenience, pain and suffering for the patient,” he adds.

Despite regular adherence to medicines, some patients are becoming resistant to frontline drugs. In Mumbai, doctors at Hinduja Hospital said they had identified patients who are “totally drug resistant,”and did not respond to any available drugs. The Indian government rejected the claim.

According to the World Health Organisation (WHO), about 450,000 people contracted DR-TB in 2012. About half of them are in India, China and Russia. An estimated four-fifths of DR-TB cases are still undetected. There were 170,000 MDR-TB deaths globally in 2012.

Madhukar Pai, associate director at McGill International TB Centre, a research organisation situated at the McGill University Health Centre in Montreal, Canada, explains that neither public nor private healthcare providers offer quality TB care. He says there are many instances of wrong drug regimens, low quality drugs, scarce monitoring of treatment adherence, patient movement between providers, adding single new drugs to already failing regimens, and inadequate use of drug-susceptibility testing. All this results in MDR and extensively drug resistant (XDR) TB.

MDR-TB treatment is expensive, the treatment often lasts up to two years, with increased risks. Access to the two new MDR-TB drugs— bedaquiline and delamanid, remains limited. They are available in India only through compassionate use mechanisms.

Most patients in India go the private sector but some abandon treatment because of high costs. By the time patients end up in public hospitals they infect many, and also develop severe forms of drug resistance, Pai says.

“In the private sector, irrational TB prescriptions are so common – doctors make up their own drug combinations. This is disastrous. And each time the patient moves from one doctor to another, physicians tinker around with the drug combination, further worsening the drug resistance,” he says.

About 10 percent of drugs in India are estimated by some doctors to be fake, which can muddle up treatment. Testing for drug-resistance is limited in the public sector. “Empiric treatment is used,” Pai says, not treatment that is tailored to a patient’s drug susceptibility profile. This results in selection of drug resistant strains.

The solution isn’t “merely technological”, says Mike Frick of the Treatment Action Group, a research and policy think thank based in the U.S.

New diagnostic machines like GeneXpert may uncover more cases of drug resistance but “it cannot solve the health system’s failure to link patients to the highest level of care that is their right,” says Frick. India fails to provide psycho-social and economic support for patients.

Globally, funding for research into TB has fallen. Governments have slashed budgets; Pfizer and AstraZeneca have abandoned anti-invectives research – increasing the wait for better drugs, diagnostics and vaccines. “It decreases our chances of replacing toxic drugs in the current MDR-TB regimen with newer, safer drugs that are easier for patients to tolerate,” Frick tells IPS.

In 2013, there were numerous reports of drug stock-outs in India, which the government denied. Many patients had to stop treatment; others were turned away from clinics. When treatment is incomplete, it creates an opportunity for drug-resistance to develop.

“The cruel irony is that even as Indian generic manufacturers continued to produce many of the TB drugs that people in other countries depend on, the Indian government couldn’t guarantee TB drug availability to its own people,” Frick adds.

TB is an opportunistic disease and HIV positive patients are more susceptible. Daniel, who asked only his first name be used, is a HIV positive patient. Six months ago he was diagnosed with MDR-TB. “The medicines are so hard, drain me of all strength,” he says.

He is forced to go to public hospital because of the exorbitant costs of medicines. “But there are long waits and everyone comes to know about you. It only adds to the existing stigma.”

Female cannabis plant. Credit: Bokske/CC BY 3.0

By Emilio Godoy and Inés Acosta
MEXICO CITY/MONTEVIDEO, Sep 27 2013 (IPS)

In Latin America, where marijuana is the most widely consumed illegal drug, there is basically no home-grown research into its effects and properties. But possible legalisation in Uruguay and the Mexican capital could open the door to new studies.

“We can’t close our eyes to serious research in other parts of the world,” Rodolfo Rodríguez, a scientific researcher at the department of pharmacology in the National Autonomous University of Mexico (UNAM) medical school, told IPS.

Rodríguez, who has been studying different psychotropic substances for 45 years, is one of six experts making up the Marijuana and Health Group at the National Academy of Medicine who are completing a theoretical study on the medicinal and therapeutic effects of Cannabis sativa.

One of Rodríguez’s interests is to learn about the drug’s effects in patients with chronic or terminal diseases, such as fibromyalgia, multiple sclerosis, or certain kinds of cancer.

The results of their work, set to come out in October or November, will inform the debate that Mexico City authorities are holding with a view to legalising the medical use of marijuana.

The left-wing city government of Miguel Mancera and the Mexico City legislative assembly are assessing the health, economic and security aspects of legalisation.

“It’s a plant with more than 400 chemical substances and more than 70 cannabinoids,” Rodríguez said. “When it is consumed, the effects aren’t only due to the delta-9 [tetrahydrocannabinol or THC, the primary psychoactive ingredient in marijuana], but to the combination of all of the chemical compounds.”

Marijuana is mostly grown in the western and southern states of Mexico, largely to supply the lucrative U.S. market. Tens of thousands of small and large farmers and rural workers depend on the illegal crop for a living.

It is used by four million people in this country of 118 million, making it the most widely consumed drug, followed by cocaine, according to the health ministry’s National Addiction Survey 2011.

In Uruguay, far to the south, it is also by far the drug of choice, consumed by slightly over eight percent of the population. But almost all of the marijuana used in the South American country is smuggled in from outside, especially from Paraguay.

Consumption and possession of small amounts of marijuana for personal use are not penalised in Uruguay, a country of 3.3 million people sandwiched between Argentina and Brazil.

And the lower house of Congress has approved a draft law that would legalise and put the production, distribution, and sale of marijuana in the hands of the state. It is expected to make it through the Senate shortly and be passed into law, with the votes of the ruling left-wing Broad Front party.

More than 6,000 studies on the properties and effects of cannabis were published in scientific journals from 2010 to 2012, according to NORML, an organisation that advocates the legalisation of marijuana.

Uruguayan biologist Cecilia Scorza, assistant researcher at the Clemente Estable Institute for Biological Research, said “it’s not worth working on something that has been studied for so long, because it would not be original research.

“With marijuana, there can be differences in terms of the quantity of the active ingredient. But it’s always the same ingredient, and the effects are the same too,” she told IPS.

She pointed out that this is not at all the case for the cheap cocaine derivative known in South America as basuco, paco or pasta base, which poses a great potential risk to the user’s health.

The drug’s impact on the region and the lack of scientific research on it have made it a prime focus of studies. “In 2005, we began to research the chemical composition of the drug and its pharmacological effects on the central nervous system,” Scorza said.

But she said it would be original to study the chemical composition of the marijuana that has begun to be produced in Uruguay, “because it would give us a notion of what people will be consuming under the new law.”

Psychologist Gabriela Olivera, a technical adviser to Uruguay’s National Secretariat on Drugs, said research was indispensable to help users stay safe.

The draft law foresees the provision of “information and education that would make it possible, for example, for a person in certain health conditions who consumes marijuana to know that if they use such and such a quantity there is an active ingredient that could provide benefits, but would also have negative consequences,” Olivera told IPS.

To carry out experiments with psychoactive substances, a permit is currently needed from the National Secretariat on Drugs, which only exceptionally makes available a small quantity from drugs that have been confiscated.

“That makes systematised research impossible,” Olivera said.

Once it is passed, the law will create the Institute for the Regulation and Control of Cannabis (IRCCA), whose mission will include advising the government and providing scientific evidence.

The evidence would involve “all aspects, from the chemical composition of the marijuana that will be sold, to the effects on people, depending on its different uses – medicinal or recreational,” Olivera said.

In addition, the Technical Forensic Institute, the Technical Police laboratory, and the Chemistry Faculty of the University of the Republic are designing a research protocol on the potency of THC and other components of the marijuana that is trafficked illegally today, the director of the Uruguayan Observatory on Drugs, Héctor Suárez, told IPS.

Research on the varieties produced and sold legally would be regulated once IRCCA was up and running, he said.

In Mexico City, meanwhile, even if the medicinal use of marijuana is legalised, patients would not start receiving prescriptions overnight, Rodríguez said.

“We are not prepared for that,” the UNAM researcher said. “We have the knowledge and the infrastructure, but it would imply an educational process in health institutions.”

Treatment with marijuana “cannot be within reach of just any doctor, and learning about it can take months or even years,” he added.

Marijuana grown for medicinal purposes. Credit: Coleen Danger/CC by 2.0

By Carey L. Biron
WASHINGTON, Aug 30 2013 (IPS)

The U.S. Justice Department on Thursday issued surprise guidance directing its attorneys not to sue states that have moved to decriminalise the recreational use of marijuana, so long as those states implement strict regulatory regimes.

The announcement marks a turnaround for the administration of President Barack Obama, who in January refused to explicitly support cannabis legalisation. Yet analysts are also suggesting that the new policy stance will have significant repercussions for countries that have been at the receiving end of the U.S. “war on drugs”.

“This action is of enormous significance, especially in Latin America, where the United States has for decades been the chief cheerleader for and major exporter of its own punitive drug policy,” John Walsh, a senior associate for drug policy at the Washington Office on Latin America (WOLA), a rights group, told IPS.

“Latin American and other countries have felt bound by various treaties not to experiment with regulatory approaches that they think could do a better job, so the significance here is in providing space in the knowledge that the U.S., at least, is not in a position to pressure them anymore.”

Indeed, the United States is seen as the major architect of three United Nations treaties that codify four decades’ worth of “prohibitionist” anti-drugs policies. While these policies today constitute the global norm, some analysts suggest it is currently breaking down."As the so-called 'war on drugs' enters its fifth decade, we need to ask whether it, and the approaches that comprise it, have been truly effective."
-- Eric Holder

In the United States, strict “mandatory minimum” jail sentences have brought the federal prison population to record numbers in recent years. Of the country’s 219,000 inmates – called “historically unprecedented” numbers – half are locked up on drug-related and overwhelmingly non-violent charges.

Earlier this month, U.S. Attorney-General Eric Holder rescinded mandatory minimum sentence guidelines for a range of crimes, including non-violent drug offences.

“As the so-called ‘war on drugs’ enters its fifth decade, we need to ask whether it, and the approaches that comprise it, have been truly effective,” Holder stated on Aug. 12, “and … to usher in a new approach.”

“Affirmatively addressing” priorities

Thursday’s announcement will remove several significant hurdles for lawmakers and entrepreneurs in the states of Washington and Colorado, where in November voters approved the legalisation of the production, distribution and use of non-medical marijuana. Such policies would be among the most permissive anywhere in the world, but they also directly contradict federal law.

In the context of this discrepancy, in recent years the Justice Department has continued to carry out irregular raids and harassment of growers and distributors of medical marijuana even in the 21 states that have formally authorised the physician-prescribed use of the drug. (Sixteen states have also decriminalised first-time offences for small amounts of cannabis.)

The new guidelines now direct federal attorneys not to pursue litigation so long as marijuana is not being sold to minors or funnelled into states that have not legalised its recreational use.

While the Justice Department memorandum will provide increased legal certainty for those involved in these new experiments in regulation, it goes much further than offering mere grudging promises not to interfere. Rather, officials suggest that de-criminalisation of marijuana could ultimately be more successful than criminalisation in achieving a menu of stated federal policy aims.

“A robust system may affirmatively address those priorities,” the memo states, “by, for example, implementing effective measures to prevent diversion of marijuana outside of the regulated system and to other states, prohibiting access to marijuana by minors, and replacing an illicit marijuana trade that funds criminal enterprises with a tightly regulated market in which revenues are tracked and accounted for.”

Long-time critics of the United States’ punitive approach to drugs interdiction have lauded the move, noting the heavy toll that communities in and out of the country have been forced to pay for drugs policies originating in Washington.

“Existing policies that rely heavily on criminalising drug use undermine human rights and have entailed serious costs in terms of violence and abuse,” Maria McFarland, deputy U.S. programme director at Human Rights Watch, an advocacy group, said Friday.

“It’s encouraging that the Justice Department memo recognises that a regulated drug distribution system may be helpful in reducing the power and wealth of criminal groups. Violent organised crime, well financed by revenues from illicit drug markets, poses a real threat to human rights and the rule of law globally. It’s crucial that governments look at alternative ways of regulating not only drug use but also the drug trade.”

New paradigm?

Several Latin American countries are already actively looking at such alternatives. Most notable is Uruguay, which earlier this month approved draft legislation that would both legalise and nationalise the production and distribution of marijuana.

Several possible regulatory approaches are also being discussed in the Mexican Congress, while leaders in several other countries, from Colombia to Guatemala, are also increasingly exploring alternatives.

“Other governments have been less outspoken than Uruguay but they are nevertheless watching what happens there very closely, hoping to learn from Uruguay’s experience and see how similar approaches may work in their own countries,” WOLA’s Walsh says.

“As a result of the new U.S. decision, these countries will now enjoy greater political space to pursue similar legalisation proposals of their own.”

Such moves have been bolstered by a recent landmark series of reports by the 35-member Organisation of American States (OAS). Those reports (available here and here) were notable in appearing to explicitly advocate for alternatives to the longstanding U.S.-led model of criminalisation.

“Decriminalisation of drug use needs to be considered as a core element in any public health strategy,” one of the reports states, noting in particular that “it would be worthwhile to assess existing signals and trends that lean toward the decriminalisation or legalisation of the production, sale, and use of marijuana.”

At a summit in Guatemala in June, the OAS member states approved the reports’ policy vision of drug use as a health rather than criminal issue. Over initial U.S. resistance, they also agreed to devote a General Assembly next year to coming up with a new drugs-related action plan.

“We are potentially on the cusp of the collapse of the existing international counter-narcotics regime,” Vanda Felbab-Brown, a senior fellow at the Brookings Institution, a Washington think tank, told IPS when the OAS reports came out. “And it looks like the Latin Americans could be the ones to pull the plug.”

Earlier this month, Reuters revealed that a special division within the U.S. Drug Enforcement Administration (DEA) has been using intelligence intercepts, wiretaps, informants and a mass database of telephone records to secretly identify targets for drug enforcement actions.

In the wake of these revelations, a former prosecutor tells IPS he believes he and his colleagues may have been unwitting pawns in the federal government’s effort to deceive defendants and the court system, thereby violating citizens’ constitutional rights.“This is changing the rules of the game so they can conceal the source and use tainted information." -- former prosecutor Patrick Nightingale

“None of us had any idea whatsoever there was a secret DEA programme that instructed DEA agents to conceal the source,” Patrick Nightingale, a former prosecutor for Allegheny County, Pennsylvania, and a member of Law Enforcement Against Prohibition, told IPS.

“My oath as an attorney and as a prosecutor was as an officer of the constitution, and not to win at all costs. This [programme] is a win at all costs mentality: whether it’s constitutional or not we’re going to use it and we can conceal it,” he said.

Called the Special Operations Division (SOD), it is comprised of some two dozen federal agencies, including the Federal Bureau of Investigation, Central Intelligence Agency, National Security Agency (NSA), Internal Revenue Service (IRS), and the Department of Homeland Security.

Everything about the SOD is secret, including the size of its budget and the location of its offices.

Reuters has also identified the IRS as a recipient of the information, pointing to a former IRS training manual that referenced the SOD programme.

As a routine practice, the SOD secretly provides the information to local authorities across the U.S., allowing them to start investigations against U.S. citizens under false pretenses, in a practice known as “parallel construction”.

For example, under parallel construction, local law enforcement will be instructed to find a reason to stop a particular vehicle – for example, through a routine traffic stop – and then once the drugs are found, the government will falsely state the drugs were found in the traffic stop.

The IRS training document details how government officials are instructed to conceal – from prosecutors, defence attorneys, and even the courts – the methods by which a suspected drug criminal is identified and then targeted for apprehension.

“Special Operations Division has the ability to collect, collate, analyze, evaluate, and disseminate information and intelligence derived from worldwide multi-agency sources, including classified projects,” the 2005 and 2006 IRS training manual says, according to Reuters.

“SOD converts extremely sensitive information into usable leads and tips which are then passed to the field offices for real-time enforcement activity against major international drug trafficking organizations,” the document states.

The Electronic Frontier Foundation (EFF), a group that defends free speech and privacy issues, calls it “intelligence laundering“.

Since the revelations on Aug. 5, the Justice Department has said it is reviewing the programme, according to reports. But such a review does not address the constitutional violations that appear to have already occurred.

“Our criminal justice system is based on the presumption of innocence and our constitution demands fair play in criminal proceedings. It demands that prosecutors reveal to the defence both the good and the bad,” Nightingale said.

“If the source of this information is so sensitive that a law enforcement agency is told to keep the information from its own team [including federal and local prosecutors] because it knows members of its team are required to divulge it to the other side [the defence], then it’s a problem,” he said.

Nightingale told IPS he had no awareness of the programme as a prosecutor, even though he worked on many cases where he sought court approval for a Title 3 wiretap based on certain evidence. Now he does not know – nor does he have any way of knowing – how many of those cases originated from a secret SOD tip.

“This is changing the rules of the game so they can conceal the source and use tainted information, depriving… defence attorneys and defendants from being able to have a fair trial as defined by the Constitution,” he said.

Hanni Fakhoury, a staff attorney with EFF, told IPS, “The NSA data is being gathered on purpose, and then directed to a different purpose.” He said the information being gathered by the NSA “should” be something that the FISA Court has been approving, although there is no way to know.

“Those orders have a broad scope. The orders aren’t public, there isn’t insight into what the orders look like, or how the court operates really,” Fakhoury said.

“The big concern is they’re not being forthright about the fact that they’re using the information directed toward a purpose not related to national security, and they’re not telling the court or the defendants the true source of that information.

“It’s yet more proof what is being said publicly [by the NSA] is not all entirely accurate,” he said. “It’s another reason why we have to very carefully scrutinise the government’s justification for these types of programmes.”

Fakhouri says the SOD programme is unconstitutional because of the Fifth and Sixth Amendments combined.

Full and fair disclosure is enshrined in the U.S. Constitution as part of the Sixth Amendment, which states, “In all criminal prosecutions, the accused shall enjoy the right… to be informed of the nature and cause of the accusation.”

The Fifth Amendment provides, “No person shall be… deprived of life, liberty, or property, without due process of law.”

The revelations also raise the possibility that individuals who have been convicted over the last 20 years on drug charges, or perhaps IRS-related charges, will challenge those convictions in court on the basis that secret evidence may have been used in the investigative process.

“I think we’re going to see a lot of those types of arguments. How successful those will be – will be a tough sell. I think it will be an interesting thing to watch,” Fakhoury said.

Cannabis sativa leaf. Credit: CC BY-SA 3.0

By Emilio Godoy
MEXICO CITY, Aug 14 2013 (IPS)

Marijuana and the closely related hemp can provide medicinal, food and textile industrial materials that could attract substantial investment and development in Mexico if cannabis were legalised and its cultivation and sale regulated, experts say.

“Cannabis presents possibilities for large-scale agricultural production, as it grows everywhere, and its current and potential uses represent an undeniable opportunity that is very attractive for economic development,” filmmaker and photographer Julio Zenil, one of the most active advocates for the legalisation in Mexico of marijuana, popularly known here as “mota”, told IPS.

Zenil, who in the late 2000s imported apparel made out of hemp fabric, is a co-author with Jorge Hernández and Leopoldo Rivera of the book “La mota. Compendio actualizado de la mariguana en México” (Mota: Current Compendium of Marijuana in Mexico), which the authors say attempts “to demystify a plant whose main problem is the hysteria and media manipulation it provokes in our society.”

Cannabis sativa is a versatile plant with different uses, depending on the strain and the environmental conditions. Tall varieties (commonly called industrial hemp) are cultivated mainly for the fibre in the stems, which have very little resin (the psychoactive portion).

Lower-growing, spreading varieties are grown for the psychoactive chemical compounds found in resin glands on buds and flowers, from which marijuana and hashish are extracted and consumed for recreational, medicinal and spiritual purposes.

The sturdy hemp plant grows almost everywhere in the world, maturing within a year and attaining heights of up to five metres, without the application of chemical fertilisers or pesticides. It also has the ability to sequester large amounts of carbon.

Hemp fibres are longer, stronger, more absorbent and more insulating than cotton fibres. The plant can be used for food, animal feed, cosmetics, oils, textiles, paper, rope-making and biofuels. The seeds, a source of hempseed oil, are very nutritious, containing high levels of essential fatty acids, vitamins and dietary fibre.

Mexico’s anti-drug strategy is riddled with contradictions. The General Health Law permits possession of five grams of marijuana for personal use, but production, distribution and sale are banned.

The country’s laws also ban production and transformation of industrial hemp, in spite of agreements with other countries, like the North American Free Trade Agreement (NAFTA) with Canada and the United States, in force since 1994, and an agreement with the European Union, which allow trade in several of its by-products.

The Single Convention on Narcotic Drugs of 1961, the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 and the Convention on Psychotropic Substances of 1971 do not restrict industrial hemp production, but they do ban the cultivation, production and trade in cannabis as a drug.

Some countries ban hemp because they confuse it with marijuana, which is produced from the flowers of the female cannabis plant.

Hemp production “has economic aspects that should be addressed. We will have to see how to regulate it,” economist Pedro Aspe, a former finance minister under conservative president Carlos Salinas (1988-1994), told IPS.

Use of the hemp plant goes back 8,000 years in China, where it was employed to make paper. There is also evidence of its existence in other parts of the world. The Spanish colonisers introduced hemp into Mexico in the 16th century and 200 years later encouraged its cultivation as a source of raw materials.

The Mexican government first restricted production and sale of marijuana in 1920, ahead of the U.S. Marijuana Tax Act of 1937, which made possession or transfer of cannabis illegal throughout the United States under federal law, except for medical and industrial uses.

Illegal cultivation of marijuana is concentrated in the western and southern states of Mexico and is aimed at the lucrative U.S. market.

The Latin America Hemp Trading, a company based in Montevideo, Uruguay that is working to establish large-scale hemp cultivation in the region, and the campaign for the International Year of Natural Fibres 2009, estimated the global hemp fibre market at over 90,000 tonnes a year, with China producing 50 percent, the European Union 25 percent, and Canada, Chile, South Korea, Australia and other countries the rest.

Optimum yield of hemp fibre is over two tonnes per hectare, while the average yield is 650 kg. Average seed yields are one tonne per hectare, according to figures published for the International Year, which was promoted by the Food and Agriculture Organisation of the United Nations (FAO).

Mexico allows imports of seeds, raw hemp, textiles, twine and cordage for rope-making.

At least eight initiatives for the decriminalisation of marijuana have been presented to the Mexican Congress and state legislatures since 2007. Three of them proposed industrial uses of cannabis.

These proposals argue that allowing and regulating legal cultivation of hemp would create a development opportunity for thousands of rural producers and stimulate new industries, such as paper-making, textiles, and the food, medical, cosmetics and construction industries.

If marijuana cultivation were allowed in Mexico, one of the first to be interested in investing in its production is agricultural businessman Guillermo Torreslanda.

“We must legalise it,” Torreslanda told IPS. “We could copy what has been done elsewhere and adapt it to conditions here. We could think about production schemes that include agricultural support and financing.”

He suggested a scheme with separate arrangements for production and distribution, in order to avoid monopolies and encourage competition.

Zenil said: “The case of Mexico is paradoxical. Trade in hemp products is perfectly legal, but since it is legally impossible to cultivate or profit from the cannabis plant, it is also impossible to create a normal hemp industry.”

Former finance minister Aspe said: “In other places, there are authentic import substitution programmes, and they are succeeding.”

The controversial topic of medical cannabis has been put under a microscope after the internationally known neurosurgeon Dr. Sanjay Gupta came out in support of its use this week.

An ounce of “Green Crack” bought from a dispensary in California. Credit: Coaster420/public domain

In a lengthy opinion piece on CNN, Gupta outlines the benefits of medical cannabis, claims that U.S. citizens have been misled by the government for years, and apologises for his role in that. This reversal of opinions occurred during the yearlong production of his documentary “Weed”, which premiers this Sunday on CNN.

“Gupta literally made a 12 or 13 year turn on this,” the executive director of the advocacy group NORML, Allen St. Pierre, told IPS. “But as a really genuine doctor who is a scientific minded person, he really did want to see the science and let it led him to a different standing.”

The benefits

Illinois is the most recent state to legalise medicinal marijuana, making a total of 20 U.S. states and the District of Columbia that allow its medical use. Approval conditions, regulations and quantity limits can vary from state to state.

The federal law enforcement agency, the Drug Enforcement Administration (DEA), has classified marijuana as a Schedule I drug, meaning it has no medical benefit and has a high potential for abuse, with nine to 10 percent of its adult users becoming addicted.

Cocaine, according to the DEA, is less dangerous than marijuana and is a Schedule II drug even though 20 percent of its users become addicted.

“They didn’t have the science to support that claim [of marijuana as a Schedule I drug], and I now know that when it comes to marijuana neither of those things are true,” wrote Gupta in his CNN piece. “It doesn’t have a high potential for abuse, and there are very legitimate medical applications.”

Gupta uses Charlotte Figi, a patient in Colorado, as an example of the benefits. She began having seizures soon after birth, and by age three she was having up to 300 a week despite being on seven different prescription medicines. Medicinal cannabis calmed her brain and limited her seizures to two to three times per month.

According to NORML, cannabis is specifically used to alleviate pain from nerve damage, nausea, spasticity, glaucoma and movement disorders. It is also a powerful appetite stimulant, which is beneficial for patients suffering from dementia, HIV and AIDS.

“The government and some of our opponents will say with a straight face that it [medical marijuana] has no utility,” St. Pierre told IPS. “It is cheaper than most pharmaceuticals and can be used for over a dozen aliments. The utility combined with the price makes it hard for them to make a convincing argument.”

A new survey done at the nonprofit organisation The Partnership at Drugfree.org found that 70 percent of respondents support the medical use of marijuana and 50 percent support decriminalisation. Forty percent of respondents supported the legalisation of marijuana altogether.

“Most frightening to me is that someone dies in the United States every 19 minutes from prescription drug overdose, mostly accidental,” Gupta wrote. “It’s a horrifying statistic. As much as I searched, I could not find a documented case of death from a marijuana overdose.”

The consequences

According to a study done in the United Kingdom, people who smoke marijuana regularly tend to produce less dopamine, a feel good chemical in the brain that plays a large role in reward-driven behaviour and motivation. Regular marijuana use can also lead to inflammation in the brain, according to the study, which can affect coordination and learning.

Gupta also admitted in his CNN piece that regular marijuana use in younger and developing brains can lead to a permanent decrease in IQ. There is also clear evidence that some users can experience withdrawal symptoms including insomnia, anxiety and nausea.

“Much in the same way that I wouldn’t let my own children drink alcohol, I wouldn’t permit marijuana until they are adults,” wrote Gupta. “If they are adamant about trying marijuana, I will urge them to wait until they’re in their mid-20s when their brains are fully developed.”

Project SAM, the nonprofit organisation advocating for the responsible use of medicinal cannabis, is urging Gupta to clarify what he is referring to when he says marijuana. According to the organisation, CBD is a non-intoxicating element found in medically used cannabis whereas street bought marijuana contains THC, which is specifically used to get a high.

“Dr. Gupta is a person Americans looks up to with high esteem. And for good reason – he is thoughtful, thorough and dispassionate about the science. That is why we are troubled by how people might interpret his comments,” Project SAM said in a press release.

Despite the highly documented consequences and concerns, marijuana is the third most popular recreational drug in the United States, behind alcohol and tobacco. About 100 million citizens use it, and about 14 million do so regularly.

Some 50,000 people each year die from alcohol poisoning and 400,000 people die from tobacco each year, but marijuana is a non-toxic drug that cannot cause death by overdose.

“The fact that this guy [Gupta] enjoys a really wonderful national reputation, and now he is saying ‘my bad’ in a culture where alpha males don’t usually admit that they are wrong, will…affirm that we are in an era of change,” St. Pierre told IPS.

Dried cannabis flowers. Credit: CC BY 2.5

By Emilio Godoy
MEXICO CITY, Aug 6 2013 (IPS)

If marijuana is legalised in the Mexican capital, as the local government proposes, this country would have to review its adherence to the three international drug control treaties, a trail already blazed by other nations.

The Mexico City Federal District city council and the leftwing government of Mayor Miguel Mancera announced that debates would begin in September on health, economic and security aspects of marijuana, popularly known here as “mota”, and medical use might by approved by the end of the year.

“Several countries have questioned the drug control treaties for health reasons,”
lawyer Fernando Gómez-Mont, former interior minister in the government of conservative president Felipe Calderón (2006-2012), told IPS. “This creates tension for the operation of the U.N. conventions,”

Under the General Health Law, amended in 2009, state governments have the authority to legislate on health issued related to illegal drugs. The law permits possession for personal use of five grams of marijuana, 500 milligrams of cocaine and 50 milligrams of heroin, but bans production, distribution and sale of these substances.

This country of 118 million people is a party to the Single Convention on Narcotic Drugs of 1961, the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 and the Convention on Psychotropic Substances of 1971.

“In Mexico, intermediate steps (on drug decriminalisation) may be taken without neighbouring countries necessarily having to follow suit. It is far more viable in the capital,” writer Jorge Castañeda, former foreign minister in the conservative government of Vicente Fox (2000-2006), told IPS.

“For example, in the United States some states have taken decisions of this kind,” said Castañeda, who has become a staunch advocate of decriminalisation.

Marijuana is the illegal drug that is most widely consumed in this country, followed by cocaine and inhalants, according to the 2011 National Addiction Survey published by the health ministry. Production of marijuana is concentrated in western and southern states.

Mexico is in urgent need of new approaches to illicit substances because of the humanitarian crisis unleashed by the repressive anti-drug strategy applied by Calderón throughout his presidency, which resulted in a high death toll and the spread of drug trafficking and drug use.

In 2012 there were 26,037 recorded homicides, a slight decline from the previous year, when there were 27,213. However, this remains one of the highest murder rates in Latin America, according to the National Institute of Statistics and Geography.

President Enrique Peña Nieto has rejected decriminalisation as a means of combating drug trafficking and is in favour of what he calls “a security strategy based on intelligence” – not very different from the policy enforced by his predecessor.

But changes in the global vision of the fight against drugs that are still illegal, especially marijuana, are exerting pressure for a shift towards policies based on prevention rather than repression and law enforcement.

“We will be very responsible in this debate,” Manuel Granados, chair of the city council Governance Committee, told IPS.

“In Mexico City we agree on replacing criminal policies with health policies. We are ready to hold this debate and, at the right time, to legislate,” said the city council member, who belongs to the leftist Party of the Democratic Revolution (PRD) which governs the capital.

The Federal District of Mexico City has been in the vanguard of decriminalising abortion and legalising same-sex marriage.

In September, when city council sessions resume, a high-level meeting will be held with delegates from the United Nations and the Organisation of American States to discuss new approaches to drugs.

Since 2007, at least eight initiatives to decriminalise marijuana have been presented in Mexico’s Congress and in state parliaments, but none has even reached debate in a plenary session.

“We wish to propose a new approach to marijuana. It is possible to create a different kind of regulatory system. We want rights for users,” Jorge Hernández, the head of the Collective for a Comprehensive Policy toward Drugs (CUPIHD) and a co-author of the book “La mota. Compendio actualizado de la mariguana en México” (Mota: Current Compendium of Marijuana in Mexico), told IPS.

Hernández proposes creating cannabis clubs, like those in Spain, where the drug can be grown and consumed privately in a regulated manner and in accordance with international regulatory treaties.

“The state must take responsibility and provide enough information. There should be the same regulation as for alcohol and tobacco. It is time to review the law. The Federal District could be a good starting point,” said Gómez-Mont.

Mexico was the only Latin American country to object in January to Bolivia’s reservation of the right to traditional uses of coca leaf, such as the age-old custom of chewing the leaves. Bolivia won the concession, which allowed the Bolivian state to re-accede to the Single Convention on Narcotic Drugs.

The Western Hemisphere’s approach to countering the use and flow of illegal drugs may soon change radically, as recently published reports by the Organization of American States (OAS) signal a region less willing to be dominated by the United States and anxious to act on a more multilateral basis.

On Thursday here in Washington, OAS Secretary-General Jose Miguel Insulza presented two reports by his organisation on the issue, endorsing alternatives to the U.S.-led status quo.

The two reports include an analytical assessment of the current situation surrounding illegal drugs in the Americas, and one looks towards potential future scenarios for a coordinated response. The two reports, released in May, were a focus of debate at the OAS General Assembly in Antigua, Guatemala, earlier this month.

While the reports did not lead to any concrete policy shifts by the OAS at the general assembly, some observers see the reports as an indication that changes could be afoot.

“A few years ago the issue was a taboo,” Coletta A. Youngers, a senior fellow at the Washington Office on Latin America, an advocacy group, told IPS. “It was seen as purely U.S.-dominated, and if you would have proposed something like these reports, people would have laughed at you.”

The reports favour the view that the overall drugs issue is a public health, rather than a security, matter. Youngers believes such a stance represents a “very useful tool” for starting a serious discussion on hemispheric drug policy.

“With these reports, we now have a basis from which we can carry forward the debate,” she says. “The question now is how we do that.”

At the general assembly in Antigua, representatives of the 35 OAS member states decided that the organisation would hold an extraordinary session to discuss drug policy in 2014. The United States initially opposed such a session, but in the end accepted the plan, merely adding footnotes to the declaration expressing its concerns.

Still, Youngers believes Washington is “very bothered” by the language of the reports – and by the fact that the rest of the OAS appears to be asserting its own interests at the expense of U.S. regional control.

“After decades of the U.S. being able to dictate policy,” she says, “Latin America is now taking ownership and saying this is an issue which needs to be debated at the regional level by all the states concerned.”

Decriminalisation

The United States is particularly troubled by the OAS’s forward-looking report, Youngers suggests. That report is critical of the approach long held by the United States, which tackles the drug issue primarily through law enforcement and views drug users as criminals.

The analytical report, too, contains language that runs counter to the prevailing system.

“Decriminalisation of drug use,” the report states in its conclusion, “needs to be considered as a core element in any public health strategy. An addict is a chronically sick person who should not be punished for his or her dependence, but rather treated appropriately.”

It goes on to weigh in specifically on marijuana, seemingly amenable to the possibility of removing it from the region’s list of illegal drugs.

“(I)t would be worthwhile to assess existing signals and trends that lean toward the decriminalisation or legalisation of the production, sale, and use of marijuana,” the report concludes.

The issues of decriminalisation of drug use and marijuana in general remain highly controversial within the United States. Federal laws here continue to maintain that the use of all illicit drugs, including marijuana, is a crime.

In only two states, Washington and Colorado, is the private production and consumption of marijuana legal, and that was only allowed following public referendums late last year that resulted in surprise decisions to legalise.

In Latin America, meanwhile, there is a wide array of opinions on decriminalisation of illegal drugs.

Guatemalan President Otto Pérez Molina, who hosted the recent OAS general assembly, surprised many when he came out in early 2012 in support of legalising all drugs. Prior to being elected, he had stated his opposition to such an approach, but apparently had a change of heart after becoming leader of a country wracked with violence related to the trafficking of illegal drugs.

Pérez referred to the OAS reports as a “triumph”.

Other Latin American states, too, have made significant moves toward the legalisation of marijuana specifically. In Uruguay, for example, personal use is permitted, and the legislature is currently debating possible ways to legalise and regulate both the production and sale of the drug.

Youngers says the OAS reports will allow more “experimentation” among countries in the region in crafting their own drug policies, a change she says would be welcome.

No consensus

Others have suggested that the implications of the reports could be far broader, affecting a global anti-narcotics system which concerns nations beyond the Western Hemisphere.

“We are potentially on the cusp of the collapse of the existing international counter-narcotics regime,” Vanda Felbab-Brown, a Senior Fellow at the Brookings Institution, another think tank here, told IPS. “And it looks like the Latin Americans could be the ones to pull the plug.”

Felbab-Brown notes that there is as yet “no consensus” within the OAS on anti-drugs policy, and says many countries are wary of any further relaxation. For instance, countries with high consumption levels (Brazil and Argentina, for example) are “lukewarm” toward less intensive interdiction policies or any further decriminalisation of controlled substances.

She is critical of the OAS reports for professing an interest in harmonised policy, however, while at the same time endorsing a country-by-country approach.

“The reports express an OAS desire to have its drug policy cake and eat it too,” she says. “What this would likely lead to is a scenario of different countries adopting different policies, generating spill-over problems and complaints from neighbours.”

As former presidents, senior diplomats and experts meet in the Lithuanian capital to discuss a litany of rights abuses, lethal epidemics and social destruction caused by repressive drug policies in Eastern Europe and Central Asia, pockets of hope for drug reform are emerging across the region.

Eastern Europe and Central Asia (EECA) is home to over 3.7 million people who inject drugs – almost a quarter of people who inject worldwide. Injecting drug use is fuelling HIV and hepatitis C epidemics in most EECA countries – almost a third of injecting drug users in the region are thought to be living with HIV while even more are infected with hepatitis C.

Many EECA countries also have some of the world’s strictest legislation on drugs. Lengthy jail sentences are routinely imposed for even the most minor drugs offences, and government approaches to harm reduction – including needle exchanges, opioid substitution treatment and social support systems – range from apathetic to actively obstructive.

However, as the enormous scale of the HIV/AIDS and hepatitis C epidemics has emerged and authorities have begun to realise the massive public health implications of drug use, some governments are softening their drugs policies, albeit mildly.

Michel Kazatchine, the UN Secretary General’s special envoy on HIV/AIDS for East Europe and Central Asia, told IPS: “Countries across the Eurasian region, from the Ukraine to Belarus and all the way to Central Asia are showing signs of moving in a more positive direction on harm reduction.”

Delegates at the International Harm Reduction Conference in Vilnius Jun. 9-12 – which brought together more than 800 scientists, politicians, researchers, health workers, doctors and drug user activists from across the world – repeatedly heard how state drug policy across the region remains widely rooted in repression and criminalisation, compounding public health problems and having no effect on reducing drug use.

Drug addicts who spoke to IPS at the conference told stories of police waiting outside harm reduction service centres to arrest addicts for having dirty needles on them, and using the residue in their needles as proof of possession.

But what also emerged from the conference was the success of harm reduction efforts in some countries and surprising reform plans in others.

Georgia’s justice minister, Tea Tsulukiani, outlined plans for sweeping reforms of the former Soviet state’s drug policy. At present harm reduction services are not legalised, there is no treatment for drug users in prisons, and possession of even the smallest amounts of drugs can end in an 11-year jail sentence.

The ministry wants to decriminalise possession of small amounts of both soft and hard drugs, overhaul healthcare services for drug users, and legalise harm reduction.

Tsulukiani told IPS: “At the moment Georgia has a repressive machine to deal with drugs. This needs to be changed to a system that is fair and human.”

In Kazakhstan, meanwhile, the health ministry at the end of last year expanded opioid substitution therapy programmes, and there has been a significant upgrade of funding for harm reduction programmes. It has also introduced a large programme to tackle hepatitis C.

But arguably the greatest changes have been seen in Ukraine, which is already being hailed as a shining example for the rest of the region of how to implement harm reduction programmes and to successfully engage authorities on drug policy reforms.

Ukraine has struggled for the last decade with one of the fastest growing HIV/AIDS epidemics in the world, driven by injection drug use. There are an estimated 290,000 injecting drug users in Ukraine.

But last year, for the first time, the rate of new HIV infections in Ukraine dropped. This has been put down to the widespread implementation of harm reduction programmes.

The Ukrainian harm reduction group International HIV/AIDS Alliance Ukraine implements the largest HIV prevention programme in the EECA, supporting 170,000 drug users in more than 300 cities. The government also recently approved the country’s first hepatitis C programme to combat the epidemic in the country.

The programme was approved largely after sustained pressure from civil society groups who led dialogue with authorities, persuading them of the public health risk of the epidemic.

Andrij Klepikov, executive director of International HIV/AIDS Alliance Ukraine, said other countries in the region should try to follow their lead.

He told IPS: “We need to get the message out about our success. Our programmes have been a success and there is so much we can easily share with other countries in the region – there is no language barrier because Russian is widely spoken around the region and there are similar situations in many countries with regard to the drug problem and related health problems.

“Our experience could be really useful for them.”

Tsulukiani told IPS that Ukraine’s implementation of harm reduction services was one example which her ministry was looking at as it formulates a body of evidence to present to other ministries “to persuade them that by implementing reforms the situation with drug use will not get worse in Georgia.”

But as delegates at the conference heard, for all the progress in these countries, drug users continue to face human rights abuses, a chronic lack of access to harm reduction services and criminalisation which does nothing to combat addiction. Prisons remain flooded with illicit drugs and are breeding grounds for diseases such as HIV and hepatitis.

Tsulukiani told IPS that one of the “pillars” of the reforms she wants to push through in Georgia are changes in healthcare services for drug users and particularly for incarcerated drug users.

“Drug users are seen as criminals and put in prison. All they get there is detox, no treatment, and they come out psychologically destroyed,” she said.

However, some people are hopeful that the situation in the region can be changed for the better, as the example of Ukraine has shown.

Alexander Kwasniewksi, former president of Poland and member of the Global Commission on Drug Policy, told IPS: “It’s not all bad news in the EECA, there are positive things happening, such as law changes and the scaling-up of services in some countries.

“And while much, much more still needs to be done, we can look at the example of the Ukraine and see that with enough pressure and work from NGOs, change can definitely be effected.”

The drug problem should be tackled not as a security issue but as a public health question, with policies for “prevention, treatment and rehabilitation,” delegations from the 34 countries participating in the 43rd General Assembly of the Organisation of American States agreed.

The meeting, which opened Tuesday Jun. 4 in the colonial Guatemalan city of Antigua, on the theme “For a Comprehensive Policy against the World Drug Problem in the Americas,” will conclude Thursday Jun. 6 with a final declaration that, it is hoped, will express a consensus position on the most viable strategies to fight drug trafficking in the region.

However, in spite of agreement that the issue should be addressed from a public health standpoint instead of the law enforcement approach used in most countries in the region today, the draft Antigua Declaration of the General Assembly of the OAS does not include concrete actions, or even a vague road map for the future.

What remains contentious and what foreign ministers must resolve before the conclusion of the OAS meeting is the follow-up mechanism that should be implemented.

Fourteen countries are proposing that the OAS Permanent Council call an extraordinary General Assembly in 2014 in Guatemala, with the goal of moving forward in the debate on new strategies to combat drug trafficking and in the design of an action plan for the period 2016-2020.

Under this proposal, the Inter-American Drug Abuse Control Commission (CICAD) would be in charge of preparatory work for the meeting.

But the other 20 countries (Cuba has been suspended since the early 1960s) are opposed to the proposal, including the United States which is in favour of continuing to debate the drugs issue but is against an extraordinary assembly and CICAD involvement.

Canada is concretely proposing that the OAS Permanent Council, instead of CICAD, determine how the issue is followed up.

Another novelty is the incorporation of “a cross-cutting human rights perspective” and a gender perspective into public policies arising from the OAS summit, with the purpose of reducing demand and supply of illegal drugs.

Too little, too slow

Sandino Asturias, head of the Centro de Estudios de Guatemala (CEG – Centre for Guatemalan Studies), told IPS that the consensus on the need to treat drug trafficking as a health problem, rather than a public security issue, reflects a change in tackling this scourge even by the United States, as it implicitly admits that the armed fight against drug trafficking has failed.

In Mexico, under conservative President Felipe Calderón (2006-2012), more than 83,000 people were killed in the context of the fight against organised crime, according to official figures. But the demand for drugs from consumer countries, especially the United States, has not declined. As a result, there is a growing consensus among governments in Latin America that it is time to consider new strategies.

“Some Latin American countries have been exerting pressure, and the idea that Washington only makes demands and the region must comply is beginning to change. I think there have been developments since the arrival of (U.S. President Barack) Obama, in the sense that there is more self-criticism,” Asturias said.

David Martínez-Amador, an expert with Proyecto Criminova in Mexico, which publishes academic papers on criminology, said that the health approach “has been put on the table.” But he criticised the fact that concrete policies, and sanctions against the use of armies in the war on drugs, have not been agreed.

“Like most of these forums, it ends with motivational speeches, hoping for discussions to continue while waiting for the extraordinary meeting; it’s a waste of time,” Martínez-Amador told IPS.

Several countries are taking steps to implement regulatory frameworks to legalise production of marijuana, including Argentina, Spain, Portugal, and in particular Uruguay, where parliament, at the behest of the leftwing Broad Front government, is debating a bill to legalise and regulate the sale of marijuana.

“This forum is just that, a forum, but when the doors close, each country has to blaze its own trail,” said the Mexican expert.

Turning the page

Guatemalan President Otto Pérez Molina, the host of this week’s OAS Assembly, proposed legalising drugs in early 2012, to shocked reactions.

During his election campaign he had said he was opposed to the idea, and days after he took office on Jan. 14, 2012, the government created a special agency to fight drug trafficking headed by its own drugs tsar, and confirmed that the Kaibil Commando, an elite army unit accused of the worst human rights violations during the 1960-1996 internal armed conflict, would lead the drug war.

No one, not even members of his own cabinet, could foresee that just one month later the retired general, who campaigned for the presidency on promises of coming down hard on crime, would declare that the time had come to consider decriminalisation as a possible solution to the rising tide of drug-related violence.

In April 2012, he tabled the issue again at the Summit of the Americas in Cartagena, Colombia, although the United States responded negatively.

Several hypotheses have been put forward as to why Pérez Molina is defending the legalisation of drugs.

The British weekly newspaper The Economist speculated that the Guatemalan president was trying to get more funds from the United States, while Natalie Kitroeff, a researcher for the New York-based Council on Foreign Relations think tank, said he was exerting pressure to lift the arms embargo imposed in 1978 on Guatemala due to human rights abuses committed during the civil war.

“The president is motivated by his image. (Pérez Molina) wants to be seen internationally as someone committed to democracy, not tainted by the past,” Asturias said.

The OAS summit is an opportunity for him to “turn the page” after the controversial trial of former dictator Efraín Ríos Montt, in which a witness directly implicated Pérez Molina of having participated in massacres in the highland department (province) of Quiché while commanding the Gumarcaj Task Force, Asturias said.

As a hepatitis C pandemic rages among drug users and threatens the lives of millions around the world, a group of high-level leaders called today on governments to reform their drug policies and raise awareness about the public health threat of hepatitis C.

Sharing needles among injecting drug users is the main driver of the spread of hepatitis C in Eastern Europe and Central Asia. Credit: Lauri Rantala/CC by 2.0

In a major new report, the Global Commission on Drug Policy, which includes former presidents, high-ranking United Nations (U.N.) officials and human rights activists, says that punitive drugs laws and repressive policies are helping spread what the World Health Organisation has described as a “viral time-bomb”.

Michel Kazatchkine, the U.N. secretary-general’s special envoy on HIV/AIDS in Eastern Europe and Central Asia, told IPS, “We need to see drug policies changed, funding moved away from the war on drugs and into public health approaches that maximise hepatitis C prevention and care.” He added that raising awareness of the issue was just as important.

The WHO estimates that at least 350,000 people die annually from diseases related to hepatitis C, which causes chronic liver damage.

According to the report, of the estimated 16 million people who inject drugs around the world, about 10 million are living with hepatitis C. In some of the countries with the harshest drug policies, over 90 percent of people who inject drugs have hepatitis C."[Hepatitis C] needs to be taken as seriously as the HIV/AIDS epidemic among drug users."
-- Michel Kazatchkine

The highest numbers are reported in China (1.6 million people), the Russian Federation (1.3 million) and the United States (1.5 million).

“The urgency of the situation cannot be overemphasised,” Kazatchkine stressed. “This needs to be taken as seriously as the HIV/AIDS epidemic among drug users.”

A failed war on drugs

The Global Commission and other advocates for drug law reform have long campaigned to end to the decades-long “war on drugs”, claiming that not only has it wasted vast sums of money and countless human lives, but it has also destroyed communities and utterly failed to halt the multibillion dollar illicit drug trade. The group has also highlighted its catastrophic public health implications.

In a report last year, the commission showed how repressive anti-drug legislation and policies, including long-term jail sentences for minor drug offences and the failure to introduce or properly support harm reduction programmes, marginalised and criminalised drug users, ultimately helping to fuel an HIV/AIDS epidemic.

This phenomenon has been seen most clearly in Eastern Europe and Central Asia – the only region in the world where new HIV infection rates continue to rise – where the sharing of needles among injecting drug users is the main driver of the disease’s spread.

The commission also said that harm reduction programmes, such as needle-exchanges, opioid substitution therapy and support networks for drug users could essentially reverse the HIV/AIDS epidemic in regions such as Eastern Europe.

Hepatitis, like HIV, can be spread by blood-to-blood contact and, globally, most HIV-infected people who inject drugs are also infected with hepatitis C.

Ignoring numbers

While the HIV/AIDS public health threat has received significant attention, the spread of hepatitis C, which is three times more prevalent than HIV among drug users, has been dangerously ignored.

“I hate to compare HIV/AIDS and hepatitis C and say one is worse than the other, but when you look at the overall absolute numbers, such as infections and so on among the drug-using community, they are even higher,” Kazatchkine told IPS.

He pointed to “an overall lack of awareness of the hepatitis C problem at all levels – from governments…to parts of the medical community and among drug users themselves”.

“There has been great awareness of HIV/AIDS over the years because of public campaigns, celebrity support and so on but that has been lacking where hepatitis C is concerned. The silence on this issue needs to be broken,” Kazatchkine added.

The report stressed that while harm reduction services can effectively prevent hepatitis C transmission among people who inject drugs, prevention can only be achieved if such services are accessible and delivered early and at the required scale.

In many places with severe hepatitis problems, access to these resources is severely limited, and where people do have access, quality is often poor.

The report highlighted how harm reduction programmes aimed at fighting the spread of the disease had been successful in Scotland. But it also showed that similar schemes in Lithuania – which has an 80 percent infection rate among drug users – were being accessed by only a tiny fraction of those who needed them.

People working to promote harm reduction and who are in daily contact with drug users at drop-in centres around Eastern Europe – which has one of the highest hepatitis C infection rates among drug users in the world – are pessimistic about the outlook for control of the disease in the region.

“It will definitely get worse before it gets any better,” said Dasha Ocheret of the Eurasian Harm Reduction Network.

She told IPS, “Given the high prevalence of up to 95 percent [among drug users] in the region, the more than 10-year history of the epidemic and almost no access to treatment, it is going to get worse.”

“There will be more deaths and higher infection rates among young injection drug users,” Ocheret believed.

Abdulhakim Belhasi (r), the spokesperson for the Libyan special police unit set up in 2012 under the crime squad to fight drug and alcohol trafficking, with two men from the sqaud. Credit: Maryline Dumas/IPS

By Maryline Dumas
TRIPOLI, Apr 4 2013 (IPS)

In Libya, a dose of LSD or the painkiller tramadol costs 78 cents, and a joint of cannabis is 7.80 dollars. Here, drugs are affordable to the poor for a simple reason. “Slashing prices is a way to create demand and open up a market,” a Western diplomat tells IPS in Tripoli, the capital.

“Prices will go up when enough people are hooked,” the diplomat, who works on defence and security, adds.

There is currently no data on the number of addicts in Libya, but the drug trade is thriving. Dr. Abdullah Fannar, the deputy director at a psychiatric hospital in Gargaresh, a wealthy suburb in east Tripoli, has noticed a change in the number of drug addicts they see there.

“The number of people suffering from addiction to illegal substances has increased. We used to have a special department for drug addiction 10 years ago, and are thinking of reopening it.”

Fannar says he receives patients from prison referred by the police, or people referred by their families, when they are suffering from withdrawal.

According to Fannar, the drug epidemic has hit “the youth and rebel soldiers suffering from post traumatic stress disorder from the war.” Other vulnerable groups — those with little education and military veterans — are easily drawn to drugs and alcohol, both of which are illegal in Libya. In early March, several dozen people died as a result of poisoning from methanol contained in locally adulterated alcohol.

Drug and alcohol trafficking are not new to Libya. Under former President Muammar Gaddafi (1969-2011), a number of United Nations reports made reference to the illegal trade between Africa and Europe via Libya. But with limited border controls under the new Libyan government, the drug trade has grown.

“We know we have a problem of alcohol and drug smuggling, especially on our southern borders,” Colonel Adel Barasi, the spokesperson for the Ministry of Defence, admits to IPS. “We are working on a surveillance strategy, training and equipping the army. God willing, the Libyan army will be able to protect our borders.”

Céline Bardet, an expert on war crimes and transnational crime, tells IPS that drug routes are drawn up at a global level, targeting unstable countries where security is weak.

“This is how things stand in Libya. There is a great deal of trafficking, and it’s likely to get worse,” she says.

Bardet, a consultant with the European Commission, believes that drug processing laboratories may exist in Libya, even if none have been found yet. Still, she points out: “The police are starting to tackle the problem with the support of international aid.”

In an eastern district of Tripoli, a special police unit set up in 2012 under the crime squad is proud to demonstrate the results of its fight against drug and alcohol trafficking.

Abdulhakim Belhasi, the spokesperson for the unit, showed IPS the seizures – seven kilogrammes of heroin and cocaine, unknown amounts of cannabis, 1,400 tablets of tramadol, unknown quantities of whiskey and vodka, and 1,400 litres of adulterated alcohol. The seizures are stored in a hangar, to be destroyed.

In the last drug seizure, which was announced on Feb. 23 by the spokesperson of the Libyan Navy, Colonel Ayoub Gacem, 30 tonnes of drugs were seized and three people were detained on a boat intercepted by Libyan coast guards the day before. The type of drugs found was not specified.

“A war is being waged through the drug trade. They want to destroy the moral fabric of our youth. It can only be Gaddafists in neighbouring countries driving this trade. They are the only ones with this kind of money,” Belhasi tells IPS, appealing for international assistance.

A young drug user who wishes to remain anonymous laughs off this statement. “Having a drink and smoking a joint has never hurt anyone! The ‘beards’ (Islamists) are hounding us so that they can impose Sharia law.”

Khaled Kara, a member of an anti-drug organisation, and former mayor of Souq-al-Juma, a district in Tripoli, denies this. “I wear a beard, I look like an Islamist but I am a moderate,” he tells IPS.

Kara is worried. “The drug traffickers are very violent. They will do anything to protect their business. They are better armed than the special unit. They have rocket launchers, while the police only have handguns.”

The men of the special unit say they would like to be better armed, and add that they also face other kinds of pressures. “My 18-month-old son was kidnapped,” says an officer who goes by the single name of Kamal for security reasons. “He was only taken for a few hours, but when I found him, there was a message for me. ‘If you don’t resign, next time it will be your wife.’”

Asked by IPS if he is afraid, Kamal, who is admired by his comrades for his acts of bravery during the revolution, simply replies: “I am here, I am working.”

One of his colleagues adds: “We fought the revolution for our country, we are fighting the drug dealers for our country.”

But most members of the special unit go out in the field wearing balaclavas.

After years of delays and obstacles, a law regulating the pharmaceutical market has come into effect in El Salvador, giving its people access to medicines at more reasonable prices, with discounts of over 50 percent for some drugs sold in high volumes, like diabetes medication.

“The Medicines Law is a major step forward for health rights” in El Salvador, Margarita Posada, the head of the Salvadoran Association of Community Health Promoters and one of the first activists to present in 2002 a bill to limit the abusive practices of drug manufacturers and retailers, told IPS.

In early January, the Dirección Nacional de Medicamentos (DNM, National Directorate of Medicines), newly created by the law, published maximum retail prices for 4,406 medicines that are on average 35 percent lower than before.

Within this list of named medicines, the drugs with the highest volumes of sales and the highest costs had their prices slashed by an average of 69 percent, good news for consumers who for decades have been paying high prices fixed by an under-regulated industry which has been accused by social organisations of committing marketing abuses.

For instance, the DNM list shows that a medicine for treating high cholesterol, previously sold at 68 dollars, will now cost 37 dollars, and another for diabetes, formerly 23 dollars, will cost 10.73 dollars. (These are chronic conditions, so savings over a year are substantial.)

The price control measures apply only to prescribed medicines, not to over-the-counter preparations, according to the law that was approved in February 2012, but only came into effect Dec. 29 when the executive branch provided it with the necessary regulations to translate it into policies.

Pharmacies have until Apr. 1 to adopt and display the new prices established by the DNM rules.

The World Health Organisation recommends that medicines should not be priced at over five times the international reference price (IRP), but in this country that multiple has been exceeded many times over, according to studies carried out by the state University of El Salvador.

“Of course, there have been abuses on the part of the pharmaceutical industry,” said Posada. The same medicine for treating high blood pressure costs the equivalent of four dollars in Ecuador, but 17 dollars in El Salvador.

The prices on the DNM list were arrived at by comparison with the cost of medicines in the rest of Central America and with IRP listings. A new list of around 7,000 products with significantly lower new prices will be issued in February.

“In (two) months’ time, all these products must be labelled with the maximum retail price,” the head of DNM, José Vicente Coto, told IPS.

As these prices are announced, the pharmaceutical sector remains as hostile as when the legislation was first being debated.

Pharmacy owners, the final link in the chain that has to absorb the price changes, met in December with DNM officials for clarification of the scope of the new regulations. But the meeting turned into a forum for the business owners to voice their collective disagreement with the enforcement of the law.

They say they will lose out because, in two months’ time, they will not be allowed to sell products they bought under the old price regime at their original cost.

“There is no doubt that we will suffer losses. We cannot lower prices just because the law says so,” said Ricardo Iglesias, the owner of La Divina Providencia pharmacy in Chalatenango, in the north of the country.

In general, the pharmacy owners complained that the regulations are forcing them to change their prices, but not the pharmaceutical laboratories that produce the medicines, nor the distributors or middlemen.

The DNM director told them that the law only regulates the retail price, but obviously it is expected that the whole production chain will have to adapt to the new rules, including the laboratories and the distributors.

Meanwhile, the Pharmaceutical Chemistry Industry Association of El Salvador (INQUIFAR), which represents the laboratories, said the sector will not survive with the prices set by the law.

Carmen Estela Pérez, the executive director of INQUIFAR, said they have identified a large set of medicines that they will not be able to sell because the prices fixed by the regulations are below the cost of production.

“The prices we have seen (on the list) are non-viable,” Pérez told a television channel. She underlined that 7,000 direct jobs and 110 million dollars a year from pharmaceutical exports are at stake.

In October 2012 the Supreme Court agreed to try the case of a constitutional challenge from a private citizen against some of the articles in the Medicines Law. This represents the pharmaceutical industry’s last card in its bid to have the legislation, and the price cuts, repealed.

Pérez hinted that the law, promoted by the parliamentary bench of the governing Farabundo Martí National Liberation Front (FMLN), might be an attempt to displace national industry in favour of ALBA Médica (Medical ALBA), an initiative she says aims to follow in the footsteps of ALBA Petróleos, an oil company that is a joint venture between FMLN mayors and the Venezuelan government.

Everything related to the Bolivarian Alliance for the Peoples of Our America (ALBA) is a source of severe irritation among conservative sectors in El Salvador, due to the close relationship between leaders of the FMLN, a former guerrilla group, and the Venezuelan government of President Hugo Chávez and his 20th Century Socialism, which promotes this alliance of Latin American governments.

Political analyst Kirio Waldo Salgado said in a television interview that if ALBA Médica enters the market, there is no need for alarm, because that is what the free market, loudly advocated in El Salvador, is all about.

Various strains of medical marijuana. Credit: scpr.kpcc/cc by 2.0

By Matthew Charles Cardinale
ATLANTA, Georgia, Jan 30 2013 (IPS)

Since the U.S. states of Colorado and Washington fully legalised marijuana via ballot initiatives in the November 2012 elections, efforts to medicalise, decriminalise, or legalise marijuana at the state level are sprouting up like so many hemp stalks on a sunny day.

Eighteen out of 50 U.S. states now allow medical marijuana, used to help cancer patients and others, and 15 others have decriminalised it, meaning that possession is a civil offence that carries no jail time.

“In terms of getting federal law change, we need to get maybe half of the states before we get congress to take some action,” Keith Stroup, founder and legal counsel of the National Organisation for the Reform of Marijuana Laws (NORML), told IPS.

“We tend to focus primarily on full legalisation, regardless of why one smokes,” he added. “The primary reason people smoke, 99 percent of them, is because they enjoy getting high. We’re not going to eliminate the high number of arrests until we completely legalise marijuana.”

In 2006, the group notes, more than 829,000 people were arrested in the United States for marijuana-related offences alone.

National organisations like the Marijuana Policy Project and NORML have both short and long-term strategies to press for continued policy change at the state level.

In the short term, MPP seeks to make New Hampshire the 19th medical marijuana state in the U.S., and to make Vermont the 16th state to decriminalise it.

Illinois is also believed to be on the verge of enacting medical marijuana legislation this year.

In the longer-term, MPP is eyeing ballot initiatives where citizens will have the opportunity to vote on whether to legalise marijuana like alcohol in 2016, including in such states as California and Oregon, two states which have declined to legalise marijuana in previous years.

MPP and NORML believe that it is better to wait until 2016 to attempt to pass these full legalisation initiatives because marijuana-related initiatives tend to do better in presidential election years, which also drive more young voters – who tend to support marijuana legalisation – to the polls.

In the meantime, bills to allow medical use of marijuana have already been introduced in 10 U.S. states, including Alabama, Illinois, Iowa, Kentucky, Mississippi, New Hampshire, New York, Oklahoma, and West Virginia, according to a list provided to IPS by MPP.

Legislators have already announced their intent to introduce medical marijuana bills in another six states, including Maryland, Minnesota, North Carolina, Pennsylvania, Tennessee, and Wisconsin.

In the last Congressional Session, US Reps. Barney Frank, a Democrat from Massachusetts, and Ron Paul, a Republican from Texas, introduced legislation to legalise marijuana at the federal level – meaning that states will get to decide their own policies altogether – but it only received 19 additional co-sponsors.

Frank and Paul both retired from the U.S. House at the end of last year. Numerous bills dealing with marijuana policy at the federal level have been introduced over the years.

“We’ve never had a hearing, or got them out of committee. This year we may get some hearings,” Stroup said.

“Every time a state supports medical use, it puts pressure on Congress to legalise it federally,” he said.

Stroup predicts that medical marijuana will be legal federally within three to four years, by the end of the Barack Obama presidency.

NORML expects to see between eight and 10 full legalisation bills in state legislatures this year as well, although it is not clear whether they will pass as soon as this year.

States where full legalisation is expected to easily pass include Alaska, California, Hawaii, Maine, Massachusetts, Nevada, Oregon, and Rhode Island. In California, Massachusetts, Nevada, and Oregon, the plan is to seek ballot initiatives for 2016.

“We’re waiting to see whether a bill will be introduced in Alaska, but if not we’re going to do a ballot initiative there,” Morgan Fox, communications director for MPP, told IPS.

In Hawaii, legislation to completely legalise marijuana at the state level has already been introduced in the State House by the House Speaker Joseph Souki.

In Rhode Island, MPP is lobbying the State Legislature to legalise marijuana, which it believes could happen as soon as 2014 or 2015.

A federal court ruling on Jan. 22 against Americans for Safe Access (ASA) presents a minor setback on the issue of federal policy and medical marijuana, but will have no impact on the various state and federal legalisation initiatives from going forward.

ASA had appealed the U.S. Drug Enforcement Agency’s refusal to grant its petition to recognise marijuana’s medical value and federally reclassify it from a “Schedule 1 substance” – which includes drugs like heroin and LSD – to a Schedule 3, 4, or 5 substance.

ASA can still appeal to a full appellate court panel and then to the Supreme Court of the United States.

The DEA also has the discretion to reschedule voluntarily at any time, even without congressional action or court order.

And if the U.S. congress passes legislation to legalise marijuana for medical purposes, removing it from the Controlled Substances Act altogether, it would make the ASA case and the other rescheduling petitions moot.

A youth smokes diamba (marijuana) at a gang base in Sierra Leone’s capital Freetown. Credit: Tommy Trenchard/IPS

By Tommy Trenchard
FREETOWN, Jan 9 2013 (IPS)

The air is heavy with the smell of marijuana as Gibrilla (23) expertly rolls a large joint at the Members of Blood (M.O.B) gang base in a poor neighbourhood of Sierra Leone’s capital, Freetown.

He is part of a generation of young people faced with a chronic shortage of jobs, many of whom have turned to routine drug use as a way to pass the time and deal with the stresses of life in what is still one of the poorest countries in the world.

“Most of the young guys smoke diamba (marijuana) here,” says Gibrilla, gesturing towards the slum neighbourhood of Susan’s Bay. He says he has been smoking since he was 11, and usually smokes about 15 joints every day. “I have my first one at about five o’clock in the morning when I wake up,” he told IPS. “It makes me feel good.”

Sierra Leone’s high unemployment rate is fuelling a culture of drug use among the country’s urban youth. Experts say the trend is responsible for acts of violent crime, while medical practitioners are concerned about serious health repercussions for long-term users, which the country is poorly equipped to address.

In another part of the city, Patrick, who estimates his age as “twenty-something”, swigs from a plastic sachet of gin as he talks of his relationship with drugs.

“I use cocaine, marijuana, brown-brown (heroin) and liquor,” he told IPS. “I did not choose to live like this. I was living the street life…sometimes I did not even have somewhere to sleep. I had nothing.”

Patrick now feels he needs drugs and alcohol just to get through the day. “I feel hopeless when I don’t have them,” he explains.

His friend Alimu, heavily tattooed, with the initials of his gang shaved into his hair, speaks of a similar dependence. “I don’t want to stop,” he says. “I need it now.”

Alimu is not sure how much he takes every day, only that he spends all the money he can get on drugs and alcohol.

Assistant Superintendent of the Sierra Leone Police Force, Ibrahim Samura, says he is alarmed by the “spate of drug abuse and addiction”.

“It is worse than before…amphetamines, cannabis and heroin are all a problem,” he says, adding that cannabis is the most widely available. “Cannabis is now grown in almost every district. In some places in the north it is even used as a currency for barter.”

Samura says that there was a large increase in drug use and addiction during and after the country’s eleven-year civil war. “People used drugs to deal with the stress of war,” he explains.

Dr. Edward Nahim at his clinic in central Freetown. Credit: Tommy Trenchard/IPS

Dr. Edward Nahim has been working on drug and mental health issues in Sierra Leone for over 40 years. He agrees that the problem is, to some extent, linked to the civil war. “The conflict itself might be a contributing factor, because once you’ve learnt bad habits it becomes difficult (to stop).”

But he also says that drug addiction in Sierra Leone is tied to a lack of job opportunities. “It is more common amongst the unemployed vagrants, because they don’t have any work to do. (They) are the ones who spend most of their time in the…drug abuse bases or ghettos,” he says.

Impoverished and traumatised youth even use drugs just to “kill boredom”, Samura says.

Youth unemployment in Sierra Leone stands at a staggering 70 percent, according to the World Bank, and many drug users in Freetown say that if the government provides jobs for them, they will no longer feel the need to use drugs and alcohol.

“If I have a job I will stop smoking,” says Gibrilla. “But when I don’t go to work in the morning I just sit down and smoke diamba.”

Ibrahim Jones, a Susan’s Bay resident sporting a ‘Fight Against Drugs’ wristband, also thinks reducing unemployment is crucial to addressing drug use. “People smoke because there are no jobs,” he confirmed.

Samura says he is concerned about the relationship between illegal drugs and violent crime. He sees drug use as closely related to an increase in “gangsterism” in Sierra Leone.

“There are over 250 criminal gangs in this country,” he told IPS, displaying a list with names such as ‘Gang Killers’, ‘Blood Drain’, ‘Hisbola’ and ‘Da Elusive Thugs’.

He believes drug use “spurs them to behave abnormally and do things they wouldn’t do in their right senses.” On drugs, these young people “have the guts to kill, they’ll be brave (enough) to stab.”

The combination of high-grade cannabis and other drugs, together with cheap but potent local liquor, is also having severe mental health repercussions for long-term users.

“Drug abuse is a big problem in psychiatry in Sierra Leone today,” says Nahim, who runs a small mental health clinic in Freetown. He says around 80 percent of his patients, all of whom are between the ages of 10 and 35 years, are suffering from drug-induced psychotic disorders.

“By the time they get to about 40 years they are dead from the physical and psychological complications of these drugs,” he admits.

He adds that the problem is worst with young men, “but the girls are catching up now”.

Sierra Leone lacks the means to effectively treat such victims of drug and alcohol-induced psychosis. Nahim uses what he calls the “cold-turkey method” to treat addicts, physically restraining them and administering “very strong tranquilising drugs” for sedation. “Then after ten days it’s over,” he says.

But relapse rates are high. After treatment there are few safeguards to prevent patients slipping back into drug use.

City of Rest Rehabilitation Centre  is one of only a handful of establishments catering to drug users and the mentally ill on a longer-term basis. More than half of its 40 inpatients are suffering from drug-related problems.

It is run by Pastor Morie Ngobeh, who uses religion and counselling to treat individuals with drug-induced mental conditions. “We rely on prayer, for God to renew their minds,” he says.

Abdulai Bah’s family admitted him to City of Rest to deal with his chronic alcoholism. It is the second time he has been a patient there, but he feels that with a job waiting for him he will be able to stay off alcohol when he leaves in January.

“Some of my relatives promised to help me start my own business. If I start to get myself engaged, I will not drink alcohol again,” he says with conviction.

(END)

While some 200 million people worldwide take cannabis illicitly, Israelis take it seriously - production and use of medical cannabis is legal here. Credit: mista stagga lee/CC-BY-2.0

By Pierre Klochendler
KIBBUTZ NA’AN, Israel , Dec 15 2012 (IPS)

With his shaky hands, eighty-year-old Moshe Roth can barely pour the green powder into his pipe. Seated in a wheelchair, he murmurs in a trembling voice, “Even the scent’s good.”

He survived the Holocaust as a child; he survived a stroke two years ago and almost lost the use of his hands; and he lost his wife last year.

But life’s a bit easier now – with a little help from a pipe packed with pot. “Grieving the loss of a loved one is more bearable with a good pipe between your lips,” he smiles. “It changed my life.

“I imagine you walking with me hand-in-hand, O my forever young, beloved beauty,” says the retired Israeli official and spare-time painter and writer, in a moving eulogy to an old black-and-white portrait of his wife.

Shortly after he takes a hit, Moshe can draw or write with an inspired, confident hand. He’s one of some 10,000 patients who freely, legally consume marijuana in Israel.

At the Hadarim nursing home, cannabis is on the menu of medical treatments. In fact, 19 patients out of 36 use medical cannabis.

“Though we know how to extend life, the pain is great. In geriatrics, the future doesn’t matter any longer. What matters is the now – how to add quality of life to longevity,” explains Head Nurse Inbal Sikorin while opening the safe containing bags of powder and flowers.

Sucked from a syringe, peppered in a yoghourt, administered three times a day in half-gramme doses, cannabis dramatically reduces the need for medication, say doctors, nurses and patients. “Why use painkillers? I feel great with cannabis,” says Rivka Haloup, 85, who suffers from acute arthritis.

Parkinson patients inhale the smoke from a vapouriser six times a day (the nurse wears a mask). But the most potent effect comes from just smoking a joint. “Cannabis doesn’t change reality but makes it easier to accept,” says Sikorin. “At their age, it’s a blessing.”

The “blessing” comes from the pastoral village of Birya, sheltered amidst the Galilee hills.

While some 200 million people worldwide take cannabis illicitly, Israelis take it seriously. Production and use of medical cannabis is legal. A strong medical research sector under adequate government supervision makes Israel one of the world’s most cannabis-friendly countries.

The local industry flourishes. On three acres, the Tikkun Olam farm is the largest of eight greenhouses licenced by the Health Ministry to grow marijuana. Hundreds of kilos are produced year-round from hundreds of heads, all legal.

“Tikkun Olam” stands for “fixing the world” – with a fix of medical marijuana. “We distribute cannabis to patients and through our chain of shops,” explains Research and Development Manager Zach Klein.

The company has a pied-à-terre on Tel Aviv’s Ibn Gvirol Avenue. A guard and closed-circuit TV cameras secure the premises. There’s no sign on the shop, and the metal shutter is pulled down.

But inside, a green world reveals itself. The leafy company logo cites Psalm 118:23:  “This is the Lord’s doing; It is marvellous in our eyes.”

Patients with chronic neurological pain say cannabis is the only drug whose side-effects are welcome. “I’ve tried every pain killer, narcotic and non-narcotic,” says a customer. “This is the first thing that has really helped.”

With all the “holy smoke” paraphernalia on display (bongs, papers, etc), you’d think Tel Aviv was Amsterdam where weed is tolerated (though the sale of the “soft” drug remains technically illegal). People show their medical prescription, and buy the stuff.

The grass comes in all shapes and forms – from chocolate to cake, gum to toffee, honey to balm. At the counter, customers are instructed on how to make the best of it.

Menachem Barabi endured four strokes. He takes 60 grammes of cannabis a month for a mere 370 shekel (100 dollar). “I was in terrible pain, I couldn’t sleep,” he says. “Thank God I take cannabis.”

“I have lymphoma cancer,” says Guy Bar-Yosef. “I lost my appetite and went down 10 kilos. I started smoking joints, and started eating again. It’s healthy, a panacea, a magic potion.”

The twelve strains currently developed by the company’s agronomists often bear names of deceased patients, even eschatological names.

Tikkun Olam Spokesman Shay Amir shows samples neatly arrayed on shelves. ”This is our flagship product – the ‘Erez’, a great analgesic; plus it stimulates appetite, sleep. You ingest it and work without losing your senses. Here, the ‘end times’ – excellent for multiple sclerosis or osteoporosis. This one’s the ‘Raphael’.”

The “Raphael” is named after Raphael Mechoulam, professor of medicinal chemistry at the Hebrew University of Jerusalem – “the grandfather of cannabis”, as they call him. “It’s an excellent drug for certain things. Nothing’s excellent for everything,” Mechoulam says matter-of-factly.

Tetrahydrocannabinol (THC), the psychoactive chemical compound that is the main active ingredient in cannabis, was first isolated by Mechoulam in 1964.

This year, a new strain which contains Cannabidiol (CBD) as an active compound – and no THC – has just been developed for consumption by patients such as children with cancer.

Studies show that CBD relieves inflammation, convulsions, anxiety, depression, post-traumatic stress disorder, schizophrenia and nausea, while inhibiting the growth of cancer cells. It is now used by 500 of Tikkun Olam’s 2,000 customers.

Israel is at the cutting edge of cannabis science, says Mechoulam. “Government officials look at our research data, and they can’t just say no.”

Here, like in most countries, recreational marijuana use is prohibited. “When you want to enjoy yourself, you don’t go to a doctor,” says Mechoulam.

Yet sometimes, the border between recreational and medical use seems blurred. After all, isn’t it the same substance? “Sick people feel down,” says Klein, Tikkun Olam’s research and development manager. “When people get high on THC, they’re up like normal.”

Researchers and growers are now preparing to move the cannabis industry forward. The government is considering distribution through pharmacies starting next year, “like with any other therapeutic drug,” says Mechoulam.

“Israel can be an example, as it provides alternatives to conventional treatment. Cannabis is one of them,” says Tikkun Olam Managing Director Ma’ayan Weisberg. “And it’s organic.”

A packet of 1,000 colourful, empty capsules costs roughly 2.25 dollars and is freely available at major medicine markets in Karachi. Credit: Adil Siddiqi/IPS

By Zofeen Ebrahim
KARACHI, Dec 14 2012 (IPS)

When 26-year-old Muhammad Qasim, a rickshaw driver from Lahore’s low-income Shahadra settlement, died last month, his family was shocked to learn that the cause of death was an overdose – of cough syrup.

On Nov. 23, shortly before going to bed, Qasim drank a whole bottle of Tyno cough syrup, which he was in the habit of doing on a somewhat regular basis.

A little while later, his mother heard strangled noises coming from his bedroom and ran in to see him foaming at the mouth. He was rushed to the hospital, where he died soon after.

Qasim’s death brought the total number of overdose fatalities up to 19 in the month of November alone. According to the police, most of the victims consumed Tyno regularly.

However, results from Qasim’s postmortem found that the actual cause of death was not simply an overdose, but asphyxia – a deficiency of oxygen in the body caused by, among other things, the presence of a toxic substance in the bloodstream.

The tragedy has rekindled public discourse on drug regulation in the country, and highlighted the need to fine-tune the Drug Act of 1976, which has consistently failed to stem the proliferation of counterfeit drugs in the market.

Against the backdrop of the Isotab drug scandal last January, in which 125 patients in Lahore died after consuming adulterated heart medication, it is becoming increasingly clear that the market is awash with substandard drugs that don’t meet the required standards.

These imitation drugs are sold openly in bazaars and shops around the country.

Though statistics on fake drugs are hard to come by, the World Health Organisation estimated back in 2004 that 40 to 50 percent of drugs consumed in Pakistan were counterfeit. In 2006 the country was ranked 13th on a list of the world’s leading producers and sellers of fake medicines.

Nadeem Iqbal, head of the Islamabad-based Network for Consumer Protection, told IPS, “It’s a huge problem and one which cannot be ignored.” Yet, very little punitive action has been taken against those involved in this fraudulent business, he added.

Furthermore, the market is highly resistant to monitoring and quality control.

According to Iqbal, gaps in drug regulations, weak institutions, and lax law enforcement policies are largely responsible for allowing criminals to easily infiltrate medical supply chains.

Despite a public outcry – led by the media and consumer protection groups – Iqbal is convinced that the situation will not change until “proper laboratory testing facilities” become available.

Efforts underway

A slew of drug-related deaths triggered a move towards the establishment of the Drug Regulatory Authority of Pakistan (DRAP), which the president signed into being last month, to control the country’s pharmaceutical industry and ensure proper licencing, pricing and quality control of drugs.

According to National Regulations and Services Minister Firdous Ashiq Awan, “No pharmaceutical company owner will be considered for membership of the Authority’s (public) board.”

While acknowledging that this is a move in the right direction, many  experts are sceptical that the newly formed agency will be able to bring the drug industry to heel.

Dr. Samrina Hashmi, president of the Pakistan Medical Association’s Sindh chapter, believes that rampant corruption in the industry makes the best of laws nearly impossible to implement.

“This agency requires transparency in governance. People should be taken on board (based) purely on merit and should be technically competent, otherwise there is danger of (the agency) falling prey to vested interest groups,” Dr Sania Nishtar, founder of the Islamabad-based non-profit health policy think tank Heartfile, told IPS.

In addition, existing laws need to be properly imposed by increasing the inspection force, speeding up court processes and handing out tougher punishments, according to experts in the medical field. Under the 1976 Drug Act, the maximum punishment for counterfeiting is ten years’ imprisonment and a fine, depending on the nature of the crime; but this sentence has yet to be handed down to a single perpetrator.

Nishtar hopes the DRAP will bring about amendments in the drug law, which has “many exploitable gaps” and requires massive amounts of resources and technical expertise in order to become a truly independent body, capable of superseding corporate agendas.

Additionally, the number of drug inspectors, pharmacists and testing laboratories needs to be increased exponentially.

At the moment the country has a field force of 250 drug inspectors to monitor over 400 pharmaceutical companies and 50,000 pharmacies, according to Nishtar. “Not only are these numbers paltry, but even (inspectors’) expertise is weak,” she pointed out.

Only 200 trained pharmacists are spread out between the country’s 50,000 chemists’ shops. “It would take the country more than 20 years to train pharmacists for these outlets,” Nishtar said. “I am not sure if the country has the capacity to do that.”

A 2001 survey of 311 of the 506 pharmacies in the garrison city of Rawalpindi, published in the International Journal for Health Care, showed that only 19 percent of pharmacies met licencing requirements, only 22 percent had qualified pharmacists, only 10 percent had temperature monitoring and only four percent possessed an alternative supply of electricity for refrigerators.

The research concluded that most drug sellers had “fragmentary knowledge regarding drug dispensing and storage, and improper dispensing practices”.

DRAP should undertake the task of setting up a network of state-of-the art drug testing laboratories at the provincial level in an attempt to quickly identify the efficacy and quality of all ingredients used, strengthen pharmacists’ capacity, and promote the production of low-cost generic medicines that can be made available to the poor, said Hashmi.

According to the WHO’s ‘World Medicines Situation Report’, Pakistan spends 77 percent of its healthcare budget on buying medicines. But many consumers end up purchasing fake drugs, which have not been properly tested or have passed their sell-by date.