GENEVA – Fifty years ago this week, US President Richard Nixon declared that drug abuse was “public enemy number one” requiring a “tough on crime” approach in the United States and abroad. The “war on drugs,” which expanded in parallel with the global political, military, economic, and cultural hegemony of the US in the post-World War II decades, has delivered the exact opposite of its own stated aims. Today we have both plant-based and synthetic production; low-scale and high-level trafficking of illicit narcotics; disproportionate sentencing and over-incarceration; violence and rights violations; and money laundering and enrichment of organized crime – all strengthened, not weakened, by repressive responses to illegal drugs.

Since 1971, every US administration has reaffirmed the war on drugs approach. This policy choice has become so culturally, socially, and politically embedded in our societies that political leaders feel constrained not to change it. Under President Barack Obama, an assertive policy known as the Attorney General’s Smart on Crime Initiative attempted to address the disproportionately harsh and ineffective federal prison sentences for drug offenses, but without questioning the deep-rooted flaws of the war on drugs, this initiative ended up merely tweaking incarceration rates.

In 2018, President Donald Trump’s administration sought to re-energize the war on drugs by hosting a global call to action at the United Nations General Assembly. This diplomatic display, which lasted 15 minutes, highlighted the end of the prohibition consensus: a number of countries, including Germany and New Zealand, refused to endorse it.

Until now, there has been scant support for lifesaving and cost-effective harm-reduction services among US policymakers. These services are concerned with reducing the health and economic costs of problematic drug use. By providing a clean needle to a person who injects drugs, public policy accepts that that person will engage in an illegal activity, but also that the higher priority is to ensure that the person does not die of an overdose, become infected, transmit HIV or hepatitis, or resort to petty crime to buy drugs and drug paraphernalia.

Harm-reduction services are needed now more than ever. Some 81,000 Americans died from drug overdoses in the year ending in May 2020, according to the Centers for Disease Control and Prevention – owing to a record number of opioid overdoses.

Fortunately, this death toll seems to have awakened US policymakers. In 2021, President Joe Biden’s administration unveiled a surprisingly bold drug policy initiative that emphasizes expanding treatment and harm reduction. By committing to an evidence-based, public-health approach, Biden is signaling that the strategies of repression and punishment have failed.

The Biden administration’s emphasis on “evidence-based harm-reduction efforts” is a radical departure from the drug-war approach. These efforts embrace a series of effective and evidence-backed health services: the distribution of medications to reverse the effects of opioid overdoses and of sterile injecting equipment, complemented with HIV and hepatitis C testing. In an unparalleled move, the US government will also invest $30 million in harm-reduction services as part of the American Rescue Plan.

These new policy approaches are also aligned with a range of state- and city-level efforts to address the overdose crisis. In the last few years, cities as diverse as Philadelphia, Ithaca, Seattle, Santa Fe, and Atlanta have been exploring more balanced policy between repression of and support for illicit drug users, similar to the four-pillar drug strategy in Vancouver, which in turn was inspired by local and national European policies.

But now that the Biden administration is changing drug policy for the better, one hopes that the US will champion a shift to harm-reduction policies internationally. In the last decade, the national and international funding of these services has contracted, covering a mere 5% of the estimated global need. More attention should be paid to the experiences of countries like Switzerland, which massively invested in harm reduction and reduced both the size of its drug-injecting population and the rate of HIV transmission.

Sadly, countries where harm-reduction services are either limited or banned outright are the leaders and drivers of the global spread of hepatitis, tuberculosis, and HIV. Just as America is one of the largest worldwide contributors to the treatment and prevention of HIV/AIDS, America must now help steer the world away from failed repressive drug strategies.

The two issues are closely connected. The US has invested $85 billion in the global HIV/AIDS response since 2003, saving many millions of lives. But drug policy, too, must change if we are to remove HIV as a global public health threat. As long as people who use drugs engage in dangerous modes of consumption, such as repeatedly sharing needles because they have no access to harm-reduction services, or because they don’t want to use these services in fear of legal sanctions, HIV will continue to stalk our societies.

The US led the world into the war on drugs, and now America must help lead us out of it. The war on drugs does not and cannot reduce harm. It fuels negative and perhaps unintended consequences, and it is outdated in the face of new challenges and threats. The illegal-drugs market is rapidly adapting to the twenty-first century and to the Fourth Industrial Revolution. The production of plant-based drugs is increasingly competing with the production of highly potent synthetic drugs closer to their consumers. The illegal market is slowly shifting away from our streets and towards crypto domains linked directly to our homes.

Fifty years of failure is enough. Now is the time for the US to lead the world toward humane, people-centered, and evidence-based drug policy for the twenty-first century.

BOGOTÁ – US administrations come and go, but America’s repressive drug strategy remains a constant. Ever since President Richard Nixon declared a “war on drugs” in 1971, the world has hoped for a change in US drug policy with every new administration. Will President Joe Biden’s administration finally abandon his predecessors’ tried-and-failed approach?

In the 50 years since the war started, drug-trafficking cartels have seldom shied away from fighting it, resorting to murder and kidnapping and violently challenging law-enforcement agencies. Meanwhile, policymakers have used military resources and tactics to fight criminal organizations, and have spent billions of dollars on law enforcement and prisons.

But all these efforts have been to no avail, because demand for illegal drugs is steady and supply adaptable. Drug use is related to people’s circumstances or choices, so reducing demand through coercion is wishful thinking. No country in the last half-century has succeeded in eradicating the illegal drug market through enforcement.

My country, Colombia, knows better than any other how high the cost of a militarized response to illegal drugs can be. For decades, the United States heavily promoted misguided policies based on forced eradication and coercive demand reduction across the Western Hemisphere. And many of our neighboring countries’ institutional frameworks have been shaken to the core by pervasive criminal corruption and the collateral damage from militarizing civil security.

Worryingly, countries in West Africa (part of a major global cocaine-trafficking route) and on the East African coast (part of a heroin route) are adopting similar drug-control tactics. These regions must not repeat the mistakes made in the West, where the consequences of US policy choices include rampant violence and neglect for public health and the rule of law. Of the world’s 50 most violent cities, an astounding 42 are in Latin America.

Colombia endured multifaceted violence for decades, while trying to raise its population’s living standards and establish democratic governance and institutions. The world should understand from our experience that, unlike in movies and television series, there are no lone heroes to decapitate transnational criminal organizations. Fighting organized crime requires political will, targeted efforts, and above all, coordination between countries. Violent crackdowns on illegal drugs do not stop supply, trafficking, and demand from increasing steadily.

Against this background, the new US administration fills many with hope. In their campaign platform, Biden and Vice President Kamala Harris pledged to end the federal ban on marijuana and not to imprison Americans solely because of drug use.

But Biden and Harris have not questioned America’s use of drug courts, which decide on rehabilitation and probation measures for people addicted to illegal drugs. In which other area of health care does a person have his or her treatment prescribed by a judge rather than a doctor?

We can all agree on the dangers that drug consumption and trafficking pose for our societies. But those who use drugs should be offered voluntary harm reduction and treatment programs. Problematic consumers need a trusting, therapeutic relationship with a physician, not sentencing by a judge.

I therefore strongly hope that the incoming director of the White House Office of National Drug Control Policy (the US “drug czar”), as well as Secretary of State Antony Blinken and public-health leaders, will use the experience and evidence we now have to promote policies that treat addiction and address the multifaceted nature of the problem. It is imperative to find common ground for collaboration and to refocus law enforcement on criminal elites.

This means, among other things, permitting countries where illegal drugs are produced to determine their policy responses. In particular, they should be able to target law-enforcement efforts at violent criminal elites, instead of focusing on eradicating subsistence farmers’ crops or arresting marginalized consumers.

The US Congress, through the Western Hemisphere Drug Policy Commission, has expressed similar views. International drug policy needs to reaffirm the importance of law enforcement and hard-law instruments against criminal bosses and violent traffickers, and shift focus to soft-power measures to assist vulnerable populations such as traditional farmers and addicted consumers.

More peaceful, cost-effective drug control requires a new approach based on education, prevention programs, voluntary agricultural substitution and infrastructure development, and partnerships with affected communities. It also calls for comprehensive treatment and harm reduction for problematic drug users and informational workshops for occasional consumers.

The Biden administration says that it will be guided by science and evidence. Until now, no US administration has wanted to acknowledge the clear signs that the war on drugs has utterly failed to achieve any of its objectives. By reforming US drug policy over the next four years, Biden could chart a much more promising course for us all.

DAKAR – By now, it has become almost a cliché to say that the war on drugs has failed. The prohibitionist approach, most fully articulated by former US President Richard Nixon, has done little to curb drug use, but it has had devastating consequences for individuals and societies worldwide. In Latin America, to cite one example, it has led to repressive state policies and the militarization of interdiction efforts at the expense of policies addressing the detrimental effects of drug use on health and social welfare.

This approach risks causing similar damage in West Africa, as the region’s own war on drugs drives an increase in state repression and human-rights abuses. In 2014, the West Africa Commission on Drugs noted that criminalizing every aspect of drug-related activity, including possession for personal use, has resulted in a host of negative consequences. Drug use has been driven underground, corruption has grown, and prisons have become massively overcrowded. And it is overwhelmingly the poor – many of whom should be helped rather than punished – who are thrown in jail, while wealthy drug users buy their way out of criminal sanctions.

But repression has not prevented West Africa from becoming a major transit hub for cocaine, heroin, and cannabis. In March, Nigerian authorities discovered and dismantled the country’s first industrial-scale crystal-meth lab, indicating that the production, distribution, and consumption of synthetic drugs could be rapidly rising in the region. West Africa lacks reliable trend data regarding drug consumption, but there are signs that it is on the rise.

Given the severity of the crisis, West Africa cannot afford to be silent at the upcoming United Nations General Assembly Special Session on the World Drug Problem. A more humane response must be adopted, one that respects human rights and treats the problem as a public-health challenge.

In January, representatives from 11 West African countries, including drug-control agents, convened in Accra at a meeting organized by the West Africa Civil Society Institute. Those present declared their support for refocusing the drug-control effort on public health and human rights, rather than criminal justice.

A similar approach is advocated in a wide variety of position papers and declarations, including the 2013 African Union Plan of Action on Drug Control, the Common African Position for the UN General Assembly Special Session on the World Drug Problem, the Addis Ababa Declaration on Scaling up Balanced and Integrated Responses Towards Drug Control in Africa, and the Abuja Declaration adopted by the Economic Community of West African States. As the Common African Position puts it, “the main objective of drug policies should be to improve the health, safety, welfare, and socioeconomic wellbeing of people and societies.”

West African countries must use the UN special session to make a clean break with the failed approach of the past decade. The region’s leaders must push for genuine reform and not allow the status quo to be reinforced through the strengthening of existing frameworks.

For starters, we must dispel the notion that progressive drug policies will result in a laissez-faire attitude toward drug use and an increase in drug trafficking. Experience in other parts of the world has shown that alternatives to prison for nonviolent, minor drug offenses can lead to better health and law-enforcement outcomes, as drug users are steered to the services they need and police, freed from chasing low-level offenders, can pursue major traffickers.

The UN’s special session must be used to lay the foundation for the reform not just of laws and policies, but also of perceptions and attitudes. As important as policy reforms can be, their effectiveness will depend on lasting changes in societal norms and mores. A clear and unequivocal message is needed, one that enables civil society to sway policymakers not only at the international and national levels, but also at the community and local levels.

Traditional and community leaders must be made to understand that the criminalization and incarceration of users does not end drug abuse, but merely fills prisons. And they must also be reassured that decriminalizing drug use does not eliminate all sanctions, as administrative penalties and treatment referrals can still be used to deter consumption.

If the UN special session is to realize “a society free of drug abuse,” it must do more than reaffirm previous agreements and pledges. It must be bold and progressive, by proposing the most cost-effective and humane approach to address global drug use. That can happen only if the affected countries and regions – including West Africa – speak out loudly and collectively.

JOHANNESBURG – While the world has been fixated on the results of the presidential election in the United States, less attention has been paid to another outcome of last Tuesday’s vote: significant steps toward decriminalization of drugs in several US states. One state – Oregon – is now set to abolish criminal penalties for possession of small quantities of all illegal drugs, from heroin to methamphetamine. This approach should be applauded – and adopted far more broadly.

According to 2018 data, about 269 million people around the world use illicit drugs, including 11 million who do so by intravenous injection – a method that carries additional risks. Nearly half of those who inject drugs are living with hepatitis C, and a staggering 1.4 million are living with HIV. According to the United Nations Office on Drugs and Crime, in 2017 alone, more than a half-million people died as a result of drug use.

This is an entirely preventable tragedy, fueled by the cruel and counter-productive approach exemplified by the so-called war on drugs. Launched in the 1970s by US President Richard Nixon, drug possession today is a criminal offense in most countries, and users face severe social stigma.

The war logic is simple: the risk of harsh punishment will act as an effective deterrent, causing drug use to diminish. But this isn’t what happens at all. Despite increasingly punitive approaches, global drug sales and use continue to increase, causing more overdoses, HIV, hepatitis C, and tuberculosis.

The threat of punishment and discrimination doesn’t drive people to quit or avoid drugs, but rather to hide their use, including from their doctors. By discouraging those who use drugs from engaging with health systems, criminalization and stigmatization – as well as racism, which compounds drug-related discrimination – contribute to negative health outcomes for individuals and communities that extend far beyond the drugs themselves.

There is a better way. Rather than attempting to force people to forswear all drug use, we should be attempting to minimize its negative impact on their health and well-being. So-called harm-reduction interventions include needle-exchange programs, whereby people can access sterile needles and syringes; drug-consumption rooms, where people can safely use drugs without risking an overdose; opioid agonist therapy, such as methadone replacement; and housing and employment initiatives.

Decades of research and practice prove that harm-reduction interventions work and are cost-effective. For example, opioid agonist therapy decreases the likelihood of overdose. And needle-exchange programs substantially reduce the spread of hepatitis C and HIV among people who inject drugs, thereby helping to decrease transmission overall. In Portugal, HIV rates have plummeted since possession of all drugs was decriminalized and harm-reduction interventions were ramped up almost 20 years ago.

The good news is that, as the latest report from Harm Reduction International (HRI) reveals, significant progress has been made in the provision of such services. Over the last few decades, 86 countries have implemented needle and syringe programs, and 84 provide some form of opioid agonist therapy. But much more remains to be done.

As the HRI report shows, there are still enormous gaps in access to harm-reduction services, even in places that offer them, such as Australia, Canada, and Western Europe. For example, there are few services tailored to women and gender non-conforming people. And harm-reduction services consistently fail to meet the needs of the groups that have borne the brunt of punitive drug policies for decades, such as people of African descent including African-Americans and indigenous people around the world.

Moreover, the services that are needed are often concentrated in cities, making them difficult to access for those in rural areas. And incarcerated people, who are at a higher risk of contracting HIV and hepatitis C while in prison – and of overdosing when they are released – usually have no access to them at all.

According to HRI, progress in expanding access to harm-reduction programs has been stalled for more than five years. As long as limited resources are being allocated to law enforcement, rather than harm reduction, significant further gains will remain elusive.

When people who use drugs suffer and die, they are often reduced to statistics and dismissed as “criminals” or “lowlifes.” But they are our friends and families, neighbors and colleagues. They are human beings, who have a right to health, equality, and respect, regardless of their gender, sexuality, race, nationality, legal status, or drug-use habits or histories.

If COVID-19 has taught us anything, it is that the health and well-being of all are interconnected. Only an approach to drug use based on public-health imperatives and human-rights principles – and that protects the most vulnerable among us – can end a war that never should have been fought.

The views expressed here do not necessarily reflect those of the United Nations.

BARCELONA – The number of women murdered is increasing in most of Central America and Mexico. In some countries, such as Honduras, the increase is four times that of men. Moreover, many of these murders are committed with extreme violence – sexual savagery, torture, and mutilations – by perpetrators (often involved in organized crime) acting with a high degree of impunity.

In countries like Chile, Argentina, and Costa Rica, where overall levels of violence are lower, the murders of women are usually committed with less violence, by partners or ex-partners in the context of “domestic abuse.”

In Latin America, all of these crimes are known as “femicides”: murders of women precisely for being women. Cases associated with domestic violence are treated leniently by courts; in some countries, jealousy or the absence of previous convictions can reduce the punishment. Those committed by strangers, often with intense cruelty – and often linked to organized-crime groups such as the Central American maras – rarely end up in court at all.

But the reality of Latin America in recent years shows some crossover between these categories. Brutal murders of women also occur in countries such as Argentina, where a surprising number of women have been burned by their partners or ex-partners. In Mexico, women have been murdered by hit men, hired by their husbands or partners to make the killing look like the work of organized crime. And, in Central American countries, women are murdered by criminal groups as a kind of threat or message to their husbands or partners.

Nonetheless, femicide in Latin America remains a matter of different realities. The rate for women in El Salvador is the highest in the region: 13.9 per 100,000. In Guatemala, the rate is 9.8 per 100,000 women, and in Mexican states such as Chihuahua, Baja California, and Guerrero, the rate has almost tripled from 2005 to 2009, to 11.1 per 100,000. On the other hand, rates in countries such as Chile and Argentina are no more than 1.4 per 100,000.

That difference underscores a fundamental reality: violence associated with the “war on drug trafficking” and organized crime – including state corruption – in some countries has specific consequences for women. Just as in war, cruelly raping women is symbolic: it creates cohesion within armed groups, reaffirms “masculinity,” and is a form of attacking “the enemy’s morale.”

But “domestic” violence is also worsening: although women all over the world are threatened by their partners, the risk is substantially raised when men have easy access to arms and a very slight probability of being taken to court, as is the case in Mexico and Guatemala, where the rate of impunity is over 95%.

Since 2007, various laws have been adopted specifically to sanction femicides: in Costa Rica and Chile, such laws are aimed solely at those murders committed by partners or ex-partners, while in Guatemala and El Salvador, murders committed by strangers are included. Similar laws and initiatives have proliferated in Mexico, too, in recent months.

It is not clear whether these laws will actually punish the crimes or merely reduce the visibility of the numbers: if a crime requires certain difficult-to-prove elements in order to be considered a femicide, a large number of murders will remain on the books as simple homicides, and the authorities will be able to say they have “reduced” the femicide rate.

In countries such as Chile or Costa Rica – as in much of the world – advocates for women’s rights demand that the state prevent femicides by responding swiftly and effectively to death threats and abuse. In the most affected countries, they also demand that murderers be tried. But new laws are not enough, given severely debilitated police and judicial systems in much of the region.

As long as the “war on drugs” remains good business not only for traffickers and money launderers, but also for developed countries’ arms industry, the flood of weapons in the region will continue to fuel violence – including extreme manifestations against women – and weaken the judicial system. Uncontrolled arms, together with impunity, make killing easy and cheap.

To be sure, violence against women exists in times of peace. But it increases and worsens in times of war. The “war on drugs” must end, and that requires worldwide changes in drug-control policies that, unfortunately, no anti-femicide initiative mentions. Ending that war won’t eradicate femicides in Central America and Mexico, but it could at least reduce the murder rate of women to the more “salutary” numbers of other countries that are lucky to be farther away from the main trafficking routes.

Read more from our "Breaking the Drug-War Habit" Focal Point.