On 26 and 27 August, 2010, the Second Latin American Conference and the First Brazilian Conference on Drug Policy took place in the noble hall of the National Law School of the Federal University of Rio de Janeiro (Brazil) with more than 400 attendees and the presence of top drug policy experts from thirteen countries in Latin America. It was the most specialized meeting to take place to date in the region. The Conference was organized at the regional level by Intercambios, a key Latin American civil association that has worked for fifteen years on issues of harm reduction and drug policy. And, locally by Psicotropicus, a pioneer in bringing the drugs debate out from obscurity and bringing it into everyday discussions in Brazil.

With the support of the Pan American Health Organization (PAHO) and other UN agencies, the meeting focused on current legislative reforms in different countries, the ineffectiveness of military responses to drug trafficking and the alternatives that are gaining force in the region. “Regarding drug policy, Latin American is more advanced than the United States,” concluded the participants after two days of debate.

“In Latin America we have ´no colonized´ perspectives: there is today a position on drug policy from Latin America and not about Latin America,” said the National Secretary of Justice of Brazil, Pedro Abramovay, inaugurating the conference. Also participating in the opening panel were: Paulo Roberto Yog de Miranda Uchoa, National Secretary for Drug Policy (SENAD); Pedro Gabriel Godinho Delgado, coordinator of the Mental Health Program of the Ministry of Health of Brazil, Luciana Boiteux, coordinator of the Research Group on Drug Policy and Human Rights in the National Law School of the Federal University of Rio, Luiz Paulo Guanabara, Director of Psicotropicus, and Graciela Touzé, President of Intercambios.

It was the first time that such a large number of experts and policy makers on drug issues met in Brazil. At the opening ceremony, Lula government officials differentiated themselves from the past twenty years of U.S. policies known as the paradigm war on drugs. “Today it is impossible to talk about militarism in our politics, when it is compared with United States policy,’ said the national secretary of the SENAD. Uchoa reminded the audience that most of the state and city councils that are being encouraged by the government of President Lula Da Silva for social participation in the definition of public policies have yet to be created.

Luiz Paulo Guanabara, Director of Psicotropicus, local organizer of the conference, claimed that there is still a need to “demilitarize the policy of decriminalizing drugs and health care” since “an economic and military system leads to intolerable levels of violence, as we have seen today in Mexico and we have seen before here in Brazil.” Founded in 2003, Psicotropicus aims to reduce significantly the harm caused by current drug policy through advocacy, dialogue, reliable information, supporting research and generating knowledge to have a society where the “global drugs problem” is approached from a different perspective.

From Intercambios, a civil association for the study and treatment of drug-related problems founded fifteen years ago in Argentina, promoter and creator of the conference, its president Graciela Touzé warned that “the shift in discourse that involves recognizing the failure of the war on drugs has not yet been translated into concrete policies that reach people.” She emphasized the need to adopt non-repressive security policies and long term state policies.

Finally, Pedro Gabriel Godinho Delgado, coordinator of the Mental Health Program of the Ministry of Health of Brazil, said “it is necessary to have public health policy responses in the areas of social inclusion and prevention”. And that “the current law is an important step forward because it makes a distinction between drug users and traffickers, but it needs further review.”

During the opening ceremony, representing the university and as the host of the law school, Luciana Boiteux reminded the audience that this same hall hosted the Senate for the Brazilian empire: “They signed here the law that ended slavery; we expect, here too, a contribution to concrete measures to achieve more humane and health-oriented drug policies”.

The meeting aimed to promote “an informed social debate with a view to promoting non-punitive policies, based on scientific evidence, to respond effectively to the various problems associated with drugs” and generate an exchange at the regional level to “update the map on drug use, associated problems, policies and interventions in the region.” The meeting aimed to promote “an informed social debate with a view to promoting non-punitive policies, based on scientific evidence, to respond effectively to the various problems associated with drugs” and to generate an exchange at the regional level to “provide an update on drug use, associated problems, policies and interventions in the region”.

A Human Rights Approach

Worldwide, people who use illicit drugs face discrimination, rejection and violence based on the arguments that they are “dangerousness” or “incapacitated.” What kind of drug policies foster human rights violations? Are there alternative actions? What are the alternatives? These issues were central in the human rights and drug policy panel, which opened the first day of the conference with Rubem Cesar Fernandes, Viva Rio’s Executive Director and Executive Secretary of the Brazilian Commission on Drugs and Democracy as moderator.

“The Brazilian legislation has moved beyond prejudice but still has clear deficiencies,” acknowledged Pedro Vieira Abramovay, National Secretary of Justice, and Ministry of Justice of Brazil: “There is a limit between trafficking and using drugs. However, a person that is finally considered ay user, if the policeman said in the beginning that he was a drug trafficker, he must spend the entire legal process in prison.”

In turn, Jorge da Silva, a member of the Brazilian Commission on Drugs and Democracy and ex- Secretary of State for Human Rights of Rio de Janeiro (2003-2006), described his experience in the military police and how he discovered the ineffectiveness of repressive policies. Quoting the case of Portugal he explained “that decriminalization does not increase consumption.” He expressed his “radical support” for campaigns to decriminalization marijuana because “we have to start somewhere.”

The president of the National Institute against Discrimination, Xenophobia and Racism (INADI) from Argentina, Claudio Morgado, stated that he is against the approach that does not consider the social aspects of risk factors as part of the problem. “The stigma of ‘addicted’ isolates the person from his or her identity: male, female, friend, and lover. The result is an approach that promotes social rejection. Finally he said that INADI supported the Mental Health bill that is being debated in Argentina and has partial approval of Congress. In its Article 4 provides that drug users have all the same rights as all that are covered by the law. “It’s a non-discriminatory legislation that we hope will progress,” he said.

To close the panel, Kasia Malinowska-Sempruch (Poland), Director of the Global Drug Policy of the Open Society Institute (OSI), focused on public health policy and harm reduction: “We can’t focus on abstinence-based policies. If abstinence is the only desired outcome we will not have access to methadone, for example. It doesn´t matter that methadone treatment of opioid allows the users back to work; it doesn’t matter that it reduces the suffering of the family; it doesn’t matter that it opens the doors for the users: as methadone does not lead to abstinence, it will not be offered in treatment,” she concluded.

The view of International organizations

What level of priority is this on their agendas? How could attention be increased? With these questions the panel, “Drug users on the multilateral organisms agenda,” joined together representatives of the United Nations Office on Drugs and Crime (UNODC), the Joint Programme on HIV / AIDS (UNAIDS ), the Pan American Health Organization (PAHO / WHO), the United Nations Development Programme (UNDP) and the International HIV/AIDS Alliance.

“Drug policy has to do with thinking about prevention, health promotion and respect of human rights, public safety, while also taking into account public security and the fight against organized crime,” said Bo Mathiesen, UNODC Regional Representative Brazil and the Southern Cone. For his part, Pedro Chequer, UNAIDS Country Coordinator in Brazil, highlighted the role of the social movement of HIV and drugs and said that “it is necessary to expand the supply of services for HIV positive drug users.”

From PAHO / WHO, Marcelo Vila, sub-regional coordinator for HIV/STD, said that prejudices and stigma against drug users also exist in public health: “If there is no health services for drug users, and if they can be judged for simply using drugs, they do not seek health services.” In the same way, David Rui Villa-Franca, representative of UNDP, said that from the agency “is prioritized human development in general and not restricted to health approach only”.

Finally, Javier Hourcade Bellocq, regional representative for Latin America and the Caribbean of the International Partnership against HIV/AIDS, executive director of Friends of the Global Fund - Latin America and the Caribbean, said that “in countries where drug users are jailed, there is a greater prevalence of HIV.”

Decriminalizing and providing services without conditions

The first step to achieving the involvement of social and health policies is to avoid the prosecution of drug users. This became clear in the Panel “social-health policies”, where the experiences of Portugal and Brazil were presented with a critical review of achievements and challenges.

The first presentation was provided by Manuel Cardoso, a member of the directive board of and Drug and Drug Addiction Institute of Portugal, experience repeatedly cited during the meeting for having decriminalized the possession of all substances in 2001: “The great framework is treatment for all, whether they come or we go for them and the second is innovative policies such as harm reduction.” The official said that they are guided by “the principles of humanism and pragmatism, don´t deny care to anyone and use scientifically proven methods.”

Luciana Boiteux, a member of the Advisory Council of the Brazilian Network for Harm Reduction and Human Rights (REDUC), noted that 70 percent of those arrested for drug trafficking are poor, unarmed men arrested in the street with small amounts of drugs. As a result, she said that operations in Rio de Janeiro “are counterproductive because it does not inhibit the illicit market but brings much death.” She concluded: “the current policies are ineffective, but a part of the international bureaucracy is satisfied with the status quo, so it does not change”.

The coordinator of the Mental Health Program of the Ministry of Health of Brazil, Pedro Gabriel Godinho Delgado, acknowledged that, despite the basic principle of universality, “the fact is the health services are reluctant to attend users who do not accept discontinuation of drug use.” He proposed two tasks: 1) attracting drug users from therapies that are not based on conditions of total abandonment, “because they become blackmail” and 2) providing non-compulsory and comprehensive treatment, “with all the necessary areas for reducing social vulnerability”.

The moderator of the panel, the secretary general of the National Drugs Council of Uruguay, Milton Romani, said that the socio-sanitary strategies presented agreed on the need to bring the issue of drugs into the field of health. Also, decriminalize users and provide universal care without stigma or discrimination as requirements for effective responses.

A good practice guide in policy reforms

At the end of the afternoon, Ann Fordham, coordinator of the International Drug Policy Consortium (IDPC) presented the Advocacy Guide prepared by the Consortium. “At a time when the world is beginning to see drugs as a health issue and we have the first examples of decriminalization of users, with proposals for alternatives to the criminal justice system, we saw the need to disseminate these experiences,” she said.

The book seeks to serve as a tool to replicate experiences and convince more governments around the world about the possibility of carrying out changes towards decriminalization and proportionality in sentencing in drug trafficking cases. The Guide was discussed by the deputy of Rio de Janeiro Carlos Minc, former Environment Minister of Brazil, who supported the principles on which the publication is structured and added that “the war on drugs not only fails to meet its objective of eliminating the supply of drugs, but also has among its side effects the promotion of territorial control of areas of the city by drug dealers.”Escuchar

Leer fonéticamente

From war on drugs to its impact on drug users

At the same time, the complexity of drugs cannot be understood without addressing its many faces. On one hand, there are production and drug trafficking, armed forces and political corruption. On the other, there are poverty and social inequality, structural conditions of Latin American societies. Among both there is the social and economic policy of each country in the region. The panel “Structural Determinants of drug-related problems” sought to bring together all these facets in the same panel. Ethan Nadelmann, from the United States, Luis Astorga from Mexico and the Brazilians Tarcisio Matos de Andrade and Monica Malta, accepted the challenge.

Nadelmann, founder of Drug Policy Alliance (DPA), said the United States “for a hundred years has imposed its vision of drugs, so there is the false belief that we must change the laws in America first, but this is not true”. He put forward the example of the Latin American Commission on Drugs and Democracy, because “for the first time former presidents dare to challenge prohibition, clearly propose the decriminalization of marijuana and promote harm reduction measures.”

The situation in Mexico from the so-called war on drugs, dramatic and unprecedented in terms of deaths, was analyzed by Luis Astorga, a researcher at the Institute for Social Research at the National Autonomous University of Mexico, who presented a timeline to show “the drug traffickers always had a link with the different political parties, and this complicity is what is making it difficult to change something.”

In turn, Tarcisio Matos de Andrade, a professor at the Faculty of Medicine, Federal University of Bahia and coordinator of the Extension Service “Alliance of Harm Reduction Fátima Cavalcanti ” focused on the determining factors linked to stigma. He cited as example the current campaign in Salvador de Bahia called “Crack: prison or coffin.” “What does this message say? That society has to offer only the drug user death or prison,” he said. He warned that “although drug use is distributed in all social classes, treatment is only for the upper classes.”

Finally, Monica Malta, from the Oswaldo Cruz Institute Foundation (Fiocruz), which specializes in scientific research on health, said it is a difficult to know in depth the situation of the drug user population because of its stigmatization and she introduced the method of Respondent Driven Sampling (RDS), where the researcher is from the community and calls other friends. Ten municipalities surveyed 3,500 drug users with this methodology and concluded that the Brazilian injecting drug users living with HIV are the most vulnerable population than other people living with the virus, because they have less access to health services. Matos concluded: “Brazil is known worldwide for its response to HIV/AIDS, but the drug user populations do not access these benefits.”

The drug users’ protagonism

Open doors, easy access and territory: These three words went through all the presentations from the panel “Comprehensive care for drug users” on the morning of Friday, August 27.

In Chile, the National School of Studies and Training on Addiction and Associated Critical Situations (EFAD) carried out a study of drug users’ access to health services which revealed that 80% of users requiring attention were not receiving it. Maurizio Zorondo, executive secretary of the institution in charge of the study, indicated that the central problem was that “the system is distant to people, with many requirements to access the service” and presented the current strategy, centered on the territory.

In Colombia, in 2006 the attention to drug users was defined as a matter of mental health and a public health priority, “which brought economic and social resources to go to communities and provide treatment,” said Ines Elvira Mejia Motta, who is coordinator of the agency in charge of the assistance and is also adviser to Colombia’s Ministry of Social Protection. The approach is similar to that presented by Chile: respecting the autonomy of the drug user and strengthening social networks. A special feature of the country is possession for personal use, decriminalized in 1994, was again penalized under former President Alvaro Uribe, “which is a barrier to access to care,” she concluded.

Why so health services fail drug users? With that question as the axis, the Department of STD, AIDS and Viral Hepatitis of the Ministry of Health of Brazil made a diagnosis that revealed, among other difficulties, the shame on both sides, “among professionals who do not dare to ask and the users who do not dare to say that they drink alcohol or consume other substances,” said Denise Serafim, representative of the organization.

“There are different views of drug users: health sees the use of drugs as a disease, justice as a crime and religion as a sin. My proposal is that the public see drug use as a right,” proposed Domiciano Siqueira, representative of the Brazilian Harm Reduction Association (ABORDA) when he opened his presentation. “The body belongs to each of us and everything that happens within it is ours,” he claimed.

About the other presentations, he said: “I have heard many speakers saying that treatment has to be decent and easily assessable, but for me the treatment must have, in short, open doors with no conditions.”

A war with no winners and many losers

The debate over whether or not structural economic factors in Latin America or cultural aspects of their societies have allowed drug trafficking and organized crime to take root and flourish in the region, was the focus of the panel, “Consequences of the War on Drugs,” summed up its moderator, Diego Giacoman Aramayo, a Bolivian specialist in problems of coca and drug trafficking.

“There are factors that led to the installation of cocaine production in Colombia,” said the Colombian Francisco Thoumi, an economist at the University of Minnesota and researcher on the political economy of drugs and crime. He listed the tropical rainforest, cocaine refining knowledge, access to chemical inputs, ability to develop international networks for trafficking and a society in conflict. “These are conditions, but that does not necessarily mean that the problem will arise,” he said before stating that “decriminalization is not enough. A policy that addresses the drug trade and violence is necessary to harmonize the law, culture and morality. The real challenge for Colombia is not to legalize drugs but to legalize Colombia; that is, establishing the rule of law in the country,” he said.

Juan Carlos Hidalgo, project coordinator for Latin America at the Center for Global Liberty and Prosperity (Cato Institute, Washington), gave an account of the failure of the war on drugs and cited as an example the price of cocaine: “A kilo in Colombia is U$S 1,600, when it comes to Panama is U$S 2,500, at the Mexican border it is up to U$S 13,000, in the United States U$S 20,000 and in retail in that country U$S 97, 000 a kilo.” According to UN statistics, the annual traffic of illicit drugs moves U$S 320 billion. “In this sense it is an economic problem although its causes are multi-faceted, but it is important to think about a solution to the economic issue, because it is what will unlock the discussion.”

Next, the Bolivian Reynaldo Molina Salvatierra, General Coordinator of the Program of Social Control of Production of Coca Leaf, reinforced this economic perspective: “If it were not a productive business, it would not have reached the size that it has reached.” Bolivia is working on a new national policy to combat drug trafficking and recognition of the coca leaf, which includes a census of coca growers and encourages legal uses of coca, such as for food and medicine.

Pien Metaal, from the Netherlands, gave the final presentation on the panel. She is a member of the Drugs and Democracy project team and coordinator of the Drug Law Reform project at the Transnational Institute (TNI). She announced that the results of a large study in eight countries on drugs and prisons will be published soon: “We have found an endemic situation: there are human rights violations that are justified by the war on drugs, in which nobody wins and many lose.”

New laws for a new paradigm

In the panel “Legislative reforms in Latin America” all agreed: the current legislation on drugs has created new crimes, has ripped social networks and has destroyed the environment. In short, it has created States conducive to human rights violations.” In most countries of the region the drug laws are special regimes, which mean they are exceptional and threaten defendants´ fundamental rights because the penalties are disproportionate. And prisons are full of mules trapped in the prison system rather than major traffickers,” said Freddy Pavón Rivera, vice minister of Justice of Ecuador.

“It is a challenge to design a drug policy because it is a sensitive issue, and the states do not have absolute freedom. It is remarkable that the same body that promotes human rights promotes the war on drugs,” the official said, in an indirect criticism of some UN agencies.

The representative of Argentina, Mónica Cuñarro, executive secretary of the National Coordinator of Public Policy on Prevention and Control of Illicit Traffic in Narcotic Drugs, Transnational Organized Crime and Corruption, held that: “UNASUR must be used as a window to find consensus for progress in human rights advocacy, because there are more things that join us than separate us. Human rights are not given to us by legislators; we must fight and build them as happened after World War II”.

For his part, Minister of the Supreme Court of Uruguay, Jorge Pino Ruibal, warned that “a good drug law does not guarantee justice or respect for human rights”. And recalled that his country since 1974 has a law in which the user is exempt from minimum penalties for possession for personal use. “It really has been a long process for the society to build the mechanisms to guarantee the rights of people,” he said.

Finally, the federal deputy drug expert, Paulo Teixeira, promoter of the first bill that was passed in São Paulo on the subject, highlighted the studies that were submitted during the Second Latin American Conference and I Brazilian Conference on Drug Policy, which reveal that persons deprived of their liberty on drug-related offenses are mostly the poorest people. Everyone realizes that we need a reform of our drug law, which is progressive in its spirit, but does not differentiate enough between the major drug dealers from consumers or small-scale dealers,” he concluded.

A way that has already started

On Friday, in parallel sessions, a meeting of Youth and Drug Policy and another about Drug Users were held, and representatives read their conclusions at the close of the Conference. “We are not part of the problem, we can be part of the solution,” said the youth.

The conference was sponsored by Open Society Institute Foundation, the British Foreign and Commonwealth Office, the STD, AIDS and Viral Hepatitis National Program of the Ministry of Health of Brazil, the Mental Health Program of the Ministry of Health of Brazil and Viva Rio.

Also, it had the support of United Nations agencies: Joint United Nations Program on HIV/AIDS (UNAIDS), United Nations Office on Drugs and Crime (UNODC), Pan American Health Organization/ World Health Organization (PAHO / WHO) and other international and national Brazilian organizations: Economic Commission for Latin America (CEPAL), Ministry of Social Assistance and Human Rights of Brazil (SEASDH) International Drug Policy Consortium (IDPC), International Harm Reduction Association (IHRA), Transnational Institute (TNI), Latin American Social Sciences Council (CLACSO) Washington Office on Latin America (WOLA), Drug Policy Alliance (DPA), American Coalition for Harm Reduction (HRC), International Federation Catholic Universities (FIUC) Brazilian Association of Harm Reducers (ABORDA); Center for Interdisciplinary Studies on Psychoactives (NEIP) Brazilian Network for Harm Reduction (NR), Group Candango of Criminology (GCCRIM), Dar Collective and Latin American Group on Drug Policy (GRULAD).

After the Conference, Intercambios civil association and Psicotropicus, regional and local organizers, respectively, highlighted the level of participation and the relevance of the contributions “to build policies to address drug-related problems effectively and from a perspective that guarantees human rights.” They also highlighted the importance of the Second Latin American Conference and I Brazilian Conference to place informed social debate on drugs on the public agenda and welcomed the opportunity to have a new meeting in 2011 in another host country of the region.

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On 26 and 27 August, the Second Latin American Conference and the First Brazilian Conference on Drug Policy took place in the noble hall of the National Law School of the Federal University of Rio de Janeiro (Brazil) with more than 400 attendees and the presence of top drug policy experts from thirteen countries in Latin America. It was the most specialized meeting to take place to date in the region. The Conference was organized at the regional level by Intercambios, a key Latin American civil association that has worked for fifteen years on issues of harm reduction and drug policy. And, locally by Psicotropicus, a pioneer in bringing the drugs debate out from obscurity and bringing it into everyday discussions in Brazil.

With the support of the Pan American Health Organization (PAHO) and other UN agencies, the meeting focused on current legislative reforms in different countries, the ineffectiveness of military responses to drug trafficking and the alternatives that are gaining force in the region. “Regarding drug policy, Latin American is more advanced than the United States,” concluded the participants after two days of debate.

“In Latin America we have ´no colonized´ perspectives: there is today a position on drug policy from Latin America and not about Latin America,” said the National Secretary of Justice of Brazil, Pedro Abramovay, inaugurating the conference.  Also participating in the opening panel were: Paulo Roberto Yog de Miranda Uchoa, National Secretary for Drug Policy (SENAD); Pedro Gabriel Godinho Delgado, coordinator of the Mental Health Program of the Ministry of Health of Brazil, Luciana Boiteux, coordinator of the Research Group on Drug Policy and Human Rights in the National Law School of the Federal University of Rio, Luiz Paulo Guanabara, Director of Psicotropicus, and Graciela Touzé, President of Intercambios.

It was the first time that such a large number of experts and policy makers on drug issues met in Brazil. At the opening ceremony, Lula government officials differentiated themselves from the past twenty years of U.S. policies known as the paradigm war on drugs. “Today it is impossible to talk about militarism in our politics, when it is compared with United States policy,’ said the national secretary of the SENAD. Uchoa reminded the audience that most of the state and city councils that are being encouraged by the government of President Lula Da Silva for social participation in the definition of public policies have yet to be created.

Luiz Paulo Guanabara, Director of Psicotropicus, local organizer of the conference, claimed that there is still a need to “demilitarize the policy of decriminalizing drugs and health care” since “an economic and military system leads to intolerable levels of violence, as we have seen today in Mexico and we have seen before here in Brazil.” Founded in 2003, Psicotropicus aims to reduce significantly the harm caused by current drug policy through advocacy, dialogue, reliable information, supporting research and generating knowledge to have a society where the “global drugs problem” is approached from a different perspective.

From INTERCAMBIOS, a civil association for the study and treatment of drug-related problems founded fifteen years ago in Argentina, promoter and creator of the conference, its president Graciela Touzé warned that “the shift in discourse that involves recognizing the failure of the war on drugs has not yet been translated into concrete policies that reach people.” She emphasized the need to adopt non-repressive security policies and long term state policies.

Finally, Pedro Gabriel Godinho Delgado, coordinator of the Mental Health Program of the Ministry of Health of Brazil, said “it is necessary to have public health policy responses in the areas of social inclusion and prevention”. And that “the current law is an important step forward because it makes a distinction between drug users and traffickers, but it needs further review.”

During the opening ceremony, representing the university and as the host of the law school, Luciana Boiteux reminded the audience that this same hall hosted the Senate for the Brazilian empire: “They signed here the law that ended slavery; we expect, here too, a contribution to concrete measures to achieve more humane and health-oriented drug policies”.

The meeting aimed to promote “an informed social debate with a view to promoting non-punitive policies, based on scientific evidence, to respond effectively to the various problems associated with drugs” and generate an exchange at the regional level to “update the map on drug use, associated problems, policies and interventions in the region.” The meeting aimed to promote “an informed social debate with a view to promoting non-punitive policies, based on scientific evidence, to respond effectively to the various problems associated with drugs” and to generate an exchange at the regional level to “provide an update  on drug use, associated problems, policies and interventions in the region”.

A Human Rights Approach

Worldwide, people who use illicit drugs face discrimination, rejection and violence based on the arguments that they are “dangerousness” or “incapacitated.” What kind of drug policies foster human rights violations? Are there alternative actions? What are the alternatives? These issues were central in the human rights and drug policy panel, which opened the first day of the conference with Rubem Cesar Fernandes, Viva Rio’s Executive Director and Executive Secretary of the Brazilian Commission on Drugs and Democracy as moderator.

“The Brazilian legislation has moved beyond prejudice but still has clear deficiencies,” acknowledged Pedro Vieira Abramovay, National Secretary of Justice, and Ministry of Justice of Brazil: “There is a limit between trafficking and using drugs. However, a person that is finally considered ay user, if the policeman said in the beginning that he was a drug trafficker, he must spend the entire legal process in prison.”

In turn, Jorge da Silva, a member of the Brazilian Commission on Drugs and Democracy and ex- Secretary of State for Human Rights of Rio de Janeiro (2003-2006), described his experience in the military police and how he discovered the ineffectiveness of repressive policies. Quoting the case of Portugal he explained “that decriminalization does not increase consumption.” He expressed his “radical support” for campaigns to decriminalization marijuana because “we have to start somewhere.”

The president of the National Institute against Discrimination, Xenophobia and Racism (INADI) from Argentina, Claudio Morgado, stated that he is against the approach that does not consider the social aspects of risk factors as part of the problem. “The stigma of ‘addicted’ isolates the person from his or her identity: male, female, friend, and lover. The result is an approach that promotes social rejection. Finally he said that INADI supported the Mental Health bill that is being debated in Argentina and has partial approval of Congress. In its Article 4 provides that drug users have all the same rights as all that are covered by the law. “It’s a non-discriminatory legislation that we hope will progress,” he said.

To close the panel, Kasia Malinowska-Sempruch (Poland), Director of the Global Drug Policy of the Open Society Institute (OSI), focused on public health policy and harm reduction: “We can’t focus on abstinence-based policies. If abstinence is the only desired outcome we will not have access to methadone, for example. It doesn´t matter that methadone treatment of opioid allows the users back to work; it doesn’t matter that it reduces the suffering of the family; it doesn’t matter that it opens the doors for the users: as methadone does not lead to abstinence, it will not be offered in treatment,” she concluded.

The view of International organizations

What level of priority is this on their agendas? How could attention be increased? With these questions the panel, “Drug users on the multilateral organisms agenda,” joined together representatives of the United Nations Office on Drugs and Crime (UNODC), the Joint Programme on HIV / AIDS (UNAIDS ), the Pan American Health Organization (PAHO / WHO), the United Nations Development Programme (UNDP) and the International HIV/AIDS Alliance.

“Drug policy has to do with thinking about prevention, health promotion and respect of human rights, public safety, while also taking into account public security and the fight against organized crime,” said Bo Mathiesen, UNODC Regional Representative Brazil and the Southern Cone. For his part, Pedro Chequer, UNAIDS Country Coordinator in Brazil, highlighted the role of the social movement of HIV and drugs and said that “it is necessary to expand the supply of services for HIV positive drug users.”

From PAHO / WHO, Marcelo Vila, sub-regional coordinator for HIV/STD, said that prejudices and stigma against drug users also exist in public health: “If there is no health services for drug users, and if they can be judged for simply using drugs, they do not seek health services.” In the same way, David Rui Villa-Franca, representative of UNDP, said that from the agency “is prioritized human development in general and not restricted to health approach only”.

Finally, Javier Hourcade Bellocq, regional representative for Latin America and the Caribbean of the International Partnership against HIV/AIDS, executive director of Friends of the Global Fund - Latin America and the Caribbean, said that “in countries where drug users are jailed, there is a greater prevalence of HIV.”

Decriminalizing and providing services without conditions

The first step to achieving the involvement of social and health policies is to avoid the prosecution of drug users. This became clear in the Panel “social-health policies”, where the experiences of Portugal and Brazil were presented with a critical review of achievements and challenges.

The first presentation was provided by Manuel Cardoso, a member of the directive board of and Drug and Drug Addiction Institute of Portugal, experience repeatedly cited during the meeting for having decriminalized the possession of all substances in 2001: “The great framework is treatment for all, whether they come or we go for them and the second is innovative policies such as harm reduction.” The official said that they are guided by “the principles of humanism and pragmatism, don´t deny care to anyone and use scientifically proven methods.”

Luciana Boiteux, a member of the Advisory Council of the Brazilian Network for Harm Reduction and Human Rights (REDUC), noted that 70 percent of those arrested for drug trafficking are poor, unarmed men arrested in the street with small amounts of drugs. As a result, she said that operations in Rio de Janeiro “are counterproductive because it does not inhibit the illicit market but brings much death.” She concluded: “the current policies are ineffective, but a part of the international bureaucracy is satisfied with the status quo, so it does not change”.

The coordinator of the Mental Health Program of the Ministry of Health of Brazil, Pedro Gabriel Godinho Delgado, acknowledged that, despite the basic principle of universality, “the fact is the health services are reluctant to attend users who do not accept discontinuation of drug use.” He proposed two tasks: 1) attracting drug users from therapies that are not based on conditions of total abandonment, “because they become blackmail” and 2) providing non-compulsory and comprehensive treatment, “with all the necessary areas for reducing social vulnerability”.

The moderator of the panel, the secretary general of the National Drugs Council of Uruguay, Milton Romani, said that the socio-sanitary strategies presented agreed on the need to bring the issue of drugs into the field of health. Also, decriminalize users and provide universal care without stigma or discrimination as requirements for effective responses.

A good practice guide in policy reforms

At the end of the afternoon, Ann Fordham begin_of_the_skype_highlighting     end_of_the_skype_highlighting, coordinator of the International Drug Policy Consortium (IDPC) presented the Advocacy Guide prepared by the Consortium. “At a time when the world is beginning to see drugs as a health issue and we have the first examples of decriminalization of users, with proposals for alternatives to the criminal justice system, we saw the need to disseminate these experiences,” she said.

The book seeks to serve as a tool to replicate experiences and convince more governments around the world about the possibility of carrying out changes towards decriminalization and proportionality in sentencing in drug trafficking cases. The Guide was discussed by the deputy of Rio de Janeiro Carlos Minc, former Environment Minister of Brazil, who supported the principles on which the publication is structured and added that “the war on drugs not only fails to meet its objective of eliminating the supply of drugs, but also has among its side effects the promotion of territorial control of areas of the city by drug dealers.”Escuchar

Leer fonéticamente

From war on drugs to its impact on drug users

At the same time, the complexity of drugs cannot be understood without addressing its many faces. On one hand, there are production and drug trafficking, armed forces and political corruption. On the other, there are poverty and social inequality, structural conditions of Latin American societies. Among both there is the social and economic policy of each country in the region. The panel “Structural Determinants of drug-related problems” sought to bring together all these facets in the same panel. Ethan Nadelmann, from the United States, Luis Astorga from Mexico and the Brazilians Tarcisio Matos de Andrade and Monica Malta, accepted the challenge.

Nadelmann, founder of Drug Policy Alliance (DPA), said the United States “for a hundred years has imposed its vision of drugs, so there is the false belief that we must change the laws in America first, but this is not true”. He put forward the example of the Latin American Commission on Drugs and Democracy, because “for the first time former presidents dare to challenge prohibition, clearly propose the decriminalization of marijuana and promote harm reduction measures.”

The situation in Mexico from the so-called war on drugs, dramatic and unprecedented in terms of deaths, was analyzed by Luis Astorga, a researcher at the Institute for Social Research at the National Autonomous University of Mexico, who presented a timeline to show “the drug traffickers always had a link with the different political parties, and this complicity is what is making it difficult to change something.”

In turn, Tarcisio Matos de Andrade, a professor at the Faculty of Medicine, Federal University of Bahia and coordinator of the Extension Service “Alliance of Harm Reduction Fátima Cavalcanti ” focused on the determining factors linked to stigma. He cited as example the current campaign in Salvador de Bahia called “Crack: prison or coffin.” “What does this message say? That society has to offer only the drug user death or prison,” he said. He warned that “although drug use is distributed in all social classes, treatment is only for the upper classes.”

Finally, Monica Malta, from the Oswaldo Cruz Institute Foundation (Fiocruz), which specializes in scientific research on health, said it is a difficult to know in depth the situation of the drug user population because of its stigmatization and she introduced the method of Respondent Driven Sampling (RDS), where the researcher is from the community and calls other friends. Ten municipalities surveyed 3,500 drug users with this methodology and concluded that the Brazilian injecting drug users living with HIV are the most vulnerable population than other people living with the virus, because they have less access to health services. Matos concluded: “Brazil is known worldwide for its response to HIV/AIDS, but the drug user populations do not access these benefits.”

The drug users’ protagonism

Open doors, easy access and territory: These three words went through all the presentations from the panel “Comprehensive care for drug users” on the morning of Friday, August 27.

In Chile, the National School of Studies and Training on Addiction and Associated Critical Situations (EFAD) carried out a study of drug users’ access to health services which revealed that 80% of users requiring attention were not receiving it. Maurizio Zorondo, executive secretary of the institution in charge of the study, indicated that the central problem was that “the system is distant to people, with many requirements to access the service” and presented the current strategy, centered on the territory.

In Colombia, in 2006 the attention to drug users was defined as a matter of mental health and a public health priority, “which brought economic and social resources to go to communities and provide treatment,” said Ines Elvira Mejia Motta, who is coordinator of the agency in charge of the assistance and is also adviser to Colombia’s Ministry of Social Protection. The approach is similar to that presented by Chile: respecting the autonomy of the drug user and strengthening social networks. A special feature of the country is possession for personal use, decriminalized in 1994, was again penalized under former President Alvaro Uribe, “which is a barrier to access to care,” she concluded.

Why so health services fail drug users? With that question as the axis, the Department of STD, AIDS and Viral Hepatitis of the Ministry of Health of Brazil made a diagnosis that revealed, among other difficulties, the shame on both sides, “among professionals who do not dare to ask and the users who do not dare to say that they drink alcohol or consume other substances,” said Denise Serafim, representative of the organization.

“There are different views of drug users: health sees the use of drugs as a disease, justice as a crime and religion as a sin. My proposal is that the public see drug use as a right,” proposed Domiciano Siqueira, representative of the Brazilian Harm Reduction Association (ABORDA) when he opened his presentation. “The body belongs to each of us and everything that happens within it is ours,” he claimed.

About the other presentations, he said: “I have heard many speakers saying that treatment has to be decent and easily assessable, but for me the treatment must have, in short, open doors with no conditions.”

A war with no winners and many losers

The debate over whether or not structural economic factors in Latin America or cultural aspects of their societies have allowed drug trafficking and organized crime to take root and flourish in the region, was the focus of the panel, “Consequences of the War on Drugs,” summed up its moderator, Diego Giacoman Aramayo, a Bolivian specialist in problems of coca and drug trafficking.

“There are factors that led to the installation of cocaine production in Colombia,” said the Colombian Francisco Thoumi, an economist at the University of Minnesota and researcher on the political economy of drugs and crime. He listed the tropical rainforest, cocaine refining knowledge, access to chemical inputs, ability to develop international networks for trafficking and a society in conflict. “These are conditions, but that does not necessarily mean that the problem will arise,” he said before stating that “decriminalization is not enough. A policy that addresses the drug trade and violence is necessary to harmonize the law, culture and morality. The real challenge for Colombia is not to legalize drugs but to legalize Colombia; that is, establishing the rule of law in the country,” he said.

Juan Carlos Hidalgo, project coordinator for Latin America at the Center for Global Liberty and Prosperity (Cato Institute, Washington), gave an account of the failure of the war on drugs and cited as an example the price of cocaine: “A kilo in Colombia is U$S 1,600, when it comes to Panama is U$S 2,500, at the Mexican border it is up to U$S 13,000, in the United States U$S 20,000 and in retail in that country U$S 97, 000 a kilo.” According to UN statistics, the annual traffic of illicit drugs moves U$S 320 billion. “In this sense it is an economic problem although its causes are multi-faceted, but it is important to think about a solution to the economic issue, because it is what will unlock the discussion.”

Next, the Bolivian Reynaldo Molina Salvatierra, General Coordinator of the Program of Social Control of Production of Coca Leaf, reinforced this economic perspective: “If it were not a productive business, it would not have reached the size that it has reached.” Bolivia is working on a new national policy to combat drug trafficking and recognition of the coca leaf, which includes a census of coca growers and encourages legal uses of coca, such as for food and medicine.

Pien Metaal, from the Netherlands, gave the final presentation on the panel.  She is a member of the Drugs and Democracy project team and coordinator of the Drug Law Reform project at the Transnational Institute (TNI). She announced that the results of a large study in eight countries on drugs and prisons will be published soon: “We have found an endemic situation: there are human rights violations that are justified by the war on drugs, in which nobody wins and many lose.”

New laws for a new paradigm

In the panel “Legislative reforms in Latin America” all agreed: the current legislation on drugs has created new crimes, has ripped social networks and has destroyed the environment. In short, it has created States conducive to human rights violations.” In most countries of the region the drug laws are special regimes, which mean they are exceptional and threaten defendants´ fundamental rights because the penalties are disproportionate. And prisons are full of mules trapped in the prison system rather than major traffickers,” said Freddy Pavón Rivera, vice minister of Justice of Ecuador.

“It is a challenge to design a drug policy because it is a sensitive issue, and the states do not have absolute freedom. It is remarkable that the same body that promotes human rights promotes the war on drugs,” the official said, in an indirect criticism of some UN agencies.

The representative of Argentina, Mónica Cuñarro, executive secretary of the National Coordinator of Public Policy on Prevention and Control of Illicit Traffic in Narcotic Drugs, Transnational Organized Crime and Corruption, held that: “UNASUR must be used as a window to find consensus for progress in human rights advocacy, because there are more things that join us than separate us. Human rights are not given to us by legislators; we must fight and build them as happened after World War II”.

For his part, Minister of the Supreme Court of Uruguay, Jorge Pino Ruibal, warned that “a good drug law does not guarantee justice or respect for human rights”. And recalled that his country since 1974 has a law in which the user is exempt from minimum penalties for possession for personal use. “It really has been a long process for the society to build the mechanisms to guarantee the rights of people,” he said.

Finally, the federal deputy drug expert, Paulo Teixeira, promoter of the first bill that was passed in São Paulo on the subject, highlighted the studies that were submitted during the Second Latin American Conference and I Brazilian Conference on Drug Policy, which reveal that persons deprived of their liberty on drug-related offenses are mostly the poorest people. Everyone realizes that we need a reform of our drug law, which is progressive in its spirit, but does not differentiate enough between the major drug dealers from consumers or small-scale dealers,” he concluded.

A way that has already started

On Friday, in parallel sessions, a meeting of Youth and Drug Policy and another about Drug Users were held, and representatives read their conclusions at the close of the Conference. “We are not part of the problem, we can be part of the solution,” said the youth.

The conference was sponsored by Open Society Institute Foundation, the British Foreign and Commonwealth Office, the STD, AIDS and Viral Hepatitis National Program of the Ministry of Health of Brazil, the Mental Health Program of the Ministry of Health of Brazil and Viva Rio.

Also, it had the support of United Nations agencies: Joint United Nations Program on HIV/AIDS (UNAIDS), United Nations Office on Drugs and Crime (UNODC), Pan American Health Organization/ World Health Organization (PAHO / WHO) and other international and national Brazilian organizations: Economic Commission for Latin America (CEPAL), Ministry of Social Assistance and Human Rights of Brazil (SEASDH) International Drug Policy Consortium (IDPC), International Harm Reduction Association (IHRA), Transnational Institute (TNI), Latin American Social Sciences Council (CLACSO) Washington Office on Latin America (WOLA), Drug Policy Alliance (DPA), American Coalition for Harm Reduction (HRC), International Federation Catholic Universities (FIUC) Brazilian Association of Harm Reducers (ABORDA); Center for Interdisciplinary Studies on Psychoactives (NEIP) Brazilian Network for Harm Reduction (NR), Group Candango of Criminology (GCCRIM), Dar Collective and Latin American Group on Drug Policy (GRULAD).

After the Conference, Intercambios civil association and Psicotropicus, regional and local organizers, respectively, highlighted the level of participation and the relevance of the contributions “to build policies to address drug-related problems effectively and from a perspective that guarantees human rights.” They also highlighted the importance of the Second Latin American Conference and I Brazilian Conference to place informed social debate on drugs on the public agenda and welcomed the opportunity to have a new meeting in 2011 in another host country of the region.