Is Strict Drug Control Essential to Realise the Right to Health?

The Panel
Further Questions
Further Reading
  • The meaning, methods of implementation and consequences of strict drug control on public health came under scrutiny at the third event of the ICHRDP-Essex Debate Series, hosted this time by the University of Pretoria.

    ‘Strict control as practiced by many governments destroys the right to health,’ said panellist Stephen Lewis, Co-director of AIDS-Free World, and added ‘It is necessary to abandon the euphemisms: strict drug control means war on drugs’.

    Mr. Mandiaye Niang, Regional Representative for the United Nations Office of Drugs and Crime, argued instead that law-enforcement, and abuses they commit, should not be conflated with overall legal framework. His rebuttal to Mr. Lewis was based on the inability to prove a causal link between violations to human rights in the pursuit of enforcing punishment for drug offences.

    He added that the international drug control system, unlike common perception, is not only guided by prohibitionism because the international drug control treaties offer alternatives to punitive responses for minor drug offences, such as rehabilitation and education.

    'If drug use outside of medical supervision is a health hazard, it must be subjected to strict control for the sake of protection of the health of people, in particular the most vulnerable. This is what we do for antibiotics and many other medications that require a prescription, and nobody questions that.'

    But Mr. Lewis, also a member of the Global Commission on HIV and Law, argued drug control is directly related to violations to the universal right to health across regions. Countries that are not implementing harm reduction measures for injecting drug user populations are engaging in dangerous risks that could be considered criminal.

    He denounced the silence of the Yuri Fedotov, Executive Director of the United Nations Office on Drugs and Crime, to the escalating HIV/AIDS epidemic in Russia, fuelled by criminalization of drug users and lack of prevention policies addressing high-risk groups.  

     ‘Where is his voice [Fedotov’s], why has he not publicly said that the head of Russia, Putin, is behaving in a fashion which is not only delinquent, but indefensible and possible criminal because so many people dying unnecessarily as a result of the refusal to introduce harm reduction policies?’

    Mr. Niang did not deny human rights violations occur in the context of law-enforcement and they should be rejected categorically, including when done at an institutional level. There is no difference when pursing punishment of different offences in the context of criminal law, for example, when someone is charged for a drug offence or a sexual offence. Law-enforcement is required to act through certain rules and if violated, they should be reprimanded.

    Another salient topic in the debate was the role and responsibility for condoning and implementing the ‘strict drug control’. Mr. Lewis said that UNODC is being complicit to violations done in implementing drug control, while Mr. Niang defended a cautious diplomacy.

    The United Nations is a global governmental organization governed by the logic of multilateralism. There are theories as to how and what ‘working’ in concert has meant throughout history of international relations. However, overall aim is said to be ‘cooperation’ among nations. There has been much debate about whether non-compliant countries should be ‘shamed’ or to maintain working relations with them to support and facilitate change.

    However, Mr. Lewis said, from his experience as former Ambassador of Canada and working in the UN, that ‘If you live a life of self-censorship you will never survive in this world, and one of the mistakes of the UN makes… is self-censorship. The inability to see that you can press things forward and take strong stance is possible.'

    • Stephen Lewis is co-founder and co-director of AIDS-Free World, an international advocacy organization that works to promote more urgent and more effective global responses to HIV/AIDS.  In addition to his work with AIDS-Free World, Mr. Lewis is a Distinguished Visiting Professor at Ryerson University in Toronto.  Mr. Lewis serves as the board chair of the Stephen Lewis Foundation, and he is a Senior Fellow of the Enough Project.  He is an immediate past member of the Board of Directors of the Clinton Health Access Initiative, and he is Emeritus Board Member of the International AIDS Vaccine Initiative.  He recently served as a Commissioner for the Global Commission on HIV and the Law. Stephen Lewis was the UN Secretary-General’s Special Envoy for HIV/AIDS in Africa from June 2001 until the end of 2006.   From 1995 to 1999, Mr. Lewis was Deputy Executive Director of UNICEF at the organization’s global headquarters in New York.  From 1984 through 1988, Stephen Lewis was Canada’s Ambassador to the United Nations. Mr. Lewis is a Companion of the Order of Canada, Canada's highest honor for lifetime achievement.  Columbia University’s Mailman School of Public Health honored Mr. Lewis in 2003 with the Dean’s Distinguished Service Award, in recognition of outstanding contributions to public health.  In 2005, he was named by TIME magazine as one of the ‘One hundred most influential people in the world’ (he was cited in the category which included The Dalai Lama, Bill Gates, Oprah Winfrey, and Nelson Mandela).  is the author of the best-selling book, Race Against Time. Mr. Lewis holds honorary degrees from Dartmouth College and Johns Hopkins University, as well as 35 honorary degrees from Canadian universities. Learn more about him and the Stephen Lewis Foundation.
    • Mandiaye Niang was selected and appointed in April 2011 as the Regional Representative for the United Nations Office on Drugs and Crime in Southern Africa by Mr. Yuri Fedotov, UNODC Executive Director. Mr. Niang is a national of Senegal. Prior to his appointment with UNODC, Mr. Niang was employed as Senior Legal Adviser and Special Assistant to the Registrar on the United Nations International Criminal Tribunal for Rwanda (ICTR).  He joined the ICTR in 1997, and has occupied various positions in the tribunal, entailing the provision of legal and policy advice, supervising legal research, drafting tribunal decisions, as well as carrying out representation and administration functions within the tribunal. Prior to his engagement with the ICTR and the United Nations system, Mr. Niang served as a prosecutor and a judge in the Regional Tribunal of Dakar, Senegal, as well as Assistant to the Prosecutor General of the Senegalese Supreme Court. Mr. Niang holds a Master’s Degree in Law from the Université de Dakar and a Post Graduate Certificate from École Nationale d’Administration et de Magistrature  in Dakar, and has published numerous articles in selective law reviews. In the course of this career, he has also acquired extensive managerial and fundraising experience and is well versed with the UNODC’s mandates and the international UN Crime and Drug Conventions. 
  • What is the responsibility of a bureaucracy in implementing, condoning, or simply not decrying policies deemed to be  hampering right to health? What legal framework would be the most suitable for addressing this problem (international criminal law, criminal law, tort law, public law)?

    What are the problems (evidence, legal tests, etc.)  in trying to establish causality between  policies and effects on the ground? 

    Would you side with Mr. Lewis' recommendation to overhaul the drug control treaties that would focus on health and well-being or rather with Mr. Niang's argument that there is enough room in the treaties to implement different strategies to counter the drug problem?

  • Barrett, Damon, ‘Security, development and human rights: normative, legal and policy challenges for the international drug control system.’ (2010) 21 International Journal of Drug Policy, 140. Available in the e-library.

    Barrett, Damon, and Manfred Nowak, ‘The United Nations and Drug Policy: Towards a Human Rights-Based Approach’ in Aristotle Constantinides and Nikos Zaikos (eds), The Diversity of International Law: Essays in Honour of Professor Kalliopi K. Koufa (Brill/Martinus Nijhoff Online 2010), 449. Available in the e-library.

    Beyrer, Chris, Kasia Malinowska-Sempruch, Adeeba Kamarulzaman, Michel Kazatchkine, Michel Sidibe, and Steffanie A Strathdee, ‘Time to act: a call for comprehensive responses to HIV in people who use drugs.’ (2010) 376 Lancet, 551.  Available in the e-library.

    Brennan, Frank, Daniel B Carr, and Michael Cousins, ‘Pain management: a fundamental human right.’ (2007) 105 Anesthesia and Analgesia, 205.  Available in the e-library.

    Drucker, Ernest, ‘Drug prohibition and public health: 25 years of evidence.’ (1999) 114 Public health reports (Washington, D.C. : 1974), 14. Available in the e-library.

    Flacks, Simon,‘Drug Control, Human Rights, and the Right to the Highest Attainable Standard of Health: A Reply to Saul Takahashi’ (2011) 33 Human Rights Quarterly, 856.  Available in the e-library.

    Gruskin, Sofia, Dina Bogecho, and Laura Ferguson, ‘‘Rights-based approaches’ to Health Policies and Programs: Articulations, Ambiguities, and Assessment.’ (2010) 31 Journal of Public Health Policy, 129.  Available in the e-library.

    Hunt, Neil, ‘Public health or human rights: what comes first?’ (2004) 15 International Journal of Drug Policy, 231.  Available in the e-library.

    Lines, Rick, ‘Injecting Reason: Prison Syringe Exchange and Article 3 of the European Convention on Human Rights’ (2007) European Human Rights Law Review, 66. Available in the e-library.

    Mohapatra, Seema, ‘Unshackling Addiction: A Public Health Approach to Drug Use During Pregnancy’ (2011) 26 Wisconsin Journal of Law Gender and Society, 241.  Available in the e-library.

    Santiago-Negrón, Salvador, and Carmen E Albizu-García, ‘War on Drugs or War against Health? The pitfalls for public health of Puerto Rican drug policy’ (2003) 22 Puerto Rico Health Sciences Journal, 49.  Available in the e-library.

    Takahashi, Saul, ‘Drug Control, Human Rights, and the Right to the Highest Attainable Standard of Health: By No Means Straightforward Issues’ (2009) 31 Human Rights Quarterly, 748.  Available in the e-library.

    Wikler, Daniel, ‘Personal and Social Responsibility for Health’ (2012) 16 Ethics & International Affairs, 47.  Available in the e-library.

    Wolfe, Daniel, ‘Paradoxes in antiretroviral treatment for injecting drug users: access, adherence and structural barriers in Asia and the former Soviet Union.’ (2007) 18 The International journal on drug policy, 246.