Health-oriented drug policy

In 2020 alone, 275 million people worldwide used illicit substances. 36 million people live with an addiction that threatens their health. Over 11 million people inject drugs – half of them are living with hepatitis C and one in eight is living with HIV. Using a contaminated syringe just once can have life-long consequences. Psychological conditions including anxiety and depression are other possible consequences of drug use, along with social isolation. In 2019, 494,000 people died worldwide as a result of drug use.

The risks can be reduced if drug policy follows the principle of Harm Reduction, and thus focuses on the health of individuals. Germany has been one of the pioneers in implementing Harm Reduction measures, which constitute one of the four pillars of the German Government’s National Strategy on Drug and Addiction. On behalf of the Federal Ministry for Economic Cooperation and Development (BMZ), the Global Partnership on Drug Policies and Development (GPDPD) advocates this health-oriented approach to drug policy at the international level.

The concept of Harm Reduction consists of a variety of measures. Practical examples include needle- and syringe-exchange programmes, opioid substitution treatment, easily accessible HIV testing and counselling services as well as drug consumption rooms. It is also important to provide information on issues like ‘safer use’ of various substances and ‘safer sex’ in connection with drug use. These measures, which do not involve any moral condemnation of drug use but instead focus on individuals and their needs and rights, can have a massive impact in terms of reducing HIV and hepatitis C transmission rates. The generally low-cost services have been proven to be effective: The World Health Organization noted back in 2004 that this approach reduces HIV infections and prevented high-risk drug use.

Harm Reduction services can be a first step in encouraging people suffering from addiction to consider treatment. The fact that the approach is not based on the precept of abstinence as the only goal make such measures attractive to those who are unable or unwilling to stop using drugs in the short term. As a result, they offer a low-threshold entry point to assistance with addiction and to state health services.

The fundamental concept of Harm Reduction emerged in the early 1990s as a pragmatic response to infections like HIV and hepatitis C. A tried-and-tested, evidence-based approach has now evolved and its implementation has been particularly effective in countries like Germany, Switzerland and Portugal.

In many other countries, however, the principle of Harm Reduction remains unrecognised in drug policy. People with a drug use disorder are offered little in the way of adequate assistance. Instead, they are stigmatised, criminalised and face long prison sentences. These purely repressive measures, which often contravene human rights, have serious repercussions for those affected and their families.

Particularly in developing and emerging countries, the problems associated with high-risk drug use are extremely acute. These countries often do not know how evidence-based addiction assistance can be made available to people who use drugs. Against this backdrop, the GPDPD advises governments interested in aligning their drug policy more to health policy considerations, as well as fostering knowledge sharing through study trips to Germany, Portugal and the Netherlands.

Germany is one of the few European countries to offer a broad spectrum of Harm Reduction measures, and to have decades of expertise. The GPDPD commissions trailblazing studies and detailed guidelines for addiction assistance for global needs. It stages regular meetings of international experts to address health-oriented drug policy. Representatives of governments, institutions of the United Nations, scientific and research institutes and civil society come together to discuss the Harm Reduction approach and pursue a common goal: ensuring that the Harm Reduction is better mainstreamed in the United Nations drug policy.  

Nobody forfeits their rights because of using drugs. Destigmatising users and individually tailored assistance services have been proven to mitigate the adverse social and health impacts of drug consumption.