Anand Grover in Jakarta Post: “Development cannot be sustainable without drug policy reform”

Read original article in Jakarta Post

By Anand Grover, former UN Special Rapporteur on the Right to Health and Senior Advocate, member of the Global Commission on Drug Policy

Indonesia boasts one of the most vibrant emerging economies in the world. As such, the country is at the forefront of contemporary global social and economic concerns, such as demography, climate change, disparities in development, and inequity in services among different provinces and social classes. Moreover, the country is committed to reforming a number of policies for the benefit of its most vulnerable and marginalized populations in line with the sustainable development agenda and its goals (SDGs). Nevertheless, the current parliamentary debate on the reform of the criminal code with the inclusion, among many others, of provisions to strengthen the Indonesian punitive response to drugs, impedes this commitment to achieving SDGs in a variety of ways.

Across different cultures and throughout history, a “drug-free society” has never actually existed. However, in an attempt to achieve that aim, many countries have enacted over-punitive policies that have only added to the pain and suffering of individuals and communities, notably in the form of increased violence. Yet drug control policies based on repression alone – in Indonesia and across South East Asia – have resulted in unprecedented human rights violations ranging from extrajudicial killings to the use of death penalty.

SGDs constitute a framework concerned with the wellbeing and the advancement of societies, on the basis of unwavering principles of people-centered, dignity-driven and justice-oriented policies. So this violence and other direct consequence of drug control, which manifest within the most marginalized and poor communities, go directly against the spirit of the SDGs themselves. Furthermore, the targets set in the SDGs cannot be considered met until they are met for everyone. This must include, therefore, people who use drugs, those who cultivate drugs traditionally, and those who fulfill small tasks in the market due to economic need. In other words, those who are furthest behind must be reached first, and no-one must be left behind.

But how can a reform of the criminal code, which cements the punitive approach, allow Indonesia to achieve SDGs without distorting their spirit or cracking down on the most vulnerable? For instance, SDG 16 aims for just, peaceful and inclusive societies, and calls on governments to promote and enforce non-discriminatory laws and policies. The reality is that harsh penalties for drug offenses are disproportionate, stigmatizing and discriminatory towards people at the low end of the drug trade.

The revision under debate in Parliament contrasts sharply with other targets of this same goal 16, which are about upholding the dignity of all citizens and providing equal access to fair justice for all. It also completely undermines SDG 3, which aims to ensure healthy lives and well-being at all ages – and for all populations – and ending public health epidemics. Yet subjecting people who use drugs to incarceration and forced treatment has shown to increase transmission rates for HIV, hepatitis C and tuberculosis, which Indonesia can ill-afford as it already has a high burden of HIV among key populations, with nearly one in three persons who inject drugs being infected with HIV. Mandatory rehabilitation, in particular, has a terrible track record in addressing problematic drug use. It is also a clear violation of the right to health and undermines the confidential therapeutic contract that should exist between patients and their doctors.

The harsh penalties considered for inclusion in the criminal code – and which are already operational through the Narcotics Act –most worryingly show the world that the policymakers have no response to drugs but an excessive escalation of the war on drugs, even if the collateral damages are human lives. But other pathways and other solutions exist, and other countries have adopted different policies more concerned with people’s vulnerabilities.

These start with harm reduction services and treatment options that have proven efficiency in ensuring that a person who uses drugs has the best possible chance of attaining physical and mental health. They include, for harm reduction: needle and syringe programs, safe injection facilities, the availability of opioid overdose reversal medication such as naloxone, and drug checking; for treatment: support for voluntary abstinence and rehabilitation (with no conditions), low-threshold programs, opioid substitution therapy, heroin-assisted treatment, awareness workshops for methamphetamine use, and services for social and professional reintegration.

We would therefore urge Indonesia to conduct an open and honest debate to review its 1976 Narcotics Act. Parliament should examine the evidence and separate the real potential harms of drug use from the perceived harms that engender irrational fear and stigmatizing policies. Accept the reality of drugs, focus on the potential harms, understand that there are many modes of use, different substances, and myriad personal situations that lead someone to consume drugs. Focus on prevention to limit first use and dependence, prioritize law enforcement towards large-scale trafficking and gangs, but certainly consider alternatives to punishment for drug use, for possession for personal use, and for low-level actors in the trade.

Indeed, as Indonesia lays the groundwork for its sustainable development agenda and experiments with innovative policies in other areas, it should consider launching – in at least one province – a pilot project where health services can deliver harm reduction services and treatment centers on a voluntary basis, where social and educational services can try more evidence-based prevention (primary and secondary) measures, and where law-enforcement agents can de facto retract from criminalizing drug use and possession. Such a policy pilot must be strictly monitored and evaluated by multidisciplinary scientists to provide evidence for drug policies that are more efficient, more humane, and more aligned with the sustainable development goals. Only through such a serious process can Indonesia provide the rest of Asia and the world with evidence on what works and what does not. Most importantly, it can then own its response and adapt it for better outcomes for its citizens.