In less than two weeks a rare United Nations General Assembly Special Session (UNGASS) on global drug policy takes place in New York. Among the issues to be debated and discussed many resonate in Southeast Asia, including the impact of drug production, trafficking and use on vulnerable countries, communities and people. Importantly, preparatory negotiations over the past year have created space for countries and policy leaders to reflect on the traditional "war on drugs" approach, but also prominently featured a debate on the need for justice reform and improved access to health services.
A major challenge for governments here in Southeast Asia is high, and rising, prison populations resulting from sentences for drug-related offences including for minor drug possession and use. Disproportionate sentences for relatively low level drug crime are not only a burden on justice systems and state budgets in the region, but have also proven to be detrimental to human rights -- most correctional facilities in the region simply do not provide a safe and healthy environment for people in custody.
One way of reducing the prison population is to ensure that drug users are able to access the right mix of health and social services that reduce the harmful consequences of drug use, including voluntary community-based drug treatment and counselling. Why does this matter in Southeast Asia? Drug use prevalence rates -- especially synthetic drugs like methamphetamine and in some places heroin -- remain very high across the region, and some cities are reporting HIV rates among people who inject drugs over 40%. The data are undeniable and lead to the conclusion that a public health response to drug use is urgently needed in the region.
Aside from putting people in prison, it is also common in Southeast Asia to confine people who use drugs to "compulsory treatment and rehabilitation centres". It is estimated that half a million people are detained in these centres every year across the region, and because most do not medically assess the dependence of those admitted there is no distinction made between those needing treatment and those that do not.
Many casual drug users that are not dependent or problematic users end up being held for lengthy periods. The blunt reality is that the centres are themselves quasi-prisons with little or no positive treatment outcomes. And in instances where medical treatment or counselling is provided in the centres, it is often generic and may actually contribute to high relapse rates on release. There has however been some recent progress -- together with UNAIDS and Unescap we convened a regional consultation in Manila last year where representatives of nine countries agreed to transition towards voluntary community-based services for people who use drugs.
Alternatives to incarceration and proportionate sentencing for drug-related offences can also reduce prison overcrowding. Through establishing the intention behind an offender's possession of narcotic drugs -- for example if it is for personal use or intended for sale to others -- clear distinctions can be made on the type of sentence a person should receive or not, and the type of services they may need. In many instances the option of referral to community-based treatment and care can be the answer, yet this conclusion can only be reached when a people-centred approach is used that places the health and well-being of individuals and communities first.
As the UNGASS approaches it is important to remember that the international drug control treaties do not mandate a war on drugs approach. Drug policy can, and should, include a balance of appropriate supply and demand reduction interventions, and be aligned with socio-economic development efforts including improved access to health care and social services. Governments should also keep in mind that dealing with demand for illicit drugs and ensuring access to public health services results in good public security.
As the lead UN agency on matters related to illicit drugs and crime we are supporting efforts across the region to provide for the rule of law and ensure services are available for drug users. We hope that the UNGASS will contribute to a rebalancing of the way the drug problem is managed here in Southeast Asia.
Jeremy Douglas is the Regional Representative for the United Nations Office on Drugs and Crime (UNODC) for Southeast Asia and the Pacific. Olivier Lermet is Regional Advisor o HIV/Aids for UNODC Regional Office for Southeast Asia and the Pacific.