Opening and closing comments at SA Drug Policy Week
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A series of fortuitous events meant that SA Drug Policy Week 2017 had one of the finest groups of international keynote speakers one could hope for - Ethan Nadelmann, David Nutt, Neil Woods and Anand Grover. All four made a huge contribution to the status of the event, and the media coverage was extensive. We lived up to our slogan, we need to talk about drugs, and SA Drug Policy Week 2017 sparked a lively debate, not only in South Africa, but regionally and globally.
We arrive at the SA Drug Policy Week 2018 to find a very different South Africa when it comes to drugs and the way in which we respond to drugs. In 2017, TBHIV Care and the Urban Futures Centre implemented the first low threshold opioid maintenance programme that we first spoke about at RUN 2016. With the entry of the Global Fund through Right to Care as the principle recipient, and TBHIV Care and Anova Health as sub-recipients, we saw services and awareness expand. The City of Tshwane became the first City in South Africa to fund opioid substitution maintenance programmes and the supply of sterile injecting equipment. The Community Oriented Substance Use Programme (COSUP) funded by the City and implemented by The University of Pretoria Department of Family Medicine is an emerging model of how cities can introduce sustainable and integrated services in response to people who use drugs. Recently the Constitutional Court passed a judgement that effectively decriminalised the possession, growing and use of cannabis in small quantities in private space. Whether or not one supports this decision, it will create momentum for the much-needed policy debate. The Drug Policy landscape, locally and internationally, is changing rapidly.
However, not all is progressive and evidence based in South Africa. While the City of Tshwane were looking towards science and compassion for new ways to reduce the impact of drug use, the City of eThekwini moved backwards. Despite engagements over a period of 36 months, and assurances that the provision of sterile injecting equipment by the Step Up Project was compliant with regulations, the Deputy Mayor closed down the programme, leaving people who inject drugs increasingly vulnerable to HIV, Hepatitis, sepsis, endocarditis and, ultimately, early death. There is still a reluctance to accept harm reduction services, not only among the general population, but also among some medical practitioners. We are still awaiting South Africa’s new Drug Master Plan. Early draft versions of this document showed a lot of promise and it could provide the clear, integrated policy framework and motivation needed to implement effective responses to drug use. Yet it remains caught within the bureaucracy of the National Department of Social Development.
There are further challenges. South Africa still pays up to thirty times more for methadone than the Ukraine. Methadone is still not on the essential drug list for long-term opioid substitution therapy. The latest cures for Hepatitis C are not available in South Africa because to register any new medication takes more than thirty-six months. There are continued assaults on people who used drugs for no other reason than that they use a drug. In the Constitutional Court Judgement, Judge Zondo framed the use of cannabis a ‘great social evil’, yet did not once refer to the ‘evil’ of the racist origins of prohibition, or the ‘evil’ of the disproportionate punishment those caught using cannabis, particularly those from marginalised communities, have experienced. We also need to consider the many people who have no ‘private space’ to live their lives.
At the SA Drug Policy Week 2018, we will examine many of these issues through a critical lens, keeping in mind the international, regional and local data, the emerging evidence from innovative programmes, and the local context. We are able to focus this year on African and South African initiatives because we have new and innovative programmes operating, and new solutions emerging. We are no longer being passive, we are doing, and we are finding new and appropriate paths towards effective drug policy and interventions that focus on not only the individual, but also the context and systemic drivers that make the use of drugs more harmful than need be, yet still so meaningful that for many the risks are worth facing.
SA Drug Policy Week would like to thank TBHIV Care and Open Society Foundations, Right to Care and the Global Fund for the resources and funding that make this event possible. I trust you will benefit from your experience, and that you will think critically about drug policy and our global, regional, national, and, most importantly, our personal response to drugs, and the people who use them.
It now gives me great pleasure to introduce our first keynote speaker. Last year we closed with a commissioner of the Global Commission on Drug Policy, and this year we will start with one. This will be the third commissioner from the Global Commission I have had the privilege of introducing to a South African audience. Three years ago, it was Madame Ruth Dreifus, former president of Switzerland and a great advocate for drug policy reform who spoke to her audience about opioid substitution therapy at a time when we had none in the public sector. We now have OST in four cities. Last year, Commissioner Anand Grover spoke of the legal arguments that he believed would secure a Constitutional Court decision that the use of cannabis in a private space was not a right that could be prohibited. He was correct, and the Court has ruled that the use of cannabis in a private place cannot be made a criminal act.
So, following from these two events, so I am looking forward to Commissioner Michel Kazatchkine’s key-note address tonight, because there seems be a pattern here: A commissioner of the Global Commission says it, and it manifests. If this proves to be true, I would not be surprised. Each of the Commissioners of the Global Commission on Drug policy is a person that has earned respect, a person to whom global leaders and policy makers will listen. Prof Michel Kazatchkine is no exception. He has a resume so long and full of achievements I could not possibly do it justice – you can read it for yourselves on the Commissions web page. These achievements have culminated in Professor Kazatchkine”s current role as a commissioner of the Global Commission. It gives me great pleasure to introduce to you Commissioner Michel Kazatchkine.
We arrive at the SA Drug Policy Week 2018 to find a very different South Africa when it comes to drugs and the way in which we respond to drugs. In 2017, TBHIV Care and the Urban Futures Centre implemented the first low threshold opioid maintenance programme that we first spoke about at RUN 2016. With the entry of the Global Fund through Right to Care as the principle recipient, and TBHIV Care and Anova Health as sub-recipients, we saw services and awareness expand. The City of Tshwane became the first City in South Africa to fund opioid substitution maintenance programmes and the supply of sterile injecting equipment. The Community Oriented Substance Use Programme (COSUP) funded by the City and implemented by The University of Pretoria Department of Family Medicine is an emerging model of how cities can introduce sustainable and integrated services in response to people who use drugs. Recently the Constitutional Court passed a judgement that effectively decriminalised the possession, growing and use of cannabis in small quantities in private space. Whether or not one supports this decision, it will create momentum for the much-needed policy debate. The Drug Policy landscape, locally and internationally, is changing rapidly.
However, not all is progressive and evidence based in South Africa. While the City of Tshwane were looking towards science and compassion for new ways to reduce the impact of drug use, the City of eThekwini moved backwards. Despite engagements over a period of 36 months, and assurances that the provision of sterile injecting equipment by the Step Up Project was compliant with regulations, the Deputy Mayor closed down the programme, leaving people who inject drugs increasingly vulnerable to HIV, Hepatitis, sepsis, endocarditis and, ultimately, early death. There is still a reluctance to accept harm reduction services, not only among the general population, but also among some medical practitioners. We are still awaiting South Africa’s new Drug Master Plan. Early draft versions of this document showed a lot of promise and it could provide the clear, integrated policy framework and motivation needed to implement effective responses to drug use. Yet it remains caught within the bureaucracy of the National Department of Social Development.
There are further challenges. South Africa still pays up to thirty times more for methadone than the Ukraine. Methadone is still not on the essential drug list for long-term opioid substitution therapy. The latest cures for Hepatitis C are not available in South Africa because to register any new medication takes more than thirty-six months. There are continued assaults on people who used drugs for no other reason than that they use a drug. In the Constitutional Court Judgement, Judge Zondo framed the use of cannabis a ‘great social evil’, yet did not once refer to the ‘evil’ of the racist origins of prohibition, or the ‘evil’ of the disproportionate punishment those caught using cannabis, particularly those from marginalised communities, have experienced. We also need to consider the many people who have no ‘private space’ to live their lives.
At the SA Drug Policy Week 2018, we will examine many of these issues through a critical lens, keeping in mind the international, regional and local data, the emerging evidence from innovative programmes, and the local context. We are able to focus this year on African and South African initiatives because we have new and innovative programmes operating, and new solutions emerging. We are no longer being passive, we are doing, and we are finding new and appropriate paths towards effective drug policy and interventions that focus on not only the individual, but also the context and systemic drivers that make the use of drugs more harmful than need be, yet still so meaningful that for many the risks are worth facing.
SA Drug Policy Week would like to thank TBHIV Care and Open Society Foundations, Right to Care and the Global Fund for the resources and funding that make this event possible. I trust you will benefit from your experience, and that you will think critically about drug policy and our global, regional, national, and, most importantly, our personal response to drugs, and the people who use them.
It now gives me great pleasure to introduce our first keynote speaker. Last year we closed with a commissioner of the Global Commission on Drug Policy, and this year we will start with one. This will be the third commissioner from the Global Commission I have had the privilege of introducing to a South African audience. Three years ago, it was Madame Ruth Dreifus, former president of Switzerland and a great advocate for drug policy reform who spoke to her audience about opioid substitution therapy at a time when we had none in the public sector. We now have OST in four cities. Last year, Commissioner Anand Grover spoke of the legal arguments that he believed would secure a Constitutional Court decision that the use of cannabis in a private space was not a right that could be prohibited. He was correct, and the Court has ruled that the use of cannabis in a private place cannot be made a criminal act.
So, following from these two events, so I am looking forward to Commissioner Michel Kazatchkine’s key-note address tonight, because there seems be a pattern here: A commissioner of the Global Commission says it, and it manifests. If this proves to be true, I would not be surprised. Each of the Commissioners of the Global Commission on Drug policy is a person that has earned respect, a person to whom global leaders and policy makers will listen. Prof Michel Kazatchkine is no exception. He has a resume so long and full of achievements I could not possibly do it justice – you can read it for yourselves on the Commissions web page. These achievements have culminated in Professor Kazatchkine”s current role as a commissioner of the Global Commission. It gives me great pleasure to introduce to you Commissioner Michel Kazatchkine.
