- Programme Director;
- Prof Tiaan de Jager, Dean, Faculty of Health Sciences, University of Pretoria;
- Prof Lekan Ayo-Yusuf, Chairperson/Head: School of Health Systems and Public Health, University of Pretoria and ALEPH conference Director;
- Ms Jeanette R Hunter, Deputy Director General Primary Health Care, National Department of Health;
- Ms Jane Marie Ogola Ongolo, United Nations Office on Drugs and Crime, Representative for Southern Africa;
- Prof Nick Crofts, Executive Director, Global Law Enforcement and Public Health Association.
I sincerely thank the University of Pretoria Faculty of Health Sciences for hosting this First Regional African Conference on Law Enforcement and Public Health to advance dialogue, research, and solutions to intersecting social, humanitarian, security, and public health challenges.
Mainly at a time when the voices of those most impacted by law enforcement and health policies across Africa are urgently calling for meaningful reform and pathways that empower communities to achieve lasting, shared value within systems rooted in compassion and sustainability. This necessitates policies that replace harmful practices with evidence-based, human-centred approaches that prioritise development and dignity.
By mending our political, economic, and social approaches and attitudes, and building a language of understanding and holistic concern, we can create a standard by which South Africa, the African continent and indeed the world can abide by.
As a member of the Global Commission on Drug Policy and the Chair of the Eastern and Southern Africa Commission on Drugs, I am privileged and honoured to be part of organisations working to inspire better drug policy globally and regionally.
The Global Commission on Drug Policy, since its establishment in 2011, champions five key pathways for reform that places human rights at the centre of every endeavour. The Global Commission’s resounding appeal to all stakeholders is:
1) Put people’s health and safety first.
2) Ensure access to essential medicines and pain control.
3) End the criminalization and incarceration of people who use drugs.
4) Refocus enforcement responses to drug trafficking and organized crime.
5) Regulate drug markets to put governments in control.
Considering that the right to health serves as the basis of our first two priorities – namely, to put the health of people and communities first, and to ensure universal access to medicines under international control – the Global Commission stresses that governments need to establish clear plans and timelines to remove the domestic and international obstacles to the provision of essential medicines under international control.
The Global Commission’s latest 2024 plenary meeting in Geneva, explored current global trends in drug markets, focusing particularly on the rapid rise of synthetic drugs like fentanyl. Synthetic substances now dominate markets across 120 countries, decentralising production and creating complex challenges even for nations with strong institutional frameworks.
The politicisation of fentanyl further complicates these issues, attaching to broader concerns such as money laundering and geopolitical tensions. Additionally, the retail drug trade has shifted significantly, with digital platforms and illicit chemists reducing the need for traditional, face-to-face transactions, making enforcement increasingly difficult.
Organised crime syndicates exploit illicit funds to manipulate politics and governance, further entrenching corruption and undermining institutions. To counter these dynamics, governments must prioritise strategies beyond punitive measures, focusing instead on targeted interventions that do not escalate violence. Strengthening the rule of law remains critical to dismantling these networks and fostering more resilient governance.
From a regional perspective, the Eastern and Southern Africa Commission on Drugs (EASCD) is equally firm on the belief that the longstanding “war on drugs” approach applied to Africa’s illicit drug markets has failed, reflecting its global shortcomings. Over six decades since the adoption of the UN Single Convention on Narcotic Drugs, the production, trade, and use of controlled substances across Eastern and Southern Africa — and the broader African continent—have expanded exponentially under the framework of prohibition.
South Africa has consistently aligned its domestic policies with the international drug control regime, striving to meet its international obligations and combat organised crime linked to drug trafficking. However, this adherence has come at a significant cost, resulting in numerous harmful consequences for the well-being of its citizens.
Over the years, we lost the focus of protecting people and children based on their own vulnerabilities, and focused instead, and at their expense, on the substances they use.
To understand how this came to be, we must look to history and the lessons it offers. On December 10, 1948, the United Nations adopted the Universal Declaration of Human Rights (UDHR), committing member states to uphold and protect the rights and dignity of all individuals.
Yet, just over a decade later, the 1961 UN Single Convention on Narcotic Drugs, followed by the 1971 UN Convention on Psychotropic Substances and the 1988 UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, established a classification of drugs that gave rise to rigid prohibition and control.[1]
These conventions shaped domestic and international drug laws, embedding policies that require urgent reform. Examining this history is essential for our understanding of the roots of current challenges and the pressing need for reform.
This prohibition paradigm, rooted in the international drug treaty framework established after World War II, reflects the political agendas, cultural biases, ideological priorities, and commercial interests of colonial and post-war powers. The criminalisation of certain substances underscores the outdated political and ideological foundations of these policies—foundations that no longer align with contemporary scientific understanding or evidence-based approaches.
Two of the most harmful and addictive substances i.e. alcohol and tobacco, were never included in a system that is supposed to render illegal many substances based on the sole criteria of their addictiveness. The distinction between ‘good’ drugs that sit outside the system and can be legally sold, freely consumed and pushed by sophisticated marketing, and ‘evil’ drugs that must be banned and their users punished, is not based on evidence, but rather is driven by views to repress targeted population groupings.
In hindsight, we can now see that we could not have been more wrong. The individuals arrested and sent to prisons – where they often became more deeply entangled in criminal networks – were our children. Those whom our outdated policies left behind without proper treatment for dependence, were our family members. Those who died from overdoses because they did not have access to fast-acting medicine or to support networks, were our own community members. Implementing repressive responses to drug use was and is expensive and has no positive impact on our pathway to a more healthy and inclusive society.
The goal of a drug-free world was an illusion, and its failure is evident in the continued rise in production, trafficking and consumption of illegal substances. The ongoing criminalisation of drug possession and drug use has only had the effect of increasing the power of gangs and syndicates who operate in the shadows through hidden and illicit markets. Demand has increased for a variety of reasons, and in response so too has supply.
Furthermore, prohibition has proved incapable of responding to serious public health crises. Along with the prohibition of illicit drugs, has been the associated blockage to access of opioid based medications that are legal and lawful.
The reality of the global south is that people on the lower end of the economic spectrum do not have access to essential pain relief medication to ease their suffering when in palliative care, or to drugs that are required for proper anaesthesia for surgery. Sub-Saharan Africa is experiencing a growing crisis of self-medication with counterfeit Tramadol (an opiate), often in life-threatening doses, in an attempt to relieve their suffering and despair.
As a consequence, the international drug control system reinforces deep-lying imbalances that favour punitive approaches rather than ensuring access to controlled medicines, despite the fact that the 1961 Single Convention has the key objective of ensuring access to and safe use of essential medicines.
Additionally, recent drug policy reform has also failed to address the underlying fallacies of the drug control system, further exacerbating the patterns of power imbalance around the globe.[2]
Although, drug decriminalisation, legalisation, and regulation are gaining traction and hailed by critics as long-overdue responses to the failures of prohibition, these reforms, are only progressive on the surface and often fail to address the deeper flaws embedded in the global drug control framework.
Recent drug policy reforms risk becoming a rebranded form of prohibition, changing the appearance of policy without altering its fundamental principles. This approach hides the contradictions and flawed assumptions that have defined drug policy since the UN Single Convention on Narcotic Drugs was adopted in 1961.
For example, in South Africa and the region, what were once localised, plant-based economies centred on khat and cannabis, have evolved into industrial hubs for drug manufacturing, trafficking, and trans-shipment. These transformations have strained the ability of states to address the resulting health and social challenges effectively.
Prohibitionist policies have consistently failed to curb drug markets, reduce violence, or address the institutional erosion they exacerbate. This global misjudgement, rooted in a short-sighted focus on prohibition, has come at significant social and economic costs.
The Global Commission’s 2024 plenary sessions underscored the critical shortcomings of these approaches, highlighting the alarming rise in prison populations and the extensive harm caused by punitive drug policies. Despite limited progress, alternatives to incarceration remain scarce, and decriminalisation has yet to gain meaningful traction.
The Commission emphasises the need for a more comprehensive approach — one that includes safer supply models, improvements in criminal justice processes such as better management of data protection, criminal records, due process, and judicial discretion, and the integration of harm reduction principles. Central to these reforms is meaningful consultation with affected communities, ensuring policies that are inclusive, evidence-based, and geared towards long-term effectiveness.
Happily though, since the 2016 UN General Assembly Special Session (UNGASS) on the World Drug Problem, 11 African nations have begun re-evaluating their drug policies, marking an important shift toward reform.
The initial steps in cannabis and hemp policy reform have largely centred on its decriminalisation and legalisation, driven by a growing consensus that the harms associated with cannabis are overstated compared to the socio-medical and economic opportunities it offers. In several countries, cannabis and hemp have transitioned from a stigmatised substance to a mainstream consumer product, generating significant tax revenue and economic benefits. These shifts have demonstrated how reform can align public health, human rights, and economic development goals.
However, as cannabis and hemp markets expand, systemic power imbalances have emerged. Western nations, such as Canada and some European nations, are imposing stringent manufacturing specifications for cannabis products. These detailed and costly requirements create significant barriers for traditional African cultivators, who often cannot afford to meet these standards.
This approach risks excluding small-scale farmers and exacerbating economic inequality, as only wealthy, established businesses can thrive in the cannabis market. For cannabis and hemp reform to have a meaningful impact in South Africa, the terms of trade cannot solely be determined by the off taker and should also tailored to the realities of local cultivators, ensuring equity and fostering inclusive economic growth.
Within the Eastern and Southern African region, health-focused reforms remain in their infancy, yet their potential is undeniable.
Introducing harm reduction strategies, such as decriminalisation, opioid substitution, and evidence-based treatment, offer cost-effective public health solutions. These approaches reduce harm, improve health outcomes, and address root causes of addiction.
But, to fully unlock the transformative potential of harm reduction, we must confront a vital question: can a harm reduction paradigm serve as a catalyst for innovation, inspiring more effective coordination and integration across law enforcement, public health, government, and the broader realms of economic and social policy?
Answering this requires intentionality and honesty in how we view and engage with these systems.
While some argue that Africa and other developing regions lack the resources and institutional capacity for lifesaving reforms, global evidence demonstrates that health-centred approaches, including harm reduction and evidence-based treatments, are more cost-effective than criminalisation. Our moral conservatism, reflected in inadequate policy frameworks, has contributed to the spread of illness and denied access to basic health services.
This deepens societal inequality and perpetuates structural violence, leaving individuals trapped in cycles of despair, pain and misery about their future.
Such disconnection and systemic inequity are powerful drivers of drug use disorders. Increasingly, evidence supports the idea that the true antidote to addiction is not merely sobriety, but meaningful connection — connection to others, to support systems, and to opportunities for healing and growth.
Programme Director, we have lost the “war on drugs”. It is now time for reparation, reflection and revision.
The lack of evidence supporting prohibition strengthens the case for repealing outdated drug laws. However, it takes political will and leadership to implement harm reduction practices.
We fail our citizens when we turn them into victims or criminals caught in a vicious cycle of drugs, crime and dependence. Drug policy reforms will not come from outside and should not be imposed on Africa; they will rather come from our regional and national debates.
We must draw inspiration from the successes of nations that have challenged and moved beyond dominant paradigms. As a continent, it is imperative to dismantle the stigmas surrounding drug use and foster open, honest dialogue. By confronting these issues directly, we can begin to mitigate the harm and create pathways toward healthier, more inclusive communities.
As leaders, we need to push the boundaries of existing drug policy and listen much more carefully to what it is that those most affected by drug use disorders really want. What they want is to stop the harm, not reinforce it.
I thank you.
[1] https://www.unodc.org/unodc/en/commissions/CND/Mandate_Functions/Scheduling.html
[2] Taylor, S., Buchanan, J., & Ayres, T. (2016), “Prohibition, privilege and the drug apartheid: The failure of drug policy reform to address the underlying fallacies of drug prohibition.” Criminology & Criminal Justice, 16(4), 452-469. https://doi.org/10.1177/1748895816633274
