In the War on Drugs, law enforcement has become the enemy of treatment, forcing drug users underground into high-risk situations. But it doesn’t have to be that way. Australia is a perfect example. In the mid-1980s Frank Hansen was a sergeant in the New South Wales drug squad. Like in the U.S., drug users were always pursued with the full force of the law. Suddenly the squad was asked to make a fundamental shift in operations, as NSW introduced a needle and syringe exchange program. They cooperated, leading to Australia’s success fighting the HIV epidemic – the intersection of police and public health.
Now, three decades later, Hansen is leading a group of senior serving and former police officers, trying to replicate this strategy around the world in countries where drug users are still jailed and HIV is rampant. HIV may not be “rampant,” but the United States sure could use his help. In 2012 the Global Commission on Drug Policy released a report arguing that the War on Drugs is fueling the HIV/AIDS pandemic among users and their partners. The report noted that mass incarceration of non-violent drug users plays an important role in increasing HIV risk and that, ''this is a critical public health issue in many countries, including the United States, where as many as 25 per cent of Americans infected with HIV may pass through correctional facilities annually.”
If that weren’t enough, the War on Drugs is also fueling a worldwide hepatitis C pandemic. The Global Commission on Drug Policy found that repressive drug law enforcement is driving high rates of infection among users who inject drugs, just as it does with HIV/AIDS. In some countries with the harshest drug policies, a shocking 90% of users have hepatitis C. The fastest rate of infection is in Eastern Europe and Central Asia, while the highest numbers of infections have been reported in China, the Russian Federation, and – you guessed it – the USA.
A unique challenge is how much governments have underestimated the problem. Hepatitis C is more contagious than HIV, but unlike HIV/AIDS it is curable - if treatment is received in time. Because drug policies criminalize drug use, people have no access to testing or treatment. In 80% of cases the disease becomes chronic, and 25% of those cases will lead to potentially fatal liver disease.
The Global Commission urges governments to decriminalize drug use and redirect resources to prevention and treatment. It’s a strategy that works, as Frank Hansen can attest. When our supposed cure to a problem is making things worse, why hasn’t our approach changed? What will it take to incorporate public health? We already know it works.
