War on drugs and impact on health care

The last few weeks have seen a heightened crackdown on drug trafficking, targeting mainly the coastal region. The renewed fight began when the two sons of the late drug lord Ibrahim Akasha and two foreigners believed to be their accomplices were taken to the United States.

Since then, there have been public proclamations and warnings by top government officials, including President Uhuru Kenyatta and his deputy, Mr William Ruto, to suspected drug barons that their days are numbered.

It remains to be seen whether this time around, the state agencies will act.

However, going by history, the group that gets the short end of the stick whenever such campaigns are launched are the lowly thousands, who are hopelessly hooked to hard drugs.

Ravaged by addiction and with no money to extricate themselves from the clutches of the vice or sustain the lifestyle, these hapless individuals are usually easily rounded up, charged and sent to jail in their hundreds as the real barons thrive.

The war on drugs the world over has been promoted primarily as a way of protecting public health and social morals. In reality, however, it has achieved the opposite.

It has failed to control or eliminate use, and has increased the potential risks and harm associated with drug taking. By fuelling the spread of disease — often with fatal consequences — drug war policies have had a devastatingly negative impact on the health of a growing population of users, more so those who inject themselves.

Direct war on drugs encourages risky behaviour among people who use drugs but have only marginal impacts on the demand. The raids by security agencies exacerbate overall health harms by encouraging high risk behaviour and push drug users into unhygienic “underground” environments, leading to overdose and death.

The raids result in alienation and stigma, which undermine outreach programmes for those who need treatment.

EDUCATION AND PREVENTION

Prevention messages that are driven by politics rather than science lead to distrust in even the best drug education and prevention efforts.

A number of core interventions have been developed by the United Nations Programmes on HIV/Aids, United Nations Office on Drugs and Crime and the World Health Organisation and form the ‘Harm Reduction’ strategy targeting people who inject drugs.

These include needle and syringe exchange programmes, opioid substitution therapy and other drug dependence treatment, Others are HIV testing and counselling, antiretroviral therapy, prevention and treatment of sexually transmitted infections and condoms for injecting drug users and their sexual partner .

Other measures are information, education and communication for injecting drug users and their sexual partners; vaccination, diagnosis and treatment of viral hepatitis and prevention, diagnosis and treatment of TB14. Harm reduction aims to reduce the health and social risks or the dangers associated with drug use.

The benefits of harm reduction can be seen, to a significant degree, as a response to harms either created or exacerbated by the war on drugs. Politically-driven drug wars create policy conflicts with the health professionals caught in the middle.

Countries have adopted the ‘Harm Reduction’ approach, whose thrust is that individuals hooked to drugs are in dire need of medical assistance. Simply put, they are patients who need a doctor and should not be hounded all the time by security personnel.

Ms Apondi is policy manager at Kenya Aids Non-governmental Consortium. Email: [email protected]