Cities have the potential to drive innovative initiatives on drugs that can inspire national change

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On 26 June 2024, at the occasion of the International Day against drug abuse and illicit trafficking, the Global Cities Hub (GCH) hosted a Geneva Urban Debate on “Advancing Drug Policy Reform at the Local Level”. The event was co-organized by the Global Commission on Drug Policy (GCDP), UN Habitat, with the sponsorship of the Permanent Missions of Colombia, Romania, South Africa and Switzerland, the Office of the High Commissioner for Human Rights (OHCHR), Harm Reduction International and the “Support don’t Punish” campaign.


The Geneva Urban Debate put the limelight on an issue that is not often discussed within the International Geneva ecosystem and at a level that is usually forgotten, i.e., the local level. It was therefore very interesting to hear what is being done at city level in terms of local drug policies. In the past decades, faced with the harsh local realities of drug users, many cities have been moving away from repression and criminalization to instead favor harm reduction, safety, public health and follow a human-rights based approach. Because of their proximity to the affected population, their ability to respond quickly and pragmatically to local needs, cities are particularly well positioned to develop and implement effective and innovative policies on drugs. In doing so, cities’ experimentation and efforts can guide the international community’s response to the world drug problem.



In more detail:


The Global Commission on Drug Policy (GCDP) – a group of eminent personalities wishing to inspire better drug policy globally – has supported the move by cities to adopt more integrated approaches to drugs, taking into account public health, human rights, social justice and safety. The GCDP recently held several consultations with cities, with the aim to develop a Cities’ strategy for drug policy reform including a set of common principles to guide local authorities. Most often, local level action provides rapid, tailored, and community focused solutions to address the urgent and various challenges of drug users. As mentioned by Michel Sidibé, member of the GCDP and former UNAIDS Executive Director, “Cities have the potential to drive innovative initiatives that can inspire national change”.


Several UN entities work on the issue of drugs, including UN Habitat and the Office of the High Commissioner for Human Rights (OHCHR). As the lead UN agency dealing with sustainable urban development, UN Habitat (Graham Alabaster) looks at drugs through an urban lens, focusing on urban health, urban space inequalities (in particular the lack of public services in certain areas), ways and means to improve local governance for better urban safety and security. In particular, UN Habitat emphasized how important it is to involve civil society and it recalled its role in brokering partnerships between civil society and local governments. As for OHCHR (Zaved Mahmood), it has been addressing the issue of drugs with the support of Member states who have put forward resolutions at the UN Human Rights Council and the UN General Assembly. OHCHR has been engaging with cities in Colombia, Ghana, Indonesia, Malaysia, Mexico, Pakistan and UK to discuss drug policies and promote human-rights based approaches at municipal approaches. The OHCHR published a report on ““Human rights challenges in addressing all aspects of the world drug problem”, touching upon the war on drugs, prison overcrowding, the use of death penalty, as well as the disproportionate impact on marginalized communities. The report makes recommendations to shift from punitive drug policy models towards approaches that promote health and human rights. These recommendations can be particularly beneficial for cities and local authorities, where law enforcement typically falls under their jurisdiction.


The Geneva Urban Debate provided a most welcome opportunity to also hear directly from cities themselves and how they drive local change. Recalling the heavy industrial past of Glasgow (UK), Casey Allan referred to the difficult history of his city with significant poverty issues and areas of deprivation, leading to abuse of drugs and alcohol. While Glasgow has been the epicenter of Europe’s drug-related deaths, the city has reacted and responded with forward-thinking and progressive policy making. A new Glasgow City Alcohol and Drug Partnership Strategy (2023-2026) has been introduced with the vision for people in Glasgow to live free from the harm of alcohol and drugs. Monitoring is also an important part of Glasgow’s efforts to better understand the drug trends and the needs of drug users. In 2019, Glasgow opened the 1st heroin assisted treatment service and Glasgow will also be the first city to soon open a safe consumption room in the UK. As for Tshwane (South Africa), Koena Nkoko recalled the fact that cities were the most impacted sphere of government by drugs. Because of their proximity with residents, local governments can design context-specific and thus relevant responses. Tshwane has, in close collaboration with the academia and civil society,  set up the “Community-oriented substance use program (COSUP) which delivers a range of services, including demand reduction, treatment, education and rehabilitation. It involves medical interventions, counselling, social services, HIV/AIDS and TB screening, needle exchange programs, opioid substitution therapy and post-rehabilitation support. Also, a “street medicine program” enables to take health services to beneficiaries, in their localities, through COSUP.


Civil society stakeholders also provided their perspectives during the Geneva Urban Debate. In particular, Judy Chang from the International Network of People who Use Drugs (INPUD) emphasized the relevance of the local level: “There is more space at local level. This is where innovation occurs, and actions are taken, and the local level better aligns with people’s lives and realities”. In particular, she recalled the importance of consulting drugs users, to ensure the adequacy of services provided. For that, formal consultation mechanisms should be put in place. Ajeng Larasati from Harm Reduction International underlined the lack of funding for harm reduction, the importance of supporting advocates to also work at the city level to increase political support and help secure domestic activity.


The Permanent Mission of Switzerland and Colombia intervened from the floor, both emphasizing the need to move away from repression towards public health and human rights-based policies, the importance of a whole-of-government approach and underlining the role of cities as “laboratories”, where experimentation can take place to guide national action on drugs. “Drug policies need dialogue and cooperation at all levels of governments”, as recalled by Colombia. Echoing previous speakers about the role of cities in the international debate on drug policies, the city of Amsterdam also intervened during the event to refer to the upcoming 6th European Harm Reduction Conference in Warsaw (Dec. 2024) and to the Amsterdam Manifesto Dealing with Drugs, which is open for endorsement. Through this Manifesto, mayors, scientists and NGOs pledge to adopt a more humane drug policy, according to four guiding principles, in order to shape policies grounded in evidence, empathy and effectiveness.


In her closing remarks, Ruth Dreifuss, member of the GCDP and former President of Switzerland, referred to the fact that the international community had decided to adopt punitive drug policies 60 years ago (in particular through the 1961 UN Single Convention on Narcotic Drugs, as well as the following 1971 and 1988 UN Conventions) and that these still apply today. There is unfortunately no international consensus over whether and how to move forward with reform. This international regime retains today a strong influence over national legislations. In spite of this, local governments still have to deal with people suffering from drug abuse who lose their jobs and homes and are considered as a threat to society. For that purpose, local governments have started to implement drug policy reforms at their level, demonstrating how necessary, useful and effective it is to prioritize health and the human rights of drug users. And the GCDP is proud to support cities who have taken that direction.


The GCH was very pleased to organize a Geneva Urban Debate on an issue that gathers both the international health and human rights communities and on which it is necessary to carve more space for cities to put forward their best practices, which have clearly demonstrated effectiveness on the ground.





World Drug Day: Advancing Drug Policy reform at the local level, 26 June in Geneva and online.


Drugs and the City



City of Tshwane