NACOSA Advocates for People-Centred Drug Policy

South Africa needs a drug policy that focuses on putting people first. There are an estimated 400 000 people using heroin with estimated 82 500 people who inject drug in South Africa. National HIV prevalence amongst people who inject drugs is recorded at 21.8%, with 83% Hepatitis C prevalence. NACOSA’s People Who Use Drugs programme funded by The Global Fund reached 31 257 people who inject drugs in 7 South African districts between April 2019 and March 2022, identifying a 23% HIV positivity yield.

The recent Africa Policy Week brought together policymakers, advocates, and experts from across the continent to discuss the theme of “putting people first” in the context of drug policy reform in South Africa. Former President Kgalema Motlanthe, who also serves as the chair of the Eastern and Southern African Commission on Drug Policy, was the key note speaker.

NACOSA highlighted the harm reduction services and current policies within South Africa. Yolaan Andrews, the NACOSA Key Populations Programme Manager presented the findings of the Global Drug Policy Index 2021. The report identifies a concerning pattern; frequent police violence and torture of drug suspects, unlawful arrests and detentions, negative impacts on ethnic groups, women, and low-income communities, and a marked imbalance in the imprisonment of non-violent offenders. “These results highlight the negative consequences of a punitive drug control policy that continues to promote racial and social inequities.” Emphasised Andrews.

“A sad example of this injustice can be found in the shocking statistics surrounding human rights violations reported on NACOSA’s People Who Use Drugs programme. In just three months at the start of the year, there were 600 human rights violations reported. Needles continue to be seized by law enforcement at an alarmingly high rate and frequent assaults and unlawful arrests were reported. These numbers show a clear need for a new approach to drug policy that addresses the root causes of these violations and recognises that criminal justice system in South Africa is ill-equipped to deal with the huge number of people arrested for possessing small quantities of drugs for personal use.” She explained

The important 2018 Constitutional Court judgement that decriminalised private cannabis use and cultivation was a step in the right direction, but the legal barrier to commercial sale and distribution of cannabis remains. The experience of the sex worker movement, which advocates for the decriminalisation of sex labour, teaches important lessons. In November 2022, Cabinet gazetted the Criminal Law (Sexual Offences and Related Matters) Amendment Bill for public comment. The sole aim of the Bill is to decriminalise the sale and purchase of sex work in South Africa, and was to follow a “two-step approach”, where decriminalisation via legislation would then proceed with regulation of the industry. However, this “two-step approach” has now provided an obstacle where the Bill is not passing constitutional muster if it does not provide for the regulation of sex work. Therefore, it is important to not only review punitive national laws, but also address discriminatory by-laws that are drafted at the local municipal level, allowing for punitive discretion.

NACOSA believes that a comprehensive approach is important for South Africa to advance its drug policy towards a more people-centred focus which includes several key components such as comparative analysis of other countries’ drug policies and learning from the successes of countries that pursue decriminalisation and harm reduction strategies. Research is also required on the current policies’ impact on public health, crime rates, rates of incarceration and social justice. NACOSA calls for a health-centric approach which invests in harm reduction, treatment, and prevention efforts aimed at addressing drug-related health issues within communities as opposed to criminalisation.

South Africa should consider the decriminalisation of specific drug possession for personal use to reduce the burden on the criminal justice system and redirect resources towards treatment and education. This will correct historical inequities through fostering social fairness, assisting marginalised populations, and correcting past injustices. As has been done in other countries, piloting policy changes on a smaller scale before nationwide implementation would provide valuable insight on their impact and necessary adjustments, with data-driven feedback informing decision-making and allowing for timely adjustments as needed.

Lastly, stakeholder involvement is crucial for effective policy reform, which includes public education campaigns that help people make informed decisions about drug use and its effects. Community involvement is also key to addressing specific geographical requirements and community concerns, but also to provide a space for the people who use drugs to actively engage and inform policy reform. Remembering always, the principle of ‘nothing about us, without us!’

By adopting these multifaceted strategies, South Africa can pave the way for a more effective and equitable approach to drug policy. The National Strategic Plan on HIV, TB, and STIs 2023-2028 highlights the call for decriminalisation and the expansion of harm reduction services. By treating drug use as a public health concern, South Africa can develop more effective addiction and harm reduction initiatives.

South Africa needs to progress on a comprehensive drug policy reform to achieve long-term transformation. This journey must include policymakers, law enforcement, healthcare providers, communities and the people directly affected. South Africa can develop a fairer and more equal society for all its residents by tackling the core causes of inequities and moving the focus to public health. “The time for change has arrived, we cannot afford to lose another life due to punitive drug policies.” Andrews concluded.