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A Review of the Global Commission on Drug Policy's Second Report
By Leilani Attilio, R.N./B.S.N.

Aggressive drug law enforcement practices have been counterproductive and created a smoke in mirrors effect on apparent “successes” such as increased drug seizures, arrests, and criminal convictions. However, the “war on drugs” has not only diverted funding from public health programs, but also facilitated the spread of the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) epidemic among people who use drugs and the community. A new report published by the Global Commission on Drug Policy outlines several pitfalls on international and U.S. domestic policies on drug use that has ultimately led to millions of new HIV infections and AIDS deaths. According to the Centers for Disease Control and Prevention, about 25% of new HIV/AIDS cases are due to sharing of needles and syringes and is the second leading cause of HIV/AIDS.

One of the most recent U.S. policies facilitating the spread of HIV/AIDS is the ban of federal funding towards domestic and international needle exchange programs. In 2009 President Obama lifted the 20-year ban. Despite the overwhelming evidence suggesting needle exchange programs are effective in decreasing the spread of HIV/AIDS and support from the American Medical Association, Centers for Disease Control and Prevention, and the American Public Health Association, the U.S. Congress re-instated the ban as part of a “compromise” on the 2012 spending package in the name of fiscal responsibility. It is worth noting that the average lifetime cost to treat a person living with HIV/AIDS is $355,000 whereas the cost per HIV infection averted through syringe access program is between $4,000 to $12,000 (CDC, 2010; Holtgrave & Pinkerton, 1997). It begs to ask the question why lawmakers would impose dubious policies. Opponents of syringe access argue increasing syringe access enables people who inject drugs, encourages people to initiate injection drug use, and ultimately sends the wrong message. However, research has shown time and again that increasing access bridges people who inject drugs to much needed social services such as drug rehabilitation and does not increase injection drug use.

Another area highlighted in the Global Commission on Drug Policy report is the steady diversion of public health funds to drug law enforcement agencies. Aggressive law enforcement practices have driven fear into people who use drugs further underground and thereby engaging in high-risk drug behaviors. The anemic budget of public health organizations has led to missed opportunities to decrease the spread of HIV/AIDS. So until a paradigm shift brings policies closer to effective practices, public health practitioners will continue to advocate and promote evidenced-based research as a means of decreasing the further harm to drug users themselves and the community at large.


Centers for Disease Control and Prevention (CDC). (2010). CDC's HIV Prevention Progress in the United States. Retrieved June 25, 2012, from
Holtgrave, D. R., & Pinkerton, S. D. (1997). Updates of cost of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. J Acquir Immune Defic Syndr Hum Retrovirol, 16(1), 54-62.

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