Harm Reduction? What happens on UN level

by Moritz Förster

140 Member States of the United Nations, 18 intergovernmental organizations, 141 non-governmental organizations, and nine UN entities had been represented at the 67th session of the Commission on Narcotic Drugs (CND) in March. More than 2500 participants attended in total. The biggest gathering of the commission ever. Ghada Waly, Executive Director of the United Nations Office on Drugs and Crime (UNODC), concluded that the UNODC pledges to support a “paradigm shift towards much stronger frameworks for prevention in Member States, whether to prevent drug use and harmful behaviours, to prevent illicit economies from exploiting and expanding, or to prevent violence associated with the illicit drug trade, with a focus on children and adolescents, as well as those who are in settings of vulnerability”. Kenzi Riboulet-Zemouli, independent researcher, reviews the 67th session for krautinvest.de.

krautinvest.de: The United Nation’s CND has held its midterm review in March in its headquarters in Vienna. The CND is the policy making body within the UN. How was the sentiment towards more progressive adjustments for adult-use cannabis policy?

Kenzi Riboulet-Zemouli: As usual at the CND since its creation in 1946, there was no substantial mention of adult use cannabis policy, except from the usual suspects and reactionary opponent countries to policy reform. The only real moments of discussions on adult use happened after Uruguay’s legalisation (because Canada did not particularly discuss the topic at the UN beyond announcement at UNGASS 2016) while the CND only ever meaningfully discussed medical uses of cannabis in 2019 and 2020 ahead of the descheduling that I worked on. So, CND is not the place to go if one wants to hear cannabis legalisation discussion.

However, the CND every year discusses general policy on controlled plants and substances that still do apply, albeit indirectly, to cannabis. The CND discusses in particular the need for access and availability of controlled medicines for patients (including cannabis therefore) and this year emphasised the importance of these two parameters: actual access to the medicine, availability of stocks… but a number of country, including many EU ones, also added that “affordability” was critical for patients.

The main topics discussed at CND are generally the medical uses, and the fight against illicit activities. There are rarely discussions about legal and non-medical cannabis, also because the discussions are articulated around mandates of the international drug control Conventions, which are essentially regulating the medical and pharmaceutical sector, and establishing penal measures for violations of the medical-pharmaceutical regulations established. The Conventions do not talk about non-medical and non-illicit uses (they are actually exempted from the Conventions, therefore outside of their general scope). 

Therefore, non-medical (adult use) cannabis is discussed at CND within this context, as a minor issue not covered by the Conventions. There is a fundamental discussion to be held on adult use being outside the Conventions: does this mean that adult use is not allowed, and that countries can simply not regulate it (as most countries, in particular in the sphere of influence of China and Russia, defend) or does that mean that adult use is simply not the topic of the Conventions, and therefore countries can regulate it sovereignly (this position is not defended at the CND in oral statements, but some legal regulations like the Swiss or Maltese ones have started incorporating some elements of that approach).

krautinvest.de: How will the results of high.level ministerial drug policy discussions affect future policy and might lead to adjustments of existing conventions?

Kenzi Riboulet-Zemouli: The High Level Ministerial Segment was a theatre: the final document of that ministerial meeting was adopted in the first 30 minutes of the debate (it had been negotiated previous to the CND meeting, in secret). The document has formally a higher ranking than regular CND documents, yet, few at CND even read it or paid any special attention to it. A more important work was ongoing in the background the week after the High Level segment: the attempt to finally close a discussion of several decades, aimed at introducing the terms “harm reduction” in CND documentation.

CND has always articulated the mandate of the Conventions under two main areas: demand reduction (focused on fighting illicit use, while maintaining licit medical uses), and supply reduction (fighting production/traffic). Incorporating the concept of “harm reduction” alongside was a goal of progressive countries and the global healthcare sector since the early 2000s. However, the method of consensus-based decision of the CND (where every country has to be satisfied with every word in every text) in use since 1946 has resulted in CND documents being always mild, over-balanced, and often unable to go beyond a simple reiteration and reformulation of previously agreed language. This so-called “Vienna consensus” has long been criticised for maintaining an inertia in CND documentation, blocking any evolution –even something as simple as adding the two words “harm” and “reduction” in a resolution.

This year, the US led a push for the inclusion of the words “harm reduction” by trying to convince all other countries and reach a consensus on a resolution calling for harm reduction measures in the fight against opioid overdoses. At the High-Level meeting, US Secretary of State Anthony Blinken came to address the CND in person, but, behind his visit and a public statement of little relevance, the US Embassy was articulating a coordinated diplomatic action for the regular CND of the following week. During one week the draft resolution on harm reduction was negotiated in an attempt to agree on the text, but, in the last hours of Friday 22nd, the draft was moved to the CND plenary for final approval without consensus. This resulted in a vote on the resolution, with the only votes against of China and Russia.

While this was not formally the first vote on a resolution since 1946 (Iran had called for a vote just minutes before the US harm reduction resolution, to preempt the precedent), it represents a turning point in CND policymaking history. If CND resolutions do not have the power to change or influence treaties, they can indeed provide policy guidance for treaty interpretation, particularly through the language they use (see High Compliance, pp. 78-79).

So, this shift of the CND from the Vienna consensus to a more normal method of decision-making by vote can represent, on the medium to long term, an opportunity for the CND to issue more meaningful texts, addressing ongoing challenges in the implementation of the Conventions, and in particular, the articularion of non-medical use with the drug control treaty system, its exemptions, and its limitations.

krautinvest.de: You have organized with various NGOs the “Cannabis Embassy” a side event about Cannabis Biopiracy. What have been the outcomes of this side event?

Kenzi Riboulet-Zemouli: Biopiracy designates the illegitimate and/or illegal appropriation of biological heritage (genetic resources) and associated traditional knowledge: the landraces of Cannabis and the knowledge of local farmers who have conserved pools of Cannabis biodiversity in their local ecosystems over generations. Landraces reach us today in 2024 only because small, dedicated, traditional growers have continued to cultivate them within their environment. The economic potential of landraces makes them highly susceptible to biopiracy. In the past, both small-scale farmers in traditional Cannabis-cultivating countries, and small-scale growers in Western countries, were victims of prohibition and repression, and seed exchange was a practice of solidarity and brotherhood/sisterhood between growers. Today, however, the situation has evolved. Western countries have provided ways for growers to formalise and regularise their activities, and practices such as breeders’ rights and the craft of new biotechnologies have created a space where plants and landraces derived from landraces can become proprietary. In many traditional Cannabis-cultivating countries, this is not the case, and farmers continue to be repressed, impoverished, and without legal pathways to regularise their craft. Ethically, there is an important issue here. But beyond moral concerns, there are now legally-binding treaties that regulate bioprospection, to avoid biopiracy. In 2024, no landrace should be collected without the full, free, prior informed consent of local traditional or indigenous custodians. A number of treaties like the Nagoya protocol (in force in the EU since 2017) or the FAO Plant Treaty, impose a series of measures and protect farmers’ rights –but they are totally ignored when Cannabis policy reforms are passed, while drug control treaties are overly-mentioned. In May, in Geneva, I will attend the negotiations of a new treaty against the patenting of genetic resources and associated traditional knowledge (future GRATK treaty). At CND, at our side-event (UN parallel conference during plenary pauses of the CND) we introduced the concept of biopiracy. It was very insightful to hear from different perspectives of Professor Chris S. Duvall, the famous breefer Sam the Skunkman, indigenous representatives from Xhosa (South Africa) and Māori (New Zealand) communities, Myrtle Clarke, and myself. The packed room indicated interest in the event from attendees, coming from government delegations, UN agencies, and civil society groups alike.

Interestingly, the side-event aligned perfectly with a call made by Bolivia’s Vice-President during the CND High-Level segment a few days earlier, announcing a series of measures to fight against biopiracy of the coca leaf, using the mechanism of Article 10 of the Nagoya protocol and the future GRATK treaty. This was much welcome, as an important government-civil society discussion on biopiracy, for both coca and cannabis, emerged as an important workflow for the years to come. It also underlined the importance to consider the whole of the international legal environment for cannabis, beyond drug control.

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