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Ideas for a fairer world

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China's Flawed Drugs Policy

By Verity Robins, Verity Robins.

China has woken up to its drug problem, but it is failing woefully in trying to tackle it. Nestled between two major heroin-producing regions, the Golden Triangle (Burma, Thailand, Laos, Vietnam) and the Golden Crescent (Afghanistan, Pakistan, Iran), China has long been a transit path for drugs headed toward the rest of the world. Along an ever-expanding network of routes that lead to China's international seaports, domestic heroin use is soaring. No longer just a transit country, it now has a sizable user population of its own. The rise in domestic heroin addiction has had disastrous social consequences, with an increase in Chinese drug cultivation and organised criminal activity, as well as a rise in intravenous drug use and a spiralling HIV/AIDS epidemic.

China's role as a drugs conduit has increased considerably over the past two decades. Throughout the 20th century, opium and later heroin, from the Golden Triangle, was smuggled to Thailand's seaports and then on to satiate drug markets throughout the world. More effective law enforcement and a stricter drug policy in Thailand in the late 1980s and early 90s reduced the state as an effective trafficking route.

Concurrently, Burmese drug lord Khun Sa, the prime heroin producer and distributer along the Thai-Burmese border, surrendered to the Burmese authorities. With the collapse of Khun Sa's army, Burma's foremost heroin trafficking route into Thailand was disrupted. Consequently, China's role as a narcotics conduit became even more crucial.

Well over half the heroin produced in the Golden Triangle now travels through China, wending its way through southern provinces Yunnan, Guangxi and Guangdong towards Hong Kong. This shift in regional drug trade routes coincided with rapid economic development in China's southwest. More robust roads allow for faster and easier transportation of illicit drugs, while an increased fiscal and technological ability to refine heroin locally has driven down its market value and increased local consumption.

By 1989, the HIV virus was detected amongst injecting drug users in China's most south-westerly province Yunnan. Needle sharing drove the epidemic, and HIV/AIDS rapidly spread to drug users in neighbouring provinces and along trafficking routes. At the turn of the century, HIV infections had been reported in all 31 provinces, autonomous regions and municipalities, with drug users accounting for 60-70 per cent of reported cases.

While the Chinese government was slow to engage substantively with a generalised AIDS epidemic in the country, a new administration taking office in 2003 under President Hu Jintao accelerated the commitment to and implementation of evidence-based HIV policies. Having woken up to the seriousness of its HIV/AIDS epidemic, the Chinese government sought increasingly progressive means to combat the crisis, calling on a range of outside actors to implement new and innovative pilot projects. During the 2000s, the government seemingly revoked its zero-tolerance attitude towards drug users, introducing needle exchange programmes and controlled methadone maintenance treatments in the most affected areas.

While the Chinese government continues to take a pragmatic approach to its HIV/AIDS crisis, the good work of these projects is offset by the 2008 Narcotics Law that vastly emphasises law enforcement over medical treatment in the government's response to drug use. This law calls for the rehabilitation of illicit drug users and for their treatment as patients rather than as criminals, yet the law also allows for the incarceration - without trial or judicial oversight – of individuals suspected by police of drug use for up to six years in drug detention centres.

To allow for this, the 2008 Narcotics Law considerably enhances police power to randomly search people for possession of drugs, and to subject them to urine tests for drug use without reasonable suspicion of crime. The law also empowers the police, rather than medical professionals, to make judgements on the nature of the suspected users' addiction, and to subsequently assign alleged drug users to detention centres.

According to Human Rights Watch, whilst in detention centres suspected drug users receive no medical care, no support for quitting drugs, and no skills training for re-entering society upon release. In the name of treatment, suspected drug users are confined under "horrific conditions, subject to cruel, inhuman and degrading treatment, and forced to engage in unpaid labour".

Not only is this law ineffective in tackling China's growing drug problem and rehabilitating its users, but incarceration of suspected addicts in detention centres represents a serious breach of the basic human rights guaranteed by both China's domestic and international legal commitments. Furthermore, the law is a counter productive policy for combating HIV/AIDS in China.

The threat of forcible detention only discourages users from seeking professional help to tackle their addictions, and from utilising needle exchange programmes for fear of incarceration. The result is to encourage "underground" illicit drug use that leads to needle sharing and hence the spread of HIV/AIDS. Effective tackling of illicit drug use requires developing voluntary, outpatient treatment based upon effective, proven approaches to drug addiction. Specific reform of the law should reverse the expanded police powers to detain suspected users without trial, and implement specific procedural mechanisms to protect the health and human rights of drug users in a standardised and appropriate way.

The Chinese government has sought to work with outside actors in combating its HIV/AIDS epidemic, particularly in its most affected province Yunnan. The UK Department for International Development (DfID) has been engaged in HIV/AIDS prevention throughout southwest China since the launch of the China-UK HIV/AIDS Prevention and Care Programme in 2001. DfID's Multilateral Aid Review, published in March this year, cut all future development aid to China. The discontinuation of DfID projects in southwest China will weaken efforts to prevent HIV/AIDS and rehabilitate drug users in the region. It also lessens pressure on China to combat these issues in a reasonable and felicitous way.

The international donor community present in China must implement policies that reflect realities on the ground by ensuring that the health care and treatment of drug users is at the core of their HIV/AIDS policies. They should also use their position of influence to nudge Beijing to rectify the flaws in the 2008 Narcotics Law with its negative implications for the human rights of suspected drug users, and for combating the spread of HIV/AIDS.

If the country's skyrocketing number of intravenous drug users and the resultant HIV/AIDS epidemic are left to fester, it could result in severe health consequences, economic loss and social devastation. China still has time to act, but it should do so now before it is too late.

June 2011