Basic HTML Version
Thursday 7 April 2011 – DAY FOUR –
Daily Update
– 3
Joao Castel-Branco Goulao
is Portugal’s national
drugs co-ordinator. In yesterday’s Dialogue Space
he explained how decriminalisation became part
of the country’s drug strategy.
PORTUGAL WAS A CLOSED SOCIETY
, with almost no
connections with European societies. Hippies and the student
activism in France – all of it passed by our society. Drugs were
present – but not for the masses.
Then there was a revolution, and soldiers came back from the
colonies with experience of using drugs. The association of drugs
with freedom was explosive and there was a boom of drugs,
beginning with cannabis. Other dealers came into the emerging
market bringing heroin, and society wasn’t prepared for it.
We were very naïve about drugs – we knew nothing. It was easy
for people to go from cannabis to heroin; it was easy to spread
experimentation and for people to get hooked.
In the late 1970s and ’80s there was an enormous spread of
heroin use. It was almost as if everyone who started using drugs
became an addict. Out of 10m inhabitants we estimated that 100,000
people were hooked on heroin – 1 per cent of the population.
Lots of people committed crime and it became an enormous health
and social problem, as well as a political problem. When asked ‘what is
your greatest fear for your children?’ people would talk about drugs.
More and more people were feeling that someone using drugs
was not a criminal but someone who needed help, so we started to
invest in treatment. A campaign to offer treatment in the mid 1990s
didn’t go in the right direction and the minister responsible realised
he had to change the paradigm.
I was among the group of specialists he invited in, and we talked
to leading countries such as Spain and Switzerland. People came to
Portugal to watch what was going on and made a lot of proposals
on treatment and harm reduction. Even if a person could not stop
taking drugs, we realised they still needed investment.
It’s still not legal to use drugs in Portugal, but you get a penalty
like not wearing a seat belt. The political Right used to say Portugal
would become paradise for drug users all over the world and that our
children would use drugs for milk! But it didn’t.
The strategy was approved in 1999 and became law. In 2005 the
Socialist Party gave it a new push and it became part of public
health, with a 75m Euro budget.
The indicators of success are good. There has been a clear
decrease in drug use among 15 to 19-year-olds and indicators show
a decrease in AIDS.
Dialogue on decriminalisation
Joao Castel-Branco Goulao
: ‘Out of 10m inhabitants we estimated that
100,000 people were hooked on heroin – 1 per cent of the population.’
there are lots of opportunities, and a lot of
great things have been happening, most of it
probably not reported. In some cases that’s
the best way to go.’
However, some government members were
adamant that they would not approve the pilot
OST programme, she says. ‘I tried to explain
the importance of the programme and to dispel
some of the misconceptions that they had, and
luckily enough they were willing to go ahead.’
One of the problems Pakistan faces is the
country’s very high rates of hepatitis B and C.
‘We have approximately 7-11 per cent
prevalence, which in a population of 180m is a
lot of people,’ she says, while HIV prevalence
among injecting drug users is thought to be
around 15 per cent. IHRA estimates that just
4.5 per cent of drug users living with HIV are
aware of their status. ‘We’re a developing
country and we don’t have a lot of money – our
blood banks now screen for hep B and C, but
we don’t have the money to screen for HIV,’
she states.
A key challenge remains the amount of
Afghan heroin coming across the border.
‘There’s no doubt about the fact that that has
played a major role in various socio-economic
issues in Pakistan, HIV/AIDS being one of the
topmost,’ she says. ‘We have also found that
much of our migrant labour that goes to the
Middle East is coming back infected, and
unfortunately they are not told of their status. In
some of the Gulf countries they do sporadic
testing and if someone is found to be positive
they are very unceremoniously deported and
throughout the process are not told what their
status is. They’re married men coming back
and infecting their wives or other partners. This
is a huge human rights issue from our
perspective and Pakistan has taken the lead
after the World Health Assembly on flagging
this issue within the context of HIV/AIDS, and
starting a dialogue with those countries to
change this practice.’
She is delighted to be addressing the 22nd
International Harm Reduction Conference, she
says. ‘I say keep up the good work. All the
activists and players in the HIV/AIDS field have
come a really long way. When I was a medical
student in 1999 I was told that HIV/AIDS would
never be an issue for a country like Pakistan
because we’re Muslim. The fact that the
government now has programmes that
respond to drug users, sex workers, MSMS
and the general public at large shows that the
people who have been advocating and
lobbying in this field have done a good job.
Everyone deserves a lot of appreciation for that
and they need to take time out to celebrate the
milestones they’ve achieved.’
Continued from p1