Externalities

Sep 25

UNAIDS report criticises punitive drug policies

Today’s ‘2013 Report on the Global AIDS Epidemic' from UNAIDS contains plenty of good news (see BBC: ‘Dramatic’ drop in global HIV infections).

But there is notable criticism on the progress and policies surrounding injecting drug users, which I’ll try to collect here:

From the foreword: 

Stigma and discrimination remain rife in many parts of the world, and punitive laws continue to deter those most at risk from seeking essential HIV services.

On the 2011 target to ‘Halve the transmission of HIV among people who inject drugs by 2015’ (from the Introduction):

The world is not on track to reduce HIV transmission among people who inject drugs by 50%, as recent evidence suggests little change in the HIV burden in this population. HIV prevalence among people who inject drugs remains high – up to 28% in Asia. HIV prevention coverage for people who inject drugs remains low, with only two of 32 reporting countries providing the recommended minimum of at least 200 sterile syringes per year for each person who injects drugs. Among 35 countries providing data in 2013, all but four reached less than 10% of opiate users with substitution therapy. In addition to exceptionally low coverage, an effective AIDS response among people who inject drugs is undermined by punitive policy frameworks and law enforcement practices, which discourage individuals from seeking the health and social services they need.

More on that in these snippets from Chapter 2:

Recent data suggest little change has occurred in the HIV burden among people who inject drugs. HIV incidence among this population remains high, with people who inject drugs accounting for more than 40% of new infections in some countries.

A package of HIV prevention, care and treatment services is recommended for the prevention of new HIV infections among people who inject drugs.

Recommended services include access to HIV testing and counselling, sterile injecting equipment (through needle and syringe programmes), opioid substitution therapy, antiretroviral therapy and other health and social services. People who inject drugs and their sexual partners also need counselling, education, behavioural interventions and access to condoms to prevent sexual transmission.

Uptake of voluntary HIV testing and counselling is extremely low among people who inject drugs, and criminalization, stigma and discrimination deter individuals from seeking services.

…draconian policy and legislative obstacles, and low service coverage, prevent meaningful HIV prevention for many people who inject drugs in many countries in [Central Asia].

Chapter 8, on eliminating HIV-related stigma, discrimination, punitive laws and practices, says:

Punitive policies pertaining to drug use – including harsh penalties for possession of small amounts of drugs for personal use, criminalization of drug dependence, compulsory drug detention and bans on drug substitution therapy or needle and syringe programmes – prevent or deter many people who inject drugs from receiving the services they urgently need. Compulsory drug detention regimes in some countries are so severe that a United Nations Special Rapporteur on torture or other cruel, inhuman or degrading treatment or punishment singled them out for denunciation in 2013. In 2012, 12 UN system agencies jointly called for the closure of compulsory drug detention and rehabilitation centres.

I wrote in 2010 on how “the UN says bad laws and discrimination, particularly in respect to drug users and homosexuals, continue to hamper the fight against Aids.” Russia is a particularly bad offender but seems to get away with it in this year’s UNAIDS report by having failed (along with the USA) to report statistics about HIV amongst injecting drug users.

PS It was this blog’s 3rd birthday yesterday! I’ve rarely posted recently due to work - and the option of other outlets for writing - but it’s still here and I’ll continue to post when it’s useful…

May 12

[video]

Apr 16

If it’s in the news, don’t worry about it. By definition, news is something that almost never happens.

…It feels insensitive to say it so close to the tragedy, but it’s true. What people should worry about are things so common that they’re no longer news. That’s what kills people. Terrorism is so rare, it’s hardly a risk worth spending a lot of time worrying about.

” —

Well put: http://www.washingtonpost.com/blogs/wonkblog/wp/2013/04/16/if-you-are-scared-they-win-if-you-refuse-to-be-scared-they-lose/


Some rough stats:

Aircraft crash deaths per day: 3

Aircraft pollution deaths per day: 27

Mining deaths per day: 33 (around half in coal mines)

Deaths caused by terrorism globally per day: 36 (over 75% of these in the Middle East and South Asia)

Global deaths from extreme weather events per day: 77

Americans killed by gun crime per day: 87

War deaths globally per day: 151

Deaths from earthquakes per day: 172

Car crash deaths per day: 3,200

Deaths from AIDS per day: 4,900

Deaths caused by smoking per day: 13,700

Deaths from air pollution per day: 16,400

Deaths of children aged 0-5 per day from pneumonia, diarrhea, malnutrition, malaria and other diseases, mostly preventable: 19,000


They’re all tragic (though we might care about some age groups more than others, and the risk varies), but these are important numbers for deciding which issues deserve the most money, time and thought.

Apr 13

Large scale whole-genome sequencing coming to the UK

I completely missed this in December, but it’s a really remarkable sign of things to come. 100,000 full genomes are to be sequenced within the NHS over the next 5 years (if all goes to plan). I think that’s more full human genomes than the total sequenced worldwide since 2000. “A revolution is approaching”.

Prime Minister David Cameron [announced] plans to transform cancer treatment in England with new proposals to introduce high-tech DNA mapping for cancer patients and those with rare diseases, within the NHS.

The UK will be the first country in the world to introduce the technology within a mainstream health system, with up to 100,000 patients over three to five years having their whole genome – their personal DNA code –sequenced. […] The Government has earmarked £100 million. […]

When the human genome was fully sequenced for the first time in 2000, the project had cost approximately £500 million.

We will soon be able to sequence a human genome for less than £1,000, and the cost is likely fall further. As a result, experts believe a revolution in the way healthcare is delivered is approaching, with personalised medicines and individualised treatments becoming available for the first time.

The sequencing of 100,000 patients’ genomes in centres capable of sequencing DNA at speed in the UK will further drive down the cost.

Dec 10

David Cameron urged to take 'now or never' step on drugs reform -

Cross-party committee says prime minister should set up royal commission on Britain’s failing drug laws

Full PDF report available at http://www.publications.parliament.uk/pa/cm201213/cmselect/cmhaff/184/184.pdf

Nov 29

Leveson encourages linking to sources: Excellent news!

For me, the details of a press standards code are as important as the overarching structure of press regulation. Encouraging online outlets simply to link to the scientific and social policy studies they talk about would, I think, be a big improvement. It gives more power to the reader, at the expense of the media’s ability to spin facts how it likes - I don’t see how that can be a bad thing or the beginning of some Orwellian nightmare.

The Executive Summary says:

"A new regulatory body should consider encouraging the press to be as transparent as possible in relation to the sources used for stories, including providing any information that would help readers to assess the reliability of information from a source and providing easy access, such as web links, to publicly available sources of information such as scientific studies or poll results. This should include putting the names of photographers alongside images. This is not in any way intended to undermine the existing provisions on protecting journalists’ sources, only to encourage transparency where it is both possible and appropriate to do so.”

Aug 27

What the Cabinet said about drugs policy (in 1970)

Over at The Poison Garden is a preliminary fisking of Peter Hitchens’s upcoming drugs policy book and its promotion. That led me to track down a fascinating document of Cabinet Conclusions. The date is 26th February 1970 and the topic is “the forthcoming Misuse of Drugs Bill”. The Home Secretary is James Callaghan, and this is a few months before Wilson loses the election to the Tories (who - very unusually - see that the previous government’s bill becomes law). In another document (the memorandum) Callaghan states that his own view is that the three-classifications idea should be ignored, and that possession of any controlled drug should have a maximum sentence of 7 years.

Here’s the drugs discussion in its entirety, with emphasis added by me (note how easily managing public opinion is put ahead of rationality and considered expert judgement):


"The Cabinet had before them a memorandum by the Home Secretary on the Misuse of Drugs Bill (C (70) 34).

The Home Secretary said that the Home Affairs Committee had recently considered the range of penalties to be provided in the forthcoming Misuse of Drugs Bill. Existing legislation on this subject distinguished in principle between the offences of simple possession of controlled drugs and trafficking in them. But, under the Dangerous Drugs Act, 1965, which dealt with heroin, cocaine, morphine and cannabis, the two offences had been treated on the same basis and the same penalty of ten years’ imprisonment applied to each. Under the Drugs (Prevention of Misuse) Act, 1964, which dealt with amphetamines, LSD and other hallucinogens, possession was punishable by two years’ imprisonment; and there was no separate offence of trafficking. The Committee had agreed that the new Bill should continue to distinguish between the offences of possession and trafficking; but they had also approved a division of drugs into three categories, each of which would attract a separate and appropriate penalty. But if—as was clearly right—the penalties for trafficking should be increased (e.g. in the case of the most dangerous drugs, from the existing limit of ten years’ imprisonment to a new limit of 14 years), it followed that the penalties for simple possession of the less serious drugs should be reduced; and the Committee had recommended that on this basis the penalty for possession of cannabis might be curtailed from ten years to three years. Further reflection, however, had suggested that public opinion might well regard a change of this kind as indicating too lenient an attitude on the part of the Government towards the potentially dangerous practice of drug-taking; and the Cabinet would wish to consider whether the political damage which the Government might suffer if this impression gained ground was sufficiently serious to justify a modification of the terms of the Bill before it was introduced.

If so, one of two courses could be adopted. The first would preserve the three categories of controlled drugs but would increase the penalties for simple possession of drugs in the two most serious categories from three years’ imprisonment to five years in the case of cannabis and from five years to seven years in the case of heroin, cocaine, etc. The second approach, which on the whole he advised, would be to abandon the distinction between categories of drugs entirely and to provide single maximum penalties for possession and trafficking respectively. The former might be either ten years or seven years’ imprisonment; the latter would be 14 years in all cases.

In discussion, there was general agreement that it would be right to maintain the distinction between the offences of possession and trafficking and to establish a more flexible and discriminating classification of the various categories of drugs. But the proposed reduction of the penalty for simple possession of cannabis from ten years’ imprisonment to three years would be liable to be severely criticised by public opinion, especially by parents and teachers. The impact of this apparent concession to the permissive tendencies in society would not be offset by the increase in the penalty for possession in the case of other drugs (e.g. LSD); and the Government might be at considerable political risk as a result. It would be very unwise to underestimate the degree of public concern on this subject and the ease with which the Governments intentions might be misinterpreted.

On the other hand, the proposals as approved by the Home Affairs Committee were the result of very careful consideration and reflected the considered judgment of expert opinion. Of the two alternative courses which the Home Secretary had suggested the second would entail a maximum penalty of seven years’ imprisonment for simple possession of cannabis; and a sentence of such severity was wholly unrealistic in relation to the offence as committed by, for example, a schoolchild. Moreover, the penalty actually imposed would lie at the discretion of the court; and, since it was most unlikely that the court would in fact deal so harshly with an offence of this kind, the law itself would be liable to fall into disuse and disrepute. The political risks of proceeding with the proposals as approved by the Home Affairs Committee could be exaggerated; and in any event it would be wrong, in a matter of this kind, to subordinate the requirements of humanity and equity to political considerations.

The Prime Minister, summing up the discussion, said that it appeared that the Cabinet were in favour, by a small majority, of proceeding with the proposals recommended by the Home Affairs Committee. But it might help to allay public disquiet if the proposed penalties for possession of controlled drugs were increased to some extent—e.g. to seven years (instead of five years) for the most serious drugs and to five years (instead of three years) for drugs in the second category, including cannabis. The Cabinet agreed that the Bill should go forward on this basis.

The Cabinet—

Invited the Home Secretary to arrange for the early introduction of the Misuse of Drugs Bill on the basis indicated by the Prime Minister in his summing up of their discussion.”


PS If anyone has or can find any of the relevant Home Affairs Committee documents, please do let me know!

OH NOES! IS LION!

OH NOES! IS LION!

Aug 25

They went to the moon. The actual moon.
“Twelve men have walked on the Moon – all American – of whom eight are still living.” The youngest is almost 77.

They went to the moon. The actual moon.

Twelve men have walked on the Moon – all American – of whom eight are still living.” The youngest is almost 77.

Aug 23

15 Old Photographs That Prove the World Used to Be Insane -

Be sure to click through to p2.

Astonishing.