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Please sign the declaration here.

Between now and 2012 it’s up to you and your friends, communities, governments, newspapers, to advocate for evidence based drug policy and strengthen the call for policies driven by evidence. Join the movement to end the failed war on drugs, sign the declaration and share it with your networks today.

The Vienna Declaration is a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. We are inviting scientists, health practitioners and the public to endorse this document in order to bring these issues to the attention of governments and international agencies, and to illustrate that drug policy reform is a matter of urgent international significance. We also welcome organizational endorsements.

The declaration process was launched as the the official declaration of the XVIII International AIDS Conference (AIDS 2010) held in Vienna, Austria from July 18th to 23rd. The declaration was drafted by a team of international experts and initiated by several of the world’s leading HIV and drug policy scientific bodies: the International AIDS Society, the International Centre for Science in Drug Policy (ICSDP), and the BC Centre for Excellence in HIV/AIDS.

Backgrounder

What the Vienna Declaration Is

Why We Need It

Policy Today: A Proven Failure

The Need for Change

Lending Your Name

What Else You Can Do

1. What the Vienna Declaration Is

The Vienna Declaration is a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. The declaration is the official declaration of the XVIII International AIDS Conference (AIDS 2010) to be held in Vienna, Austria from July 18th to 23rd, 2010. The declaration was drafted by a team of international experts and initiated by several of the world’s leading HIV and drug policy scientific bodies: International AIDS Society, the BC Centre for Excellence in HIV/AIDS, and the International Centre for Science in Drug Policy (ICSDP). It was prepared through an extensive consultative process involving global leaders in medicine, public policy and public health.

2. Why We Need It

The world needs a new approach to dealing with illicit drugs. The primary international response to the health and social harms posed by drug use has involved a global “war on drugs” aimed at reducing the availability and use of illegal drugs through drug law enforcement.

3. Policy Today: A Proven Failure

In June 1998, the UN General Assembly hosted a Special Session on illegal drugs under the slogan “A drug free world – We can do it.” The session set out international drug control strategies and law enforcement goals for the subsequent decade in which it was hoped the world could be made “drug free.”

However, it is now clear that drug law enforcement has not achieved its stated objectives. In fact, illicit drugs remain readily available worldwide, and the previous three decades have seen drug prices continue to fall while drug purity continues to increase. In addition, the over-reliance on drug law enforcement has resulted in overwhelmingly negative health and social consequences. This includes the enrichment of organized crime and associated violence, the spread of HIV among injection drug users, as well as other devastating harms as outlined in the Vienna Declaration.

The negative effects of drug control efforts in the United States led to a unanimous resolution at the 2007 annual United States Conference of Mayors that stated that the War on Drugs has failed. The resolution called for a “New Bottom Line” in drug policy, and demanded a public health approach focused on reducing the negative consequences associated with drug abuse while ensuring that policies do not exacerbate problems or create new social problems of their own.

4. The Need for Change

The need for evidence-based public health approaches is clear, yet drug law enforcement continues to be the dominant policy approach at the expense of all others, including public health interventions that have been proven effective. For instance, methadone maintenance therapy remains illegal in Russia and other parts of the world where HIV is spreading most rapidly among heroin users. This ban persists despite the fact that methadone is on the World Health Organization’s list of Essential Medicines and is recognized as one of the most effective treatments for heroin addiction.

The status quo cannot be tolerated any longer: illicit drug policy must be based on scientific evidence to protect and improve the health and well-being of individuals and communities around the world.

5. Lending Your Name

By signing the Vienna Declaration, you will be adding your name to those who have already called for the implementation of evidence-based policies that can meaningfully improve community health and safety by reducing the toll of drugs globally.

6. What Else You Can Do

To spread the word and support the organizations bringing forward this important work, click here. If you are a scientist, academic or health practitioner holding a PhD or MD who would like to continue to speak out about the need for evidence-based drug policy, please click here.

The Vienna Declaration

The criminalisation of illicit drug users is fuelling the HIV epidemic and has resulted in
overwhelmingly negative health and social consequences. A full policy reorientation is needed.

In response to the health and social harms of illegal drugs, a large international drug prohibition regime has been developed under the umbrella of the United Nations.1 Decades of research provide a comprehensive assessment of the impacts of the global “War on Drugs” and, as thousands of individuals gather in Vienna at the XVIII International AIDS Conference, the international scientific community calls for an acknowledgement of the limits and harms of drug prohibition, and for drug policy reform to remove barriers to effective HIV prevention, treatment and care.

The evidence that law enforcement has failed to prevent the availability of illegal drugs, in communities where there is demand, is now unambiguous.2, 3Over the last several decades, national and international drug surveillance systems have demonstrated a general pattern of falling drug prices and increasing drug purity—despite massive investments in drug law enforcement.3,4

Furthermore, there is no evidence that increasing the ferocity of law enforcement meaningfully reduces the prevalence of drug use.5 The data also clearly demonstrate that the number of countries in which people inject illegal drugs is growing, with women and children becoming increasingly affected.6 Outside of sub-Saharan Africa, injection drug use accounts for approximately one in three new cases of HIV.7, 8 In some areas where HIV is spreading most rapidly, such as Eastern Europe and Central Asia, HIV prevalence can be as high as 70% among people who inject drugs, and in some areas more than 80% of all HIV cases are among this group.8

In the context of overwhelming evidence that drug law enforcement has failed to achieve its stated objectives, it is important that its harmful consequences be acknowledged and addressed. These consequences include but are not limited to:

HIV epidemics fuelled by the criminalisation of people who use illicit drugs and by prohibitions on the provision of sterile needles and opioid substitution treatment.9, 10
HIV outbreaks among incarcerated and institutionalised drug users as a result of punitive laws and policies and a lack of HIV prevention services in these settings.11-13
The undermining of public health systems when law enforcement drives drug users away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.14-16
A crisis in criminal justice systems as a result of record incarceration rates in a number of nations.17, 18 This has negatively affected the social functioning of entire communities. While racial disparities in incarceration rates for drug offences are evident in countries all over the world, the impact has been particularly severe in the US, where approximately one in nine African-American males in the age group 20 to 34 is incarcerated on any given day, primarily as a result of drug law enforcement.19
Stigma towards people who use illicit drugs, which reinforces the political popularity of criminalising drug users and undermines HIV prevention and other health promotion efforts.20, 21
Severe human rights violations, including torture, forced labour, inhuman and degrading treatment, and execution of drug offenders in a number of countries.22, 23
A massive illicit market worth an estimated annual value of US$320 billion.4 These profits remain entirely outside the control of government. They fuel crime, violence and corruption in countless urban communities and have destabilised entire countries, such as Colombia, Mexico and Afghanistan.4
Billions of tax dollars wasted on a “War on Drugs” approach to drug control that does not achieve its stated objectives and, instead, directly or indirectly contributes to the above harms.24

Unfortunately, evidence of the failure of drug prohibition to achieve its stated goals, as well as the severe negative consequences of these policies, is often denied by those with vested interests in maintaining the status quo.25This has created confusion among the public and has cost countless lives. Governments and international organisations have ethical and legal obligations to respond to this crisis and must seek to enact alternative evidence-based strategies that can effectively reduce the harms of drugs without creating harms of their own. We, the undersigned, call on governments and international organisations, including the United Nations, to:

Undertake a transparent review of the effectiveness of current drug policies.
Implement and evaluate a science-based public health approach to address the individual and community harms stemming from illicit drug use.
Decriminalise drug users, scale up evidence-based drug dependence treatment options and abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights.26
Unequivocally endorse and scale up funding for the implementation of the comprehensive package of HIV interventions spelled out in the WHO, UNODC and UNAIDS Target Setting Guide.27
Meaningfully involve members of the affected community in developing, monitoring and implementing services and policies that affect their lives.

We further call upon the UN Secretary-General, Ban Ki-moon, to urgently implement measures to ensure that the United Nations system—including the International Narcotics Control Board—speaks with one voice to support the decriminalisation of drug users and the implementation of evidence-based approaches to drug control.28

Basing drug policies on scientific evidence will not eliminate drug use or the problems stemming from drug injecting. However, reorienting drug policies towards evidence-based approaches that respect, protect and fulfil human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.

REFERENCES
1. William B McAllister. Drug diplomacy in the twentieth century: an international history. Routledge, New York, 2000.
2. Reuter P. Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction 2009;104:510-7.
3.United States Office of National Drug Control Policy. The Price and Purity of Illicit Drugs: 1981 through the Second Quarter of 2003. Executive Office of the President; Washington, DC, 2004.
4. World Drug Report 2005. Vienna: United Nations Office on Drugs and Crime; 2005.
5. Degenhardt L, Chiu W-T, Sampson N, et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: Findings from the WHO World Mental Health Surveys. PLOS Medicine 2008;5:1053-67.
6. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. Lancet 2008;372:1733-45.
7. Wolfe D, Malinowska-Sempruch K. Illicit drug policies and the global HIV epidemic: Effects of UN and national government approaches. New York: Open Society Institute; 2004.
8. 2008 Report on the global AIDS epidemic. The Joint United Nations Programme on HIV/AIDS; Geneva, 2008.
9. Lurie P, Drucker E. An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA. Lancet 1997;349:604.
10. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS 2002;16:F25.
11. Taylor A, Goldberg D, Emslie J, et al. Outbreak of HIV infection in a Scottish prison. British Medical Journal 1995;310:289.
12. Sarang A, Rhodes T, Platt L, et al. Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study. Addiction 2006;101:1787.
13. Jurgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infectious Disease 2009;9:57-66.
14. Davis C, Burris S, Metzger D, Becher J, Lynch K. Effects of an intensive street-level police intervention on syringe exchange program utilization: Philadelphia, Pennsylvania. American Journal of Public Health 2005;95:233.
15. Bluthenthal RN, Kral AH, Lorvick J, Watters JK. Impact of law enforcement on syringe exchange programs: A look at Oakland and San Francisco. Medical Anthropology 1997;18:61.
16. Rhodes T, Mikhailova L, Sarang A, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Social Science & Medicine 2003;57:39.
17. Fellner J, Vinck P. Targeting blacks: Drug law enforcement and race in the United States. New York: Human Rights Watch; 2008.
18. Drucker E. Population impact under New York’s Rockefeller drug laws: An analysis of life years lost. Journal of Urban Health 2002;79:434-44.
19. Warren J, Gelb A, Horowitz J, Riordan J. One in 100: Behind bars in America 2008. The Pew Center on the States Washington, DC: The Pew Charitable Trusts 2008.
20. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Social Science & Medicine 2005;61:1026.
21. Ahern J, Stuber J, Galea S. Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence 2007;88:188.
22. Elliott R, Csete J, Palepu A, Kerr T. Reason and rights in global drug control policy. Canadian Medical Association Journal 2005;172:655-6.
23. Edwards G, Babor T, Darke S, et al. Drug trafficking: time to abolish the death penalty. Addiction 2009;104:3.
24. The National Centre on Addiction and Substance Abuse at Columbia University (2001). Shoveling up: The impact of substance abuse on State budgets.
25. Wood E, Montaner JS, Kerr T. Illicit drug addiction, infectious disease spread, and the need for an evidence-based response. Lancet Infectious Diseases 2008;8:142-3.
26. Klag S, O’Callaghan F, Creed P. The use of legal coercion in the treatment of substance abusers: An overview and critical analysis of thirty years of research. Substance Use & Misuse 2005;40:1777.
27. WHO, UNODC, UNAIDS 2009. Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injection drug users.
28. Wood E, Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review 2010;29:99-100.

Vienna Declaration Writing Committee

For comments and insights from members of the Vienna Declaration writing committee and other signatories click here.

Evan Wood, MD, PhD (Chair)
Director, Urban Health Research Initiative
Associate Professor, University of British Columbia
Canada

Frederick L. Altice, MD
Professor of Medicine & Director of Clinical and Community Research
Yale University School of Medicine
USA

Dennis Altman AM, FASSA, MA
Professor of Politics, La Trobe University
Director, Institute for Human Security
Australia

Judith D. Auerbach, PhD
Vice President, Science & Public Policy
San Francisco AIDS Foundation
USA

Anurita Bains
Senior Advisor, Office of the Executive Director
The Global Fund to Fight AIDS, TB and Malaria
Switzerland

Prof. Françoise Barré-Sinoussi, PhD
Nobel Laureate
Professor and Head, Unit of Regulation of Retroviral Infections, Department of Virology
Institut Pasteur, Paris

Damon Barrett
Senior Human Rights Analyst, International Harm Reduction Association
Australia

Jacqueline Bataringaya, MD, MA
Senior Policy Adviser

, International AIDS Society
Switzerland

Chris Beyrer, MD
Professor, Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
USA

Maria Patrizia Carrieri, PhD
Researcher, Institut National de la Santé et de la Recherche Médicale
France

Grant Colfax, MD
Director of HIV Prevention and Research
San Francisco Department of Public Health
USA

Marcus Day, DSc
Director, Caribbean Drug & Alcohol Research Institute
Saint Lucia

Don C. Des Jarlais, PhD
Professor of Epidemiology
Director of the International Research Core Center for Drug Use and HIV Research
USA

Françoise Girard
Director, Public Health Program, Open Society Institute
USA

Robin Gorna
Executive Director, International AIDS Society
Switzerland

Carl L Hart, PhD
Associate Professor of Psychology
Departments of Psychology and Psychiatry, Columbia University
USA

Ralf Jürgens, PhD
Consultant, HIV/AIDS, Health, Policy and Human Rights
Canada

Adeeba Kamarulzaman, MD
Head of Infectious Disease Unit, University of Malaya Medical Centre
Malaysia

Michel D. Kazatchkine, MD
Executive Director, The Global Fund to Fight AIDS, TB and Malaria
Switzerland

Thomas Kerr, PhD
Director, Urban Health Research Initiative
Associate Professor, University of British Columbia
Canada

Danny Kushlick
Head of Policy, Transform Drug Policy Foundation
England

Rick Lines
Deputy Director, International Harm Reduction Association
Australia

Barbara McGovern, MD
Associate Professor of Medicine, Tufts University School of Medicine
USA

Julio S.G. Montaner, MD, FRCPC, FCCP, FACP, FRSC
Professor, Chair in AIDS Research and Head of Division of AIDS, University of British Columbia
President, International AIDS Society
Canada

David Nutt, MD, FRCP, FRCPsych, FMedSci
Director, Neuropsychopharmacology Unit, Division of Experimental Medicine
Hammersmith Hospital, Imperial College of London
England

Thomas L. Patterson, PhD
Professor of Psychiatry, University of California, San Diego
USA

Tim Rhodes, PhD
Professor and Director, Centre for Research on Drugs and Health Behaviour
London School of Hygiene and Tropical Medicine
England

Brigitte Schmied, MD
President, Austrian AIDS Society, AIDS 2010 Local Co-Chair
Head of HIV Outpatient Clinic, Otto-Wagner-Spital Vienna
Austria

Steffanie Strathdee, PhD
Harold Simon Professor and Chief, Division of Global Public Health, Department of Medicine
University of California, San Diego School of Medicine
USA

Sharon Walmsley, MD, MSc, FRCPC
Professor, Department of Medicine, University of Toronto, Division of Infectious Diseases
Canada

Dan Werb, MSc
Research Associate, BC Centre for Excellence in HIV/AIDS
Canada

Alexander Wodak, FRACP, FAChAM, FAFPHM, MBBS
Director, Alcohol and Drug Service, St. Vincent’s Hospital
Australia