06.03.2016 Ruth Dreifuss: "What I expect from this year's UNGASS is, above all, honesty"
Interview with Ruth Dreifuss. After an interval of 18 years, a second United Nations Special Session (UNGASS) on the World Drug Problem is to be held in New York in April 2016. Former government minister Ruth Dreifuss represented Switzerland at the 1998 Special Session as health minister. She will now be attending an UNGASS for the second time. We asked Ms Dreifuss what had changed since 1998.
Ms Dreifuss, you are regarded as the driver behind the four-pillar drug policy based on prevention, treatment, harm reduction and law enforcement. In the 1990s, this very successful model brought about a huge reduction in the number of drug-related deaths and is still the basis of Switzerland's drug policy. Is the four-pillar model still fit for purpose when it comes to dealing with present-day phenomena such as excessive drug use at night-life venues, new substances or mixed drug use?
Ruth Dreifuss: The principles embodied in the four-pillar model, focusing as it does on public health policy, are still valid today. The model can be applied to all forms of addiction, whether substance abuse or behavioural addictions such as gambling. There are, in all the problem areas, rules that require a certain measure of law enforcement. There is, in all areas, a need for prevention activities, which is probably the most challenging component of the model. In all areas, there has to be an array of treatment services available. And, in all areas, there is a need for reduction of the harm done to those affected and their environment.
With its 25 years of experience with the four-pillar policy, what can Switzerland offer the global community?
It's important for Switzerland to share the experience – both positive and negative – it has gained with its drug policy, just as all states should share their experience of their drug policies with others. That will be a key point at the UNGASS. The states must gather, analyse and assess their experience and then share it with each other. This will create a solid, substantive basis for further development of drug policy. I therefore believe that Switzerland's function as a role-model lies more in the political process that in the actual four-pillar policy.
We have been worldwide pioneers of a number of measures. I'm happy to remind you that the first controlled contact centre, the "Fixerstübli" injection room, was inaugurated in Switzerland as far back as the 1980s, in the small and very tranquil town of Berne. Since then, several European countries – and also ones further afield such as Canada – have adopted this measure. We were not the first to prescribe heroin, but when we did so it was done all the more meticulously, including scientific monitoring.
What in your opinion are the biggest challenges currently facing drug policy at the national and international levels?
The greatest challenge stems from the contradiction that underlies current drug policy. On the one hand, we prohibit, for instance, the use, purchase or cultivation of illicit drugs. On the other, we help people who have broken these laws. This contradiction is characteristic of the majority of societies that are committed to the protection of public health and the health of their individual citizens. We and the global community as a whole should eliminate this contradiction as soon as possible. We should stop punishing grown-up people who are a risk only to themselves but not to society. If we are really serious about achieving the aims of our drug policy, i.e. public health, wellbeing and safety, we can no longer maintain a prohibition-oriented system. States need to regain control of the entire drug chain instead of leaving it in the hands of the Mafia.
The use of cannabis recently ceased to be a punishable offence in some federal states of the USA and in other countries. Is this the right approach?
These are interesting examples because they represent an attempt to find a way out of the contradiction. The next few years will show whether these specific models are worth emulating. The contradiction is particularly glaring in the case of cannabis. Though this substance is not harmless, it is actually very similar to the legal substances tobacco and alcohol: it is widely used in the community, it does not lead so quickly to dependence and many people use it only for a few years. So why on earth is cannabis still prohibited and still classified in the same category as heroin and cocaine? And as we know, there is a long tradition of using cannabis for medical purposes.
The Single Convention on Narcotic Drugs and the two supplementary UN conventions on worldwide drug control are very strict and leave no scope for attempts at decriminalisation like those in the USA. Will these agreements need to be adapted if we are to master future problems?
Yes, and they will be, though not (yet) at the forthcoming UNGASS. The most urgent measure is the decriminalisation of activities preparatory to personal use and of use itself. Progress will be made in this area. The treatment of drug use as a punishable offence is a current subject of discussion and criticism in many countries and organisations, with voices speaking in favour of decriminalisation. The UNODC, the United Nations Office on Drugs and Crime, is moving in a similar direction. This step is necessary if we are to eliminate the contradiction. But there are also other drug-related offences that need to be reconsidered. For instance, the South American drug mules – they're often women – who swallow packages of cocaine and smuggle them across borders in their stomachs. Such actions should be rated as minor offences and not punished with imprisonment. These people are usually driven purely by economic necessity to commit the offences and are victims as well as offenders. While we must put a stop to their activities, we should also help them to find their place in society and to go on providing for their children.
As health minister, you were a member of the Swiss delegation that took part as in the last UNGASS on drugs in 1998. What do you remember of this UN Special Session?
I remember the many taboos. There were certain things you just couldn't say in 1998. I felt at the time that my speech was very courageous. Now it seems to me to be positively shy! Of course I also remember the final declaration. It was meant to convince us that we could free the world from drugs within ten years. Such stupidity, completely divorced from reality! It was a hypocritical consensus that nobody really took seriously. An international conference should at least be honest, even if does not bring about noteworthy progress.
Eighteen years later you'll be taking part in another UNGASS. What do you expect from it?
Honesty. After fifty years of international drug policy, it should be possible to take stock in an honest fashion, free from taboos. We have to admit to ourselves that we're confronted with a shambles. We are not living in a drug-free world today – quite the contrary, in fact. There are more drugs now than in 1998. New drugs have appeared on the scene, criminal organisations have become more powerful. There are now more narco-states like Guinea-Bissau in West Africa, where the entire state apparatus is in the service of organised crime. Certain Central American states are probably also moving in this direction. These are defeats that we have to acknowledge. On the other hand, I think that progress will be made at the UNGASS in several respects. Health-related measures will be taken on board and the proportionality of punishments imposed for drug-related activities will at least be discussed.
Will the "war on drugs" be ended in the near future?
I have my reservations about this expression. The "war on drugs" policy was imposed on Latin America by the USA. It has cost the lives of hundreds and thousands of people – farm workers, users, people living in transit states. I prefer the term "consequences of the international drug control regime". This regime can probably be reformed. Certain countries continue to use very brutal methods in the name of drug control, of course. In the USA there are mass arrests and convictions, with all the social consequences for the people involved. The very few pardons that the President granted last year demonstrate the absolute inhumanity with which drug users or, for that matter, small-time dealers are treated.. Forty years in prison for being caught buying or selling a small amount of drug for the second time is something that fortunately doesn't happen here in Europe. Many Asian countries are even stricter. Offenders have to expect the death penalty or involuntary treatments. Other examples include the withholding of medical treatment from addicts suffering from AIDS or hepatitis as long as they continue to be users. In many places drug users most seriously in need of help are subjected to incredible brutality and marginalisation. I don't, of course, mean users from "high society".
As a member of the International Commission against the Death Penalty, you are calling for the abolition of capital punishment. Has there been any progress on this issue?
It's hard to say. China is the country with the highest number of death sentences carried out, but we don't have any details. The number of executions is kept secret and it's very difficult to obtain information on the trials. There has been a slight improvement in that death sentences can no longer be handed down by local and regional courts but are now subject to the authority of higher courts. In addition, we hope to see progress in countries in which it is mandatory for judges to apply the death penalty without full consideration of the facts of the individual case. There's a further problem in many Asian countries: drug use is officially not a punishable offence. But the amount allowed for possession is so small that hardly any users stay below this limit. Users are therefore automatically treated as dealers – and in many countries the punishment for this offence is death. Regarding the abolition of the death penalty in general, there has been a development: it is again a topic of international debate. More and more countries are undertaking, in the framework of a UN resolution, to stop carrying out the death penalty or to remove the corresponding article from their legislation. In many countries, however, the death penalty is very closely associated with drug policy. In Iran, for instance, 80 percent of executions are for drug-related offences. The situation is probably similar in Indonesia and presumably in China and Saudi Arabia as well.
Drug trafficking is estimated to generate a turnover of about 300 billion dollars a year. What action needs to be taken to break up organised crime's role in this business?
We need international cooperation and conventions against international crime. In this respect, there is a particular need for action from Northern countries. We certainly cannot solve the problem by militarising the conflict, as in Mexico. The criminals whose activities we need to stop wear three-piece suits and are probably sitting not so far away from us in some office or other. They possess lots of money and have probably parked it in banks, invested it in property or are laundering it in small businesses. But is it possible to permanently break up a drug cartel? The answer is no. The cartels are very flexible and, using the money they've earned from drugs, they have established themselves in other areas of criminal activity, for instance trafficking in people, organs or arms. I nevertheless believe that the drug cartels would earn massively less money if we had a different drug policy.
You've continued to work as a member of many bodies despite reaching retirement age over ten years ago. Since November 2015 you are now also co-chair of the new high-level panel on promoting innovation and access to health technologies. How do you manage to do it all?
Certainly without the help of performance-enhancing drugs! Maybe politics has the same effect as sport and releases endorphins. But joking apart. I was interested in these issues – from the viewpoint of justice – long before I became a member of the Swiss government. And as long as I have the health and strength to do so, I want to promote them. It's my good fortune to very flexible. My ability to work is not affected by whether I eat and sleep regularly or not – and frequent intercontinental travel doesn't bother me at all. My memory, of course, is not quite as good as it was, but at 76 I think that's permitted.
From 1972 to 1981, economist and social scientist Ruth Dreifuss (b. 1940) worked at the Directorate of Development Cooperation and Humanitarian Aid (now the Swiss Agency for Development and Cooperation/SDC). In 1981, she was appointed Central Secretary of the Confederation of Swiss Trade Unions. On 10 March 1993, the Swiss Federal Parliament elected her to the Federal Council (Swiss Government). In 1999 she became the first woman to be President of Switzerland. From 1993 to 2002, she was Head of the Federal Department of Home Affairs and, as health minister, was in charge of the Federal Office of Public Health. Ruth Dreifuss lives in Geneva. She is currently active as a member of the Global Commission on Drug Policy and the International Commission against the Death Penalty, and is co-chair of a recently established UN panel on innovation and access to medicines.