Chapter 10: The social context of injection drug use and harm reduction programs in Sub-Saharan Africa by Ediomo-Ubong E. Nelson

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Introduction
There is significant disillusionment in many parts of the world with the dominant, prohibitionist approach to illicit drugs‘ control. The approach. which rests on the three international conventions, namely the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances, and the 1988 Convention against Illegal Traffic in Narcotic Drugs and Psychotropic Substances, attempt to control the supply and use of illicit drugs by means of legal prohibition. After roughly six decades of attempting to control the use of drugs by suppressing production and distribution, it is now widely acknowledged that the approach is of limited effectiveness. Production and trafficking have been suppressed in some places, but they have ballooned elsewhere. Demand for cocaine, heroin and new synthetic drugs are on the increase globally (UNODC, 2012).
Across the world, counter-narcotic operations have engendered political instability, violence, corruption, mass incarceration, and violations of the human rights of people who use drugs (PWIDs), including the right to health (Pollack & Fleuter, 2014; WACD, 2014), which has been influential in undermining support for the global drug control regime, and strengthening the momentum for policy shift towards public health and harm reduction. A vast body of evidence suggests that harm reduction measures are effective in preventing HIV infection among people
who use illicit drugs; such that these programs are considered an important factor in the prevention of HIV among people who inject drugs (PWlDs) (see the review by Csete et. al., 2016).

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