Monthly Archives: April 2022

Should marijuana be legal in the United States? Over the past 20 years, Americans have reversed their views on that question to a degree rarely seen in politics. In 2001, 34 percent of Americans said yes, according to Gallup. Today its 68 percent. A breadth of polling suggests a majority of Americans now favor either decriminalizing all drug use or significantly changing the punishment for it.

While there has been some bipartisan movement on the issue, politicians dont seem to be walking entirely in step with Americans. As Congress considers legislation that would decriminalize marijuana and end the sentencing disparity for crack and cocaine offenses, Galen Druke speaks with FiveThirtyEight contributor Lester Black about what Americans think should be done about drugs and how politicians are responding.

You can listen to the episode by clicking the play button in the audio player above or by downloading it in iTunes, the ESPN App or your favorite podcast platform. If you are new to podcasts, learn how to listen.

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Politics Podcast: Americans Think The War On Drugs Failed. Do Politicians Agree? - FiveThirtyEight

A presentation discussing the war on drugs was sponsored by IUPs Title IX, Social Equity office and Office of Students Wellness and Engagement on Wednesday.

Dr. Mai Naito Mills was the speaker, an associate professor of criminology at the University of West Georgia in the department of civic engagement and public service.

Mills obtained her masters in criminology from IUP.

The presentation was unique in that it required good bit of audience involvement through technology.

She started by talking about what exactly a wrongful conviction is and what kind of circumstances can lead to an individuals conviction.

Mills also discussed the case of Curtis Flowers, an example of direct appeal.

There was a quadruple murder in Winona, MississippiCurtis Flowers was the one charged for this crime. He was actually put on trial six times for this crime.

This trial went on so many times due to racial discrimination and the ignorance of the prosecutor at this time. The Supreme Court found racial bias in the case, which eventually led to the charges being dismissed in 2020.

Getting a pathway for a wrongful conviction are very, very, very hard to overturn. The cause of a wrongful conviction can be official error, false accusation, false confession, false evidence, and mistake ID. False accusation are the most common types of error in wrongful convictions.

Mills next touched on the total number of drug arrests. In fact, over 64,000 federal inmates are currently behind bars for drug offenses for more than any other category of conviction, a problem that is highlighted. According to the National Registry of Exonerations (NRE) there have only been 3,000 exonerations.

Mills talked about the amount of racial discrimination with drug cases and prosecutions, specifically discrimination against African Americans. The Harris County exoneration emphasized this. Despite Black people only making up 20% of the population, they made up 62% of drug related exonerations.

She eventually focused on three specific drug convictions in Pennsylvania. One had their charges dismissed when it was discovered that the officials involved were corrupt. Another had their convictions dropped due to an officer lying on the stand. The third had an inadequate defense official. In summary, there is a big problem with official corruption in this field.

Overturning these wrongful convictions has been getting more attention recently thanks to activism and social media. More people are noticing this problem and are demanding change and fighting for the rights and innocence of others.

Mills cited The Innocence Project as an organization to support in fighting wrongful drug convictions.

Those interested in learning more about Mills can check her out at https://www.westga.edu/profile.php?emp_id=90868.

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IUP hosts presentation on war on drugs, how students can be involved - Indiana University The Penn Online

The Days Associated Press article on fentanyl deaths, States seek solutions as fentanyl deaths keep rising, (April 4), once more shows the abysmal failure of Americas drug laws, which are heavily based on Nixons fraudulent War on Drugs (see Harpers, 4/2016). It is glaringly obvious that, as one police chief said, we cant arrest our way out of our drug problem. The only sensible solution is to decriminalize all drugs.

Interdiction stops only a tiny percentage of drugs from coming over our borders. Jailing offenders destroys individuals, families, and overcrowds our prisons. Untold billions trillions even squandered on enforcement and incarceration should be shifted to addiction treatment, both effective and far less expensive.

Legalizing drugs will eliminate todays violent drug trade which, like prohibition in the roaring twenties, is controlled by warring thugs. Better still, drug users will know the content and strength of legalized drugs. Overdoses will of course still happen, but they will be far fewer. Perhaps, too, a dose of lifesaving naloxone could be included in every legal drug sale.

Legalized drugs can be regulated, and taxed, like sales of alcohol and tobacco bo th addictive drugs as dangerous or more so than illegals. It is past time to get rational about drugs.

Sanford (Sandy) D'Esopo

Old Lyme

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The Day - All drugs should be decriminalized - News from southeastern Connecticut - theday.com

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The Untold Story of Harm Reduction and the Future of Addiction

Following decades of advocacy efforts led by people who use drugs, the first sanctioned overdose prevention centers in the United States were opened in New York City at the end of 2021. Drawing on the expertise and ministry of people with experiences of substance use and overdose, OPCs provide sanctuary for people who use drugs, including social connection, access to compassionate social services and other health care, safer use supplies, and monitoring by people trained to respond to an overdose event or other medical emergency. The new sites, which are housed in existing syringe service programs in Manhattans East Harlem and Washington Heights neighborhoods, saved over 115 lives in their first six weeks of operation.

There was significant public opposition to these sites, even though accidental drug overdose now kills more Americans annually than gun violence and automobile accidents combined. The national response to the overdose crisis has been largely shaped by the criminalization and dehumanization of people who use drugs. In the enduring spirit of Nixons all-out offensive against public enemy number one, the war on people who use drugs has decimated families, incarcerated millions of people (most of whom are Black or Brown), enabled the spread of infectious diseases such as hepatitis C and HIV, and failed to prevent problematic substance use or make evidence-based treatment for substance use disorder more widely accessible.

Maia Szalavitz makes the case that there is a better way, one that has been proven to save lives and that is positively transforming social narratives and policies on drugs and the people who use them. It is called harm reduction, and it finds its roots in the creativity and wisdom of people with lived experience of substance use.

The harm reduction model is a set of practices for minimizing drug-related harm, a person-centered philosophy for addressing substance use across the spectrum, and a movement for social justice which recognizes the multitude of social determinants that impact a persons relationship with substance use and their vulnerability to drug-related harm.

Szalavitz details the development of harm reduction as it has been created and led by people who use drugs and others living at the margins and as it grew from a grassroots public health effort to a global social justice movement. Rooted in her experience with injection drug use and recovery, she weaves an intimate account of her conversion to this new way of thinking about drugs and the people who use them, alongside the evolution of harm reduction in policy and practice as it took shape in the lives of its early practitioners and then began to express itself in the lives of people who use drugs in communities across the country.

Szalavitz centers humanity and human connection in her narration of the growth of this movement for healing and justice. Beginning with the height of the AIDS crisis and ending with the current overdose crisis, she charts the rise of an expansive way of understanding and responding to substance use and addiction.

The harm reduction model replaces judgment with empathy and punishment with love. It recognizes the conditions of substance use as indivisible from the social conditions people are subject to. It puts the power of defining recovery in the hands of people who use drugs. Harm reduction insists that we move beyond the old ways, beyond unjust laws and moralizing about drug use. It asks us to proclaim that people who use drugs are deserving of respect and dignityand that their lives have inherent value.

Szalavitz anchors her narrative of the harm reduction movement in protests against the political indifference to the loss of human life as the AIDS epidemic took hold. By the end of the 1980s, injection drug use was fueling the HIV epidemic in New York City. Due to limited access to sterile syringes, people who used drugs were forced to share injection equipment, and as a direct result HIV spread rapidly. This wound was deeply felt both by people who use drugs and by their loved ones.

Community members, people who use drugs, and health professionals began to form collectives, such as the AIDS Coalition to Unleash Power and the Association for Drug Abuse Prevention and Treatment. They began taking safer use supplies to places where people were using drugs, such as shooting galleries and garbage-strewn lots on the citys Lower East Side. In addition to illegally distributing syringes, they distributed bleach and safer use education, including instructions on how to clean used syringes. They took help and healing to the people, meeting them where they were ata core tenet of harm reduction philosophy.

Undoing Drugs portrays the course of harm reduction as it grew from a fringe effort to the mainstream in the United States. The book recounts multiple drug panics (amphetamine, heroin, crack cocaine, prescription opioids), the development of antiretrovirals to treat HIV, the legalization of syringe access in an increasing number of communities, and the expansion of community-level naloxone distribution. In the context of increasing overdose fatalities across the country, Szalavitz reflects on the current state and future of harm reduction with a quote from Anthony Fauci. Looking back on his experience with the HIV crisis, Fauci said: Im flashing in my mind . . . [to] how difficult it is for society to accept harm reduction . . . and then when you accept it, you realize, why didnt I do this before?

With more than 841,000 lives lost to drug overdose in the United States since 1999, Undoing Drugs makes it undeniably clear that the time for a more robust uptake of harm reduction, led by people who use drugs, is upon us. The human toll of the war on people who use drugs would be even graver if not for the lifesaving and life-giving ministries of people who use drugs, and their persistence, resilience, and love in action despite innumerable odds. Szalavitz concludes with these words: Through harm reduction, we can undo the ideology that underpins damaging policies and make way for a future that is healthier, happier, and more humane for everyone.

A version of this article appears in the print edition under the title Embracing harm reduction.

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How harm reduction is winning the war against drug overdoses - The Christian Century

The environmental impacts of cocaine have long been known. Studies raised alarm bells in the 1990s over narco-driven deforestation, soil degradation and pollution in Latin America. Today, the impacts all along the illegal drug supply chain are even better understood and documented, but remain underrecognized and underreported.

Meanwhile, the titanic struggle continues between those determined to curb illegal drug use and the shadowy forces intent on producing, trafficking and consuming the quintessential party drug snorted by millions, as they propel biodiversity loss, adverse land-use change, waterway contamination with toxic chemicals, and adjacent criminal industries such as wildlife trafficking and gold mining even contributing to climate change.

From source nations to consumer countries, the infamous white powder known as coke, or blow, is leaving a trail of environmental destruction that is contributing to the destabilization of Earths safe operating space, vital to keeping our planet habitable.

In 2019, an estimated 234,200 hectares (578,720 acres) of coca were grown in Bolivia, Peru and Colombia. That was down 5% from the year before, but still resulted in major environmental impacts. Back in 1985, Peru was the global hub of coca production, growing around 65% of the global total, with Bolivia at 25% and Colombia just 10%. Years of aggressive anti-trafficking efforts in Peru and Bolivia forced the cultivation shift to Colombia one of the worlds most megadiverse nations, hosting close to 10% of Earths biodiversity.

The latest figures released by the U.N. Office on Drugs and Crime (UNODC) and the Colombian governments monitoring program show 143,000 hectares (353,400 acres) of coca in Colombia in 2020, a decline for the third year in a row. But despite less coca being grown there, 8% more cocaine was produced, totaling approximately 1,228 metric tons. More efficient crop management, along with mega labs that churn out vast quantities of coca paste and cocaine, are thought to be behind this increase.

Statistics from the U.S. Office of National Drug Control Policy paint a different, more concerning picture, estimating 245,000 hectares (605,400 acres) of coca grown in the same year.

But coca and cocaine production are just one part of a complex web of problems placing Colombias biological riches at risk. Among the most severe is deforestation: In 2020, nearly 13,000 hectares (31,100 acres) of Colombias forests were felled to support coca cultivation. Thats 7.54% of the countrys total 171,685 hectares (424,243 acres) of tree loss from all activities, including cattle ranching and agricultural expansion.

The same study found that a further 22.4% of deforestation (38,449 hectares or 95,010 acres) occurred within 1 kilometer (0.6 miles) of coca plantations and was due to linked activities including the construction of clandestine airstrips, and to tangentially related activities, such as coca productions contribution to the agricultural frontiers advancement.

Parsing out the precise causes of all this additional deforestation is complicated, says Liliana Davalos at Stony Brook University, who has studied the links between coca and deforestation for 20 years. I wanted to discover whether it was happening in places where deforestation wouldnt happen otherwise, she says. The answer is, it depends.

The degree to which coca production directly causes deforestation is very locally specific, she explains. In the Andean region of Colombia, for instance, which weve studied closely, in places like San Lucas, we see that coca plays a disproportionate role where no other crops are grown, or [there are] no pastures, or a much lower level of pastures There are huge effects in the Andean upland region and great, great potential for damages to biodiversity based on the spatial database we have.

But at lower elevations in the Amazonian region, the picture is less clear. We find that once we take into account social factors of [human] migration, growth, [and] construction we really dont find an impact from cocoa cultivation in the Amazon, coca is more of a passenger than a driver of the process which is a process of frontier deforestation, incorporating vast tracts of land into the financial system.

Cocaine production does other harm. It releases toxic chemicals into the environment via processing labs. Chemicals commonly used by the mega labs include toluene, sulfuric acid, acetone and gasoline. It takes 284 liters of gasoline to make 1 kilogram of cocaine, or about 34 gallons a pound, and a significant portion of Colombias gasoline supply is likely diverted to produce coke. And it only takes one part of dumped petrol to contaminate 750,000 parts of groundwater.

In addition, estimates suggest up to 3.5 million metric tons of chemicals per hectare per year, or about 1.6 million tons per acre, are used in the processing of cocaine, resulting in soil degradation and more water pollution. A 2014 survey determined that 98.7% of coca farms also use insecticides or fungicides, 92.5% apply chemical fertilizers, and 95.5% use herbicides. Together with cocaine itself found in Amazon Basin waterways the potential toxic impact of production is likely vast, though poorly understood or monitored.

Combatting cocaine growers has also been environmentally detrimental. Aerial spraying with the controversial herbicide glyphosate, popularly known as Roundup, is argued by critics to have left a legacy of ecosystem and human harm.

Long encouraged and funded by U.S. drug enforcement, the practice that began in Colombia in 1994 was banned there in 2015 due to concerns over its role as a carcinogen. But the current government under President Ivn Duque is pushing to reintroduce spraying to tackle the drug problem. This March he even approved the use of low-flying drones for that purpose. While considered potentially effective in the short term at reducing coca crops in specific areas, such a reinstatement would not only pollute, but perpetuate other troubles.

Aerial spraying [sings] the siren song that it eliminates coca cultivation rapidly, explains Vanda Felbab-Brown, a senior fellow at the Brookings Institute. But it does so in ways that are problematic from [an] environmental and human public health perspective.

She compares the ballooning proliferation of coca cultivation in Colombia to the situation elsewhere. Weve got countries [like Peru and Bolivia] that havent applied that policy, and they have their wedges of coca that just stay put, she says. Then, We have a country [Colombia] that, by using this aerial fumigation technique seems to be associated with this giant explosion [of impacts] in every ecosystem.

Last year, the U.S. and Colombian governments announced a new counternarcotics strategy, which includes an environmental protection aim alongside drug supply reduction, rural security and development goals. The United States will assist the Colombian government in its efforts to monitor and counter these environmental crimes that sustain and fuel narco-trafficking groups that have a profoundly negative impact on Colombias environment, states a U.S. White House press release.

This focus on environmental crime has already manifested itself in Operation Artemis, a military operation in Colombia for reducing deforestation. In addition, a recently passed bill promises harsher drug production penalties, including jail time. However, concerns are that such actions will predominantly impact Colombias small-scale farmers.

Colombias national parks are impacted by coca growing, with an estimated 7,214 hectares (17,826 acres) in 12 federal preserves seeing illegal production in 2020, an increase of 6% over 2019. Catatumbo-Bar is the worst affected, suffering deforestation, lawlessness and a host of issues related to cocaine trafficking. Other parks and protected areas affected include Sierra de la Macarena, the Nukak Reserve and Paramillo Massif.

With coca in national parks, the production is not that big, explains Ana Maria Rueda, a senior investigator at Fundacin Ideas para la Paz, a Colombian think tank. But what theyre [seeing is] territorial control [by criminals], for example, related to traffic routes to take cocaine out of Colombia.

This expansion of coca growing and cocaine processing on protected lands presents a risk to biodiversity. An update to Colombias Red List Index in 2020 implicated coca cultivation and its contribution to forest loss and habitat fragmentation as increasing the extinction risk to bird species, including the yellow-knobbed curassow (Crax daubentoni), plumbeous forest falcon (Micrastur plumbeus), scarlet-breasted dacnis (Dacnis berlepschi), and plate-billed mountain toucan (Andigena laminirostris). Of the 13 species that saw their conservation status deteriorate, eight were affected by illicit cocoa expansion, the report notes.

Indigenous lands and peoples are also being gravely affected. Nearly 50% of Colombias coca is grown in special management zones, including Indigenous lands, traditional Afro-Caribbean communities, national parks, and other areas of environmental significance.

That criminal activity has made Colombia one of the most dangerous places on Earth to be an environmental rights defender, with 17 lethal attacks directed against activists supporting coca crop substitution programs in 2020. In the Peruvian Amazon, cocaine production and trafficking threatens the lives and livelihoods of Indigenous peoples, including the beleaguered Shipibo-Conibo along the Ucayali River.

Weve really seen an expansion in recent years of threats and killings of community leaders in the Peruvian Amazon. I wont say that all of them are directly related to drug mafias, says Andrew Miller, of Amazon Watch, an NGO. But I think a number seem pretty obviously connected to this broader struggle for control over the territory.

According to the Peruvian government, the region of Valle de los Ros Apurmac, Ene y Mantaro (VRAEM) accounted for 43% of coca grown in the country in 2020, out of a total illegal crop of 61,777 hectares (152,654 acres). Other Peruvian regions have seen increases too. [W]ere working with communities, in Ucayali and Huanaco. The Indigenous groups there say were the new VRAEM where the coca production is exploding, says Miller. Mongabay Latam last year identified 16 Indigenous communities threatened by deforestation due to drug trafficking in Ucayali alone.

In the 1980s and early 90s, cocaine flowed from South America to the U.S. through the Caribbean. As interdiction efforts shut down trafficking routes there, the drug was routed through Central American countries in transit to Mexico. By 2011, an estimated 60% of cocaine moved via Central America by land, sea and air, taking an environmental toll its forests and protected areas.

A 2022 study found that the Maya Biosphere Reserve lost as much as 234,612 hectares (579,739 acres) of forest between 2000 and 2018. It is one of Guatemalas most important biodiversity hotspots. Forest loss was particularly severe on the reserves western side, says study author Jonathan Vidal Solrzano, which could have consequences for iconic endangered species such as the jaguar.

The ideal scenario would be to have large areas where these jaguars can live and also corridors so they can move from Guatemala to Mexico, he explains. But nowadays theres practically no forest cover or normal, old-growth forests [on the Guatemalan side of the border]. Theres not so much connectivity as there used to be.

It is worth noting that in Guatemala, 27 of the 86 [protected areas] lost over 30% of forest cover during the period analyzed, and eight lost over 50%, the study notes, with Laguna del Tigre National Park, for example, losing 93,858 hectares (231,928 acres). Something has to change, particularly how protected areaswith large deforestation ratesare managed, says Solrzano.

While researchers stress that tying drug transport directly to land cover change is complex, and that tracing both direct and indirect impacts is not always possible, studies are connecting those dots. Research in 2017, for example determined that 15-30% of deforestation in Nicaragua, Honduras and Guatemala was linked to narco-trafficking. This figure rose to as much as 30-60% in protected areas. These included Guatemalas MayaBiosphereReserve and Hondurass Rio Platano Biosphere Reserve. Those statistics, says Kendra McSweeney, professor of geography at Ohio State University and part of the study team, are likely underestimates.

McSweeney and other scientists see two links between cocaine trafficking and land-use change, what they describe as narco-deforestation and narco-degradation. In the first instance, forests are cut to make way for clandestine airstrips. That land is subsequently converted to cattle pasture to launder money and permanently claim territory. An influx of destabilizing cash may then follow, creating a synergy for the appearance of other industries, both licit and illicit. This ramps up further degradation and development.

A study released last year found that large-scale sustained forest losses of 713,244 hectares (1.76 million acres) in Guatemala and 417,329 hectares (1.03 million acres) in Honduras correspond with areas undergoing shifts in control towards large landowners, often related to narco-trafficking.

I dont think that its an overstatement to say that drug trafficking is one of the environmental concerns for Central America, says Jennifer Devine, at Texas State University, who researches the environmental impacts of narco-trafficking in Central America. Not just because of narco-cattle ranching, but because drug trafficking undermines systems of governance throughout the region.

The weakening of local governance generates myriad criminal problems, includingland grabbingin protected areas, infill of wetland areas, forest fires [set by land grabbers], illegal logging, mangrove degradation, timber poaching, flora and fauna trafficking, gold mining, and roadbuilding, Devine and others wrote in a published paper in 2020 examining the widespread impacts of drug trafficking going beyond deforestation.

Whats really concerning is that drug trafficking environmental impacts are affecting protected areas, says Devine, with laundered narco-capital and illicit ranching infiltrating forests which should be protected as being ecologically and culturally vital.

But researchers Devine and McSweeney stress that decoupling the environmental and human impacts of the war on drugs is simply not possible. Whats driving land-use change, whats driving deforestation, is the cat-and-mouse game of interdiction, says Devine. Its really important to remember that the approach to military interdiction is in large part responsible for a lot of the environmental impacts we see, including glyphosate being used in Colombia, [with] impacts on waterways, all the way to narco-cattle ranching in Central America.

Today, Panama and Costa Rica are becoming important cocaine trafficking nodes, with the lucrative European market as the final destination. The two nations accounted for 80% of drug seizures in Central America in 2021.

This shift occurred over the past decade, says Nicholas Magliocca, assistant professor of geography at the University of Alabama. Traffickers are regularly using Costa Ricas Osa Peninsula, on the countrys southwestern coast, as a transit point a region known for its biodiverse Corcovado National Park. While most drugs are thought to be shipped via maritime routes, air transport is also being spotted. Were starting to see some more of these clandestine airstrips show up, Magliocca says.

Costa Ricas attraction to traffickers is partly based on its legal maritime network, which can be exploited to move product. Late last year, for example, 1.2 metric tons of cocaine shipped in a container of bananas was seized in the United Kingdom.

Narco-driven deforestation and associated carbon emissions are massive, notes Magliocca. But for him, the issue is also one of equity, because it is Indigenous peoples and traditional communities that are predominantly impacted by the interdiction game played between traffickers and law enforcement.

A recent study led by Magliocca found that when interdiction efforts in Central America forced traffickers to shift from one route to another, Indigenous lands were often a first choice. Protected areas and Indigenous territories offer that kind of contested land governance, marginalized populations, and remoteness that facilitate these operations. So theyre always going to be very attractive.

Unless you address those equity issues, and empower these populations, then youre not going to tackle the environmental sustainability issues, argues Magliocca.

A similar scenario is seen in producer countries such as Peru, according to Miller, with seizure of Indigenous lands by narco-traffickers, ranchers and others often tied up in a wider fight for recognition of land rights and land titles. The more immediate arguments that [these rural peoples] have been making is that the [ancestral land] rights of local communities need to be respected, he says.

That lack of respect is also apparent in Colombian national parks, where drug enforcement often involves the removal of long-established rural inhabitants from protected areas; a practice that isnt working, Rueda says. She suggests that a window of opportunity now exists for the government to enter into agreements with communities located in, or around, parks, providing traditional people with alternative sustainable livelihoods linked to conservation.

Its all about moving towards the inclusion of the environmental approach within alternative development, Rueda says. This is a social issue and were [erroneously] dealing with it as a criminal issue.

In Mexico, drug-trafficking organizations have been traced to environmental crimes such as illegal logging. Likewise, theyve entered into legal businesses to invest and launder illicit profits including the lucrative avocado market, for example causing further forest loss and pressure on freshwater. Recent research by Felbab-Brown highlights growing connections between Mexican drug-trafficking organizations and wildlife trafficking to China.

Oftentimes, the linkages between the cartels and wildlife trafficking are exaggerated, she states. But based on field research, thats not the case in Mexico. Drug traffickers there, she found, are now mixed up in a variety of trading schemes, ranging from the legal commercial fisheries industry to the illegal trafficking of endangered totoaba, sea cucumbers and terrestrial species such as jaguars.

Narco penetration into fisheries is a well-known phenomenon, with fishing vessels often used to transit drug shipments. A 2020 report noted 292 cases of seizures on such vessels between 2010 and 2017 globally, with combined volume of 522.1 metric tons worth $16.5 billion. While this figure includes multiple illicit drugs such as marijuana and methamphetamine, cocaine made up roughly half of the seizures.

In addition, [B]ecause of the large volumes [of drugs] being traded the cartels are using barter in wildlife as a transfer of value between illegal economies, says Felbab-Brown. Wildlife products, she explains, are now traded by drug-trafficking organizations in exchange for the precursor chemicals used to make synthetic drugs such as methamphetamine. The problem of synthetic drugs continues to grow year-on-year in the region. The full findings will be released in a series of reports in the coming months.

This generates a great threat to biodiversity in Mexico, says Felbab-Brown, especially since it has done little to curb wildlife trafficking to China.

Back in producer countries, drug-trafficking organizations are also linked to illicit and licit trades, including wildlife trafficking, illegal logging, and gold mining. Drug traffickers may not engage in these activities directly, but the infrastructure, routes and transport methods they create are used to facilitate these other forms of crime, says Daan van Uhm, assistant professor in criminology at Utrecht University in the Netherlands.

On the Colombia-Panama border in the Darin region, groups involved in cocaine production, such as the Gulf Cartel, branched out into gold mining in recent years. Gold mining and smuggling has been dubbed one of the easiest and most lucrative money laundering tools in the history of drug trafficking in Colombia. It also puts pressure on forests and biodiversity, and contaminates water with chemicals such as mercury.

Last year, the Gulf Cartels leader was arrested and the Colombian government optimistically declared the end of the countrys largest illegal drug operation. But the majority of the networks there are operating as substructures, explains van Uhm, who carried out field research in the Darin region between 2017 and 2019. They are connected to each other, but they can operate independently. I cant imagine that [the arrest] has impacts on the organization of cocaine trafficking or on environmental-related crimes.

Cocaines environmental damage is less visible in consumer countries where no forests are felled to produce and transport coca but harm is still being done. Once coke is snorted, smoked, injected or otherwise ingested, the body metabolizes most of it. But some is excreted in urine, enters directly into waterways, or passes through wastewater treatment plants that dont necessarily remove all of it,

The study of cocaine and other illicit drugs in wastewater isnt new. For years, this esoteric branch of science, known as wastewater epidemiology, has been used to investigate drug trends in cities and countries around the world.

The European Monitoring Centre for Drugs and Drug Addiction has been running such tests across the EU since 2011, tracing cocaines main metabolite, benzoylecgonine. The latest findings from 2020 showed some of the highest consumption in urban areas including Antwerp, Belgium; Amsterdam in the Netherlands; and Zurich, Switzerland. Similar methods have tracked drug use at public events such as music festivals and even college basketball games in the U.S.

Though the detection of drug-use trends via wastewater data is well established, what this outflow of coke means for the environment is poorly understood. But a growing number of studies have begun to shed light on this question, with troubling findings.

The European eel (Anguilla anguilla) is critically endangered, according to the IUCN Red List. Anna Capaldo, a professor at the University of Naples Federico II, Italy, and her colleagues have been studying cocaines effect on the species. The damages induced by cocaine suggest that this drug affects the physiology of the eels, and potentially of all the aquatic species exposed to it, she states.

Though this research was conducted in labs, it utilized levels of exposure that can be found in natural aquatic ecosystems, showing the potential harm. For example, when the gills are damaged [by cocaine exposure], the eels ability to oxygenate blood worsens. In the same way, a damaged skeletal muscle could not support the swimming of eels during their reproductive migration to the [Atlantic Oceans] Sargasso Sea.

Capaldo and her team are currently studying cocaine impacts on eel reproduction and brain function. Other studies have shown that mussels, sea urchins and zebrafish species are impacted.

An estimated 20 million people used cocaine in 2019 about 0.4% of the worlds adult population. In North America, 6.9 million people and in Europe 5 million are thought to use coke annually. Though consumption is highest in these two regions, studies are finding traces of cocaine in wastewater globally from Barbados to Brazil. The latter treats about 43% of its wastewater, though this plummets to 5% in rural areas. Cocaine and benzoylecgonine are among the pollutants regularly emitted into the Amazon River.

Cocaine is extremely damaging, but it does degrade relatively quickly in the environment, explains Dan Aberg at the Wolfson Carbon Capture Lab at Bangor University in Wales. However, that quick degradation may be offset by the steady flow of cocaine residues into the environment via wastewater.

Last year, Aberg and his team investigated the presence of cocaine and other pollutants released into waterways at the Glastonbury Festival, one of the U.K.s largest music events. Levels of cocaine released during the festivals surge were high enough to be potentially damaging to the European eel, says Aberg. In this case, exposure was mostly due to open-field urination and a lack of wastewater treatment.

Cocaine is far from the only pollutant entering waterways, estuaries and oceans. Its part of a toxic cocktail of pharmaceuticals, heavy metals, pesticides, microplastics and much more, that makes up wastewater and sewage. Recently, the Stockholm Resilience Centre, an international consortium of scientists, declared that the planetary boundary for novel entities chemical contaminants introduced by humanity has been transgressed, putting Earths operating systems and human civilization at risk. Cocaine excreted via urine, along with the toxic precursors used in its production, are among the many tens of thousands of novel entities of emerging concern.

A 2020 study led by Pavel Hork at the Czech University of Life Sciences grabbed headlines. His research showed that exposure to methamphetamine another illicit drug identified in wastewater samples altered behavior patterns and elicited signs of addiction in brown trout (Salmo trutta). To date, no one knows how drug mixtures, such as meth and cocaine, might combine with other pollutants to impact aquatic species.

I totally agree with the Stockholm Resilience Centre that chemical pollution is one of the greatest threats for life in general, [as we pass] the novel entities boundary, says Hork. There are a lot of contaminants of emerging concern, not only illicit drugs, but also standard prescription medicines like antidepressants and many others that are overused by human society. Their risks may vary along with their additive, synergistic or antagonistic effects.

Despite the fact that our knowledge is increasing, we are still at the beginning, he warns.

There are ways of guarding against this form of environmental harm. Removing cocaine residues from wastewater is possible, though treatment facilities vary in effectiveness. Other nature-based solutions, such as constructed wetlands, offer cleanup alternatives.

In Horks mind, there is an easier and cheaper solution: The best pollutant is the one that is not released in the environment, he states. Everybody should think about it and use medicines, drugs and other chemicals responsibly [and for] real need.

Banner image: Coca plantation on a hillside near Caranavi, western Bolivia. Image by Neil Palmer/CIAT via Flickr (CC BY-SA 2.0).

Citations:

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Fabregat-Safont,D., Ibez,M., Bijlsma,L., Hernndez,F., Waichman,A.V., De Oliveira, R., & Rico,A. (2021). Wide-scope screening of pharmaceuticals, illicit drugs and their metabolites in the Amazon River.Water Research,200, 117251. doi:10.1016/j.watres.2021.117251

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The rest is here:

All coked up: The global environmental impacts of cocaine - Mongabay.com

The Oregon senator, who's working on his own bill, speaks after the U.S. House passes legislation for a second time.

U.S. Sen. Ron Wyden says it's time for Congress to lift federal cannabis restrictions dating back more than 80 years to the Great Depression.

The Oregon Democrat made his statement after the House approved similar legislation April 1, the second time it has done so in 18 months. Wyden, who is chairman of the tax-writing Senate Finance Committee, has been working on his own version with New Jersey Sen. Cory Booker and Senate Majority Leader Chuck Schumer of New York. They released a draft last summer, and plan to unveil legislation after Congress returns from its Easter recess. It is known as the Cannabis Administration and Opportunity Act.

Rep. Earl Blumenauer, also an Oregon Democrat, has been a champion of both House bills to do away with federal restrictions that have existed since 1937. The bills are known as the Marijuana Opportunity Reinvestment and Expungement Act.

Under a 1970 law known as the Controlled Substances Act, the federal government classified marijuana as a Schedule 1 drug with no medical value, similar to heroin. It did so after then-President Richard M. Nixon declared a "war on drugs" that even its proponents concede has largely failed.

In a statement issued after the House vote, Blumenauer said:

"As we mark 50 years of the devastating War on Drugs, it is past time for Congress to catch up with the public and majority of states who have legalized some form of cannabis, and pass legislation to decriminalize the adult use of recreational cannabis."

Blumenauer was a 24-year-old state representative in 1973, when Oregon became the first state to make possession of one ounce or less punishable as an infraction comparable to a traffic offense and a maximum fine of $100. Oregon voters approved a medical-use law in 1998 and full legalization in 2014, although Colorado and Washington preceded it.

According to the National Conference of State Legislatures, Oregon is among 18 states in which marijuana is legal for medical and recreational use. Twenty-nine other states have full medical marijuana programs or allow use of cannabis components with low or no psychoactive chemicals that induce intoxication. Only Idaho, Kansas and Nebraska bar public access to any form of cannabis, other than hemp, whose status was changed by a federal law in 2018.

"Ending federal cannabis prohibition is urgent business," Wyden said in a tweet. "I congratulate the House on passing this bill and I urge my Senate colleagues to support my legislation. It's past time for Congress to listen to the will of the voters."

But the latest legislation, whether it's the House bill or Wyden's draft bill, faces a highly uncertain future in an evenly divided Senate where 60 votes are needed to pass something that is not budget-related or an executive or judicial appointment.

During a speech Wednesday, April 6, in support of Ketanji Brown Jackson's nomination to the U.S. Supreme Court, Wyden criticized Republicans who say that matters such as abortion rights should be left to states as a conservative majority on the high court appears poised to restrict or overturn its 1973 decision in Roe v. Wade.

"If Republicans believed in states' rights, they'd respect the right of Democratic states to pass gun safety laws. They'd respect the right of states to legalize marijuana. They'd respect the right of states to ensure we have clean air and water," Wyden said. "But Republicans oppose all of those priorities, challenge those laws in federal court and undermine them in Congress."

The Senate did pass cannabis legislation of its own on March 24. But the bill (S 253) simply streamlines applications for research and encourages the Food and Drug Administration to develop cannabis-derived medicines. The bill went to the House on a unanimous-consent vote; there was no roll call.

The latest House bill (HR 3617) went to the Senate on a 220-204 vote mostly along party lines. Just three Republicans joined Democrats to vote for it; two Democrats voted with Republicans against it.

A similar bill passed the House in a December 2020 post-election session. Its chief significance was that it was a step toward ending cannabis prohibition that has been in effect since 1937, when Congress made possession of it illegal unless someone paid a tax for federal permits that were unavailable.

That bill did not come to a vote in the Senate.

The House has passed another bill (HR 1996), known as the SAFE Act, almost a year ago to remove barriers that cannabis-related businesses face in using the banking system. The barriers force those business to conduct many transactions in cash with all the problems that ensue. A 321-101 vote, with all Democrats in favor and Republicans split 106-101, sent that bill to the Senate, where it has not moved.

"The MORE Act decriminalizes cannabis at the federal level and provides restorative justice for communities which have suffered from the disproportionate and deliberate enforcement of cannabis prohibitions," Blumenauer said. "Today's vote to pass the MORE Act in the U.S. House of Representatives is one step to ending the deplorable, misguided War on Drugs. It is also a critical turning point.

"I have spent time talking to parents of children with seizure disorders, veterans suffering from post-traumatic stress disorder (PTSD), small businesses, and the very communities who have been unfairly impacted by the War on Drugs, and they all agree: The federal government must end the failed prohibition on marijuana," he added. "Today's passage of the MORE Act brings us one step closer to winning the fight."

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Wyden: Time to end federal restrictions on cannabis - Portland Tribune

I will cut taxes. I will raise Social Security. I will win the war on drugs. I will defund the police. I will support the police. I will cut government spending. I will slash gas prices. I will drill for oil and natural gas. I will protect the environment. I will defend the Second Amendment. I will ban guns. I am against abortion. I am for a womans right to choose.

Vote for (insert politicians name). Its that time of year when all the political ads flood the airwaves. I am 68 years old and started voting when I was 18, and I have been hearing the same B.S. for 50 years. Every politician will promise whatever he or she thinks will get you to vote for him or her. But the only thing they really care about is getting reelected.

If they really cared about the citizens of this country, why do they spend millions to get elected to a job that doesnt pay millions? Is it because they can make millions once they get elected?

At one time, we voted for the best candidate; now, we try to figure out who is not the worst. When you listen to the political ads, stop and think, can this joker really do what he or she is promising, or is it just another line of B.S.?

Joe Palumbo

Arnold

More:

Letter to the editor: Candidates keep telling us what we want to hear - TribLIVE

Nobel Winner: Hep C treatment is 'greatest reward'

Charles Rice said winning the Nobel Prize in medicine is one thing but being able to witness people being successfully treated with drugs to eliminate hepatitis C is "the greatest reward." (Oct. 5)

AP

Somerset County had the highest rate of new hepatitis C infections in 2019, according to the state Department of Health.

In 2019, the most recent data year, 171 individuals between 15 and 39 years old were infected with hepatitis C. This translated to 294.83 individuals per 1,000 residents.

The next highest counties were Schuylkill County, with a rate of 264.42 per 1,000, and Clearfield County with 239.91.

In 2018, Somerset County had a rate of 309.28 only second to Lycoming County with 340.37.

Pennsylvania overall received mediocre grades for its hepatitis elimination and prevention in the study, and advocates say limited access to harm reduction programs and outdated policies are large contributors to the state's poor grade.

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Highlands Health offers free HIV, hepatitis C and other tests to anyone regardless of income or location. Executive Director Rosalie Danchanko said the situation she's seeing is an epidemic.

"I'm worried," Danchanko said. "I really am."

Somerset County has the perfect storm for hepatitis C to spread, according to Danchanko.

Hepatitis C is a virus that affects the liver. It's the leading cause of liver cancer and liver transplants, and is transmitted through blood, predominantly spread through sharing needles and syringes.

While individuals who inject drugs are the most at risk of developing hepatitis C, those who do not use drugs can also be infected, as the virus is spread through microscopic blood.

The stigma that the virus only affects those sharing needles means few people are being tested, and some die. Additionally, community advocates believe prejudice against individuals with substance use disorder is another reason potentially life-changing harm reduction initiatives like syringe service programs are not prioritized.

While needle-sharing and unprotected sex are both common sources of new hepatitis C infections, Danchanko said older populations are also affected for unknown reasons.

"We think, back in the day, when we got vaccinated, we all waited in line together," she said. "We're not sure."

Danchanko also said that HIV, Hep C and other epidemics took a backseat to the COVID-19 pandemic over the last two years.

"It can't be ignored," she said. "To have this kind of ranking for Appalachia, for Cambria and Somerset, it scares the bejesus out of me."

Danchanko and the Highlands Health clinic are asking everyone to get tested and remove the stigma around it.

Hepatitis C has a 90% cure rate, with most new treatments including 8-12 weeks of oral antiretroviral therapy.

The ONeill Institute for National and Global Health Law at Georgetown University Law Center, the National Viral Hepatitis Roundtable (NVHR), and the Center for Health Law and Policy Innovation at Harvard Law School (CHLPI) in January launched Hep ElimiNATION, a partnership to study viral hepatitis elimination efforts across the country.

Hep ElimiNATION is the countrys first comprehensive analysis of the policies and strategies aimed at viral hepatitis elimination in the U.S. Hep ElimiNATION assigned letter grades to 52 jurisdictions based on the state's current capacity to eliminate viral hepatitis by 2030 and in alignment with the Department of Health and Human Services Viral Hepatitis National Strategic Plan.

States were graded on their viral hepatitis elimination plan development; harm reduction laws and policies; budget allocations; improving viral hepatitis prevention, treatment and outcomes; reducing viral hepatitis-related disparities and health inequities; improving viral hepatitis surveillance and data usage; and achieving integrated, coordinated efforts that address the viral hepatitis epidemics among all partners and stakeholders.

Out of the 8.5 possible points, Pennsylvania only received 1.5, receiving a C grade.

"The primary reason is that syringe service programs aren't legal in Pennsylvania," said Adrienne Simmons, director of programs for NVHR. "Possessing substance-use or drug-use equipment is illegal in the state. There are vast disparities in access to harm reduction services."

Syringe service programs (SSPs) are currently authorized in the cities of Philadelphia and Pittsburgh, but are not legal statewide.

SSPs are community-based prevention programs where individuals who use drugs can receive substance use disorder treatment, access to and disposal of sterile syringes and injection equipment, and vaccinations, testing and other treatment for infectious diseases.

According to the CDC, SSPs are associated with a reduction in approximately 50% of incidents of HIV and hepatitis C transmission. New users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs when compared to individuals who do not use those programs.

"We rank support for harm reduction policies in Hep EimiNATION framework because we know most of the new hepatitis infections are linked to injection drug use," said Daniel Raymond, director of policy for NVHR. "(SSPs) are a great place to screen people who inject drugs to find out if they have Hep B and C, and to give care also for substance abuse and hepatitis."

Although Pennsylvania isn't the only state where SSPs are illegal, in bordering states such as Ohio, West Virginia, New York and Maryland, SSPs are authorized.

"Pennsylvania is not unique here," Raymond said, noting that syringes are categorized as drug paraphernalia in the state, which many hepatitis, HIV and addiction advocates say is a 1970s legal barrier that became a stronghold during the "War on Drugs" era.

"It made it illegal to buy or use anything considered paraphernalia," Raymond said. "States like Ohio and West Virginia and a lot of other states in the broader region have authorized and legalized syringe services in the last years. Pennsylvania has lagged behind the curve."

To legalize SSPs statewide, Maggie Barton, deputy press secretary for the Pennsylvania Department of Health, said legislation must be passed.

Gov. Tom Wolf's administration is in support of legalizing SSPs and met with the Pennsylvania Harm Reduction Network (PAHRN) last October to find ways to mobilize that effort.

"We believe syringe service programs are a critically needed tool to add to our toolbox statewide to provide a bridge to treatment and social services and ultimately help to reduce the number of drug overdose deaths," Barton said. "Syringe services programs also increase public safety and protect law enforcement and first responders by properly disposing of used syringes."

In January, state Reps. Sara Innamorato, D-Allegheny County, and Jim Struzzi, R-Indiana County, introduced bipartisan legislation to expand SSPs to local service providers throughout the state.

"The federal government is allocating funding to states that offer SSPs, but Pennsylvania can't access this money until SSPs can operate in every corner of the commonwealth," Innamorato said in a release.

Until legislation is passed to legalize SSPs statewide, Struzzi said Pennsylvania is missing out on potentially millions of dollars.

In these times of extreme mental, social and physical stress, it is imperative that we do all that we can to treat addiction and provide these harm reduction services," Struzzi said in the release. "In addition, by having this legislation written into law, it will open the door to millions in federal dollars that we can use to truly impact the lives of Pennsylvania residents and families struggling with addiction.

While illicit drug use isn't safe, Alex Tatangelo, a nurse practitioner with Central Outreach Wellness Center in Aliquippa, said it's important to educate people and provide harm reduction opportunities for those who are going to use drugs anyway. Countless studies show SSPs are an invaluable way to do that.

"What we want to do is engage people in prevention, engage people in getting clean needles and part of the engagement we want to talk about is safe drug use," Tatangelo said. "Is any drug safe? No. But can we make it slightly more safe? Yes."

SSPs can prevent overdose deaths, according to the CDC, by "teaching people who inject drugs how to prevent overdose and how to recognize, respond to and reverse a drug overdose by providing training on how to use naloxone."

These community centers offer a more holistic approach to substance abuse treatment by providing education, resources, medical assistance and a safe space for people who inject drugs.

Suzanna Masartis, chief executive officer of Community Liver Alliance, said SSPs are "more than a needle exchange."

"It's about helping to refer to mental health and other health services, vaccination for Hep A and B, and also Hep C and HIV testing and linkage to care services," Masartis said. "It's about meeting people where they are."

Access to those services also can "prevent a barrier to infectious disease outbreaks, including outbreaks with Hep C," said Jennifer Fiddner, epidemiology research associate supervisor with the Allegheny County Health Department.

More than 2,500 new HIV infections occur each year among those who inject drugs. Hepatitis C and HIV transmissions can be reduced by two-thirds when combined with medications that treat opioid dependence, the CDC reports.

"In my experience, these programs work best when supported by the community, but they also often confront misunderstanding and stigma," Raymond said. "If the average person took some time to learn about these programs and think about the programs with an open mind, I think we would end up with a lot more buy-in for this missing piece of the puzzle."

More than 2.4 million people nationwide were living with hepatitis C in 2016, and 250,000 have chronic hepatitis in Pennsylvania. Now, infections could be closer to 3 million.

Simmons believes the number of hepatitis C infections is "only the tip of the iceberg."

"We don't have the surveillance and testing infrastructure in place to test all the cases. And that was exacerbated by the pandemic. It's multifactorial," she said.

Simmons also mentioned the disparity in federal funding between HIV/AIDS and hepatitis C. The Biden administration allocated $39 million this year for hepatitis prevention and treatment, compared to $167 million for HIV/AIDS.

"It's part funding, it's part poor public health infrastructure, and it's also stigma around the disease," Simmons said. "There is a universal recommendation that all adults be tested at least once in their life. We haven't seen that since COVID."

Raymond said hepatitis C infections appear to be "linked to the relative lack of harm reduction services and engagement in treatment. That's why we feel urgency in calling this out before we end up with another generation with a chronic infection that can be ultimately life-threatening."

The American Association for the Study of Liver Diseases and the CDC recommend every person be tested at least once in their lifetime for hepatitis C, and high-risk individuals should be screened yearly.

While hepatitis C is largely contracted through intravenous drug use, Tatangelo said there's a misconception that that's the only way to be infected.

"People think, 'I never used IV drugs so I'm not at risk,'" Tatangelo said. "Have you had sex with someone who uses? Have you snorted cocaine with someone?"

Approximately 45% of people infected with hepatitis C do not recall or report having specific risk factors, the CDC reports. Many people who have hepatitis do not show symptoms and may not know they are infected. Sometimes symptoms arise weeks or even months after exposure. Common symptoms include fever, fatigue, nausea, vomiting, abdominal pain, joint pain, dark urine and jaundice.

Baby boomers those born between 1945 and 1965 are at high risk for hepatitis C infection, according to the CDC, as many could have been infected during medical procedures in the years after World War II when blood transfusions and other technologies were not as safe as today.

Other ways people can contract hepatitis C is by getting tattooed or pierced with an unclean needle, or using a dirty or shared razor or toothbrush, Scholz said.

"There are so many avenues you can contract this," Tatangelo added.

"Even if they don't have health insurance, there may be avenues we can take to still get them treated for hepatitis C," Tatangelo said. "Health insurance in our country isn't a right, and it should be. The more people we see the more we can connect to health insurance and get screened for diabetes, colon cancers, HIV, and be on a better road to general wellness."

For more information about hepatitis C treatments, call 866-WE-CURE-HEP-C. To see statewide treatment and screening facilities visit the Department of Health website.

Continued here:

Somerset County had the highest rate of infection for this virus in Pa. Drug use is cited. - Daily American Online

The conventional wisdom that we need to reduce spending on prescription drugs is all wrong. In an ideal health care system, wed spend more on drugs, not less.

Rather than spending trillions of dollars on hospital infrastructure, moderately effective palliative treatments, and burdensome administrative processes, the U.S. could spend a smaller sum on powerful medicines that prevent, control, and even cure disease.

Access to a larger pool of innovative medicines would improve life for everyone, but especially for historically marginalized groups who bear the heavy economic and health burdens of disease. If more medical conditions could be managed with medications rather than with frequent doctor or hospital visits, we would likely see reduced overall health care costs and less variation in health status across social groups and geography.

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How can this dream vision of a healthier, more equitable world and a more effective health care system become a reality?

For starters, policymakers must end their perpetual war on biopharmaceuticals. For years, Congress has been singling out drug costs even though medicines account for only 12% of total U.S. health care spending and are often the most effective tool for fighting disease.

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Prescription drugs can significantly reduce the need for expensive emergency room visits, surgeries, hospitalizations, and long-term care. In fact, a Congressional Budget Office estimate found that an increase in the use of prescription drugs decreased spending on medical services.

We can look at the progress that has been made treating hepatitis C, an often-fatal liver disease. Barely a decade ago, 20% of people with hepatitis C would develop cirrhosis, a complex and expensive condition that can necessitate a liver transplant. Today, there are once-daily medications that can cure up to 95% of cases with few to no side effects. A course of one of those medicines costs $24,000. That is certainly not cheap, but it is one-twenty-fifth the cost of a liver transplant, which costs $600,000 on average.

Or consider the advancements made in treating HIV. Once a death sentence, there are now medications that can prevent nearly all new infections. Thanks to continued research, long-acting injectables may soon allow for bimonthly treatment. Widespread use of these drugs could eradicate HIV in the United States a disease that currently costs the health care system $28 billion a year.

And theres no clearer example of the life- and cost-saving power of medicines than the Covid-19 vaccines. Each Pfizer shot costs the U.S. government about $24 its available at no out-of-pocket cost to patients, in order to maximize uptake but can prevent hospitalizations that cost tens of thousands of dollars. By preventing hospitalizations and missed working days, the Covid-19 vaccines boosted Americas gross domestic product by $438 billion in 2021 alone, according to a new study from Heartland Forward, a think tank.

Theres no question that the cost of medicines in our current system can impose a real and sometimes overwhelming financial burden on some patients. But the solution isnt to reduce overall spending on these effective tools. It is to improve the quality of insurance coverage and ensure that all patients have access to the medicines prescribed by their doctors.

This likely means capping out-of-pocket costs, moving away from co-insurance, and developing alternatives to high-deductible health plans. A study in the New England Journal of Medicine, for instance, found that out-of-pocket caps substantially reduced spending for patients without increasing health plan spending. Policymakers should also investigate recent reports highlighting the role industry middlemen play in the high costs of medication.

Americas innovative life sciences researchers could soon send diseases like Alzheimers, Parkinsons, and ALS the way of measles and polio. With sustained investment in biopharma research and development, more and more diseases that lead to complex and costly care in our current system will be prevented or managed with novel medicines. Those advances will come at a cost, but theyll still be much less expensive, in the long run, than the status quo where a majority of health care costs stem from hospitals, doctors visits, and long-term care spending.

Just as importantly, the cost of these novel treatments should go down over time as patent protection ends and generics and biosimilars enter the marketplace. This represents a critical investment opportunity for society not the burden some say drug spending is.

There will never be a world in which prescription drugs represent 100% of health care costs. Accidents and other calamities will continue to require complex and comprehensive care. But when most diseases can be effectively managed or cured by drugs, they should represent a larger percentage of a more effective and less costly heath care system.

Jean-Franois Formela is a partner at Atlas Venture in Cambridge, Mass., where he focuses on novel drug discovery approaches and therapeutics. John Stanford is the executive director of Incubate, a Washington-based coalition of life-science venture capitalists.

See the rest here:

To spend less on health care, invest more in medicines - STAT

Introduction

Serious human rights violations continue in the Philippines. On September 15, 2021, the International Criminal Court (ICC) agreed to open a formal investigation into extrajudicial killings and other abuses that may amount to crimes against humanity committed during President Rodrigo Dutertes war on drugs from 2016 to 2019, and extrajudicial executions committed in Davao City in the southern Philippines from 2011 to 2016, when Duterte was mayor. Various human rights groups allege that between 12,000 and 30,000 people have been killed in the drug war.

The governments counterinsurgency campaign has resulted in the unlawful killings of civilians and red-taggingaccusing activists and others of being combatants or supporters of the communist New Peoples Army. Many of those red-tagged are subsequently killed. Journalists covering the insurgency or investigating abuses and corruption also face harassment and violence.

In July 2020, the Philippine government and the United Nations launched a joint human rights program to address human rights violations and accountability failings in the country, reflecting domestic and international concerns about drug war killings. Rights groups, including Human Rights Watch, consider the program inadequate, and continue to call for an independent international investigation.

In October 2021, Maria Ressa, the co-founder and executive editor of the news website Rappler, won the Nobel Peace Prize for defending media freedom, in particular for resisting the Duterte governments attempts to muzzle the press. Ressa and her colleagues face seven criminal charges for Rapplers independent and courageous reporting.

Extrajudicial Killings

In the last UPR review in 2016, the Philippine government merely noted recommendations by various UN member states to end impunity for extrajudicial killings and to hold perpetrators accountable (recommendations 133.137 through 133.155).[1] The government also denied that the deaths that occurred in the war on drugs were extrajudicial killings. These deaths, it said, were the result of legitimate law enforcement operations or deaths that require further investigation following the established rules of engagement by the countrys law enforcers.[2]

Since that review, the killings of suspected drug users and dealers and many others have continued on a massive scale. As of January 31, 2022, the government said 6,229 individuals have been killed by the authorities in police anti-drug operations.[3] This number does not include the deaths of thousands of others attributed to unidentified assailants, many of whom are believed to be state agents. Very few of these killings have been seriously investigated.

In September 2021, a pre-trial chamber of the ICC granted the prosecutors request to open a formal investigation into alleged crimes against humanity in the Philippines from the time the country ratified the ICCs Rome Statute on November 1, 2011, until its withdrawal from the treaty on March 16, 2019. In its decision to approve the investigation, the pre-trial chamber stated the governments anti-drug campaign cannot be seen as a legitimate law enforcement operation, and the killings neither as legitimate nor as mere excesses in an otherwise legitimate operation. The chamber also said there has been a widespread and systematic attack against the civilian population as part of a state policy.

The review followed the admission by the Department of Justice before the UN Human Rights Council in February 2021 that officers failed to follow official protocols during these operations.[4] In many cases, police made no effort to examine allegedly recovered weapons, verify ownership, or conduct ballistic examinations. In most of the cases the Justice Department reviewed, police also failed to follow standard protocols in the coordination of drug raids and in the processing of crime scene evidence.

The Justice Department investigation has faced criticism for repeated delays, lack of transparency, and refusal to involve the national Commission on Human Rights in its review. In a transparent effort to head off ICC involvement, the department released in October 2021 a preliminary report affirming that police were culpable in at least 52 cases and promised to investigate further. In January 2022, the Justice Department announced that police officers implicated in four of these cases have been indicted. The names of the individuals and numbers of indictments have not been released.

On November 18, 2021, the ICC prosecutor, Karim Khan, notified the court that the Philippine government requested a deferral of the ICCs investigation, claiming that it had begun its own investigations into cases of extrajudicial killings attributed to the police during drug war operations. As part of the deferral request, the Philippines government cited the Department of Justices review of 52 cases in which they found administrative liability on the part of its law enforcement agents, and the Justice Departments recommendation for further investigation for possible criminal charges.

Under the complementarity proviso of the Rome Statute, the tribunal can only investigate allegations if a country does not conduct genuine proceedings relevant to crimes that could otherwise be prosecuted before the court. On November 23, the Office of the Prosecutor asked the Duterte administration for information substantiating its investigations. The government has yet to publicly respond to the request and has reiterated its argument that the ICC does not have jurisdiction over the Philippines.

Human Rights Watch submitted a letter to the Department of Justice seeking details about the governments claim that it was investigating police involvement in the killings. Philippine rights groups have found the number of pending investigations grossly inadequate to address the scale of the killings, for which official figures are far below estimates from nongovernmental organizations.

Apart from killings related to the war on drugs, the targeting of political activists, civil society actors, and journalists has likewise continued since the 2016 review.

The murder of journalists has continued unabated since the 2016 UPR review. According to the National Union of Journalists of the Philippines, 22 journalists have been killed since 2016, typically by unidentified gunmen.[5] In December 2021, journalist Jesus Malabanan was shot dead in his home in Calbayog City. In October 2021, Orlando Dinoy of Newsline Philippines and Energy Radio RM was killed in his home in Digos City. In July 2021, Reynante Cortes, a radio broadcaster known for his on-air commentary on local politics and corruption, was fatally shot as he was leaving his radio station in Cebu City. In November 2020, newspaper columnist and radio commentator Virgilio Maganes was killed by gunmen in Villasis town, Pangasinan province.

In the second UPR cycle, the government said it supported measures to end extrajudicial killings (recommendation 131.32) and made note of similar recommendations (133.137 through 133.155) in the 2016 cycle. The extrajudicial and summary killings of suspected criminals, many of them children, continued, however, with practically zero accountability for those responsible. A report by Human Rights Watch in 2014 detailed the involvement of the police and local government officials in the systematic targeting of individuals in the city of Tagum in Mindanao by using hired assassins who took orders and payment from municipal officials.[6] These killings were patterned after similar killings perpetrated by the so-called Davao Death Squad in Davao City, where Duterte was mayor for decades.[7] Not a single person has been brought to justice for these killings.

In the 2016 UPR cycle, the Philippine government supported recommendations by various states (recommendations 133.34 through 133.42) for it to develop, enforce, and publicize its National Human Rights Action Plan. The plan was touted as a key framework to address human rights issues in the country. However, details of the 2018-2022 action plan are practically unknown outside of the Duterte government. Philippine human rights groups told Human Rights Watch in March 2022 that they have never been consulted by the government about the action plan or know the status of the document. The Commission on Human Rights apparently does not have a copy of the plan.

Despite recommendations (133.13 through 133.17, 133.119) for the Philippines to allow a visit by the UN Special Rapporteur on extrajudicial, summary or arbitrary executions, the government has refused the request. The Duterte administration in 2017 and 2018 attacked the then-Special Rapporteur, Agnes Callamard, publicly demonizing her through official statements that often came from the president himself.

Recommendations to the Philippine government

Attacks Against Rights Defenders, Civil Society

In the 2016 UPR cycle, several states urged the Philippine government (recommendations 133.170, 133.173 through 133.182) to ensure a safe environment for civil society and human rights defenders. In response, the government merely noted these recommendations.

The countrys 52-year-long communist insurgency has continued since the last cycle. During counter-insurgency operations against the New Peoples Army, government security forces frequently targeted leftist activists, including peasant leaders, environmentalists, human rights lawyers, and Indigenous group heads, among others. Government and military officials often red-tag such individuals through announcements and social media, putting them at grave risk of attack. The National Task Force on Ending Local Communist Armed Conflict is the main government agency engaged in red-tagging. It is composed of officials from several government agencies, including the military and the police.

The police and the military continue to target individuals for arbitrary arrests on suspicion that they are members of the communist movement. A recent and widely denounced arbitrary arrest was that of Dr. Natividad Castro, a human rights defender who in 2016 spoke at the UN Human Rights Council about the abuses committed against Indigenous peoples in the Philippines.

Senator Leila de Lima, a chief critic of President Dutertes war drugs, has been in police custody since her arrest in February 2017. The authorities arrested her after she sought to investigate extrajudicial executions committed in the context of the anti-drug campaign.

In January 2022, the House of Representatives overwhelmingly passed the Human Rights Defenders Protection Act, which is intended to protect rights defenders by defining the rights and fundamental freedoms of human rights defenders, declaring state responsibilities, and instituting effective mechanisms for the protection and promotion of these rights and freedoms.[8] The Senate has yet to pass its own version of the bill.

Recommendations for the Philippine government

Freedom of the Press

In the 2012 UPR cycle, the Philippine government noted a recommendation by states to effectively investigate and prosecute attacks against journalists. It also noted similar recommendations (133.170 through 133.182) in the 2016 cycle.

Media freedom and freedom of expression received a big boost in October 2021 when Maria Ressa, the co-founder and executive editor of the news website Rappler, was awarded the Nobel Peace Prize, along with Russian editor Dmitry Muratov. Ressa and Rappler have been the target of reprisals, mainly through libel and tax evasion cases, from the Duterte government and its supporters for the websites reporting on drug war killings and for helping to expose what Ressa called Dutertes weaponization of the Internet to target critics of the government and dissidents.

In April 2021, journalists from the Northern Dispatch, a weekly newspaper, were harassed by municipal police in Kalinga province for covering an event organized by leftist groups. Journalists of the same newspaper were later red-tagged by authorities. In September 2021, leftist media organizations Bulatlat and AlterMidya alleged that the Philippine military was launching denial of service attacks on their websites. Frenchie Mae Cumpio, a journalist in the central Philippines, has been in police detention since February 3, 2020, on allegations that she supported communist rebels.

Recommendations to the Philippine government

Counterterrorism

In the 2016 UPR cycle, the Philippine government supported recommendation 133.75, which urged the government to continue efforts to combat terrorism, the drug trade and drug use, within the framework of the Constitution, the law and international human rights standards. However, since its passage in July 2020, the Anti-Terrorism Act has been denounced because, as the UN High Commissioner for Human Rights noted, it dilutes human rights safeguards and creates a chilling effect on human rights and humanitarian work.[9] Since its passage, the law has been challenged in the courts but has nevertheless been used by the government against activists, Indigenous peoples, unionists, and alleged communist insurgents.

Recommendations to the Philippine government

Childrens Rights

Children have been severely impacted in the governments war on drugs, with many of them being killed and others suffering the psychological, economic, and social costs of the brutal campaign.[10]

Childrens rights in the Philippines enjoyed a boost in March 2022 when President Duterte signed a law raising the age of sexual consent from 12 to 16, with an important exemption to avoid criminalizing consensual sexual activity among children close in age. Earlier, in December 2021, a bill that had been pending in Congress that seeks to ban child marriage automatically became law after Duterte did not sign it. The law sets tough penalties for arranging a child marriage and mandates that the government establish programs to prevent child marriage.[11]

In a major step backwards, the government is supporting a bill that seeks to lower the age of criminal responsibility from the current 15 to 12. In the 2016 UPR cycle, several states urged the Philippine government not to make this change (recommendations 133.162 through 133.169), which President Duterte had made part of his campaign against crime. The government noted this recommendation, as it also did in the 2012 UPR cycle.

Recommendations to the Philippine government

Womens Rights

Abortion, including in cases of rape, incest or when the health and life of the pregnant woman is at risk, remains illegal in the Philippines. States urged the government to reverse this policy in the UPR 2012 and 2016 cycles (recommendations 133.232).[12]

Recommendation to the Philippine government

LGBT Rights

In the UPR 2016 cycle, the Philippine government was urged to enact legislation to counter discrimination against LGBT people (recommendation 133.126) and responded by expressing support for it. However, the anti-discrimination bill introduced in 2000, now called the SOGIE Equality Bill, remains pending in Congress as it faces opposition from conservative legislators.

Recommendation to the Philippine government

[3] #RealNumbersPH Year 5, Philippine Drug Enforcement Agency, https://pdea.gov.ph/index.php?option=com_content&view=article&layout=edit&id=279 (accessed March 22, 2022).

[4] "Philippines Admits Police Role in Drug War Killings," Human Rights Watch, https://www.hrw.org/news/2021/02/25/philippines-admits-police-role-drug-war-killings (accessed March 30, 2022)

[5] "Filipino journalist who helped probe Dutertes drug war shot dead," Al Jazeera, https://www.aljazeera.com/news/2021/12/9/filipino-journalist-who-investigated-duterte-drug-war-killed (accessed March 28, 2022).

[6] "One Shot to the Head: Death Squad Killings in Tagum City, Philippines," Human Rights Watch, https://www.hrw.org/report/2014/05/20/one-shot-head/death-squad-killings-tagum-city-philippines (accessed March 28, 2022).

[7] "You Can Die Any Time: Death Squad Killings in Mindanao," Human Rights Watch, https://www.hrw.org/sites/default/files/reports/philippines0409webwcover_0.pdf (accessed Marwch 28, 2022).

[8] "House Bill 10576: Defining the rights and fundamental freedoms of human rights defenders, declaring state responsibles, and instituting effective mechanisms for the protection and promotion of these rights and freedoms. House of Representatives, https://hrep-website.s3.ap-southeast-1.amazonaws.com/legisdocs/third_18/HBT10576.pdf (accessed March 30, 2022).

[9] "Situation of Human Rights in the Philippines," Office of the High Commissioner for Human Rights, https://www.ohchr.org/sites/default/files/Documents/Countries/PH/Philippines-HRC44-AEV.pdf (accessed March 28, 2022).

[10] 'Our Happy Family Is Gone': Impact of the 'War on Drugs' on Children in the Philippines, Human Rights Watch, https://www.hrw.org/report/2020/05/27/our-happy-family-gone/impact-war-drugs-children-philippines (accessed March 28, 2022).

[11] "PCW lauds passage of bill criminalizing child marriage at Senate," Philippine Commission on Women, https://pcw.gov.ph/pcw-lauds-passage-of-bill-criminalizing-child-marriage-at-senate/#:~:text=In%20the%20Philippines%2C%20the%20legal,reaching%20the%20age%20of%20fifteen (accessed March 29, 2022).

[12] "Facts on Abortion in the Philippines: Criminalization and a General Ban on Abortion," Center for Reproductive Rights, https://www.reproductiverights.org/sites/crr.civicactions.net/files/documents/pub_fac_philippines_1%2010.pdf (accessed March 29, 2022).

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Human Rights Watch Submission to the Universal Periodic Review of the Philippines - Human Rights Watch