Monthly Archives: February 2015

View From the Ground: Rosario, Argentina

In early January around 2,000 members of Argentina’s military-style border force – known as the gendarmeria – left the country’s second city of Rosario.  They had arrived 9 months earlier, on April 9th, carried clandestinely into the city as part of an elaborate rouse involving a fake climate change conference.  In a surprise display of force the local press justifiably described as “cinematic”, six helicopters hovered above while more than 80 raids were launched on known ‘bunkers’, the one room buildings that serve as illicit drug dispensers and are almost wholly located in the villas, the poor neighbourhoods that form a loose rim around the city centre.  At the forefront of proceedings was the National Security Secretary, Segio Berni.  “This was the largest operation in the history of Argentina, with the objective of pacifying the area of Rosario,” he told the press.

Since 2012 drug trafficking and violence have become issues of public debate in the city.  The violence and the trafficking had been going on in isolation in the villas, separate from the affluent heart of the city, but the issue was forced into the public eye and onto the political agenda thanks to the dedicated work of the activist organisation Frente Popular Dario Santillan after three of its members were killed on New Year’s Day 2012 by a local drug gang who mistook them for rivals.  Since a spike in mid-2010, violence has been spiralling upwards.  The city’s homicide rate is now the highest in the country.  Overwhelmingly, the victims are young men and boys; confrontations between rival gangs involved in the drug trade – generally small outfits, and often family-run – are considered to be behind a sizeable proportion of the deaths.  In response, “insecurity” has become the buzzword among politicians and the media.  It’s election time here at the moment and the posters blanketing every advertising space promise to combat insecurity, to bring back security, to make Rosario normal again.  Official mentions of the root causes – poverty, exclusion, corruption – are rare.  Policies designed to address them are even rarer.  (I know an activist group that struggled for a year and a half just to have lights put above a football pitch so the kids in one villa could have something to do in the evenings.)  The growing use of Argentina as a transit point for cocaine headed to Europe has increased the stakes and likely contributed to the violence, as have a provincial police force heavily involved in the trade and the lacklustre efforts of the judiciary and the government.  But in the public mind, and according to government policy, the embodiment of insecurity, the cause and the consequence, is a drugged-up 16 year old with a gun (a forthcoming GDPO Situation Analysis will discuss the treatment of children here involved in the trade).  “What these kids need,” local journalist, author, and political candidate Carlos del Frade told me, “is education, sport, art, activities.  They don’t need the gendarmeria in the neighbourhood.”  But that’s what they got.

It was something of an omen of things to come that while the mega-operation of April 9th looked impressive, the haul that day – 25 low-level actors involved in small-scale selling, “three guns, a couple of thousand dollars and some drugs”, quoting the former governor of the province – was less so.  The gendarmeria continued the established trend of pursuing the lowest and most visible link in the trafficking chain. Over their 9 month stay they did reduce violence in certain areas of the city; when they were replaced by the provincial police, shootings resumed.  Their presence also resembled an occupation and abuses were reported.  A university study of one area found selling alcohol was not permitted after 10pm, shopping receipts needed to be kept at hand to show proof of purchase, youngsters were detained arbitrarily and prevented from gathering outside, and people riding motorbikes were constantly stopped and searched.  Drug traffickers, local sources suggest, responded by selling more at night, and switching from ‘retail’ selling to ‘delivery’ – a text message is sent and a motorbike appears with the goods.  After the bandage was ripped off in January the blood began flowing again – as would be expected.

Party politics is central to all this.  When the gendarmeria were withdrawn, Berni, of the ruling Frente Para la Victoria party, could not resist using the opportunity to fire some parting shots at the Socialists who govern Rosario and Santa Fe.  The Socialists blame the national government for not sealing up the borders and not acting on drug trafficking, which is a federal, not provincial crime.  The national government blame local corruption.  Both have a case.  Berni rightly took some flak for politicising the issue, but this was merely an open recognition of what previous actions have made clear.  Even major operations are largely reactive and serve to score political points: when the provincial government were impelled to move on the city’s biggest drugs gang two years ago, the national government sent their forces into the province to capture a powerful drug trafficker – “I’m caught in the middle of a political war”, he somewhat justifiably told the press.  Nice rhetoric aside, the national government, which has sworn not to follow a War on Drugs approach, has done exactly that with the sending of the gendarmeria.

For now there are few signs things will improve.  Post-gendarmeria, the public debate is focused on the narrow question of whether they should come back or not; the governor of the province, Antonio Bonafatti, is adamant they return.  The national government seems to be enjoying watching their provincial rivals suffer.  Not enough is being done or said, on a national or provincial level, about the conditions behind the violence and trafficking – present in many cities across the country – or about the corruption in the police, the judiciary and the government; some local experts are incensed the provincial government didn’t use the breathing space provided by the national forces to overhaul the notoriously corrupt police force.  The short term seems to be the sole consideration for parties focused on upcoming elections. “The long term exists only for theoretical dalliances,” remarked a local columnist while discussing the dominance of the “security” issue within local political campaigns.  But serious, sustained programs designed to address deep-rooted issues are imperative if the many youngsters growing up in the villas who feel helpless and excluded and angry, who have lost a sense of value for life, are to have a better future than the one offered to them today.  Youngsters like 23 year old Pablo Martinez, who died this February while playing russian roulette.

By Ross Eventon

CND decision to schedule ketamine would undermine WHO treaty mandate

This blog was first posted here

The UN Commission considers to bring ketamine under the control of the 1971 Convention on Psychotropic Substances contrary to WHO recommendations
Monday, February 16, 2015

The 58th Session of the UN Commission on Narcotic Drugs (CND) in March 2015 has been asked to consider a Chinese proposal to place ketamine – an essential medicine used for anaesthesia – in Schedule I of the 1971 Convention (E/CN.7/2015/7 and E/CN.7/2015/81). Ketamine is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine under any of the 1971 treaty schedules will reduce its availability and further deepen the already acute crisis of global surgery.

The WHO has strongly and repeatedly recommended against international control, warning it would constitute a public health crisis in countries where no alternatives are available. The CND is taking place in Vienna on 9-17 March 2015.

> See also: Fact Sheet on the Proposal to Discuss International Scheduling of Ketamine at the 58th CND

On the UNODC website, in the CND section, appears a page under the title “Scheduling procedures” containing incomplete – and therefore misleading – information with regard to the options available to the CND in the case of a decision on ketamine. It says that the Commission “may decide – contrary to a recommendation of WHO – to add a substance to a schedule of the 1971 Convention or refuse to do so, to add a substance to a different schedule than recommended, or to remove a substance from the schedule in which it is listed or refuse to do so. However, the CND has to take into account the assessment from the WHO, which shall be determinative as to medical and scientific matters, and to bear in mind the economic, social, legal, administrative and other factors communicated to it by the Parties.”[1]

The footnote to the paragraph references the Commentary on the 1971 Convention [2], which indeed talks about the Commission’s “very wide discretionary powers” but it adds that this “does not mean that it may act arbitrarily”. [3] The key procedural question on the table in the case of ketamine is whether the CND “may decide – contrary to a recommendation of WHO – to add a substance to a schedule of the 1971 Convention”, a correct direct quote from the Commentary. [4] However, the Commentary also specifies that “there are cases in which the Commission would be bound to act in accordance with recommendations of WHO”, cases that unequivocally apply to the current case of ketamine:

commentary-1971-par22

The WHO Expert Committee in its latest review clearly established that “ketamine abuse currently does not appear to pose a sufficient public-health risk of global scale to warrant scheduling. Consequently, the Committee recommended that ketamine not be placed under international control at this time.” [5] According to the Commentary quote above, that means that “the Commission would not be authorized to place it under control.”

Moreover, the Commentary also mentions specific restrictions on the CND to decide about adding substances to Schedule I:

commentary-1971-par24

Again, the WHO Expert Committee is very clear on that issue:

“Ketamine is included in the WHO Model List of essential medicines and the WHO Model List of essential medicines for children as well as in many national lists of essential medicines. Ketamine has analgesic, hypnotic and short-term memory loss (amnesic) effects and is useful for induction of anaesthesia, procedural sedation and analgesia. Compelling evidence was presented about the prominent place of ketamine as an anaesthetic in developing countries and crisis situations. The ease of parenteral administration gives ketamine a major advantage when anaesthetic gases are impossible to use owing to limited equipment and a lack of appropriately trained specialists.”[6]

According to the Commentary quote above, this means that the CND cannot decide to place ketamine in Schedule I. This renders the Chinese proposal to include ketamine in Schedule I invalid under the terms of the treaty, thereby ruling out the option of calling for a vote on the proposal. Also the note prepared by the Secretariat on “Changes in the scope of control of substances”, is confusing and misleading. After describing the Chinese proposal, under the heading “Action to be taken by the Commission on Narcotic Drugs” the note explains the voting procedure specifying that a decision requires a two-thirds majority, concluding:

“The Commission should therefore decide whether it wishes to place ketamine under Schedule I of the 1971 Convention or, if not, what other action, if any, might be required.”[7]

The Secretariat does not point out the obvious contradiction with the WHO recommendation (which is only included in the note as an annex) and the procedural limitations the WHO conclusion places on the nature of the decision the CND can make. Instead, the issue is presented under the title “Consideration of a notification from China concerning the proposed recommendation for international control of ketamine under the Convention on Psychotropic Substances of 1971” and the note implies that the normal action to take would be to call for a vote. The WHO recommendation not to place ketamine under international control is only included as an annex.

Conclusion

Both the UNODC website text and the note by the secretariat give the misleading impression that the CND has full discretion to decide against the WHO recommendation and that the procedurally normal course of action would be for CND Member States to vote on the Chinese proposal. Under the terms of the 1971 Convention, as clearly explained in the Commentary, neither is correct. While the CND does have more discretionary powers in scheduling decisions under the 1971 Convention compared to the 1961 Single Convention, there are clearly established restrictions how far a CND decision can deviate from the WHO recommendations. Those restrictions fully apply in the case of ketamine and exclude the option for the CND to place ketamine under international control. The WHO review outcomes have rendered the Chinese proposal for scheduling invalid under the terms of the 1971 Convention.

The importance of following the proper procedure of scheduling in the international drug control system goes much further than the urgency right now to prevent the public health disaster that would be triggered by scheduling ketamine. Allowing this procedure to proceed unquestioned would set a dangerous precedent for scheduling other substances such astramadol and khat in the future in a similar way bypassing WHO advice. It would once again marginalize the role of the WHO in the UN drug control system and undermine the specific treaty mandate given to the WHO Expert Committee to provide an evidence base to scheduling decisions. It would be yet another example that the original treaty balance between assuring adequate access of controlled substances for medicinal purposes while preventing diversion and abuse, has been lost. It is also a good litmus test for the welcome but often vague discourse of shifting towards a health and human rights-based drug control approach. Keeping ketamine out of the treaty schedules is a good example of what taking that discourse serious means in practice.


[1] Scheduling procedures, UNODC web page (visited 8 February 2015), first paragraph 11 (there are two).

[2] Article 2(4)-2(6), 1971 Convention. See also the Commentary on the Convention on Psychotropic Substances , pp. 45-72.

[3] Paragraph 19, p. 70.

[4] Paragraph 20, p. 71.

[5] WHO Expert Committee on Drug Dependence: thirty-sixth report, WHO technical report series no. 991, 2015, p. 45.

[6] Ibidem.

[7] E/CN.7/2015/7, Changes in the scope of control of substances, Note by the Secretariat, p. 10.