File Wikileaks logo #CrusadeGate: US Crusade on Harm Reduction newly leaked cable (not yet reported on elsewhere) exposes how the United States placed extreme political pressure on the leaders of the member states of the United Nations to successfully prevent the United Nations from including “harm reduction” in UN drug policy, which is only addressed every ten years. The scientific facts are astoundingly clear regarding harm reduction (see end for open access literature reviews). Harm reduction is a particularly serious issue because it does not only save the lives of drug users but prevents the spread of HIV. Due to our (European) strategies of harm reduction such as methadone programmes and needle exchanges for intravenous drug users Europe has some of the lowest HIV rates in the world. America and Russia have the worst HIV rates in the developed world because both of these countries do not practice harm reduction measures. This message is particularly serious coming from the US because according to US law items which prevent HIV being transmitted are not only denied to health authorities but they are actually illegal to posess, therefore pushing harm reduction charities such as needle exchanges underground. If this were to happen here we would see levels of HIV sky-rocket towards the appalling levels seen in the United States and Russia. If this is not worrying enough the rhetoric being used to support the US strategy is frankly sickening. The rhetoric is that the more dangerous drug taking is, the less people will take drugs. The fact that this results in countless unnecessary deaths and transmission of HIV which would otherwise be completely preventable is not considered.

In the cable the European standard of harm reduction is described as an “EU Crusade on Harm Reduction” (sic). The irony here is on a number of levels. Firstly, a “crusade” is a war based on the imposition on moral/religious values. The US is conducting a crusade based on the morality of drug abuse yet it is the US however who are accusing Europe of a “crusade on harm reduction”. Secondly, this is clearly not a European crusdade on harm reduction, perhaps it could conceivably be a crusade for harm reduction but definitely not on harm reduction. Thirdly, assuming that is what they meant, a “crusade for harm reduction” is perhaps the most poetically, paradoxically absurd description of a basic health care principle I’ve ever heard. Fourthly, it is patently obvious that it is the US and not Europe who is actually entering a “crusade on harm reduction” namely because they are the only ones crusading in any way shape or form with regard to this issue. (Ok, so are the Russians but they’re just as barmy). Finally, I hope I need not explain the final tragic irony of describing the imposing of a new morally driven blanket ban on a basic health care principle that stops the spread of HIV as a “crusade”. The original crusades resulted in a still existing blanket ban on the primary barrier to HIV transmission and this is of course, the main reason we have a global HIV crisis in the first place. My only conclusion is that this wording was a failed attempt at very dark humour. Trust the Americans to fail at irony. Damn, I’ve just pissed off both of the world’s largest superpowers and the world’s largest religion in one fell swoop. Maybe we should keep the nukes afterall. At least nukes don’t give us AIDS.

Footnote: The title of paragraph four of the leaked cable is “Is it EU Solidarity or (the) UK Leading the Crusade?“. If the Americans insist on calling a basic life saving health care principle called “harm reduction” a crusade and suggesting it is us that are leading the charge then this is perhaps the first crusade in our history that we can actually be proud of.

Addendum: Alan Clear, the director of The Harm Reduction Coalition reported the actual events that resulted from this only now released cable…

“Would the UN Member States assemble a political declaration almost identical to the last one? The 1998 version dealt with drug demand reduction by adopting what we now know to be the expensive, ineffective, and disastrous law-and-order route that has cost the US alone 40 billion per year–without significantly reducing either supply or demand–and made us the world’s largest jailer of our own people.

…Or would this be the year that member states would move towards a public health and human rights approach to drug policy?…

…to reject the inclusion of the term “harm reduction” in the Political Declaration being endorsed at this meeting is extremely short sighted and problematic. It puts the US in the position of sitting in judgment of successful programs being run by many countries globally; it also ignores the very successful use of harm reduction in the United States to stem the tide of overdose deaths, low threshold drug treatment and Hepatitis C treatment and care in major centers including New York City. Worst of all, it negates the sound science behind interventions like safer injection spaces or heroin prescription programs.

…This meeting is unfortunately timed. Whereas the new Obama administration is making steps to move in a more progressive human rights based direction, the groundwork for the drafting of the Political Declaration has taken place with State Department employees who took their direction from the previous administration and haven’t yet been presented with a new agenda. Sadly it will be another 10 years before there will be an opportunity to revisit UN drug policy again.”

The full Leaked cable… (Click “Read More” to view the original cable with key points highlighted)

Reference ID Created Released Classification Origin


UNCLAS UNVIE VIENNA 000031     SENSITIVE  SIPDIS     E.O. 12958:  N/A  TAGS: SNAR KCRM UN PGOV AORC UK CO RS JA CA FR SW GM  EI, IT     SUBJECT:  Breaking the UNGASS Impasse on "Harm Reduction"     REF:  A) UNVIE 00001, B) Tsai-Pala 1/23 email     ¶1. (U) This is an action message for INL/PC and IO/T.  Please see  paragraph 7.     -------  Summary  -------  ¶2. (SBU) Negotiations for the UNGA special session have hit an  impasse, created by EU insistence on adding the controversial term  "harm reduction"
to various parts of the draft UNGASS action plan  and political declaration.  While Canada, an opponent of the term's  inclusion, is considering conceding to EU demands, other opponents  are standing firm with the U.S. in preventing such a problematic  element's inclusion.  Mission has engaged counterparts at every  level, from experts to ambassadors in an attempt to break the  impasse and find compromise language.  Mission believes there is  increasing pressure within the EU to resolve this gridlock and avoid  an embarrassing showdown at the March Commission on Narcotic Drugs  (CND) but some delegations will be inclined to hold this issue  hostage up until the opening of the CND, in hopes the US will  relent.  To facilitate EU compromise, Mission recommends that the  Department reach out to various capitals and the European Commission  to help underscore the firmness of U.S. resolve-both to our allies  and to the EU, before the EU horizontal group meeting in Brussels on  February 4.  Mission has urged like-minded countries here (Japan,  Russia, Colombia) to take similar actions.  End Summary.     ------------------------------  EU Crusade on "Harm Reduction"
 ------------------------------  ¶3.  (SBU) There have been difficult negotiations in Vienna on the  "harm reduction" issue in the demand reduction chapter of the draft  UNGASS action plan (Ref A) and political declaration.  The Czech  Republic reiterated this demand on January 26 on behalf of the  presidency.  The plan will be annexed to the political declaration  expected to be issued by ministers attending the high-level segment  of the UNGASS review meeting in Vienna March 10-12, 2009.  The main  divide is between EU advocates for including "harm reduction" in the  plan, and those who oppose such inclusion, namely U.S., Russia,  Japan, Colombia
and possibly Canada.  Although opposed to harm  reduction, Canada's experts in Ottawa are receptive of a recent  compromise (including the term in a footnote rather than in the  text), and we understand that Ottawa will have a discussion on the  political level to decide how to handle this issue.     -----------------------  Is it EU Solidarity or  UK Leading the Crusade?
 -----------------------  ¶4. (SBU) Recent meetings to reach a compromise with EU had been  inconclusive.  The USG (United States Government) cannot accept including the specific term  "harm reduction" in any part of the action plan.
 The USG also wants  the section to focus on "prevention, treatment and rehabilitation"  in the consideration of any demand reduction strategy.  The EU, on  the other hand, appears less concerned about treatment and  rehabilitation.  The EU presented a very hard-line position in the  opening rounds of these negotiations in mid-January.
 Subsequently,  Mission conducted extensive consultations at all levels, including  between Ambassador and the DCM with their counterparts.  Mission's  conclusion is that the EU may not have a tightly united front.
 The  UK is the primary and most vocal crusader on this issue,
although  Netherlands does lend occasional support, as do Spain and the EC.  Importantly, other EU countries, initially implacable, appear to be  wavering (e.g., Germany).   Still others have expressed varying  degrees of flexibility, including France, Belgium, Ireland, and  Italy, as well as Sweden, which is closest to the U.S. position.     ----------------------  Next Steps for Mission  ----------------------  ¶5. (SBU) Mission continues to engage with both skeptics and  proponents of "harm reduction."  To that end, Mission plans to  offer alternative language, previously sent to INL/PC (Ref B) at the  next informal consultations.  Mission's language is based on the  November 2008 UNGA resolution on international drug control  (A/63/432), which found consensus in New York.  Importantly, that  language was co-sponsored by 58 countries, including  the U.S. and  at least 7 EU countries.  Mission will propose inserting "care" into  the language as a way to address EU concerns.  U.S. proposed  language for paragraph 9 of the draft Action Plan, therefore, would  read,      "Develop, review and strengthen, as appropriate, prevention,  treatment, care and rehabilitation of drug use disorders and to take  measures to reduce the social and health consequences of drug abuse  as governmental health and social priorities, in accordance with  international drug control treaties, and where appropriate, national  legislation."     (Note:  The 7 EU co-sponsors of the November 2008 UNGA resolution  are: Austria, Belgium, Czech Republic, Denmark, Ireland, Italy, and  Latvia.  End Note.)     ¶6.  (SBU) Mission has shared this language with Japan, Russia, and  Colombia, as well as the CND chair Namibia, who is chairing the  current negotiations on the political declaration.  Offering this  language will allow Mission to more constructively engage the EU and  the chair of the working group (Iran) (who has taken a very active  role in trying to find consensus).  Although Iran chair had  originally scheduled another informal meeting for the afternoon of  January 27, Namibian ambassador told Missionoffs and their Japanese  and Russian counterparts the morning of January 27 that she would  announce the cancellation of that meeting until further notice.  She  said she had heard from many delegations that there should be a  "cool down" period on this issue.  According to her, many  delegations are opposed to the EU position, even though they did not  speak up on the floor.     ¶7. (SBU)  Mission has suggested like-minded countries (Russia,  Japan, Colombia) to intervene at the ambassadorial level in Vienna.  We have also suggested that their capitals demarche relevant  countries.  Mission will also ask the G-8 chair in Vienna, the  Italian ambassador, to convene a meeting of the G-8 members to  underline the same.  By engaging EU member states in a different  context, it may help them to reevaluate their dogmatic and  unproductive approach.     -------------------  Recommended Actions  -------------------  ¶8. (SBU)  Action Request:  The EU's horizontal group will have its  next coordination meeting on drugs in Brussels on February 4.  In  order to break EU unity on this issue, and thereby create a climate  in Vienna conducive to compromise, Mission recommends engagement  both with skeptics and supporters of the issue.  Specifically,  Mission recommends;      (i)  Department instruct USEU to contact the European Commission's  horizontal group on drug control (Carol Edwards at the EC).  Instructions should note that the potential for embarrassment is  great for the EU,
should the EU hold hostage an entire document  because of one sub-issue in one section of the action plan..  Mission believes that each passing week without compromise will add  increasing pressure within the EU to resolve this issue and prevent  embarrassment for national ministers planning to attend the CND.  Instructions should also note that the March CND will be the first  foray of the Obama administration into the international drug arena,
 and all sides should be keen to make it a positive one.
    (ii)  Department instruct U.S. Embassies Tokyo, Moscow, and Bogota  to reach out to host governments and emphasize our need to continue  supporting each other, as well as the firmness of U.S. resolve and  the continuity of our policy vis-`-vis "harm reduction."  It is  important that our allies on this issue remember that the burden is  on the EU, as the proponent of the term, to convince other  delegations-not the other way around.     (iii)  Department instruct U.S. Embassy Ottawa to persuade Ottawa at  a political level that it should at least consider remaining silent  on the EU proposal for the time being, and/or until the EU shows  more flexibility.  Although there is pressure in Vienna on all  delegations to commit to the EU proposal, Ottawa should remember  that there is no need to accede to hard-ball tactics, and that the  goal is for all sides to find common ground.     (iv)  Department instruct U.S. Embassy London to underscore the need  to find common ground. 
Mission believes that UK's expert in Vienna  is a driving force behind the current EU approach, and that she may  find herself isolated within the EU as other delegations begin to  feel the urgency for compromise.
    (v)  Department instruct U.S. Embassy Prague to reaffirm with the EU  presidency the importance of finding common ground.  Instructions  should note the importance the USG places on getting US-EU relations  off on the right foot, and that nothing related to the CND  jeopardizes that common goal. Instructions should also note that the  Czech Republic was one of the co-sponsors of the November 2008 UNGA  resolution on International Drug Control (A/63/432).     (viii)  Finally, that Department instruct U.S. Embassies Berlin,  Brussels, Paris, Dublin, Rome, and especially Stockholm (as well as  any other capital who may be more sympathetic to the need for  compromise) to underline the firmness of our position, and the  importance of finding common ground for the March ministerial  meeting.  Instructions should also note that Belgium, Ireland and  Italy co-sponsored the November 2008 UNGA resolution A/63/432.  In  particular, it should be noted that the current EU proposal  effectively eliminates the draft's previous focus on prevention,  treatment and rehabilitation.  Although there may be some  disagreement on "harm reduction," Mission believes all delegations  should be concerned that the elimination of prevention, treatment  and rehabilitation from their prominent place in the draft may give  the wrong signal that member states are no longer focusing on the  critical need to reduce the demand for drugs.



Logan DE, & Marlatt GA (2010). Harm reduction therapy: a practice-friendly review of research. Journal of clinical psychology, 66 (2), 201-14 PMID: 20049923 (PDF)

Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, Myers B, Ambekar A, Strathdee SA, & 2009 Reference Group to the UN on HIV and Injecting Drug Use (2010). HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet, 375 (9719), 1014-28 PMID: 20189638 (PDF)

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  • Mafficker

    Surely you must mean the US is moralising about drug use that is not socially sanctioned and calling that drug abuse whether or not such use results in harm to the user or others.

    They do not want it to be known that most drugs can be used safely and responsibly through practice of harm reduction principles. This would undermine the ‘moral’ foundations of their ‘crusade’ for a drug free world, excepting alcohol and tobacco, of course!

  • Paul

    The joys of GoogleReader…just wondering why your post (April 26) Interview with an Underground Chemist was removed without notice? We all edit and retract but usually we explain.

    • Neurobonkers

      Hi Paul,

      I’m glad someone noticed! I wasn’t sure whether people were actually using google reader for my blog, I’m very glad some are – it’s a brilliant tool! It was actually a somewhat more boring reason, I noticed I was getting a large number of incoming links relating to the previous couple of posts by webmasters who were just linking to my top level page rather than the posts themselves. I wanted to avoid confusing the new visitors and keep those posts on the top of the stream so I decided to pull that article until the buzz quietened down.

      Anyway, I’ve made it available here: (same URL) and you’re more than welcome to comment or share!

      By the way, I just took a look at your blog, excellent stuff, I’m gonna have to have a play with that map tool, judging by your blog you might find this post interesting (though I’m sure it won’t come as news at all) ->


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