UNGASS Women 2016: Sub-Saharan Africa[1]

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Research on the impact of drug policies in Africa – and especially their impact on women – is scarce. While drug use, cultivation and trafficking are prevalent in most African countries and punitive drug laws aimed at reducing supply are enforced, little attention has been paid to the impact of these laws. Most existing research is focused on West Africa, due in part to the establishment of the West Africa Commission on Drugs. Regarding the paucity of research on incarcerated women in Africa, researcher and women’s rights advocate Lisa Vetten writes:

Many African governments have neither the infrastructure nor the resources to gather and publish routinely data on imprisonment. Some governments also do not welcome scrutiny of their prison systems. Further, criminology is rarely taught in African universities (South Africa excepted), and the opportunities for academic writing and publishing are limited in many countries, particularly those which have gone through long periods of conflict and civil war. Articles and reports published in francophone or lusophone Africa are rarely translated into English, and vice versa.[2]

This critique applies equally to the lack of information on drug policies’ impact on women. UNGASS 2016 thus provides an important platform for African states and non-governmental organizations to come together to discuss common issues, share knowledge and seek solutions to common problems.

Regional Drug Policies

In 2013, the African Union (AU) adopted its AU Plan of Action on Drug Control (2013-2017), with the stated aim of “improv[ing] the health, security and socio-economic well-being of people in Africa by reducing drug use, illicit trafficking and associated crimes”.[3] The Plan of Action encourages AU member states to, among other things: improve data collection on drug-related issues; ensure that drug policies respect human rights; take a public health approach to drug control; divert drug users away from the criminal justice system; and reduce drug trafficking. The Plan of Action neither mentions women specifically, nor does it include policy suggestions for how states could better address women’s specific vulnerabilities and needs in terms of drug use and drug-related crime. To date, there has been limited reporting by member states on progress made in implementing the Plan of Action.

In preparation for the UNGASS 2016, the AU submitted its Common African Position (CAP) for the UN General Assembly Special Session on the World Drug Problem, April 19-21 2016.[4] The CAP notes that the drug trade “constitute[s] a serious threat to public health, public safety and human rights, in particular for all people who use drugs”, and that it undermines socio-economic and political stability and sustainable development.[5]

The CAP acknowledges that many people in Africa become involved in the drug trade out of financial need, and that the cultivation of drug crops is many people’s only livelihood. It encourages states to pursue to development as a means of reducing drug trafficking and use, but cautions that “alternative development programmes must be properly sequenced, with alternative livelihoods already in place prior to the eradication of illicit crops”.[6] It also expresses commitment to providing employment to African youth, who are vulnerable to becoming involved in the drug trade, due to high rates of unemployment. This is especially important for young African women, whose unemployment[7] rates are similar to young men’s, but whose rates of financial inactivity[8] are significantly higher than young men’s: on average, 20% of young African men aged 15-24 are not involved in any form of education, employment or training, while the rate for young women in the same age group is 35%.[9] This is likely due to women and girls’ involvement in domestic labor, including caring for children and family members, which is generally not recognized as ‘work’, and is not compensated financially.

The CAP calls for “the collaboration of public health and justice authorities in pursuing alternative measures to conviction or punishment for appropriate drug-related offences of a minor non-violent nature”. Although more focused on treatment and prevention than harm reduction, the CAP prioritizes drug users’ safety: “People who use drugs must be given support, and must benefit from treatment, health services and protection. Resources should be allocated towards treatment programmes, including in prisons.”[10]

The CAP does not specifically mention women or suggest how states’ drug policies can be reformed to address women’s needs.

There is, however, inconsistent support for the CAP, with representatives from several African countries expressing uneasiness with some of its content. In February 2016, the ‘Africa Group’ – chaired by South Africa’s diplomatic mission in Vienna and consisting of only 15 of 54 African countries – submitted a document to the UN in preparation for UNGASS 2016. This document is in conflict with the AU’s Common African Position: it makes no mention of harm reduction, and focuses only on criminalization of the supply and use of illegal substances. The document appears to have been drafted in parallel with the CAP, and was submitted without the AU’s knowledge, causing considerable controversy.[11]

In 2008, the Economic Community of West African States (ECOWAS) adopted the Political Declaration on the Prevention of Drug Abuse, Illicit Drug Trafficking and Organised Crime in West Africa and an accompanying Regional Action Plan.[12] ECOWAS has prioritized harmonizing states’ drug laws and policies, in order to unify the region’s approach to drugs. Neither the Political Declaration nor the Action Plan make any reference to how drug policies could take women’s needs into account.

The West African Commission on Drugs (WACD) was established in 2013. Its objective are: “to mobilise public awareness and political commitment around the challenges posed by drug trafficking; develop evidence-based policy recommendations; and promote regional and local capacity and ownership to manage these challenges”.[13] WACD acknowledges the failure of the militarized ‘war on drugs’ and supports the decriminalization of drug use (and possession of drugs intended for personal use), but encourages law enforcement to work to reduce trafficking: “We abhor the traffickers and their accomplices, who must face the full force of the law. But the law should not be applied disproportionately to the poor, the uneducated and the vulnerable, while the powerful and well-connected slip through the enforcement net.”

In its 2014 report Not Just in Transit: Drugs, the State and Society in West Africa, WACD makes several recommendations for how governments and other stakeholders can best address the growing drug trade and minimize its impact. These include:

  • Treat drug use as a public health rather than a criminal justice matter.
  • Address the socio-economic causes and consequences of drug use.
  • Decriminalize drug use and low-level non-violent drug offences.
  • Focus law enforcement efforts on high-level traffickers and organizations, and on corruption that allows organized crime to thrive.
  • Collect baseline data on drug use and drug trafficking.

With regards to drug treatment, the report recommends that treatment be “culturally appropriate and gender-sensitive”, as “the needs of pregnant women and women with children are often particularly acute”.[14] Aside from noting that there is a higher prevalence of HIV amongst women who inject drugs, the report does not go into further detail on women’s specific needs and how these could be addressed in drug policies.

The West African Common Position towards the United Nations General Assembly Special Session 2016 on the World Drug Problem[15] was developed by representatives from West African government ministries and law enforcement agencies, as well as drug policy experts and members of civil society at the Regional Consultation on Drug Policy Reform on “The Road to UNGASS”, held in Accra, Ghana in January 2016.[16] The Common Position calls for West African countries to complement criminal-legal responses to drug-related crime with a public health approach to drugs by integrating harm reduction into national drug policies, allocating more resources to harm and risk reduction and drug treatment programs, including in prisons, and to enable civil society and the private sector to provide services for drug users. The Common Position also encourages law enforcement agencies to fight drug trafficking, and to strictly enforce anti-trafficking laws, especially against those who sell to minors. While the Common Position supports the punishment of all traffickers, it prioritizes targeting “major drug barons and cartels”, and encourages states to use non-custodial sentencing alternatives for minor non-violent drug-related offences. The Common Position recommends that states ensure the provision of and access to legal opiates and uncontrolled pain-relief drugs. The Common Position calls for more research into drug-related issues in order to develop evidence-based policies and programs.

A snapshot of national policies & their impact

Law enforcement policies

African countries not only cultivate and export drugs, but also serve as transit countries for drugs being trafficked around the globe. Opportunities for drug trafficking have been created by the movement of people displaced by civil wars and unrest, and by weakened and under-resourced governments and law enforcement agencies. Supported and encouraged by the UN and western governments, African governments have tended to take a strong law enforcement approach to drugs, focusing on attempting to reduce the supply of drugs by tightening border control, arresting and prosecuting traffickers and seizing drug shipments.[17] The ‘war on drugs’ in Africa has not been focused on high-level organizers of the trade (many of whom reside outside of West Africa) or on addressing the corruption that allows organized crime to thrive,[18] but has instead focused on low-level couriers, dealers and users (many of whom are women), and has done little to dismantle organized crime networks. Harsh punishment of drug use has resulted in the criminalization and incarceration of thousands of people, and has had serious public health consequences.

In Liberia, punitive drug policies are compounding the civil war’s negative impact on Liberian communities. Unemployment is high, and many youths are driven to drug dealing by financial need, and to drug use as a means of coping with difficult living conditions. Drug use is illegal, and many drug users are incarcerated, rather than provided with harm reduction or treatment options. This is a drain on state resources, and damaging to individuals.[19]

In recent years, Ghana has been expanding the scope of its drug control tactics, for example by including in its surveillance operations the monitoring of websites where psychoactive drugs are sold, and strengthening sanctions for offences related to synthetic psychotropic drugs (eg. methamphetamine).[20]

The South African government’s drug policies have largely been focused on drug seizures, arrests and prosecutions,[21] resulting in the criminalization of drug users, people with substance abuse disorders, people driven to couriering and selling drugs out of financial need, and in some places, entire communities where drug use is prevalent, or perceived to be prevalent. Because there is an enormous backlog of criminal cases in the courts (for all offences, not just those related to drugs), many people charged with drug-related (and other) offences spend months or even years in pre-trial detention awaiting trial.

In a 2006 study of women in prison in the Gauteng province in South Africa, 8% of women in the study were incarcerated for drug-related offences.[22] In 2013 study of 55 women in prisons in the Western Cape province,[23] six women (11%) had been arrested for drug-related crimes, including trafficking. Although the study’s sample was not representative of the female prison population, this was in line with national trends: in 2004, 11% of women in South African prisons were incarcerated for drug-related offences. Almost half of the women in the study had histories of substance abuse, and this was considered to likely be under-representative of the true prevalence of substance use/abuse prior to incarceration amongst South African women in prison. For nearly one in four of the women in the study, alcohol and drugs had played a central role in their offending, according to their own interpretations of what had led them to offend. Drug use and dependency frequently brought women into contact with risky people and situations, which combined with other aspects of their lives (poverty, histories of violence, insufficient support networks) led to their involvement in illegal activities.

In South Africa, the government is attempting to reduce the cultivation of drug crops by aerially spraying fields with poison. This has serious consequences for rural farmers and communities, whose main source of income is often the cultivation and sale of drug crops, chiefly marijuana. A woman in South Africa, whose family farms marijuana, explains: "When they spray us and we are desperate for money we have to go to the loan sharks to borrow cash. We never know how we will pay them back, but people are hungry so what can we do?"[24]

In 2003, it was reported that Botswana’s female prison population had risen over the previous 10 years, due in large part to the increased incarceration of women for property and drug-related offences. In a study of women in Botswanan prisons, ages 16 to 65, respondents under the age of 25 were primarily incarcerated for infanticide, abortion and petty theft, while all but one of the women over the age of 50 were incarcerated for marijuana possession. One woman in the study had received a 12-year sentence for marijuana possession.[25]

People arrested for drug-related offences are often mistreated by the police. For example, in Kenya, instances have been reported of police beating suspects, demanding bribes, arbitrarily detaining people, and refusing to administer medication necessary for people attempting to stop using drugs while they are detained.[26] Such actions are illegal, but there are rarely any repercussions for police officers.

Research conducted in Ghana, Guinea, Mali, Nigeria, Senegal and Sierra Leone found that people arrested for drug-related offences tend to be small-scale cannabis dealers and/or users, and that they spend long periods in pre-trial detention, where they often contract other illnesses before being sentenced or released. Many countries, such as Guinea, provide the option of paying a fine instead of serving time in prison, which more often than not means that higher-ranking traffickers do not go to prison, while lower-ranking traffickers (often women) and drug users who are unable to afford to pay a fine (or a bribe) have no choice but to serve time in prison.[27]

Although there is little available data on the number of women incarcerated in African prisons and jails for drug-related offences, data on the number of women in prison for all offences indicate a slight increase over the past 20 years in the rate at which women are incarcerated.[28] The percentage of women incarcerated in African prisons ranges from between 1% and 11% of total prison populations.[29]

The conditions in which women arrested and prosecuted for drug-related offences are detained are often poor, especially for women awaiting trial in remand centers or police stations. Women may also be temporarily held in unofficial places of detention before being moved to official facilities, or may be held in men’s facilities. Prisons are ill-equipped to provide for women’s physical and health needs (including menstruation, pregnancy, preventative screening for breast and cervical cancer, and substance abuse disorders).[30]

Due to the smaller size of female prison populations, there are fewer women’s facilities than men’s, meaning that women are often incarcerated far from their families, who often cannot afford to travel the long distances to visit them. News reports[31] indicate that many foreign women – mostly from other African countries – are detained in African prisons after being arrested and prosecuted for drug trafficking offences; women are thus detained far from their families and communities, often in countries where they don’t speak the local languages. As women are overwhelmingly the primary caregivers for children in Africa, women’s incarceration has serious consequences for families: research conducted in Zimbabwe, South Africa and Uganda found that children whose mothers were in prison suffered from abuse and neglect at the hands of the people meant to be looking after them, that they had to drop out of school because they couldn’t afford to pay school fees, and that they rarely saw their mothers.[32]

Services for drug users

There are very few harm reduction or drug treatment programs in Sub-Saharan Africa. Existing services are poorly funded, are not specialized, and are often provided by health care providers and other people (such as traditional healers) not trained in meeting drug users’ needs[33]; these services can thus do more harm than good. In 2014, only five Sub-Saharan African countries[34] had drug harm reduction programs, and only Kenya, Mauritius and Tanzania explicitly mentioned harm reduction in their national drug policies.[35] According to the most recent data, published in 2014, only Kenya, Tanzania and Mauritius have government-run needle and syringe programs and government-run opioid substitution treatment (OST) programs.[36] Other OST programs are privately run, charging high prices for methadone and buprenorphine, making this treatment unaffordable for most people who require it. It is estimated that less than 1% of injecting drug users in sub-Saharan Africa have access to needle and syringe programs and OST programs.[37] The lack of support for harm reduction and drug treatment services is due in part to the stigmatization of drug users. The lack of harm reduction programs is especially troubling in light of the fact that the increase in drug trafficking through African countries has led to an increase in the number of people who inject drugs,[38] and the high – and growing – prevalence of HIV in Sub-Saharan Africa.[39]

This is particularly problematic for women who inject drugs, as they have significantly higher mortality rates than men who inject drugs, they are more likely to engage in risky injecting and sexual behaviors, they face injection-related problems, and their progression from first use to dependence is faster than men’s.[40] Further, HIV prevalence – which is higher amongst women in the general population – is particularly higher amongst women who inject drugs than men who inject drugs: in Senegal, 21.1% of women who inject drugs are HIV positive, as opposed to 7.5% of men; in Tanzania, 66.7% of women who inject drugs are HIV positive, as opposed to 29.9% of men, with 72% of women who inject heroin being HIV positive, as opposed to 45% of men; in Kenya, women who inject drugs’ HIV prevalence (44.5%) is almost three times higher than men’s (16%)[41]; in South Africa, women who inject drugs’ HIV prevalence (17%) is slightly higher than men’s (14%); and in Nigeria women who inject drugs’ HIV prevalence (21%) is seven times higher than men’s (3.1%).[42]

Women also have greatly reduced access to harm reduction services. A 2013 study of gender inequalities in harm reduction services in Dar es Salaam, Tanzania found that only 8% of service users were women. In a 2013 South African study, less than 20% of women who used drugs were aware of drug treatment programs.

Civil society’s response

While governments have tended to focus on law enforcement efforts to reduce drug supply, there has been an effort within civil society to promote harm reduction.

The Ugandan Harm Reduction Network (UHRN) works to promote the health of people and communities affected by drug use, through advocacy, information dissemination and capacity-building.

The Kenyan Harm Reduction Network advocates for a harm reduction approach to drug use in drug policy. In 2012, the International Network of People who Use Drugs ran capacity-building workshops for drug user advocates in Kenya and Tanzania to determine existing and potential platforms for people who use drugs to contribute to the development, implementation and evaluation of national policies and programs affecting people who use drugs.[43]

In February 2016, the TB/HIV Care Association organized South Africa’s first Drug Policy Week,[44] bringing together representatives from government, academic institutions and civil society, as well as international experts to discuss current South African drug policies, and how best to improve them. This marks an important first step in South African civil society addressing the need for drug policy reform.

The way forward

There is a clear need for drug policy reform in terms of the decriminalization of drug use and drug trafficking, and the expansion of harm reduction and treatment services for drug users. Perhaps more pressingly, there is an urgent need for data collection on drug use, drug-related offences, national and municipal drug policies and practices, and services for drug users, as the current dearth of information is a major barrier to the design and implementation of effective policies.

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[1] The geo-political region of Sub-Saharan Africa includes all African countries that lie fully or partially south of the Sahara desert, excluding Sudan, which is considered to be part of North Africa. Information on North African drug policies can be found in a separate UNGASS Women 2016 information brief.

[2] Vetten, L. 2008. “Uncharted territory: The imprisonment of women in Africa”. In Human Rights in African Prisons. Sarkin, J. (Ed). South Africa: HSRC Press. Pp. 134-154. At: http://www.hsrcpress.ac.za/downloadpdf.php?pdffile=files%2FPDF%2F2220%2F07_African_Prisons.pdf&downloadfilename=Human%20Rights%20in%20African%20Prisons%20-%207.%20Uncharted%20Territory%3A%20The%20Imprisonment%20Of%20Women%20In%20Africa [Accessed April 5, 2016].

[3] African Union. 2012. AU Plan of Action on Drug Control (2013-2017). Submitted for consideration by the 5th Session of the Africa Union Conference of Ministers of Drug Control (CAMDC5). CAMDC/EXP/2(V). At: http://sa.au.int/en/sites/default/files/AUPA%20on%20DC%20(2013-2017)%20-%20English.pdf [Accessed April 3, 2016].

[4] African Union. 2015. African Position (CAP) for the UN General Assembly Special Session on the World Drug Problem, April 19-21 2016. Addis Ababa: African Union. At: http://www.unodc.org/documents/ungass2016//Contributions/IO/AU/Common_African_Position_for_UNGASS_-_English_-_final.pdf [Accessed March 22, 2016].

[5] African Union. 2015.

[6] African Union. 2015.

[7] Unemployment is defined as being without work, but actively looking for work.

[8] Inactivity is defined as doing nothing at all, or being involved in activities that do not contribute to economic activity. Women’s domestic labor in their own homes is often not recognized as contributing to the economy, but it of course does, in that it enables other members of the household to work outside of the home.

[9] African Economic Outlook. 2015. “Who are the Unemployed, Discouraged & Inactive Youth in Africa?” African Economic Outlook. At: http://www.africaneconomicoutlook.org/en/theme/youth_employment/youth-in-african-labour-markets/who-are-the-unemployed-discouraged-inactive-youth-in-africa/ [Accessed May 16, 2016].

[10] African Union. 2015.

[11] Cullinan, K. February 7, 2016. “[Updated] Elite ‘African Group’ in Vienna undermines AU drug policy”. Health-e News. At: https://www.health-e.org.za/2016/02/07/elite-african-group-in-vienna-undermines-au-drug-policy/ [Accessed April 3, 2017].

[12] ECOWAS. 2008. Political Declaration on the Prevention of Drug Abuse, Illicit Drug Trafficking and Organised Crime in West Africa. At: http://www.unodc.org/westandcentralafrica/en/ecowaspoliticaldeclaration.html [Accessed April 3, 2017].

[13] West Africa Commission on Drugs. 2014. Not Just in Transit: Drugs, the State and Society in West Africa. West Africa Commission on Drugs. At: http://www.wacommissionondrugs.org/report/ [Accessed March 27, 2016].

[14] West Africa Commission on Drugs. 2014.

[15] Tachie-Menson, H., et al. January 20, 2016. West African Common Position towards the United Nations General Assembly Special Session 2016 on the World Drug Problem. Accra, Ghana. At: https://www.unodc.org/documents/ungass2016//Contributions/Civil/WADPN/West_Africa_Common_Position_toward_the_UNGASS_Final.pdf [Accessed March 27, 2016].

[16] Delegates from Benin, Burkina Faso, Cabo Verde, Cote D'Ivoire, Ghana, Guinea, Guinea-Bissau, Liberia, Nigeria, Senegal and Sierra Leone attended the Consultation.

[17] International Drug Policy Consortium. 2016. Sub-Saharan Africa. At: http://idpc.net/policy-advocacy/regional-work/sub-saharan-africa [Accessed April 1, 2016].

[18] West Africa Commission on Drugs. 2014.

[19] Ane, M. March 3, 2016. “West African Commission on Drugs visits Liberia”. Kofi Annan Foundation. At: http://www.kofiannanfoundation.org/news-releases/west-africa-commission-on-drugs-visits-libera/ [Accessed March 23, 2016].

[20] International Narcotics Control Board. 2016. Report of the International Narcotics Control Board for 2015. New York: United Nations. E/INCB/2015/1. At: https://www.incb.org/incb/en/publications/annual-reports/annual-report-2015.html [Accessed April 4, 2016].

[21] Shelly, S. March 9, 2016. “South Africa Is Still Fighting an Apartheid-Like Drug War”. Open Society Foundations. At: https://www.opensocietyfoundations.org/voices/south-africa-still-fighting-apartheid-drug-war [Accessed April 4, 2016].

[22] Haffejee, S., Vetten, L. & Greyling, M. 2006. “Violence and abuse in the lives of women and girls incarcerated at three Gauteng women’s prisons”. Research Brief No. 03. Center for the Study of Violence and Reconciliation. At: http://www.csvr.org.za/docs/correctional/violenceandabuse.pdf [Accessed April 4, 2016].

[23] Artz, L., Hoffman-Wanderer, Y. & Moult, K. 2013. Hard Time(s): Women’s Pathways to Crime and Incarceration. South Africa: UCT/European Union and the Office of the Presidency. At: http://www.ghjru.uct.ac.za/ghjru/publications/recent-research-reports [Accessed April 4, 2016].

[24] Tolsi, N. March 27, 2016. “Killing the economic lifeblood of the Eastern Cape's weed-producing people.” Sunday Times Lifestyle. At:
http://www.timeslive.co.za/sundaytimes/lifestyle/2016/03/27/Killing-the-economic-lifeblood-of-the-Eastern-Capes-weed-producing-people [Accessed April 11, 2016].

[25] Modie-Moroka, T. 2003. Vulnerability across a life course: an empirical study: women and criminality in Botswana prisons. Journal of Social Development in Africa. 18(1). At: http://pdfproc.lib.msu.edu/?file=/DMC/African%20Journals/pdfs/social%20development/vol18no1/jsda018001008.pdf [Accessed April 4, 2016].

[26] Kageha, E. 2015. Drug Laws and Human Rights in Kenya: Disharmony in the Law and Training Recommendations to Law Enforcement. Amsterdam: Mainline. At: http://idpc.net/publications/2015/09/study-on-drug-laws-and-human-rights-of-drug-users-in-kenya [Accessed April 13, 2016].

[27] West Africa Commission on Drugs. 2014.

[28] Vetten, L. 2008.

[29] International Centre for Prison Studies. 2016. “Highest to Lowest - Female prisoners (percentage of prison population)”. World Prison Brief. At: http://www.prisonstudies.org/highest-to-lowest/female-prisoners?field_region_taxonomy_tid=15 [Accessed April 5, 2016].

[30] Vetten, L. 2008.

[31] Ogbeche, D. January 28, 2016. “Drug trafficking: Nigerian woman sentenced to life imprisonment in Tanzania”. Daily Post. At: http://dailypost.ng/2016/01/28/drug-trafficking-nigerian-woman-sentenced-to-life-imprisonment-in-tanzania/ [Accessed April 5, 2016]; Kriel, R. February 25, 2015. “SA woman in Kenya court for drug trafficking”. ENCA. At: https://www.enca.com/africa/east-africa/south-african-woman-appear-kenya-drug-trafficking [Accessed April 3, 2016]; AllAfrica. October 9, 2014. “Angola: Number of Women Involved in Drugs Trafficking On the Rise”. AllAfrica. At: http://allafrica.com/stories/201410100103.html [Accessed April 4, 2016]; AllAfrica. October 29, 2013. “Mozambique: More Drug Traffickers Arrested At Airport”. AllAfrica. At: http://allafrica.com/stories/201310300304.html [Accessed April 4, 2016].

[32] Vetten, L. 2008.

[33] West Africa Commission on Drugs. 2014.

[34] Kenya, Mauritius, Senegal, South Africa, Tanzania.

[35] West Africa Commission on Drugs. 2014; Harm Reduction International. 2014. The Global State of Harm Reduction 2014. Harm Reduction International. At: http://www.ihra.net/contents/1524 [Accessed May 5, 2016].

[36] West Africa Commission on Drugs. 2014; Harm Reduction International. 2012; Kageha, E. 2015.

[37] International Drug Policy Consortium. 2016.

[38] Harm Reduction International. 2012. The Global State of Harm Reduction 2012: Towards an integrated response. Harm Reduction International. At: http://www.ihra.net/files/2012/07/24/GlobalState2012_Web.pdf [Accessed April 4, 2016].

[39] Phelan, M., Nougier, M. & Bridge, J. 2013. “HIV prevention among people who use drugs in East Africa”. IDPC Briefing Paper. At: http://idpc.net/publications/2013/08/idpc-hri-briefing-paper-hiv-prevention-among-people-who-use-drugs-in-east-africa [Accessed April 4, 2016].

[40] Roberts, A., Mathers, B. & Degenhardt, L. 2010. Women who inject drugs: A review of their risks, experiences and needs. The Independent Reference Group to the United Nations on HIV and Injecting Drug Use. At: https://www.unodc.org/documents/hiv-aids/Women_who_inject_drugs.pdf [Accessed April 1, 2016].

[41] This may be an undercount: one study conducted in Mombasa found that 85% of women who injected drugs were HIV positive. (Ndetei, D. 2004. UNODC study on the linkages between drug use, injecting drug use and HIV/AIDS in Kenya. University of Nairobi. In Kensy, J., et al. 2012. ‘Drug policy and women: Addressing the negative consequences of harmful drug control’. IDPC Briefing Paper. International Drug Policy Consortium. http://www.grea.ch/sites/default/files/drug-policy-and-women-addressing-the-consequences-of-control.pdf [Accessed April 15, 2016].

[42] United Nations Office on Drugs and Crime. 2015. World Drug Report 2015. New York: United Nations; United Nations Task Force on Transnational Organized Crime and Drug Trafficking as Threats to Security and Stability. 2014. ‘A Gender Perspective on the Impact of Drug Use, the Drug Trade, and Drug Control Regimes’. UN Women Policy Brief. UN Women. At: https://www.unodc.org/documents/ungass2016/Contributions/UN/Gender_and_Drugs_-_UN_Women_Policy_Brief.pdf [Accessed April 13, 2016].

[43] Harm Reduction International. 2012.

[44] South African Drug Policy Week. At: http://www.sadrugpolicyweek.com/ [Accessed April 4, 2016].