Harm reduction - the right policy approach for Africa?

African policy makers find themselves confronted by a phenomenon of rising substance use particularly in urban areas. The knowledge base in terms of prevalence rates, medical consequences, patterns and cultures of consumption remains patchy. Responses are largely driven by imported models advocated by drug control agencies and development partners. There are two inherent flaws to this – first, many of the methods from treatment modalities to drug enforcement techniques were designed for completely different social and cultural scenarios. Secondly, the mode of operation is that of a ‘war on drugs’, where the problem is inherent to the drug itself. The consequences of such a policy can be even more devastating than the drug use itself. The harm reduction paradigm that takes drug use as a fact of modern life, but addresses its problems with regulative intervention provides a policy orientation that is more promising. Existing drug cultures – khat, kola, iboga – that originated and are unique to Africa should be understood within both traditional and quickly evolving modern contexts. A system of regulation should be advocated against vested professional and organizational interest.