Africa: Putting Young People at the Centre of Drug Policy Reform

In South Africa, the debate about protecting young people from drugs is increasingly raising a different question: are current policies actually helping those who need support most? Charity Monareng, Executive Director of Students for Sensible Drug Policy International, said answering that question requires looking beyond prevention and asking whether young people have meaningful access to information, healthcare, and harm reduction, and whether they have a say in designing the policies and services intended for them. Monareng said young people are experts in their own lives, yet for decades they have been invoked to justify tough drug laws without their voices being included in shaping those laws. "Adults can sit in rooms and come up with programmes and policies, but if they are not relevant or do not speak to the realities of young people, then it's just a futile exercise," she said. Keep up with the latest headlines on WhatsApp | LinkedIn Young people should be involved from the earliest stages of policy development through to implementation and evaluation, she said, rather than being brought in simply for consultation. Her argument forms part of a wider international debate over whether drug policies designed in the name of protecting children and young people are actually keeping them safe - a question at the centre of a new policy brief by the Global Commission on Drug Policy. Putting young people at the centre of drug policy For decades, children and young people have been invoked to justify tough drug laws, with governments arguing that punitive policies are necessary to protect them from the dangers of drug use. But the new policy brief challenges that approach, arguing that policies designed in the name of protecting young people have often failed to consider how drug laws affect their health, rights, families and everyday lives. It calls for children and young people to be recognised not simply as people who need protection from drugs, but as rights holders with a meaningful role in shaping the policies that affect them. The call is informed by a collaborative initiative involving the Global Commission on Drug Policy, Youth RISE and the Global Campus of Human Rights, which brought together children and young people from across several regions to examine how drug policies affect their lives. Participants called for policies that move away from punishment and place greater emphasis on support, including youth-friendly mental health services, evidence-based education, harm reduction and meaningful participation in policymaking. The Commission consulted more than 150 people from 47 countries across five continents while developing the brief, bringing together young people, families and others with lived experience alongside experts from the drug policy and child rights sectors. Drug policy, said moderator Jacqui Thornton, has sought to challenge the established status quo and open up conversations that are being considered difficult, politically sensitive or even taboo, bringing evidence to the fore and putting people, their health, their rights, their lived realities at the centre of the debate. Thornton said that conversation is often avoided altogether, oversimplified, or "framed almost exclusively around prevention", even though drug policies themselves are frequently justified in the name of protecting children and young people in the first place. Former Colombian President Juan Manuel Santos said the contradiction between protecting children and relying on punitive drug policies can no longer be ignored. Protecting children must be one of the fundamental responsibilities of government. However, he said, policies need to be judged by their results, not by the rhetoric used to justify them. "For decades, punitive drug policies have been defended partly on the basis that harsh laws and enforcement are necessary to protect our children," said Santos, a commissioner and member of the Global Commission on Drug Policy and a Nobel Peace Prize laureate. "But the evidence increasingly shows a much more complicated and troubling picture." Santos quoted his fellow Global Commissioner and fellow founder of The Elders, the late Kofi Annan, who put it starkly: "Drugs have destroyed many lives, but wrong government policies have destroyed many more." That tension, Santos said, is precisely why the Global Commission on Drug Policy was created - to open up difficult conversations. For more than a decade, the Commission has challenged policies that evidence shows are failing to achieve their stated objectives and can themselves cause serious harm. Children and young people, he said, are often invoked to justify the status quo in drug policy, yet policymakers have rarely stopped to systematically examine what those policies actually mean for their rights, health, families and futures. "It is not an easy area and the debate is too often reduced to one message, prevention," he said. The brief, he said, was designed to "demystify" the issue and look at its full complexity. Prevention matters, but it cannot constitute the whole response. Young people who use drugs exist and need accurate information, health services, harm reduction, treatment and support. Many other children are affected by drug policy without using drugs themselves — through violence, criminalisation, family separation, exploitation and barriers to essential medicines. Santos said Colombia and its communities have paid an "enormous price" for the global war on drugs, through violence, organised crime, displacement and lost opportunities and livelihoods. Young people, he said, are often among the most vulnerable in contexts where poverty, violence and a lack of opportunity prevail, while illicit economies can offer opportunities that the legitimate economy does not. "We will not change that reality simply through greater repression," he said. Instead, governments had to offer young people better opportunities and "a genuine stake in their future". Santos also drew on his experience as Colombia's president, recalling the public backlash he faced when he called for a discussion about changing the international approach to drugs. He said some mothers feared that regulation would expose their children to drugs, until he reframed the debate around whether a child caught using or possessing drugs should be sent to prison or receive treatment. Drugs, he said, are a reality in society and are not simply going to disappear. Good public policy starts by recognising that reality and asking how to reduce harm, including the harms caused by the policies and markets that surround drugs themselves. "If our objective is to protect children, are the policies we have adopted in their name actually making them safer?" Too often, said Santos, the answer is no, and the next question, which the brief begins to unpack, is what needs to change. Impact of drug policy on families For Anne-Marie Cockburn, the consequences of drug policy are not abstract. They are personal. A charity campaigner, founding family member of Anyone's Child and mother of Martha, she spoke about the death of her daughter, who died after taking MDMA at the age of 15. Cockburn said Martha had been open with her about taking ecstasy, but that her own fear and reaction had prevented them from having a more constructive conversation. "I was terrified, and she wasn't. I didn't listen. I wish I had," she said. Looking back, she wishes she had listened instead. "I wish I had asked her some questions. I wish I'd allowed her to tell me what it was like to be her in the world that she was living in at that time. But I silenced her." After Martha died in 2013, Cockburn discovered that her daughter had searched online for medical information about ecstasy. She said Martha had been trying to educate herself about the drug, but did not know that the MDMA she obtained was highly concentrated or that the amount she had was enough for several people. What followed, Cockburn said, was "a hideous nightmare that haunts me and motivates me every day to be part of this important conversation for change." She added: "We don't need to ask permission for change. We need to demand it." Cockburn said parents faced a similar problem, with much of the available information focused on abstinence, resilience and peer pressure rather than helping parents respond when a child was already intending to use drugs. She said honest conversations about drugs should be possible without judgment, shame or stigma. Children like Martha, she said, end up dead because it's as though there's a prohibition on robust, honest harm reduction educational resources, and she rejected the argument that education amounts to encouragement. "As we know, education creates knowledge, and the absence of that allows ignorance to flourish," she said. She said young people were often frightened of getting into trouble and that this fear could cost valuable time that might potentially save a life. "I lay the blame entirely on our laws and cultural fear that teaches young people to worry more about getting into trouble than automatically calling for help," she said. "Prohibition didn't keep my daughter safe." Her experience, she said, had convinced her that prohibition had failed to protect her daughter. Cockburn now advocates, alongside other families involved with Anyone's Child, for drugs to be legally controlled and regulated. Growing up in the shadow of prohibition The impact of drug policy on families was also reflected in the experience of Aden McCracken, a YouthRISE representative, young drug user and drug user rights advocate, who described how prohibition shaped his childhood and family life. McCracken said both of his parents had used drugs after being prescribed OxyContin as teenagers in Appalachia in the United States. When doctors stopped prescribing the drug, he said, his parents were pushed into an unregulated opioid supply, with the consequences of drug prohibition eventually shaping his childhood. The consequences followed quickly. As doctors began shutting their doors and stopped prescribing a safe supply of OxyContin, his parents were forced into withdrawal and into the unregulated opioid market. From that point, McCracken said, his childhood and his parents' lives were shaped directly by aggressive drug policy: repeated prison sentences, forced rehabilitation programmes, state surveillance, loss of housing, employment and education, deep poverty, and repeated overdoses and deaths. "No child should have to live in fear watching their parents get arrested over and over again for personal possession, yet I did," he said. Children can suffer the consequences of drug policy without ever using drugs themselves, McCracken said, including through family separation, poverty and the criminalisation of their parents. "The systemic violence of prohibition does not stop with people who use drugs," he said. "It reverberates and leaves scars throughout entire families and across generations." Prohibition, he said, robbed me of my childhood and robbed my parents of being able to be the parents they always wanted to be. He said that his story is far from unique. Young people who face structural marginalisation - through racism, poverty, gender identity, disability, migration status or other forms of inequality - often carry an even greater burden of these harms, he said. "When we ask whether drug policy keeps young people safe, we must ask ourselves safe from what?" he said. "Of course drugs can carry risks, but prohibition is far from harmless and rather compounds these risks." He called for an approach that moves beyond criminalisation and gives young people access to honest information, voluntary evidence-based healthcare and youth-sensitive harm reduction services. "Young people do not simply need protection from drugs; we need protection from the harms, violence and death produced by prohibition," said McCracken. "If our drug policies are not keeping people alive, then we have to be willing to change them." The role of the courts Judge Eduardo Melo said children's involvement in drug markets was often rooted in social conditions including inequality, inadequate housing and a lack of opportunities, particularly in marginalised neighbourhoods. He said that ILO Convention 182 classified such involvement as one of the worst forms of child labour, and that several international legal standards similarly prohibit the recruitment of children into hostilities, whether by states or other armed groups. Treating these children primarily as young offenders, said Melo, can produce stigma that entrenches the very patterns of behaviour the system is trying to correct. A public security approach centred on repression can also weaken trust in state institutions, particularly the police, while allowing organised crime groups to fill gaps left by the state. In communities affected by violence, children can face further consequences, including death, school dropout and reduced access to essential services. Melo called for a shift towards a human-rights-based approach focused on improving living conditions and strengthening children's rights, rather than treating drug-related involvement solely as a criminal justice issue. "The idea of child-friendly or child-centered justice challenges us to make judicial responses more meaningful," he said. He called for procedures that respect children's individual needs and create space for more participatory and dialogue-based approaches. Children's rights Philippe Jaffé said the brief examines whether states' obligations under the UN Convention on the Rights of the Child are reflected in current drug policies. He said governments often invoke Article 33 of the Convention, which calls for children to be protected from illicit drug use and from exploitation in the production and trafficking of drugs, to justify punitive approaches. But Article 33, he argued, cannot be interpreted as a mandate to simply prohibit drugs, criminalise children or punish vulnerability. He said that Article 33 is certainly not a license to only prohibit drugs or to criminalize children or to punish vulnerability or ignore the cause by drug enforcement itself. Instead, he said, Article 33 must be read alongside the wider Convention, particularly Article 3, which requires the best interests of the child to be a primary consideration. Jaffé said drug policy is rarely shaped around those best interests. Instead, decisions are often driven by arrest numbers, prosecutions, drug seizures, eradication targets, sentencing practices and policing priorities, while laws and restrictions on health services can be introduced with little consideration of their impact on children. The consequences, he said, are predictable. Children lose parents to imprisonment, grow up in communities affected by violence, are separated from caregivers and can be denied access to controlled medicines. Rather than being protected, children are often treated as "collateral damage". He said punitive policies can also discourage adolescents from seeking information, counselling or treatment. Fear of police contact, school sanctions and other repercussions can keep young people away from services they need, with the greatest burden falling on children already affected by poverty, marginalisation, involvement in the care system or insecure migration status. Jaffé also addressed the absence of young people from many drug policy decisions, despite their direct experience of how those policies affect their lives. Young people who use drugs, children of people who use drugs, and those affected by policing, bereavement or family separation, he said, are rarely treated as people with valuable first-hand knowledge of what drug policies mean in practice. A drug policy that makes children invisible, he argued, cannot be described as protective - "it must be replaced". From problems to solutions Santos said the next step was for governments to have the political courage to follow evidence, even when it challenges long-standing assumptions or popular opinion. Reforming policies that are failing or causing harm, he argued, is itself a form of protecting children. "Simply telling young people to say no and then punishing them when prevention fails is neither comprehensive nor effective," he said. Real protection, Santos said, must include access to health services, accurate and age-appropriate information, harm reduction, treatment and support, alongside protection from violence, exploitation and exclusion. Drug policy, he added, cannot be left to law enforcement alone: health, education, social protection, justice and child rights actors all need a role, as do children and young people themselves. "We need to stop treating children simply as a justification of drug policy and start recognizing children as people with rights, with needs, experiences, and futures that our policies directly affect," he said. Cockburn said that shift also needs to translate into practical harm reduction. She called for health hubs where young people and families can access reliable drug information, learn what to do in an emergency and understand their rights, as well as drug-testing services to help reduce the risks associated with unregulated substances. Reflecting on Martha's death, Cockburn said access to a known and clearly labelled product could have made a critical difference. "It's harm reduction at its best," she said, arguing that accurate information about dosage and contents could help young people make safer decisions. She also called for drug education to become a more normal part of conversations with children and families, rather than something surrounded by fear and stigma. "Let's make it as normal as age-appropriate sex education, so the world doesn't lose another Martha," she said. McCracken said young people who use drugs had long created their own networks of care, shared information and developed harm reduction responses, often with little institutional support and despite the risk of legal repercussions. He said that meaningful reform also requires changing who gets to shape drug policy. Young people who use drugs have long created their own networks of care, shared information and developed harm reduction responses, he said, but are often excluded from formal decision-making. "Meaningful participation must start with accepting that young people who use drugs are key experts and authorities in drug policy," he said. He warned against treating youth participation as simply inviting young people to share their experiences after decisions have already been made. Too often, he said, young people are asked for their stories without being given any real influence over the outcome. "This is not meaningful participation. This is extraction," he said. Instead, young people affected by drug policy should have a lasting role in designing and implementing policies, services and solutions. "If they want to truly protect our rights and our lives, then they need to stop speaking for us, stop making decisions for us, and finally start giving power over to us," said McCracken. Toward restorative justice, not incarceration Melo said that when children become involved in drug dealing, juvenile justice systems should prioritise protection, rehabilitation and reintegration rather than incarceration. He argued that incarcerating children is particularly problematic when international standards recognise their involvement in drug markets as a form of exploitation rather than simply treating them as offenders. The UN Convention on the Rights of the Child also establishes detention as a measure of last resort. Where a broader transformation of drug policy is not yet achievable, Melo said, juvenile justice systems should still be reformed to prioritise rehabilitation and reintegration, or at minimum restorative approaches, over criminalisation. Countries are already experimenting with alternatives, he said, and international judicial dialogue should expand to share and build on those practices. "If a drug policy leaves children unseen, unheard... governments have failed" Governments, he said, have an obligation under the Convention on the Rights of the Child to consider the needs, circumstances and capacities of children affected by drug policy, including those who use drugs, children whose parents use drugs and those coerced into trafficking. "Above all, we should begin every drug policy decision with a basic question: What will this mean for children?" he said. That means investing in accurate information, confidential and age-appropriate health services, harm reduction and mental health support. "If a drug policy leaves children unseen, unheard, less safe or cut off from care, governments and societies have failed," Jaffé said, adding that the new brief "points in the right direction." From prevention to harm reduction The South African debate becomes more concrete when it comes to what happens after prevention fails and whether young people who are already using drugs can access support without facing punishment or exclusion. Monareng said good programmes are meaningless if the surrounding legal environment does not facilitate their implementation. "They're just gonna be great on paper and nowhere else," she said. The first practical step, she argued, is decriminalising drug use and possession, since fear of arrest is the single biggest barrier keeping people from accessing services. From there, she said, governments need to build youth-friendly services that speak directly to young people's needs, while also addressing the social conditions - often concentrated in marginalised, over-policed communities - that lead young people to use drugs in the first place. But she said legal reform needs to be accompanied by services that are designed around the realities of young people. South Africa's approach, she said, remains too heavily focused on prevention. She said that even where policies exist, the information given to children is often rooted in fear rather than reflecting their actual experiences. She pointed to the National Drug Master Plan, which she said has touched on prevention, early intervention and, at best, "lip service to harm reduction," but has not translated into youth-friendly services on the ground. Rehabilitation facilities exist, she said, but are not tailored to young people, women or girls specifically. In schools, drug education can centre on messages such as "don't do drugs", while offering little support to young people who are already using them. Comprehensive harm reduction, Monareng said, is defined by the World Health Organization as an approach that treats a person holistically - including needle and syringe programmes, opioid substitution therapy, psychosocial support, and sexual and reproductive health. But in much of Africa, she said, political discourse reduces harm reduction to needle and syringe programmes alone, provoking resistance from politicians who insist children aren't injecting drugs, even as evidence shows young people are. "How do we address that issue if we are not acknowledging harm reduction as a lifesaving service?" she asked. She also pointed to what she described as an inconsistency in South Africa's approach to age and access to services. Measures intended to protect children, she argued, can sometimes prevent them from receiving the support they need. "It's very confusing that the approaches that we are using to quote-unquote protect children are actually doing more damage and more harm than really allowing them to access these services," she said. The problem, she said, cannot be separated from the circumstances in which many young people live. Poverty, trauma, displacement, violence and exclusion can increase vulnerability to drug use and exploitation. Criminal networks, she said, often fill a gap left by the state, providing income and a sense of belonging that formal institutions fail to offer, which is why families are sometimes reluctant to report relatives' involvement. Prohibition itself, she said, fuels this dynamic by pushing the drug trade underground and into the hands of criminal networks that profit from an illicit economy worth billions of dollars. "We need to start treating social issues from the root cause," she said, "and not just putting like a plaster on bigger issues." Monareng said decriminalisation is an achievable first step, alongside redirecting resources toward treatment. She pushed back on the idea that reducing demand alone would solve the problem, arguing that most people who use drugs are doing so in response to social issues such as trauma and poverty, rather than for pleasure - meaning the response has to address root causes, not just consumption. Meaningful participation, she said, must extend beyond one-off consultations and translate into practical support within communities. That means involving young people throughout the policy process, from development through implementation, while creating peer-led programmes where they can support others facing substance-use challenges. Her approach combines decriminalising drug use and possession with giving young people a genuine role in shaping policy - not as a token gesture, but as an ongoing part of how programmes and services are designed and delivered. "What that looks like is involving young people from the beginning till the implementation of policies or programmes in a way that is not tokenistic," she said. She pointed to peer-support services as one way of putting that principle into practice, with young people supporting and guiding others experiencing substance-use challenges. "Really looking at peer-led programmes where young people are leading," said Monareng.