Epidemiologist Elizabeth Pisani and other leading commentators describe which countries are leading the way in tackling HIV infection among injecting drugs users in this 10 minute BMJ video.]

Consensus is growing within the drugs field and beyond that the prohibition on production, supply, and use of certain drugs has not only failed to deliver its intended goals but has been counterproductive. Evidence is mounting that this policy has not only exacerbated many public health problems, such as adulterated drugs1 and the spread of HIV and hepatitis B and C infection among injecting drug users, but has created a much larger set of secondary harms associated with the criminal market. These now include vast networks of organised crime, endemic violence related to the drug market,2 corruption of law enforcement and governments, militarised crop eradication programmes (environmental damage, food insecurity, and human displacement), and funding for terrorism and insurgency.3 4

These conclusions have been reached by a succession of committees and reports including, in the United Kingdom alone, the Police Foundation,5 the Home Affairs Select Committee,6 The prime minister’s Strategy Unit,7 the Royal Society of Arts,8 and the UK Drug Policy Consortium.9 The United Nations Office of Drugs and Crime has also acknowledged the many “unintended negative consequences” of drug enforcement,10 increasingly shifting its public rhetoric away from its former aspirational goals of a “drug free world,” towards “containment” of the problem at current levels.