The African Union Commission (AUC) has held an annual continental consultation for Drug Demand Reduction (DDR) since 2015. AUC member states are each represented by their respective DDR national focal points, allowing member states an opportunity to present national DDR activities in a peer-review platform that also allows engagement with invited subject matter experts. This year’s consultation was held in Arusha, Tanzania from 10-13 December 2024, and included Traditional Leaders from Southern Africa. The theme for this year’s consultation was “Prevention is better than Cure: Towards enhanced Health, Security and Socio-Economic Wellbeing of People in Africa”.
Ms. Angela Martins, the AUC Director for Social Development, Culture and Sport in The Department Of Health, Humanitarian Affairs And Social Development opened the session by reinforcing the AUC’s focus on prevention for the upcoming year. She highlighted the importance of adopting person-centered, holistic evidence-based strategies that form the core of all DDR activities and recognize the importance of collaboration to achieve successful prevention programming at a structural and clinical level. Ms. Martins spoke to the significance of Traditional Leaders as a key pillar in the collaborative efforts tailored for the African continent, particularly with reference to prevention, referral and recovery support. Prevention interventions must intentionally seek to counter stigmatization and prevent isolation, while safeguarding future generations in strategies prioritizing partnership, community and compassion.
Ms Maggie Nardi, Deputy Assistant Secretary for Global Programmes and Policy in Africa and the Middle East at the Bureau of International Narcotics and Law Enforcement Affairs (INL), US State Department raised the alarm as Fentanyl evolves into an issue of global concern. She reiterated that synthetic drugs remain a significant contributor to overdose deaths, with polydrug use continuing to be a major challenge globally. With 23 new substances/precursors being recognized at this year’s Commission on Narcotic Drugs, Ms. Nardi reminded the audience about the Global Coalition to Address Synthetic Drug Threats, which was launched on 7 July 2024 by United States Secretary of State, Antony Blinken to facilitate a global collaborative effort to track and tackle the rising threat posed by synthetic drugs, and to further serve as a platform to link donors for DDR to programmes requiring funding support. Ms. Nardi confirmed that INL is committed to supporting the strengthening of The Pan African Epidemiology Network on Drug Use (PAENDU) and to increasing expertise in epidemiology as a key element of DDR on the continent in addition to efforts to strengthen the workforce competence through the Universal Prevention Curriculum (UPC), the Universal Treatment Curriculum (UTC) and the Universal Recovery Curriculum (URC).
The meeting was addressed by Hon. Ms. Jenista Mhagama, the Minister of Health, United Republic of Tanzania, who advocated for a stronger focus on prevention while scaling up treatment and recovery services. She highlighted that this can only be successful for the continent through a comprehensive, integrated approach with interagency and international collaboration to enhance national, regional and continental cooperation.
In Tanzania, a call centre has been set up to report potential substance manufacturers and traffickers, in addition to use of social media as a key mechanism to deliver prevention messaging and promote access to care services, while an extensive network of evidence based services, such as Medication Assisted Therapy (MAT) for Opioid Use Disorder, have been strengthened through policy and legislation. The group was able to visit the excellent MAT facilities at the Mt Maru Hospital in Arusha.
Dr Abel Basutu, the Senior Drug Control Programme Officer in Department of Health, Humanitarian Affairs and Social Development at the AUC shared that the continent has a massive youth population, reflected further by Dr Cassian Nyandindi, Assistant Commissioner for Prevention and Treatment, Drug Control and Enforcement Authority, United Republic of Tanzania, who added that more than half of Tanzania’s population is youth. Mr Aliyu Mukhtar Usman and Ms Winnie Gori, representatives of the African Union Youth Forum on Drug Prevention, expressed the importance of youth involvement for sustainability of prevention and treatment engagement. They stressed the importance of a genuine exchange of ideas and incorporation of youth input. There are currently 75 Youth Ambassadors across 26 English speaking countries on the African continent, an essential and ready resource that could benefit from funding support for activities and to facilitate an annual youth engagement.
The UNODC, represented by Su Hyun Hong and Anselme Simeon presented an overview of the UNODC/WHO International Standards on Drug Use Prevention and family-based interventions respectively. They clarified what determines whether an intervention is evidence-based, how one selects evidence based intervention appropriate to setting, and factors that contribute to the success of a prevention strategy. The UNODC “Review of Prevention Systems” (RePS) tool which seeks to map prevention resources and services at a national level and compare how closely these align to the UNODC/WHO Standards, thus providing a mechanism for monitoring and evaluation of national prevention planning and implementation. Other interventions discussed include the CHAMPS Initiative, the UNODC Youth Initiative, as well as a school-based prevention intervention. Dr Nadine Harker, a member of the ISSUP Scientific Council, presented an overview of considerations for workplace interventions, and pointed out that the impact of these goes beyond just the workplace and impacts families and communities. George Murimi, the Programme Manager for Africa Projects at the Colombo Plan Drug Advisory Programme (CP DAP) shared the importance of not confounding training personnel in the dissemination of curricular interventions. Accordingly, there should ideally be dedicated well trained and accredited trainers for prevention.
Goodman Sibeko, the ISSUP Scientific Advisor presented an overview of ISSUP, pointing out that the AUC was part of the original group calling for improved coherence and collaboration in DDR, a call which resulted in the formation of ISSUP. He presented on the synergistic relationship between some other key network partners active on the African continent, particularly the International Consortium of Universities for Drug Demand Reduction (ICUDDR), the International Technology Transfer Centers (ITTC), Colombo Plan, and clarified how these activities align with UNODC, AUC and AUC Member State DDR priorities and activities. He then shared an overview of the Introduction to Evidence-based Prevention (INEP) course geared towards providing recipients with the essential principles of evidence-based substance use prevention and the INEP Plus course which capacitates ISSUP National Chapters to cascade INEP training at a national level. In describing the benefits of ISSUP membership and encouraging Member States to support ISSUP National Chapters on the continent, Dr Sibeko went further to highlight some of the benefits of ISSUP membership, including incentives for publishing with the Addictology Journal, and access to extensive online resources such as networks, Knowledge Share, and job postings.
The Traditional Leaders from the SADC additionally attended a UNODC training session for policymakers. This assisted in provided context for the incorporation of Traditional Leaders in DDR, a priority for AUC, particularly to support prevention, early detection and referral, and recovery interventions. During the proceedings a leadership structure for the Southern Africa Network of Traditional Leaders on Drug Demand Reduction (SANTLDDR) was formalised, with HRH Kgosi Thabo Seathlolo, Chairperson of the South African National House of Traditional and Khoi-San Leaders (NHTKL) being elected the inaugural Chairperson, HRH Dr Chisunka Justin from Zambia as the Secretary-General and HRH Maminirina Gilbert from Madagascar as the Rapporteur. The establishment of the SANTLDDR represents an essential component of the AUC’s commitment to engaging and collaborating with indigenous structures to facilitate the reach and longevity of DDR efforts on the continent.
The interest in ISSUP, and the excitement with the formation of the SANTLDDR indicate a strong desire for strengthened collaboration on the continent. The deep engagement in the discussions around evidence-based prevention practices bodes well for the development of the field. Congratulations to AUC on a successful engagement and to HRH Kgosi Thabo Seathlolo on his election.
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