One year ago, at the Summit of the Americas held in Cartagena, Colombia, the Heads of State and Government commissioned the OAS to prepare a Report on the Drug Problem in the Americas. Barely two days ago, we completed that assignment by delivering to the President of Colombia, Juan Manual Santos, who chaired that Summit, and to all the Presidents and Prime Ministers, the document entitled The Drug Problem in the Americas.

Today, it is my pleasure to present this Report to the OAS Permanent Council and to the Inter-American Drug Abuse Control Commission.

Why was this Report necessary? First, because the Americas are home to approximately 45 percent of the world's cocaine users, to about half of all those who use heroin and opioids, and a quarter of those who smoke marijuana. The use of cocaine paste, crack, inhalants, amphetamines, and the unlawful use of legal pharmaceutical drugs have increased. On a par with Europe's, our Hemisphere's use of drugs is one of the highest in the world and triggers a wide range of effects that are harmful to health in both the short and the long run. And the dependency to which all drug users are exposed, regardless of whether those drugs are legal or illicit, destroys not only the lives of those who are dependent on them, but also those of their families and of those who surround them.
In addition to that damage to health, the process whereby drugs are produced, distributed, sold and used has generated an illicit business that is detrimental to the human and material well-being of our citizens and to the integrity of our institutions.
An illegal economy worth billions of dollars, which is operated by transnational criminal networks and diversifying into arms trafficking, contraband, hijacking, trafficking in persons, prostitution, illegal mining, kidnapping, and extortion. It also translates into crimes causing tens of thousands of victims of violence every year in the Americas and ensuring that some of our countries have the highest homicide rates in the world. Drug trafficking also corrupts both government officials and private sector agents at every level, thereby undermining our economies and our institutions and, in extreme cases, even jeopardizing our democratic governance.

Conscious of these challenges, the Heads of State and Government of the Americas decided to forge ahead in the quest for more effective ways to unravel and handle this complex problem.
To that end, an explicit mandate was assigned to the Organization of American States. The text of that mandate, announced by the Chair of the Sixth Summit of the Americas in Cartagena, Juan Manual Santos, entrusts the OAS with:
and I quote, "analyzing the results of current anti-drug policy in the Americas and exploring new approaches aimed at strengthening that struggle and making it more effective." (end of quote)

Shouldering that responsibility, we brought together a large group of civil servants, private sector specialists, academic experts, and social and political leaders from all over the Hemisphere, who contributed with their views and specialized knowledge, their experience and enthusiasm, to the preparation of this Report.

In practice, the mandate involved two tasks, which we needed to reconcile. On the one hand, we were to evaluate current drug policy (or policies) and outcomes, tapping all available sources of knowledge; on the other, we were asked to explore new ideas and approaches that, looking ahead, could pave the way to a broad debate.

We accomplished the former in the volume entitled Analytical Report and the latter in a Scenarios Report. These two parts are intertwined, although the themes and methodology may differ. The Analytical Report depicts the "Drug Problem" as it is and exactly how it manifests itself in our individual countries and subregions. The amount of money it moves and who benefits from it. How it erodes our social fabric and undermines not just the health of our peoples, but also the quality of our governments and even our democracy.

Based on those facts and the perceptions of their protagonists, the Scenarios Report outlines how they might evolve, depending on what policies are pursued and decisions taken in the future. Faced with a phenomenon with varying impacts on different countries, reactions may also differ. The four scenarios we present attempt to discern what those reactions might be and what repercussions they might have.

I will now briefly describe the main contents of these Reports.


THE ANALYTICAL REPORT

The Drug Problem is a matter that concerns us all, above all because of the violence and illegality associated with it. However, we need to start by focusing squarely on the human plight of drug victims. For that reason, our Analytical Report begins with an explanation of the harm done to human beings by drug use, in an attempt to grasp the reasons why society has become concerned with such use and has decided to control drugs. Thus we begin with the impacts of drugs on human health.

Research in the neurosciences over the past few decades has found evidence of a close link between brain structures and behaviors associated with drug use. As I said earlier, drug use has a wide range of detrimental impacts on health over the short and medium term. They range from clots inside blood vessels to heart attacks, stroke, and cerebral atrophy. Drugs affect and alter multiple systems and organs, especially the brain, and the consequences are particularly dire among young people.

Drug addiction is not, as was once thought, a "poor decision," a voluntary choice, which could be undone by another decision. The addictive use of drugs is an illness and needs to be treated as such.

However, that use prompts illicit economic activity designed to satisfy the demand for prohibited products.

Our countries experience and feel what we call the "Drug Problem" in different ways that can even differ from one region to another within countries. The protagonists and geographical circumstances vary and so do the impacts of the drug problem and the intensity with which they are felt.

That makes it difficult for a single set of policy recommendations to encompass the variety and extent of the challenges posed by a process in which so many different parts are played out.

For that reason, the Analytical Report conceives of the problem as a process, tracking the course of illicit activity from the cultivation of crops, to the production of drugs, their distribution (or transit) along routes and the violence accompanying it, through to their sale and end-use.

Chapters 3, 4, 5, and 6 of the Report are devoted to close scrutiny of each of these stages, examining, for instance, the process from coca leaf to the final sale of cocaine. In undertaking that study, we examined the volume of activity, its various manifestations, its environmental impact, and the State's response to it, including the consequences and limitations of that response.

Chapter 7 is dedicated to the study of the use made of different drugs in our countries, the volumes involved for each product, who it gets to, currently practiced forms of treatment and prevention, and their effects on social exclusion and the exercise of human rights.

The available data show that 24 percent of all marijuana users in the world live in the Americas and, of the latter, 81 percent live in North America.

The Americas is also home to between 7 million and 7.4 million cocaine users, a prevalence rate of 1.2 percent, comparable to the rate in Europe. Although drug use has declined in North America and increased in South America, the main destination of this quintessentially American drug continues to be North America and Europe.

In the past 10 years, the use of cocaine paste, which used to be limited mainly to the Andean countries, has gradually spread to other countries. North America accounts for most of the heroin use in our region. Nevertheless, its use, too, is beginning to spread to other countries in the region.

Globally, amphetamine-type stimulants are the most popular category of drugs after marijuana. In the Americas, their use varies widely, from country to country. Extasis-type substances are also extensively used by young people in many countries in the Hemisphere.

As regards State efforts to address drug use, only 18 of the 33 countries in the Americas evaluated under the OAS Multilateral Evaluation Mechanism (MEM) have reported the existence of a national anti-drug plan or strategy, Fifteen either had no current plans in effect or failed to provide information.

One problem besetting numerous countries in the Hemisphere has to do with the controlled-drugs-related growth of the prison population. Society pays an ever higher price for this, not just because of the cost of maintaining that population but also because of the loss of inmates' potential contribution to the economy.

At the same time, drug use is also associated with widespread social exclusion and even outright rejection. To the extent that drug use is penalized or stigmatized, the segments of the population that are most vulnerable to problematic use are inhibited from resorting to timely information, public health care services, and, in general, to prevention and treatment programs. Thus, drug use could be considered both a consequence and a cause of social exclusion.

Social agencies tend to regard problematic drug users as a kind of "disabled person" or social "deviant," generally speaking with ties to crime, violence and dangerousness, and posing a threat to society. For that reason, problematic drug users are excluded from routine settings in which social and emotional ties are forged and social bonding takes place. Frequently, they are even excluded from the programs designed to treat their dependency.

Our scrutiny of this process enables us to conduct a detailed analysis of two phenomena of particular concern to our societies and governments: the drug-trafficking economy and the violence that goes with it.

Based on previous studies by the United Nations and agencies in a number of governments, we established that the retail drugs market in the Americas is worth US$151 billion, or nearly half (47 percent) of the global retail market. Just the North American share of the retail market accounts for 44 percent of the world total.

Based on several sources, it transpires that, in the Colombian jungle, it costs between US$585 and US$780 to produce a kilogram of cocaine paste, and that the same kilo can be transformed into two kilos of cocaine valued at US$330,000 in North America. In other words, in the course of the illegal drug trade's chain of value, it can increase its value 500-fold.

As far as cocaine is concerned, most of the value-added in this illegal economy is found at the end-market stage, where presumably much of the profit is also generated. Barely more than one percent of the value generated corresponds to the revenue of the original producers in the Andean countries, while the retailers in the drug-using countries pocket almost 65 percent of the revenue.

At the same time, those huge profits represent enormous volumes of money which trigger another grave problem for our region, albeit mainly in the producer and transit countries. We are talking here about the corruption of public and private sector officials, who get entangled at some point in this economic process as facilitators or operators. We are talking, too, about the undermining of institutions, especially in the financial sector, mired in the business of "laundering" that money and thereby forging dangerous linkages between what is legal and illegal.

When the corruption generated by the problem of illegal drugs and the organized criminal penetration of institutions reaches a certain level of intensity, State institutions may even be co-opted and reconfigured. No other illegal economy in the region can match the illegal drugs economy's ability to erode institutions.

The other major facet of corruption generated by the illegal drugs economy has to do with its need to hide the illicit origins of assets and funds and incorporate them into the legal economic system, i.e. "money laundering."

Traditionally, the financial sector, and banks in particular, have been used for money laundering. However, and largely in response to prevention measures applied to the financial sector, criminal organizations have diversified their procedures and now also use other economic agents, including insurance companies, stock and securities brokers, exchange bureaus, wire transfer companies, casinos, mineral and precious stone traders and concessionaires, real estate dealers, and independent professionals.

Based on United Nations estimates, we note that the drug-related profits available for money laundering through the financial system amount to between 0.4 percent and 0.6 percent of global GDP. It is also possible to estimate that roughly half of those profits are laundered in the jurisdictions in which they are generated and that they flow into the banking sector, the real estate sector, and other kinds of investments. In the specific case of cocaine, and according to the same source, some 46 percent of the gross profits from retail sales of the substance and 92 percent of the gross profits made by wholesalers are available for money laundering, which translates into the finding that 62 percent of the total gross profits from cocaine trafficking, which, as we have seen, are immense, are available for laundering.

The second critical issue examined in the Analytical Report refers to the various types of criminal violence associated with the different stages in the chain of value of the illegal drugs economy, including the violence accompanying the end-stage in which those substances are used.

All activities relating to the "Drug Problem" are, per se, criminal, without prejudice to the fact that some uses are decriminalized. The perpetration of those crimes, especially those relating to the illegal drugs economy, triggers other crimes and, above all, massive criminal violence associated with the "protection" of those criminal activities and with disputes among rival criminal factions.

That world of crime and violence surrounding the "Drug Problem" is today the most visible side to it and that which does most harm to the people in our Hemisphere and to the institutions designed to protect them and strive for their well-being and prosperity.

As I pointed out already, this activity has fostered the rise or strengthening of gigantic transnational criminal networks, which have ended up extending their operations to other types of crime, so much so that one wonders whether even the disappearance of the illegal drugs economy would mean an end to their criminal machinations.

Directly associated with the violence spawned by the illegal drugs economy is illegal arms trafficking, which has become one of the main headaches for citizen security in the region. Lethal violence from the use of firearms in Latin America and the Caribbean far exceeds the global average (which is 42 percent of all homicides). According to the OAS's 2012 Report on Citizen Security, 68 percent of homicides in the Caribbean are committed with firearms. In Central America, the figure is 78 percent, in North America 55 percent, and in South America 83 percent.

In relation to the criminal violence associated with the Drug Problem, our Report focuses on possible explanations of why that violence is more intense and virulent in some countries than in others.

Our conclusion is that that difference is most likely due to two factors: economic and social conditions on the one hand and, on the other and in particular, the very different abilities of States to guarantee protection for their citizens and, above all, effective law enforcement.

As regards the former, much has been said–and reiterated throughout this Report–about the links between social exclusion, poverty, and crime. One characteristic feature of the drug trade is that, even though some of its bosses become extremely rich, they, their lieutenants, underlings, foot soldiers, and henchmen come from disadvantaged social sectors, in which drugs perform a dual function: becoming a source of employment and way of life and, at the same time, a means of hiring cheap and abundant labor.

Social development and the elimination of exclusion, especially in the drug production and transit countries, are keys to overcoming the drug problem. They do not, as some would claim, constitute the only conditioning factor, but certainly deserve mention.

The second reason for differences in levels of violence is that those countries in which criminal violence and cruelty are most intense are also countries in which institutions are geographically too thinly spread and poorly articulated, with little coordination among them; in which financial and human resources are limited, and where there is a lack of appropriate information with which to shape the formulation and implementation of security policies. Underlying all these woes is widespread impunity and hence an equally pervasive culture of contempt for the State. That culture triggers a vicious circle in which the community opts not to turn to institutions (crimes are not denounced, disputes are settled privately, people take justice into their own hands) because the police do not go after criminals, the courts do not hand down judgments, and prisons not only fail to rehabilitate, often enough they serve as shelters from which criminals continue to operate.
Obviously, guaranteed impunity lowers the cost of violence as much as the risk of punishment increases it. That is probably why a drug trafficker who uses violence and cruelty as a way of resolving disputes with rivals or law enforcement officials in countries in which he runs no real risk of punishment for his crimes will use different methods in countries in which such punishment may be deemed inescapable.

Chapter 9 of our Analytical Report focuses on legal and regulatory alternatives to the problem, their origins and characteristics. It describes and analyzes current trends toward decriminalization, penalty reduction, and legalization; the likely costs and benefits of those various alternatives; and other, non-juridical, options.

Yet our Report exposes not just what is going on today; it also shows what the future could bring. As I mentioned earlier, there is a second volume in our Report on the Drug Problem complementing the part I have just described. In this second part, we sought to show not today's reality, but rather what tomorrow could look like. By that I mean: illustrate some possible futures with respect to the problem that concerns us.

For that, we have chosen scenarios showing what could come about depending on what courses of action we pursue. Using a well-tried and tested methodology, we identified four scenarios that could come about if certain things happen and certain political decisions are taken. Familiarizing ourselves with these possibilities, analyzing their causes and effects, and drawing conclusions from them are tasks that we consider essential for our individual and collective thinking about the Problem.

We have called this Second Part of our report, Scenarios for the Drug Problem in the Americas.

And as we are well aware that not just one future exists, but many that can be forged on the basis of decisions today, we offer four possible scenarios of what the future drug problem in the Americas could look like. Three of the four scenarios depicted –“Together”, “Pathways” and “Resilience”- describe three different future alternatives, depending on whether the focus is on institution building, experimentation with legal changes, or the community's capacity to respond to the problem.
In order to compare and make the best use of them, it is important to note that they are based on different visions of the Drug Problem. That is, moreover, an insight based on how they came about: the scenarios were constructed at successive meetings headed by people who had those different visions.

"Together" sees the drug problem as a serious problem of pervasive insecurity, triggered not only by drug use, but also by the frailty of institutions incapable of coping with the criminal phenomenon. Naturally, its focus is on strengthening those institutions so that they can exercise their oversight functions.

(It is important to stress here that this scenario by no means denies the importance of treatment and prevention; but it does attach paramount importance to institutional strengthening of the mechanisms for combating crime. In reality, no scenario will be "pure." They differ in terms of where the main emphasis lies.)

"Pathways" takes a very different tack, inasmuch as it sees the regulatory framework and suppressive measures to control drugs as being a core part of the problem itself. Here, the insight is that the way drug use and trafficking are persecuted exacerbates the problem rather than solving it. Consequently, this scenario stresses the need to seek alternative treatments and legal and regulatory frameworks, which include decriminalizing and even legalizing the use of some products.

"Resilience"–the third scenario–does not preclude the possibility of institution-building or in-depth reforms to the general approach, but it starts from the premise that the drug problem is a manifestation of underlying social and economic dysfunctions, which cause addiction and violence. Consequently, this scenario emphasizes the need for action by a well organized community, based on support from local governments, companies, and nongovernmental organizations.

The fourth scenario, "Disruption," is distinct from the others in that it alerts us to what could happen if we are incapable in the short run of reaching a shared vision that allows us to join forces to address the problem, while respecting diversity in our approaches to it. Its starting point is that the cost of the drug problem is already excessive, that there probably will not be any major changes in strategy, and that, therefore, each player should decide on a policy that best suits its own interests.

Each of these scenarios poses an enormous variety of collective and multilateral opportunities and challenges that need to be at the heart of subsequent debate. With drugs, as with any other complex social phenomenon, there is a wide range of motivations and convictions that shape the social fabric. For that reason we are convinced that the scenarios provide a useful starting point for helping our leaders and, ultimately, our peoples establish collective and sustainable roadmaps within the diversity of approaches.
In mandating the OAS to prepare this Report, the Heads of State and Government of the Americas bestowed upon us a heavy burden of responsibility. At the same time, however, they set very precise limits to our response. That is why the Report I am presenting today sets forth facts that can facilitate decision making, but does not put forward solutions. It is up to our leaders to choose those solutions, knowing that, in the debates to come, they can rely on a solid basis for their deliberations. We believe, nevertheless, that it forms part of our obligation and responsibility to contribute to those deliberations. The best way to do it is to submit for the consideration of the Heads of State and Government of the Americas and of all those who will subsequently take part in this dialogue, some conclusions that follow directly from the analysis presented in this Report.
I would now like to put forward what I consider to be the four principal conclusions of our reflections:
First, although the drug problem in the Americas constitutes a single process, it does allow for different approaches at each of its stages and in the different countries in which they play out. The health problems associated with substance use are undoubtedly to be found in all our countries, because in all of them there is evidence of drug use. Nevertheless, the impacts of the problem in terms of the number of people affected and in comparison with other health problems also besetting the population, are undoubtedly worse in the countries of North America, where drug use is more widespread. In contrast, the impact on the economy, the social fabric, security, and democratic governance is greater in the planting, producing, and transit countries located in South and Central America, Mexico, and the Caribbean.
Likewise, while some countries have more resources and more robust institutions for coping with the damage done by the illegal market in and use of drugs, others have manifestly weak institutions that render them virtually incapable of dealing with the problem.

We must therefore acknowledge that, although all our countries bear responsibilities in the quest for solutions, the latter vary.

Second, the links between drugs and violence in our countries are complex and have a greater impact in countries in which the State is not able to deliver effective answers.
We admit that there may be other conditions that explain the prevalence of crime and violence in some of our countries. That our individual histories as nations, our cultures and idiosyncrasies, and, above all, the poverty and social inequality rampant in some countries also play a decisive role in the explanation of this phenomenon. Nevertheless, it seems equally obvious that to resolve the problem there is always going to be a need for formal institutions that do actually guarantee citizen security and strive to secure the well-being and prosperity of all.
Third, a public health approach to drug use is required in all our countries, with more resources and programs to ensure success.

National, international, and hemispheric drug policies have gradually come to treat addiction as a chronic and recurrent illness calling for a health-oriented approach involving a wide range of services. These policies include promoting healthy lifestyles, protecting users with measures designed to restrict the availability of psychoactive substances, prevention, treatment, rehabilitation, and reintegration into society.

Treatment for drug dependency needs to be available at all general and specialized care levels in the health system, with particular emphasis on early diagnosis and brief primary care intervention. Our Report shows that in many countries in the Hemisphere, there is a notable gap between public health goals and the actual care provided for disorders related to the use of psychoactive substances.

Finally, overcoming the problem calls for a multi-faceted approach, great flexibility, a sound grasp of often different circumstances, and, above all, the conviction that, in order to be successful, we need to maintain unity in the midst of diversity. Greater flexibility could no doubt lead to acceptance of the possibility of amending domestic legislation or promoting changes to international legislation, focusing, in particular, on marijuana, for which initiatives are already under way in some of our countries, with regard to decriminalization and legalization. On this last point, which has caused quite a stir in recent days, I would like to underscore the following: it is clearly contradictory to say one wishes to treat drug addicts as people suffering from an illness and at the same time punish them for drug use. That does not mean that that sick person should not be treated in order to get rid of his or her dependency; nor does it preclude interning that person in a health establishment to prevent risk to her or his health or the security of others. However, we do not believe that sending seriously drug-dependent people to prison constitutes appropriate treatment. What's more, we think it might exacerbate their condition and even render it irredeemable.

Naturally, none of these transformations should cast doubt on or question progress achieved so far as regards collective action in our Hemisphere. Rather, promoting them should be based on identifying whatever serves each country's needs and that which meets the needs of all. We need at all times to remember that in that balance between the individual and the collective, between national sovereignty and multilateral action, lies the foundation for our peaceful coexistence and the partnership we have managed to forge in the course of our histories as nations that are independent and yet act in unity and solidarity in the international sphere.
My friends:

In this way, the OAS General Secretariat has responded to the explicit mandate conferred upon us by the Sixth Summit of the Americas.

I believe this is the right moment to thank the 178 people from almost all the countries of the Hemisphere, who participated directly in this effort, preparing studies of different facets of the problem, attending meetings and workshops, agreeing to be interviewed, or delivering, sincerely and enthusiastically, opinions and comments that contributed to final preparation of the Report I present you with today.

I would also like to thank those countries and institutions that, as friends of the OAS, publicly or privately, contributed to the materialization of this work.

Many of those protagonists deserve special mention, but, as that is not possible, let me name six who must not go unmentioned. Paul Simons, the Executive Secretary of CICAD, and Adam Blackwell, OAS Secretary for Multidimensional Security, were directly responsible for all the work of the General Secretariat, and Paul coordinated directly with the CICAD team the preparation of all the studies used in the Analytical Report. Álvaro Briones not only took part in the preparation of both Reports. He also played a fundamental part in their final drafting.

The Scenarios Report is the product of our cooperation with the Centro de Liderazgo y Gestión, in Bogotá, Colombia, and especially its President, Gustavo Mutis, and with Joaquín Moreno, who played a key executive role, and Adam Kahane, who created the method and core concepts of the Scenarios Report. It was a pleasure and an honor to interact with him for this Report.

Lastly, in delivering this Report a few days ago to the Heads of State and Government and, today, to the Permanent Council of the Organization of American States and the Inter-American Drug Abuse Control Commission, I would like to thank you all once again for your support and involvement.

As we have reiterated, we sincerely trust that this document will not be construed as a conclusion, but merely as the start of a long-awaited debate. We believe we have embarked upon a path of strengthening our hemispheric efforts in a sphere that affects all our peoples alike and thathat therefore demands our collective commitment and solidarity.