From Crime to Development: How Drug Policy Can Advance Health and Equality

The report “Development Dimensions of Drug Policy”, prepared under the auspices of the United Nations Development Programme and enriched with research from the Transnational Institute and the London School of Economics’ International Drug Policy Project, situates the global drug issue squarely within the realm of human development. Rather than framing it narrowly as a problem of crime or health, the study argues that drug policies shape livelihoods, gender relations, inequality, governance, and even the legitimacy of states. For decades, the international response has been dominated by prohibition and law enforcement, yet the persistence of illicit markets shows that punitive approaches have failed to deliver their promised results. Instead, they have deepened poverty, eroded trust in institutions, and perpetuated cycles of exclusion. By aligning drug policy with the Sustainable Development Goals, the authors argue, societies can move from a narrow obsession with seizures and arrests to a focus on human well-being and inclusion.

Drugs and the Rural Survival Economy

One of the strongest narratives in the report is the role of illicit crops in sustaining marginalized rural communities. From coca in the Andes to poppy in Afghanistan and cannabis in parts of Africa, these crops often represent the only viable livelihood in places where legal markets are weak, infrastructure is absent, and land rights are precarious. Farmers cultivate them not to rebel against the law, but to survive. Yet prohibition criminalizes these livelihoods, subjecting families to eradication campaigns that destroy their only source of income. The authors highlight that alternative development programs rarely succeed when they merely replace coca or poppy with coffee or maize. Success requires addressing broader needs, secure land tenure, access to markets, rural infrastructure, and credit systems. Without such structural investment, eradication simply deepens hardship, undermining faith in government and making reliance on illicit crops all the more entrenched.

Health, Rights, and the Cost of Punishment

The report also underscores how punitive policies undermine public health. Criminalization drives people who use drugs underground, cutting them off from life-saving services. The absence of harm-reduction measures such as needle exchanges, opioid substitution therapy, or supervised consumption facilities fuels preventable epidemics of HIV and hepatitis C, while fear of arrest increases the risk of overdose. The authors frame these realities as violations of the fundamental right to health. Universal health systems, they argue, cannot claim inclusivity if they exclude or stigmatize people who use drugs. The evidence is clear: societies that integrate harm reduction into health systems save lives, reduce long-term costs, and create pathways for rehabilitation. Stigma, however, remains a persistent barrier, particularly for marginalized groups who already experience exclusion and discrimination.

Gendered Inequalities and Women Behind Bars

A particularly striking section deals with gender. Women have become some of the fastest-growing groups in prison populations worldwide, largely for low-level drug offenses. Many are caught as couriers, small-scale sellers, or cultivators, roles that are expendable in the illicit chain yet heavily penalized. For many women, entry into the drug economy is linked to poverty, coercion, or survival in the face of gender-based violence. Imprisonment devastates not only their lives but also the well-being of their children and families, reinforcing cycles of vulnerability. The report warns that drug policies blind to gender dynamics perpetuate injustice. Alternatives to incarceration, social protection systems, and support for caregiving roles are identified as essential components of a more humane and effective approach. By acknowledging women’s lived realities, policymakers can design strategies that protect rights rather than perpetuate harm.

Security, Inequality, and the Need for Change

The report paints a sobering picture of how drug policies intersect with governance and security. Prohibition often fuels violence by strengthening organized crime groups, corrupt networks, and armed factions that profit from illicit markets. In countries from Mexico to Afghanistan, militarized enforcement has produced devastating human costs, deepened insecurity, and eroded trust in state institutions. Communities find themselves trapped between violent traffickers and heavy-handed security forces, neither of which provides safety. At the same time, inequality runs through every dimension of drug policy. Indigenous peoples, ethnic minorities, and urban poor communities are disproportionately targeted in enforcement crackdowns and mass incarceration campaigns, while the profits of the drug trade accumulate elsewhere. The authors argue that drug policy must be understood as a social justice issue: unless inequality is addressed, both the drug economy and punitive responses will continue to reproduce exclusion and vulnerability.

The report calls for a decisive shift from punishment to development. The success of drug policy, it argues, should be measured not in hectares eradicated or tons seized, but in the health of communities, the reduction of inequality, the strength of institutions, and the expansion of human rights. Effective alternatives include rural development initiatives that create sustainable livelihoods, health systems that integrate harm reduction, gender-sensitive reforms that shield women and families from disproportionate punishment, and governance strategies that build trust rather than fear. Instead of reinforcing cycles of violence and exclusion, drug policies can, and should, be reoriented to foster resilience, inclusion, and sustainability. In this vision, the drug issue is no longer treated as an isolated threat but as part of the broader social fabric of development. Only by abandoning punitive orthodoxy and embracing human-centered approaches can societies hope to reduce harm and build conditions in which both individuals and communities thrive.