Can production and trafficking of illicit drugs be reduced or merely shifted ?

The production of cocaine and heroin, the two most important drugs economically, has been concentrated in a small number of poor nations for 25 years. A slightly larger number of developing nations have been affected by large-scale trafficking in these two drugs. This paper reviews what is known about drug control programs and considers non-traditional options. The usual array of programs for suppressing drug problems, enforcement, treatment, harm reduction and prevention have been assessed almost exclusively in wealthy nations. Although treatment has been shown to be cost-effective, it is of minimal relevance for reducing the drug problems of nations such as Afghanistan, Colombia, Mexico or Tajikistan, which are primarily harmed by production and trafficking rather than consumption. Efforts to reduce drug production and trafficking have not been subject to systematic evaluation but the best interpretation of the available evidence is that they have had minimal effect on the quantities produced or trafficked. It is reasonable to conclude that international drug control efforts can do more to affect where these drugs are produced rather than the quantity. If that is the case, and given that spreading a specific level of production or trafficking to more rather than fewer nations probably decreases global welfare, it may be appropriate to consider a less aggressive stance to current producers and to make strategic decisions about the location of an industry producing a global bad.Crime and Society,Economic Theory&Research,Markets and Market Access,Alcohol and Substance Abuse,Post Conflict Reconstruction

Coda: What Impasse? A Skeptical View

Certain substances are harmful to health but, at least after a while, become very attractive to their users

Healthcare in Equatorial Guinea, West Africa: obstacles and barriers to care

Introduction: the provision of healthcare services in developing countries has received increasing attention, but inequalities persist. One nation with potential inequalities in healthcare services is Equatorial Guinea (Central-West Africa). Mitigating these inequalities is difficult, as the Equatoguinean healthcare system remains relatively understudied. Methods: in this study, we interviewed members of the healthcare community in order to: 1) learn which diseases are most common and the most common cause of death from the perspective of healthcare workers; and 2) gain an understanding of the healthcare community in Equatorial Guinea by describing how: a) healthcare workers gain their professional knowledge; b) summarizing ongoing healthcare programs aimed at the general public; c) discussing conflicts within the healthcare community and between the public and healthcare providers; d) and addressing opportunities to improve healthcare delivery. Results: we found that some causes of death, such as serious injuries, may not be currently treatable in country, potentially due to a lack of resources and trauma care facilities. In addition, training and informational programs for both healthcare workers and the general public may not be effectively transmitting information to the intended recipients. This presents hurdles to the healthcare community, both in terms of having professional competence in healthcare delivery and in having a community that is receptive to medical care. Conclusion: our data also highlight government-facility communication as an opportunity for improvement. Our research is an important first step in understanding the context of healthcare delivery in Equatorial Guinea, a country that is relatively data poor