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Rethinking Drug Policy Through Human Dignity and Public Health
Gerald Kombo
June 16, 2025
Addiction is not just about substances. It is about a search for relief. A search for power even if illusory. And it cannot be solved with punishment alone.
At the Fourth High-Level Consultation Meeting and Flagship Report Launch of the Eastern & Southern Africa Commission on Drugs, Hon. Esther Passaris, OGW, Member of Parliament for Nairobi County, offered not just political insight but a personal testimony of strategic patience a leadership philosophy that sometimes means knowing when not to act. Drawing from her own journey in public service, she reflected on the importance of timing, empathy, and emotional intelligence in decision-making, especially within complex socio-political contexts like drug policy reform. Her contribution stood out as both introspective and instructive, grounding the broader regional dialogue in lived leadership experience.The Strategic Pause: Lessons in Timing and Leadership
When Hon. Passaris first drafted Kenya’s Harm Reduction Bill, the political environment was deeply hostile to progressive drug policy. Government sentiment, influenced by faith-based abstinence campaigns, framed addiction as moral failure rather than a health concern.
“Sometimes, the most courageous thing a legislator can do is wait,” Hon. Passaris reflected. “I had seen what happened when we rushed the reproductive health bill without adequate coalition-building. I wasn’t going to let that happen again.”
Words were backed by hard truths
Somewhere in Nairobi tonight, a parent will borrow bus fare to take their child to rehab, yet that same child can still find heroin on the street corner tomorrow morning.
The Human Behind the Statistic
The data is as brutal as the lived experience. A 2022 NACADA report found that 10% of Kenyans use at least one psychoactive substance. Drug use is closely linked to school dropout, gender-based violence, mental health crises, and violent crime.
Among people who inject drugs (PWID), HIV prevalence is 16.1% nearly triple the national average. Women who use drugs face compounded challenges: violence, stigma, and isolation.
Still, there’s progress. Between 2010 and 2023, HIV infections among PWID fell by 41%—thanks to harm reduction strategies like needle exchange programs, opioid substitution therapy (OST), and peer-led outreach services.
“This didn’t happen by accident,” Hon. Passaris emphasized.
The Harm Reduction Bill 2024: Blueprint for Regional Change
The proposed Harm Reduction Bill 2024 is Kenya’s first attempt to legally define and institutionalize harm reduction as a public health mandate not a criminal issue.
It is anchored on seven key pillars:
Legal Recognition – Harm reduction as an essential public health service.
Access to Care – OST, HIV/hepatitis services, and needle exchange included in the national health package.
Shared Governance – Coordination between national and county governments.
Data-Driven Decisions – Mandated national surveys and public reporting on drug use.
Reintegration Support – Mental health services, vocational training, and post-rehab care.
Gender-Responsive Approaches – Targeted funding and services for women.
Multi-Agency Leadership – Collaboration across Health, Justice, Education, Civil Society, and PWUD-led groups.
“We’re not asking for charity. We’re demanding what every Kenyan deserves: dignity, safety, and the right to healthcare,” said Hon. Passaris.
Financing the Future
Despite clear evidence of effectiveness, harm reduction remains underfunded. Currently, only two harm reduction centers serve Nairobi’s population of 4 million.
Hon. Passaris urged a shift in narrative from charity to cost-effectiveness.
14 million more people projected to use drugs in Sub-Saharan Africa by 2050.
16.1% HIV prevalence among PWID, compared to 5.7% nationally.
Mortality from opioid dependence is multiple times higher than general rates.
Women face higher risks of violence, social exclusion, and untreated trauma.
41% drop in HIV incidence among PWID in East & Southern Africa since 2010—thanks to harm reduction.