A legislation at struggle with itself: How Ghana’s drug coverage is failing its public fitness undertaking – Life Pulse Daily
Editor-in-chiefFebruary 5, 20266 Mins read40
Ghana’s Drug Policy Paradox: When Public Health Rhetoric Clashes with Punitive Reality
Introduction
Ghana’s Narcotics Control Commission Act (Act 1019) of 2020 was hailed as a transformative piece of legislation that would shift the nation’s approach to drug policy from punitive enforcement to public health-centered rehabilitation. However, six years after its passage, a troubling paradox has emerged: while the law speaks the language of healing, its core remains rooted in criminalization. This contradiction has created a system that simultaneously promises rehabilitation while perpetuating the very harms it claims to address.
Key Points
- Act 1019 attempts to balance public health approaches with punitive enforcement, creating internal contradictions
- HIV prevalence among people who inject drugs has reached 12.5%, compared to 2% in the general population
- Legal ambiguity around possession thresholds gives law enforcement excessive discretion, leading to arbitrary enforcement
- Fines for possession are prohibitively expensive, effectively criminalizing poverty
- Treatment is offered only after prosecution, creating lifelong barriers for those seeking help
Background
When Ghana passed the Narcotics Control Commission Act in 2020, it was celebrated internationally as a progressive step forward in drug policy reform. The legislation promised to establish a dedicated rehabilitation fund, prioritize treatment and harm reduction over pure enforcement for low-level drug offenses, and treat substance use disorders as public health issues rather than criminal matters.
The Act emerged from growing recognition that Ghana’s previous approach—heavy criminalization and incarceration—was failing to address the root causes of drug use and was instead creating a cycle of poverty, disease, and marginalization. International bodies like the United Nations and the West African Commission on Drugs had long advocated for decriminalization and health-centered approaches, and Act 1019 appeared to align with these recommendations.
However, the reality on the ground tells a different story. Despite its progressive rhetoric, the law maintains a punitive core that criminalizes personal possession and use, creating a fundamental contradiction that undermines its stated public health objectives.
Analysis
The Public Health Law That Criminalizes Patients
The most fundamental contradiction within Act 1019 is its attempt to simultaneously function as both a healer and a jailer. Section 3(i) of the Act mandates that the Narcotics Control Commission ensure “substance use disorders are treated as a public health issue.” Yet, Sections 41 and 45 of the same Act explicitly criminalize the personal possession and purchase of drugs.
This internal conflict forces the law to prosecute the very individuals it claims to help. Rather than establishing a “user-as-patient” paradigm, it reinforces the outdated “user-as-criminal” model. This contradiction actively deters people from seeking the services the law supposedly supports, as they risk arrest and prosecution simply for possessing drugs for personal use.
The human cost of this contradiction is severe. When people fear seeking help, they avoid HIV testing, clean needle programs, and other harm reduction services. This fear-driven avoidance has contributed to the dramatic rise in HIV rates among people who inject drugs—now 12.5% compared to just 2% in the general population.
Legal Ambiguity as a 10-Year Sentence
A critical failure of Act 1019 is its refusal to define clear, quantified thresholds that distinguish personal use from trafficking. The law’s definition is dangerously vague, stating that possession for personal use is a quantity that “does not exceed what can barely be utilized by an individual in one day” (Section 113).
This ambiguity grants arresting officers immense discretion to determine whether an individual is a patient or a felon facing a mandatory minimum 10-year prison sentence. This creates fertile ground for inequity and corruption, as police can reportedly charge individuals with the more serious offense of supply if they decline to pay solicited bribes.
The devastating effects of this legal gray area are not theoretical. In a 2023 study, a judge recounted being forced by the law to sentence a young woman to 10 years in prison for sending a small amount of drugs to her boyfriend hidden inside a meal of waakye. What was a simple act of personal connection was twisted by a poorly written law into a life-changing prison sentence.
When Alternative Sentencing Becomes an Illusion
Act 1019 was praised for introducing non-custodial sentences as alternatives to incarceration. However, the fines for possession for personal use—ranging from GHS 2,400 to GHS 6,000—are prohibitively expensive for most Ghanaians. When contextualized against the average monthly wage in Ghana of around GHS 3,700, these fines become essentially unpayable for the majority of the population.
If an individual cannot pay the fine, they face imprisonment. By international standards, these penalties are exceptionally punitive. In Switzerland, for example, possessing a small amount of cannabis results in a simple administrative fine. As one official from the Narcotics Control Commission bluntly stated, “The users vulnerable to pay fines for use aren’t generally able to pay… It’s the poorer people who don’t have any choice but to smoke in the slums, in the streets, etc who get caught.”
The system has simply created a different pathway to imprisonment for the poor, ensuring that those with the least resources face the harshest consequences.
Punishment Before Treatment: A Flawed Path to Wellness
The law’s approach to rehabilitation contains a critical timing flaw. Under Section 45(5), the offer of treatment comes only after an individual has been prosecuted and convicted. A true public health model diverts people into the healthcare system instead of the criminal justice system, preventing the lifelong stigma of a criminal record.
The current Ghanaian model is “punishment followed by an offer of treatment.” It brands individuals as criminals first, creating immense barriers to future employment, education, and housing long after their sentence is served. This approach contradicts fundamental public health principles, which emphasize early intervention and support rather than punishment as a prerequisite for care.
Practical Advice
For Policymakers and Legislators
1. **Amend threshold definitions**: Parliament must urgently amend Sections 37, 41, and 45 of Act 1019 to specify drug quantities that distinguish personal use from trafficking. The ultimate goal should be complete decriminalization of possession and purchase for personal use.
2. **Reform sentencing structures**: Pass the Non-Custodial Sentencing Bill to provide genuine alternatives to incarceration for petty offenses. This will reduce prison congestion, save national resources, and allow the justice system to focus on serious crime.
3. **Protect harm reduction services**: Clarify the law to legally protect the distribution of medical supplies like sterile syringes and naloxone. These are not “drug paraphernalia” but life-saving medical supplies essential to preventing overdose deaths and the spread of disease.
4. **Implement comprehensive training**: Mandate training for law enforcement and security agencies to view people who use drugs as patients needing referral to health services, not criminals to be arrested.
For Healthcare Providers and Community Organizations
1. **Advocate for policy change**: Document and publicize the real-world impacts of current policies to build public support for reform.
2. **Expand harm reduction services**: Continue providing essential services like needle exchange, naloxone distribution, and HIV testing, while advocating for legal protections.
3. **Build community support networks**: Create safe spaces where people who use drugs can access services without fear of arrest or stigma.
4. **Collect and share data**: Systematically document the health outcomes and barriers to care to inform evidence-based policy reform.
For Individuals Affected by Current Policies
1. **Know your rights**: Understand the current legal framework and your rights when interacting with law enforcement.
2. **Seek available services**: Despite barriers, access available health services including HIV testing, treatment, and harm reduction supplies.
3. **Connect with support networks**: Join community organizations that advocate for drug policy reform and provide mutual support.
4. **Share your story**: When safe to do so, share personal experiences to help policymakers understand the real-world impacts of current policies.
FAQ
**Q: What is the main problem with Ghana’s current drug policy?**
A: The primary issue is the fundamental contradiction between the law’s public health rhetoric and its punitive enforcement mechanisms. While claiming to treat drug use as a health issue, the law continues to criminalize personal possession and use, creating barriers to treatment and driving people underground.
**Q: How has the policy affected public health outcomes?**
A: The contradictory approach has led to alarming public health consequences, including HIV prevalence of 12.5% among people who inject drugs (compared to 2% in the general population), hepatitis C rates of 12.7% in certain regions, and an estimated 45% of people who use and inject drugs suffering from moderate to severe depression.
**Q: What specific changes are needed to improve the policy?**
A: Key reforms include: defining clear possession thresholds, decriminalizing personal use, reforming sentencing to provide genuine alternatives to incarceration, protecting harm reduction services, and training law enforcement to refer people to health services rather than arrest them.
**Q: How does Ghana’s approach compare to other countries?**
A: Ghana’s approach remains more punitive than many countries that have implemented successful public health models. Countries like Switzerland, Portugal, and several others have decriminalized personal drug use and seen significant improvements in public health outcomes, reduced crime rates, and cost savings for the justice system.
**Q: What can ordinary citizens do to support reform?**
A: Citizens can support reform by educating themselves about the issues, advocating for policy changes, supporting organizations that provide harm reduction services, and sharing accurate information to counter stigma and misinformation about drug use and policy reform.
Conclusion
Ghana’s Narcotics Control Commission Act 2020 represents a law in conflict with itself. Adopted with progressive, health-oriented aspirations, these goals are being undermined by a punitive legal core that continues to criminalize and punish the very people it seeks to help. The 2025 IBBS data are more than just numbers; they are a mirror reflecting a public health crisis fueled by our own draconian policies.
Ghana took a courageous first step with Act 1019, signaling an intent to treat drug use as a health issue. But now, it must complete the journey. By amending the law to prioritize health and compassion, Ghana can create a coherent and effective drug policy—one that saves lives by supporting its most vulnerable citizens and focuses its law enforcement resources on the organized crime that poses a genuine threat to public safety.
The path forward requires political courage and a commitment to evidence-based policy. The data is clear: the current approach is failing. It’s time for Ghana to align its laws with its stated public health goals and create a system that truly serves the needs of all its citizens, particularly those most affected by drug use and the criminal justice system.
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