20 February 2025 – Substance use disorders represent one of the most pressing public health challenges of our time, with profound consequences for individuals, communities, and societies. Drug use disorders affect physical and mental health, undermine economic stability and national security and strain public health systems. With drug use rising globally, comprehensive policies and treatment programmes are urgently needed.
Drug use is linked to a range of severe health issues, including mental health conditions, suicides, HIV/AIDS, hepatitis, tuberculosis, and cardiovascular disease. According to the United Nations 2024 World Drug Report, an estimated 292 million people – 5.6% of individuals aged between 15 and 64 – used drugs in 2022. That the economic burden of drug use – including its association with crime, health problems and lost productivity – accounts for around 2% of GDP in some countries exemplifies the far-reaching impacts of this crisis.
The situation in the World Health Organization’s (WHO) Eastern Mediterranean Region, where 6.7% of the population report drug use, higher than the global average of 5.6%, is alarming. Opioid use is widespread in countries such as Afghanistan, the Islamic Republic of Iran and Qatar. In Egypt, tramadol use has become as prevalent as cannabis. Prescription drug misuse – including benzodiazepines and Captagon – is increasingly common in Iraq, Libya and the Syrian Arab Republic.
Since 1990, the number of people in the Region with drug use disorders has increased twofold. In 2019, an estimated 3.4 million individuals were suffering from these disorders. The skyrocketing figures correlate with alarmingly high rates of HIV and hepatitis C among drug users in the Region. The prevalence of HIV among drug users is 18.2%, compared to 12.4% globally, and hepatitis C affects 51.4% of people who inject drugs, well above the global average of 48.9%.
Despite the significant health and social consequences of substance use disorders, there is a glaring treatment gap. While the 2024 World Drug Report highlights that only 1 in 11 people with drug use disorders receive the necessary treatment globally, the corresponding rate in the Region is 1 in 13. The shortfall can be attributed to a lack of access to healthcare services, the non-availability of essential medications and the stigma surrounding drug use which prevents many people from getting the help they need.
To address these challenges, the WHO Regional Office for the Eastern Mediterranean launched the Regional Director’s Flagship Initiative to Strengthen Public Health Response to substance use. The initiative aligns with WHO’s commitment to achieve Sustainable Development Goal (SDG) 3.5 which aims to strengthen the prevention and treatment of substance use disorders.
The substance use flagship initiative seeks to:
leverage WHO’s role as the leading coordinating authority for global health to bring together UN agencies, public sector entities, civil society organizations, professional associations and academia to collectively address substance use issues;
focus on evidence-based interventions to prevent drug use, minimize harms and promote protective factors; and
enhance access to treatment for drug use disorders and related conditions across communities and healthcare platforms.
To advance these efforts, a policy dialogue was held in Abu Dhabi, United Arab Emirates, from 16-18 February 2025. Facilitated by the WHO Regional Office for the Eastern Mediterranean, in collaboration with the National Rehabilitation Centre in Abu Dhabi, the meeting brought together public sector entities, UN agencies, civil society organizations and academic institutions.
The objectives of the policy dialogue include:
orienting stakeholders on the goals and objectives of the flagship initiative on substance use;
defining roles and responsibilities to support the implementation of the initiative in countries across the Region; and
initiating the development of country-specific plans to guide implementation of the initiative.
The flagship initiative has identified evidence-based, cost-effective strategic interventions to improve access to treatment and support services for populations affected by substance use and substance use disorders across the continuum of care while protecting and promoting the rights of persons with substance use disorders. These interventions necessitate coordination among public, private, and civil society entities working in health, social welfare, education, law enforcement and criminal justice to help ensure more individuals receive the care they need and reduce the social and economic burden of substance use disorders in the Region.
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