Compared with drug-control programmes in Bolivia and Peru, "there's a total lack of balance between stick and carrot," says Klaus Nyholm, the UNDCP's man in Bogota.At first sight, Mr Pastrana appears to have had more success in modernising the armed forces.
According to the UN's drug-control programme, this year's crop is likely to yield 1,900-2,700 tofnes opiumium, bringing Afghanistan back to its mid-1990s level.
"Pervez Musharraf is the best thing that happened to this country in years," says Simon Gillett, who until recently helped run a development project connected with the UN's drug-control programme.
According to Bernard Frahi, who heads the UN drug-control programme for Afghanistan and Pakistan, the immediate priority is to make sure that farmers have access to seeds, fertiliser and credit for alternative crops before the next opium-planting season in the autumn.
Countries such as Pakistan and Afghanistan now have many more heroin addicts than the United States; and synthetic drugs like speed and ecstasy are made in developed countries.Pino Arlacchi, who became boss of the UN's drug-control programme in September, points out that it has taken only one year (a millisecond in UN time) for the world's governments to agree on a general "global" strategy.
Police and drug prevention and control programmes routinely raid the drug trafficking networks and the "shooting galleries" where drugs and injection equipment are sold or exchanged and where drug injection take place.
In addition, alternative drugs are needed to counteract the spread of drug resistant TB which threatens global control programmes [ 4].
12 14 A community-based approach is also employed by national lymphatic filariasis (LF) control programmes, whereby community drug distributors or community health workers (CHWs) provide community-wide delivery of albendazole plus ivermectin (or diethylcarbamazine in areas not endemic for onchocerciasis) to entire populations aged 2 years and above.
Finally, we make recommendations for monitoring drug efficacy in the field, as components of control programmes, in order to maximise the ability to detect drug resistance, and if it arises to change control strategy and prevent the spread of resistance.
Conflict-affected countries often suffer severe disruptions to disease control programmes, interruptions of drugs and medical supplies, destruction of infrastructure, displacement of communities, and flight of health workers [ 2].
