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The Republic of Tunisia

WHO

Drugs: Health or Crime Issue?

BMUN Position Paper

Countrys Position

Drugs have variable categories. Common ones include heroin, cocaine and cannabis.

There are also numerous methods of using drugs, such as inhalation, smoking, consuming,

absorbing, or injecting with a needle. Signs of addiction may be evident once people fall under

the influence of drugs. The United Nations has certain treaties on drug use. The Single

Convention on Narcotic Drugs in 1961 aims to combat drug abuse by coordinating international

action. There are two forms of intervention and control that work together. First, limiting the

possession, use, trade in, distribution, import, export, manufacture and production of drugs

exclusively to medical and scientific purposes. Second, combating drug trafficking through

international cooperation to deter and discourage drug traffickers. (Single Convention on

Narcotic Drugs 1961) The Convention on Psychotropic Substances in 1971 establishes an

international control system for psychotropic substances. It responded to the diversification and

expansion of the spectrum of drugs of abuse and introduced controls over a number of synthetic

drugs according to their abuse potential on the one hand and their therapeutic value on the other.

(Convention on Psychotropic Substance 1971)

Drugs usage is a common problem on a global scale and a still-lingering issue in the

North African country of Tunisia. Since January 14th 2011, teenager drugs abuse became an

unprecedented problem in Tunisia. Some high school students even went to class under the

influence of drugs. Dealers existed everywhere around high schools. Buying and selling drugs in

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front of school gate were not controlled or stopped by school police. At the same time, the price

of common drugs was cheap, ranging from 1.5 dollars to 6 dollars; this created opportunities for

students to engage in new types of drugs. However, many Tunisian students did not think that

consuming drugs was illegal behavior, as exemplified by a high school student in the Riyadh

district of La Marsa claiming that he didnt understand why they don't legalize drug use, as they

have done in some European countries." (Zebais). The feeling of drugs could make them forget

the dangers or health issues that caused by drugs. "I feel good when I smoke marijuana. It calms

my nerves, I relax, and the world becomes beautiful. There is no way I could give up my daily

marijuana cigarette." (Essam) As students situations worsened, teachers and principal had to use

violence to keep them in line. As a result, the verbal and physical assault between students and

teachers increased. Furthermore, the cause of drugs using among high school was concluded as

lack of care from school and family. This comes in light of an absence of any form of control,

and because the educational system is preoccupied with political developments and security

problems plaguing the country. The Ministry of Education is becoming aware of the dangers

posed by this problem and its seriousness. This pushed it to organize an awareness week at the

beginning of January and to distribute fliers to pupils. Furthermore, the ministry has organized

awareness campaigns within institutions and held a conference that brought together

representatives from educational institutions, civil society, and relevant ministries to discuss the

situation and find solutions. The participants agreed to develop a joint action plan to fight drug

use, to intensify awareness campaigns throughout the year, and to develop mechanisms for

monitoring their progress.

Tunisia has had laws concerning drug use for more than twenty years. However, Law 52

was considered as a tough law which people had deprecation on it. The Al Sajin 52 ruled that

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smoking zatla, or cannabis resin, is punishable by between one and five years in jail. It was

with the same law prohibiting judges from passing lighter sentences for extenuating

circumstances. According to a statistic data, it shows that nearly tens of thousands of Tunisians

have been convicted because of Law 52. As a result, more than half of the 13,000 people in pre-

trial detention, and around one third of Tunisias 11,000 convicts were arrested for drugs abuse,

and cannabis in particular. (Afrique) If you smoke a joint in Tunisia, you risk getting arrested,

beaten up by the police, sent for a urine test, and then sentenced to a year in an overcrowded

prison with hardened criminals as your cellmates. (Guellali). The harsh law did not help high

school students or adults get rid of drugs. In an opposite way, some people more preferred to try

to break the law, to challenge the government. Some examples demonstrated that the law

adversely affected young peoples life. Others just smoke a joint or just have their first try on

drugs; but they were arrested as soon as they were caught. There was no process of teaching

them why consuming drug is dangerous and harmful. After they came out of the jail. others

would belittle on them. The law is over reacted on drugs problems; and that destroyed young

peoples life. However, the phenomenon of consuming drugs among high schools did not get

better. Moreover, in society, people felt that the law was unreasonable. It did not have any effect

on controlling drugs. Human Rights Watch has long documented the human rights violations that

accompany the criminalization of drug use. Throughout the world, there has been individual and

collective devastation resulting from this war on drugs, often accompanied by racial or social

discrimination and typically affecting the most disadvantaged populations. This is no different in

Tunisia.

Drug consumption is first considered as a health issue, especially for young people. The

use of needles is a common cause of HIV/AIDS. Most abused drugs directly or indirectly target

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the brain's reward system by flooding the circuit with dopamine. When the drugs enter the brain,

they can actually change how effectively the brain functions, leading to potential issues, such as

a weakened the immune system, increased susceptibility of infections and heart attacks. (Zebais)

However, according to Law 52 in Tunisia, the drug using is more considered as crime issues.

Even smoking is relating to drugs over time. As of December 15, 2015, 7,451 people convicted

of drug related offenses were in Tunisias prisons 7,306 men and 145 women according to

the Justice Ministrys General Administration of Prisons and Rehabilitation. About 70 percent of

them about 5,200 people were convicted of using or possessing cannabis, called zatla in

Tunisia. People convicted of drug offenses constitute 28 percent of the total state prison

population. (Guellali) Obviously, the issues of drugs in Tunisia squint towards crimes.

Recently, health ministry director general Nabil Ben Salah said the health and justice

ministries are trying to "humanise" the legislation, although decriminalising the drug is not an

option."People tend to trivialise the effects of cannabis whereas it's very harmful, especially for

adolescent brains, it can destroy a huge number of brain cells. (Aiba) A reform under

consideration would authorise judges to take mitigating circumstances into account before

passing judgement, said Ben Salah. But lawyer Ghazi Mrabet, a founding member of Al Sajin

52, said the whole system was resistant to change because of a lucrative business connected to

cannabis-related arrests. "People come to see me whose child has been arrested for [cannabis]

use who are ready to do anything to prevent them going to jail," including paying bribes to police

and magistrates, the lawyer explained to AFP. "When I refuse, they turn to other lawyers, who,

according to what clients tell me, who make sure the urine test is negative or the name disappears

from police reports," he said. At the other end of the spectrum, "some judges end up with tears in

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their eyes as they deliver the verdict" because they have to hand down jail terms, he said, calling

for a national debate. (Zebais)

Proposed Solution

1. Based on the Republic of Tunisias recent situation, a new drug law is drafting. The new law

will be reasonable on punishment processes of drug users. The Republic of Tunisia gives these

byelaws:

i. The new law will rule clearly about dosage of drug using. (Ranging from different

kinds of drugs) Arrested drug users will take urine drug test first. If the dosage of drug is in a

safe dose, the user will be given warning on record instead of one year or seven months jail time

as before.

ii. The arrested drug users who do not have any records related to drug use before, will

not be convicted at the first offense, but will be given warning on their records.

iii. The most important problems are in high schools. So, the drug using will be

completely banned in high school. To accomplish this goal, government of Tunisia will add more

school policies in each high school. The dealers in front of school will be arrested for at least

seven months in jail without further discussion.

iv. For the citizens in the Republic of Tunisia, drug production can only be for medical

purposes. The total amount of production must be reported to local offices. The offices will give

producer permission to demonstrate that the production is eligible.

v. All exporting, importing or smuggling of drugs will be banned in Republic of Tunisia.

2. In order to improve the problem in on students about drug using, the Republic of Tunisia

advises WHO to establish a periodic urine drug test for high school students. For every month,

each school will ask student to report their testing results. For students who are tested as drug

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using, they will receive warning from school district. After that, they have to take the lessons

relate to dangers of drugs. The teaching of the dangers of drugs is much more important than

directly arresting. The purpose of WHO is to let people know the harm of drug using in order to

eliminate the phenomenon from its root. Furthermore, because the periodic urine drug test will

be taken in high school, the cost of the test will be directly charged on government.

3. The last proposed solution for WHO to solve the problem of drug using is to propagandize the

dangers of consuming drugs. Some students may know about it, some may not. So, it is

necessary to make everyone know the harm of drug; give them the conception of drug.WHO can

hold public lecture in different countries, especially for developing countries.

Response to Questions to Consider

1. The problems of drug using are in different levels and different situations based on the

geography of each country. As countries in North Africa like the Republic of Tunisia or like

Colombia, the tropical type climate gives these countries opportunities to produce drugs. Some

of the productions are used for medicines; however, majority of them are used for selling,

exporting or economic purpose. People in these countries or around the global may know the

negative or dangerous effects of consuming drugs. But they cannot eliminate the phenomenon

completely. When the benefits are worth to even risking life, people will not think the misused

drug as a dangerous behaviour. Moreover, for some new drug users, they will be attracted by the

cheap price. Drugs can make people easy to addicting. The influences on psychology will make

people get deeper into drug. At that time, although they want to stop it, it will be hard to control

themselves.

2. As the recent legalization of marijuana exists in U.S. and some European countries, the health

problem has increased as a result. For example, Colorado in U.S. became the legalization state of

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marijuana. Following the amendments passage, Colorado had just six months to create a legal

and regulatory framework for the growing, sale and distribution of recreational cannabis. At that

time, medical marijuana, which was recognized by the state in 2000, remained largely

unregulated, lacking rules governing dosage, purity, growing practices, etc. (Haun) When people

notice that it is legal to smoke weed, they will consume more than they did before. The

transporting of marijuana between states also increases. The most important issue is concerned to

high school students. The dealer of weed will be more active around high schools than before. If

young people start consuming marijuana from high school age, that will be resulted as serious

health problem such as heart attack or even AIDS. Moreover, the death rate of drug using will

increase over time.

3. The reconciliation of traditional used drug and recreational drug use can be accomplished

through limit the amount of drug producing. If people just produce the amount of drug which is

enough for medical purpose use, there will not be left for people who use it as illegal. Also,

government can hand out permission on drugs. If people want to produce drugs for medical

using, they have to limit the amount of production.

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Work Cited

Afrique, Jeune. "Cannabis: Why It Is Urgent to Reform the "law 52" in Tunisia." Marijuana

News. 420 Intel, 04 Feb. 2016. Web. 21 Feb. 2016.

<http://420intel.com/articles/2016/02/04/cannabis-why-it-urgent-reform-law-52-tunisia>.

Aiba, Ines Bel. "Rights Group: Tough Laws Wrong Response to Tunisia's Drugs Problem."

Middle East Eye. Middle East Eye, 7 May 2014. Web. 19 Feb. 2016.

<http://www.middleeasteye.net/news/rights-group-tough-laws-wrong-response-tunisias-

drugs-problem-102744812>.

"Convention on Psychotropic Substance 1971." United Nations Office on Drugs and Crime.

United Nations Office on Drugs and Crime, 2016. Web. 16 Feb. 2016.

<https://www.unodc.org/unodc/en/treaties/psychotropics.html>.

"Effects of Drug Abuse and Addiction." Gateway Foundation. Gateway Alcohol and Drug

Treatment, n.d. Web. 17 Feb. 2016. <http://recovergateway.org/substance-abuse-

resources/drug-addiction-effects/>.

Guellali, Anna. "In the Joint for a Joint: Tunisia's Repressive Drugs Law." Human Rights Watch.

Think Africa Press, 30 May 2014. Web. 19 Feb. 2016.

<https://www.hrw.org/news/2014/05/30/joint-joint-tunisias-repressive-drugs-law>.

Haun, Marjorie. "The Unexpected Side Effects of Legalizing Weed." Newsweek. The Daily

Signal, 6 June 2015. Web. 17 Feb. 2016. <http://www.newsweek.com/unexpected-side-

effects-legalizing-weed-339931>.

Single Convention on Narcotic Drugs 1961 United Nations Office on Drugs and Crime. United

Nations Office on Drugs and Crime, n.d. Web. 16 Feb. 2016.

<https://www.unodc.org/unodc/en/treaties/single-convention.html>.

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"Tunisia: Widespread Abuses Under Drug Law." Human Rights Watch. Human Rights Watch,

02 Feb. 2016. Web. 19 Feb. 2016. <https://www.hrw.org/news/2016/02/02/tunisia-

widespread-abuses-under-drug-law>.

Zebais, Henan. "Tunisia Sees Sharp Rise in Drug Use Following Revolution - Al-Monitor: The

Pulse of the Middle East." Al-Monitor. Al-Monitor, 03 Feb. 2013. Web. 19 Feb. 2016.

<http://www.al-monitor.com/pulse/culture/2013/02/drug-use-increase-tunisia.html>.

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The Republic of Tunisia

WHO

The Double Burden of Disease

BMUN Position Paper

Countrys Position on Topic

In Tunisia, the prevalence of non-communicable diseases has been on the rise since 1990;

for example, ischemic heart disease, stroke, diabetes, lung cancer, and chronic kidney cancer

have all become imminent leading causes of death. In 2014, NCDs accounted for 82% of deaths

in Tunisia (Somai). Since NCDs typically require extended periods of healthcare treatment, it

exacerbates the situation, into what can be described as a national health emergency.

As a result, the Republic of Tunisia has begun to direct its efforts on mitigating this

pressing matter. Article 38 of Tunisias Constitution dictates that health is a human right,

whereby the state has guaranteed free healthcare for the poor. Through a European Union-funded

project, Policy Dialogue on Health Policies, Strategies and Plans, a consultative process

informing citizens of medium- and long-term reform orientations to decrease health inequities,

and to better respond to expectations of the population and the changed demographic and

epidemiological environment (Tunisia). Several UN organizations, including UNICEF, UNDP,

FAO, UNAIDS, UN Women, UNOPS, WFP, OHCHR, UNHCR, and WB, are present in Tunisia

to help deal with this issue. The United Nations Development Action Framework 2015-2019

installed in 2014 utilizes three strategic methods: 1. democratic governance; 2. a sustainable

economic model; 3. equal social protection and access to social services for all people. By using

a combination of these three strategic approaches, the UNDAF has five strategic priorities, the

first two of which target communicable diseases and non-communicable diseases. Regarding

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communicable diseases, Tunisia and WHO plan to enact monitoring of multisectoral action for

controlling vector-borne diseases and a vaccine action plan with emphasis on reaching out to the

unvaccinated to potentially eliminate several CDs. In terms of addressing non-communicable

diseases, nutritional standards will be set and intervention measures to prevent disorders for

substance abuse will be enacted as well. (Tunisia)

Furthermore, as a member of the African Union, Tunisia attended the World Health

Organization (WHO) and African Union Commission (AUC) Joint Meeting for African

Ministers of Health Luanda, Angola. The WHO Regional Director for Africa, Dr. Luis Sambo,

asserted that it was necessary that expert knowledge and solutions were imperative, should

Africa wish to mitigate the effect of the double burden of disease. Additionally, Ambassador

Olwale Maiyegun, Director of Social Affairs of the African Union, expressed the viewpoint of

AU member states in his statement that the AUC considers disease, not only as a health matter,

but as a human development issue. (Africas Health Challenges). According to Stefano Lazari,

the Tunisian representative to WHO, Tunisia has the best health indicators across the board of

all the countries in North Africa [due to] a large number of qualified specialists, strong public

and private hospitals, good equipment and a high level of service (Chipman). Moreover, at least

90% of Tunisian citizens have access to basic levels of health care, to preserve the overall

national health, and improved medical education, to produce a stabler health system.

However, one central concern that Tunisia faces is the economic, and consequently,

health care-related inequities within its population and regional areas. Tunisians in wealthier

areas have access to far superior medical services and equipment, while those in poorer areas are

left with low-quality resources (Chipman).

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Since Africa was previously primarily plagued with infectious diseases, its health care

programs are centered around short-term aid, but not focused on the numbers of chronic diseases

that are creeping up rapidly. To exacerbate the situation, the elongated longevity of its

population, in comparison with prior decades, is placing an immense strain on its already limited

resources and financial capabilities.

Donor funding is one of the main branches of support for healthcare in most African

governments. However, this can be potentially unreliable for multiple reasons:

First, donor funding tends to be short-term, and relies on financing from foreign

governments, multilateral or non-government organisations, all of which are suffering

from continued global economic instability. Second, donor funding has traditionally been

focused on single ailments or conditions, rather than on the multi-condition,

comprehensive healthcare system that Africa will require in the future. (Chipman).

Proposed Solution

As unequal distribution of wealth is an idiosyncratic factor of Tunisias economy, the

disparity in the quality of medical services and healthcare access between the rich and the poor

should be addressed by sending a team of medical-affiliated government officials regularly to

these less fortunate areas, in order to thoroughly monitor the condition and effectiveness of the

medical facilities located there. In addition, it is their responsibility to contact the necessary

personnel or attain the resources crucial to rectifying any conditions that are insufficient or

ineffective in these areas. Direct medical relief, if applied to its full extent, will effectively

mitigate the adverse effects of the double burden of disease.

To specifically target non-communicable diseases, the Republic of Tunisia believes that it

is essential to focus a greater proportion of reform efforts on the younger generation because the

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chronic conditions, known as NCDs, generally culminate from the effects of ones habits as an

adolescent. One solution would be to install a more persistent educational campaign, one that is

integrated into the school education system and entails exactly what constitutes a healthy diet

and a proper exercise regime. Admittedly, these messages likely will not have drastic effects on

the health of children, but they are intended to give them a more salutary perspective of how to

live their daily lives. To actually facilitate the reduction of NCDs in the developing generation,

teaching and advocating in schools is not enough; through all other forms of media, the

government should promote the concept of eating healthy and exercising, while portraying

unhealthful habits and foods in a far more detrimental way.

Focusing still on targeting NCDs, the government should set certain nutritional standards

that must be met by consumer food products and restaurants; otherwise, the government will

have the jurisdiction to publicly condemn the aforementioned product. Additionally, it will

become necessary to raise prices not just on tobacco and alcohol, but also on the foods that fail to

meet government-instituted standards.

Furthermore, national healthcare seems to be more directed towards short-term relief,

providing solutions to ubiquitous communicable diseases, which have troubled Africa for

decades. The rise of NCDs must not be overlooked, however, as previously undeveloped or

underdeveloped areas grow more and more urbanized. It is time that healthcare be geared

towards more long-term diseases. If the trained medical officials and personnel within Tunisia

are not adequately prepared to meet the needs of the people, NGOs and other medical institutions

can be brought in to expand their education, thereby enhancing the health care abilities of these

developing areas.

Response to Questions to Consider

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1. Located in northern Africa near the equator, Tunisias warm, humid weather makes it far more

conducive for mosquitos and other bacteria and viruses to survive than less tropical countries.

Communicable diseases for which mosquitoes are responsible in Tunisia include yellow fever,

dengue fever, cholera, and West Nile Virus ("Geography Influences Economic Growth"). This,

combined with the severe inequity in the distribution of economic resources in Tunisia, expedites

the spread of communicable diseases. In addition, if a region is mostly desert, the lack of rainfall

results in lowered crop output, which may increase the ubiquity of non-communicable diseases,

such as obesity and heart disease, due to the restricted availability of natural produce.

2. For a developing country, insufficient economic funds and health resources may pose a

problematic obstacle in tackling the issue of double burden of disease. Currently, many low-

income countries have been highly dependent on community volunteers and external funding,

with only two bilateral donors (MDGs to SDGs). Delegates to the First Global Ministerial

Conference on Healthy Lifestyles and Noncommunicable Disease Control in 2011 recognized

that NCDs cause 60 percent of global deaths, 80 per cent of which occur in developing

countries (Declaration on NCDs). As many victims of NCDs begin to develop health

implications at a tender age, education for schoolchildren and young families is critical in order

to set them on a proper path for healthful success. Installing educational programs is not a cost-

heavy burden, therefore making it a feasible option for developing countries. While these

educational campaigns can help to drastically ameliorate the health decisions that youth are

making, consequently affecting their potentials for NCDs, said campaigns can also help to

diminish the immense numbers affected by CDs by offering methods of protection against

environmental deterrents. For example, reiterating the importance of mosquito netting can help

reduce the number of cases of malaria and other mosquito-induced diseases.

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3. In relation to well-developed countries, the responsibility of making healthful food decisions

and maintaining appropriate exercise levels falls mainly upon the individual. Since these

resources are more readily available in developed countries, the individual is within full power to

decide if he should make use of them; whereas in underdeveloped and developing nations, these

resources are scarce and unattainable for vast portions of the population. Without a better

alternative, residents of these poorer countries are confined to a lifestyle that will presumably

lead to long and short term health burdens. As a result, it falls upon the national government or

health institutions to acquire the necessary resources to alleviate the predicament.

4. Although the exact effect of double burden of disease on refugee population is unknown, the

issue is prevalent amongst refugees. A 2010 study conducted in Algerian refugee camps found

that in women, 14.8% were stunted and 71.4% had central obesity, while in children, 29.1%

were stunted and 2.4% were overweight (Grijalva-Eternod). These statistics indicate that while

the immediate nutrition and health care relief provided to the refugees does save lives in the short

run, the content of the nutritional supply does not protect them from developing chronic diseases

related to malnourishment. As obesity and diabetes are on the rise in many developing areas,

including refugee camps, it is imperative to partition the efforts of relief groups to increase focus

on non-communicable diseases, which are not as emphasized in these developing areas.

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