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Exploiting the most vulnerable: Why the lack of transparency in drug treatment matters…


Authors: Alice Uhl, Elizabeth Saenz, Laleh Ashrafi, Melissa Rincon, QiHUi Gui, Sean Luke, Radolf Nortey

September 2021

Listen to the Audio Recording here.


Drug use is constantly rising around the world and around 36.3 million1 people have a drug use disorder (DUD). This disorder is a complex, chronic, and relapsing disease associated with significant health risks; and consequently, requiring drug treatment services.

In recent years, there have been a significant increase in reports highlighting the critical need for transparency within drug treatment facilities and amongst the various actors involved.

The lack of transparency can be described as a significant threat to global development, democracy, and human well-being. It undermines the national capacities of governments and leaves behind the most vulnerable of our society such as people with drug use disorders. People with drug use disorders face discrimination and stigma, characterizing them as a vulnerable population in our society and exposing them to the risks within the system.

Furthermore, the ongoing COVID-19 pandemic has exacerbated the risk of non-transparent processes in the health sector. The pandemic increased the health sector burden, which was already challenged by overcapacity in many countries. Thus, facilitating a lack of transparency in essential services such as drug treatment for people with SUD.

The health response to drug use disorders requires a multidisciplinary, comprehensive, and public health-oriented response from various institutions and organizations due to its complex interface. Hence, evidence-based drug treatment is a crucial management approach. This includes a wide range of pharmacological and psychosocial interventions with varying levels of intensity designed to meet the needs of the patients.

The drug treatment system translates into significant costs, and specialized services required at a specific level of frequency. Critical to the survival of this treatment system is the existence of transparency within service transactions or financial processes. The lack of transparency thereof hampers an individual’s access to treatment and correspondingly their basic right to health.

The emerging reports of a lack of transparency within drug treatment facilities presenting in various forms such as patients brokering, data manipulation, and privacy violations highlight the urgent call for action. Decision-making points which are liable to a lack of transparency, need to be investigated; and existing anti-corruption mechanisms need to be adapted to the specific needs of people with drug use disorders, most especially with a focus on their vulnerability.

Addressing the lack of transparency in drug treatment services will not only improve the health of people with drug use disorders in line with SDG 3.5 but will also promote further development goals such as SDG 10 “Reduced Inequalities”, SDG 16 “Peace, Justice and Strong Institutions”, and SDG 17 “Partnership for the goals”.

To explore the topic further, watch the recording of Dr. Elizabeth Saenz's Webinar here:

1 UNODC World Drug Report, 2021