Introduction: Drugs as a Development Issue?

The global drug control regime has not always recognized developmental approaches to be a relevant component within the pillars of the UN drug control system. It is only the UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988), the last of the three conventions that constitute the basis of the current control regime, which makes a reference to rural development measures to ‘increase the effectiveness of eradication efforts’ (UN 1988: §14, 3a). It unmistakably assigns development interventions a subordinate role towards repressive measures to deal with the issue of illicit drug crop cultivation. However, single UN member states have started at an earlier stage to understand the persisting supply of plant-based narcotic drugs as a consequence of development deficits among the traditional source countries of drugs such as cocaine, heroin and cannabis. Amidst a domestic opioid use crisis in the 1980s, the German government decided to strengthen its anti-narcotics efforts through development interventions in drug source countries. Starting with the Thai-German Highland Development Programme in 1981, German development cooperation has since then been one of the key proponents of a development-oriented approach to address the world drug problem, focusing on the issue of illicit drug crop cultivation. At the core of the paradigm of a development-oriented drug policy approach is the recognition that many drug-related problems are entrenched with development deficits and are not predominantly incentivised by the purpose of criminal gains. Therefore, according to the German approach of alternative development (BMZ 2013), illicit drug crop cultivation is considered to be driven by underlying root causes that should be properly understood, analysed and addressed with the means of socio-economic development. Phenomena such as illicit drug crop cultivation are considered a symptom of underlying deficits in development, but not as the problem as such. As fieldwork and research has shown (see e.g. Garzón and Gelvez 2018; GIZ 2014; Reuter 2010; Thoumi 2010; UNODC 2015; Mansfield 2016), illicit drug production is in many cases driven by poverty, lack of access to land and legal markets, poor infrastructure, insecurity and persisting armed conflict that is fed by illegal drug economies.

From Alternative Development to Sustainable Development?

While this understanding may appear to be almost commonsensical in 2018, the notion of drugs as a development issue is rather recent. It has not always been accepted by the governing institutions of international drug policy, such as the Commission of Narcotic Drugs (CND) and related organs, as can be seen in the late appearance of the term ‘rural development’ within the 1988 Convention. Until a few years back, only few governments included development-oriented approaches in their domestic or international drug control strategies, most of them from Southeast Asia (e.g. Thailand) and South America (e.g. Bolivia, Colombia and Peru). Based on the engagement of those governments, on many occasions seconded by Germany and other European governments, alternative development (AD) was established gradually as an element of UN drug supply control policies. The 1998 UNGASS Action Plan on International Cooperation on the Eradication of Illicit Drug Crops and on Alternative Development recognized AD as:

‘a process to prevent and eliminate the illicit cultivation of plants containing narcotics and psychotropic substances through specifically designed rural development measures in the context of sustained national growth and sustainable development efforts in countries taking action against drugs, recognizing the particular socio-economic characteristics of the target communities and groups, within the framework of a comprehensive and permanent solution to the problem of illicit drugs’ (UNGA 1998b).

The 1998 Special Session of the General Assembly included AD as one element to attain the then-defined goal of eliminating the totality of global drug crop production within ten years. While the forthcoming ten years passed by without getting overwhelmingly close to this objective, 1998 may still be considered the crucial moment for AD as a future wild card for development within the UN drug control system. Subsequently, AD maintained its role in UN drug control, persisting to be the only development-oriented approach inside the rather repressive set of agreed-upon instruments to tackle the global supply of illicit drugs. The 1998 Political Declaration (UNGA, 1998a) also enshrined the principles of shared responsibility and balanced approach as guiding principles of the UN drug control system, obliging the consumer countries of plant-based drugs to support the source countries – most of them developing countries – in their efforts to tackle the production of coca, opium poppy and cannabis. The universal recognition of a shared responsibility of producer and consumer countries, since then repeated innumerable times by Commission on Narcotic Drugs (CND) resolutions, is the continuing basis for an engagement of OECD-based donors and development agencies in supporting source and more recently also transit countries in their efforts to reduce the supply of illicit drugs. Thereby, the principle of shared responsibility turned out to be the life insurance for AD in the decades to come, with AD being established as a ‘soft version’ (Reuter 2010: 112) of supply control. It is only until recently that some of the countries affected by massive drug crop production have become increasingly independent from international funding and donor efforts in promoting AD, in some cases taking over a donor or advisory role in third countries, even beyond regional boundaries (Felbab-Brown 2017).

However, the approach of AD was both considered a very limited concept addressing exclusively the illicit cultivation of coca and opium poppy, and – therefore – a regionally very limited approach, with actual implementation only in Southeast Asia and South America. Hence, the concept was far from being universally endorsed, regularly questioned regarding its effectiveness and plagued by widespread misinterpretations of its possible impact. The concept of AD in international drug control has been evolving ever since, with several milestones between UNGASS 1998 and UNGASS 2016. While the Political Declaration and Plan of Action 2009 (…) to Counter the World Drug Problem (UN CND 2009) adopted the broader term of ‘development-oriented drug control’ to describe socio-economic interventions addressing a wide range of drug-related problems beyond the mere drug crops, this term could not sustainably replace the term AD – and by that narrow down the concept (UNODC 2015: 77–78).

It was not until the UNGASS 2016 that the door for development-oriented thinking in international drug policy was pushed wide open. Chapter VII of the UNGASS 2016 Outcome Document not only assigns a prominent role to AD but goes even further in seeking to broaden the scope of development towards urban drug markets and drug trafficking (UNGA 2016: 7h, j, k), formerly exclusive realms of law enforcement within drug supply control. The global endorsement of a broadened role of development within the widely perceived bellicose UN drug control system may have come as a surprise for observers, but has clearly been the consequence of a process initiated more than a decade before.

The German Approach of AD and Development-oriented Drug Policy

Germany, through the Federal Ministry of Economic Cooperation and Development (BMZ), is one of the few current and former CND members that has adopted a development pillar in its international drug policy at an early stage (Drug Commissioner of the Federal Government 2012), enshrined within the corresponding EU framework documents on drugs (Council of the European Union 2006, 2012, 2017). The current stance on AD of the BMZ (BMZ 2013) is the product of a long-standing engagement of German development cooperation that goes back to the early 1980s. The Federal Government realized the transnational character of global drug markets at a time when a heroin epidemic heavily hit Germany and other European countries (BMZ 2012).

BMZ started its cooperation with drug source countries earlier than the international recognition of the principle of shared responsibility. The first German government-funded AD project was the Thai-German Highland Development Programme. Lasting from 1981 to 1998, the joint project of the Thai and German governments has until today remained the longest-standing AD programme. Its objective was to promote the development of the northern opium poppy growing regions right at the core of the Golden Triangle. Today, the project is considered a far-reaching best-case study for the success and sustainability of AD and the added value of international cooperation in this field (BMZ 2012: 41).

The Thai-German Highland Development Programme was groundbreaking and turned out be seminal for the forthcoming approach of development-oriented drug policy within German development cooperation. Within this framework, the understanding of AD as an intervention seeking to address the root causes of illicit drug economies evolved, as opposed to a mere means of narrowly defined crop substitution.

Subsequently, in 1990 the BMZ for the first time commissioned the then GTZ GmbH with the implementation of a headquarter-based international drug policy programme, the so-called Action Programme Drug Control. The multilateral character of the drugs issue and the growing role of the UN in the definition of guiding norms on AD post-1988 led to the initiation of the Programme. It was mandated to internationally promote the approach of AD and related development-oriented interventions on both the supply and demand side within German development cooperation and on an international level. For almost three decades now, the BMZ has commissioned both headquarter-based and field operations in the area of development-oriented drug policies, implemented by the GIZ GmbH, NGOs and United Nations Office on Drugs and Crime (UNODC) field offices.

The current BMZ approach of AD and the National Strategy on Drug and Addiction Policy (Drug Commissioner of the Federal Government 2012) is based on the idea of addressing the frameworks leading to the establishment of illicit drug economies: poverty, weak statehood, ongoing armed conflict, lack of infrastructure, lack of technical capacity for legal agriculture and lack of access to productive means such as land. The fact that only very few drug crop producing countries provide almost the universal supply of illicit cocaine and heroin is the crucial argument for a development-oriented approach to address this problem. If only a handful of countries in the world almost monopolize the global production of opium poppy and coca bush, even though many more could do so, it is not criminal rent seeking but the deficits in development that should be addressed (Reuter 2010: 99–100). A common misconception regarding this approach is the highly profitable value chain of illegal drugs, which, thus the assumption, makes it impossible for legal AD production to compete. However, this argument does not properly apply to the farmers cultivating illegal drugs. Their market share of the profit generated from illegal drugs is marginal. The value of the raw material of coca leaf and opium poppy is low and represents only a negligible part of the retail price on major consumer markets in the Global North. Cocaine and heroin are in general derived from cheap agricultural products, where value is generated through the export of these refined substances under conditions of illegality. Small-scale farmers do not benefit from the exponentially growing value generated through the drug export, but they are taking the risk of cultivating drug crops under illegality (Brombacher & Maihold 2009: 18–20; Brombacher 2013: 270–274). The risk of drug crop eradication, exposure to criminal networks and non-state armed groups as well as criminalization by law enforcement agencies heavily diminishes the incentives of drug crop cultivation. Hence, the practice of AD shows that farmers usually display a strong self-interest in turning to alternative options of legal agricultural production. Such options are safer and financially comparable to coca leaf or opium poppy, allowing the farmers to distance themselves from public repression, highly unpredictable war economies and organized crime players. The medium- and long-term stability and reduced risk environment of a licit livelihood is preferred over short-term financial gains of a drug crop based income system. Even in the traditional and partly legally regulated coca growing areas in Bolivia, Peru and, on a very small scale in Colombia, very similar patterns emerge. The ‘dual use’ (Brombacher 2013: 274) character of growing coca and the under-regulation of the licit market for traditional uses exposes coca farmers in Bolivia and Peru to similar risks as in predominantly illegal drug markets (Thoumi 2003: 79–80; Brombacher 2013: 264–266).

Parallel to the growing awareness that the nexus of development and drugs is key to understand and tackle drug crop cultivation, the indicators of how to measure the impact of those interventions have evolved. The mixed results of AD projects can often be explained with a pattern of short-term oriented supply side indicators, i.e. prioritizing the reduction of highly visible illicit crops in the short-term over the difficult-to-attain data on human development on the mid- and long-term (see e.g. Garzón & Gelvez 2018; Lupu 2004; Reuter 2010: 113–115; Mansfield & Pain 2005; Mejía & Posada 2010; IEGDPM 2018). While the predominant impact measurement paradigm has been the amount of reduced hectares of drug crops, several development agencies and international experts have promoted the use of human development indicators in analyzing the results of AD interventions (TNI 2014: 66–67). Poverty is the crucial element in this changing paradigm of impact assessment, even though the relationship between poverty and the emergence of rural drug economies is complex and controversial (Thoumi 2003: 48–50). If poverty is recognized as a key driver of emerging or persisting drug economies, then poverty reduction should be the key indicator to measure the success of AD – and not the reduction of surface under drug crops. While this logic is widely accepted scientifically, it is politically less attractive than a clear case for short-term reductions in illicit crops. Therefore, the double-target problem (seeking the reduction of crops in the short-term, while promoting development on the long-term) is still dominant in international debates and impedes the operationalizability of AD (BMZ 2013: 8; Farthing & Kohl 2005).

On a domestic level, the respective BMZ terminology evolved in 2008 from the term development-oriented drug control to development-oriented drug policy. This change recognized the non-control character of promoting rural development in drug crop cultivating areas and prioritized the framework conditions as key targets of such interventions instead of the illicit crops as such (BMZ 2012: 43–46). The very term AD may therefore be misleading, since it connotes a rather substitution-oriented strategy in dealing with illicit drug crops. While the BMZ today also operates with the term ‘rural development in drug crop producing regions’ to describe its efforts in this field (BMZ 2013), others use the term ‘promotion of sustainable/licit livelihoods’ (UNODC 2015: 80–81; Mansfield 2017: 9). However, due to the universal inter-governmental acceptance of the term AD and despite persisting expert criticism (see e.g. Mansfield & Pain 2005; Buxton 2015), it has survived any intents for replacement at the UN level. At the same time, the alternative livelihood approach is often used in a similar way to the concept of AD. Both terms coexist without a clear-cut distinction between them, being a ‘concept in flux’ (UNODC 2015: 81).

Playing the Development Wild Card: From the 2009 Plan of Action towards UNGASS 2016

The logical development of a truly development-led approach to address illicit drug economies in rural settings – with a set of development-based impact indicators – has not been an unidirectional process. Even the recognition of the proper sequencing principle, universally accepted through the 2009 UN Plan of Action (§47f), cannot be interpreted as a general acceptance of a prioritization of development over eradication in dealing with illicit drug crops, since the repressive element of eradication is terminologically only postponed by the very term of proper sequencing. Additionally, this principle has never again found universal recognition in any other of the forthcoming UN framework documents on drugs, with the notable exception of the UN Guiding Principles on Alternative Development 2013 (UNGA 2013: §A9), even though based on very controversial negotiations on this issue. The 2014 Joint Ministerial Statement1 and the 2016 UNGASS Outcome Document do not include the literal reference to the term ‘proper sequencing’, a clear setback in terms of UN language.

While BMZ has been a key proponent of this principle and a development-oriented approach within the UN drug control system, only the alliance of several champions from governments, the UNODC and civil society has made it possible to emancipate a holistic development approach from a rather phenomenologically superficial and symptom-oriented global drug control system. Due to the well-known difficulties of consensus-based decision making in the creation of unanimously accepted principles at the UN level, BMZ opted early for the promotion of networks of like-minded actors in further defining and promoting the concept of AD. The international 2002 Feldafing Conference, hosted by BMZ and several partners from civil society and the UN, was a milestone at that point. The Feldafing Declaration built the basis for the 2002 CND-Resolution 45/14, calling ‘upon Member States to exploit more fully the potential of alternative development as an appropriate means of drug control, as well as sustainable human development’. The strength of the strategy to convene interested parties outside the formal UN system, afterwards successfully replicated in the Thailand- and Peru-led ICAD-initiative (International Conference on Alternative Development 2011 and 2012) that drafted the UN Guiding Principles on Alternative Development 2013, lies in the linkage of implementation-based experiences and their ex post translation into UN normative. Germany, through BMZ and its implementing agencies, has used its decades-long experience of implementing AD projects in countries as diverse as Thailand, Myanmar, Laos, Afghanistan, Bolivia, Peru and Colombia as basis for feeding those experiences back to the international level and into the drafting processes at the UN level.

The club character in promoting AD globally was maintained through the ICAD II in 2015, hosted by the Government of Thailand, seeking to foster the implementation of the UN Guiding Principles (GPDPD 2015; ICAD 2 2015). The spirit of ICAD has been taken up by the Thai Mae Fah Luang Foundation – a widely acclaimed royal Thai foundation with decades of experience in implementing AD projects within Thailand and other countries in Asia. Furthermore, the UNODC secretariat and BMZ established a series of Expert Group Meetings, which have meaningfully contributed to the broadening of the scope of development within the UN drug control system. Through a continuous expert dialogue, the negotiations for the UNGASS 2016 Chapter VII were seconded and the respective negotiations accompanied (UN CND 2016). Civil society played a crucial role in this process, since relevant NGOs such as the Transnational Institute (TNI) and Washington Office on Latin America (WOLA) thrive to bring in the perspective of affected communities in drug crop producing areas into the international debate that is frequently government-centric.

Not surprisingly, the process of widening the leeway for development within international drug control was favored by the increasing disenchantment of some UN Member States, civil society and academia with the high societal and political costs of a merely repressive approach in dealing with their domestic drug policies (Collins 2014: 9). While some have opted for blaming the UN conventions for the unintended consequences of drug control, others have started to seek alternative drug policy options within the UN drug control framework, i.e. adopting certain elements of the AD approach and translating them into their domestic drug policies. While for decades, only a few UN Member States had engaged in the international debates on AD, recently more and more governments have taken over a development-oriented stance (UN CND 2014). AD appeared to be almost universally accepted in the framework of the UNGASS 2016 preparation process.2 A whole range of non-traditional drug-crop producing and also transit countries from South and East Asia, Northern and Western Africa and Latin America started to include AD and other elements of a development-oriented drug policy in their respective domestic or regional drug policy framework documents. Thereby, these countries have contributed to a moment of unprecedented recognition of socio-economic factors and interventions to address the world drug problem. The annual reporting scheme to the UNODC also reflects the grown-up role of AD as an increasingly diversified element within global efforts of drugs supply control (UNODC 2015: 88–90). The formerly predominant approach of AD as a drug-crop substitution scheme has evolved into a plethora of highly diverse national approaches, stretching the once universally accepted AD definition from 1998 very far. AD may today combine rural development elements with regulatory mechanisms, the geographical or ethical acceptance of traditional growing and use of plant-based drugs, private business development or counterinsurgency measures (see e.g. Felbab-Brown 2010; Lupu 2004; Farthing & Kohl 2010; TNI 2010; Brombacher 2013; Windle 2015; Blickman 2017). The most remarkable observation within the UNGASS process is that not only some of the non-traditional proponent countries of AD reported cannabis or opium poppy cultivation on their territories, but that also non-growing countries called for AD and announced AD to be implemented in their respective countries or regions. Considering the very much rural character of traditional AD, many observers wondered how to interpret this renewed interest in the concept by non-traditional source countries for plant-based narcotic drugs.

UNGASS 2016 shed some light on this potential contradictory evolvement: as manifested through the national and regional contributions to the UNGASS Outcome Document (see section 3), a growing number of UN Member States have moved towards the recognition of their domestic drug problems as a direct result of underlying development deficits. This resulted in an expansion of the scope of development responses to drug issues beyond rural drug crop cultivating areas, calling for socio-economic interventions to deal with urban drug markets and drug trafficking (UN 2016: VII §h, j, k), once the exclusive economic zone of law enforcement.

Even though for many practitioners and experts this terminological widening has turned out to be a conceptual headache, it is fair to say that the monopoly of AD as the sole developmental response within UN drug supply control policy has been broken, opening leeway for a more coherent development-oriented drug policy for implementing agencies, the UNODC and affected countries. This new narrative can hardly be overrated. If some critics consider the UNGASS Outcome Document to be not innovative enough in its provisions – in the field of development a major yet silent revolution has taken place through the unequivocal broadening of the scope of development within UN drug control, feeding directly into the much-needed approximation of the UN drug control system and the Sustainable Development Goals (SDGs).

A Driver of Sustainability: The Link Between SDGs and AD

Global drug control policies are interrelated with developmental issues in many ways, and therefore have an impact on the achievement of global sustainable development objectives (UNODC 2016a). However, some observers have found drug control polices to be inconsistent or even contradictory to the global development agenda, especially in the field of illicit drug crop cultivation and production (Health Poverty Action 2015; Buxton 2015; IEGDPM 2018). By taking a closer look at the policy linkages, much speaks in favor of locating AD into wider development roadmaps.

UN Member States adopted the SDGs on 25 September 2015 with a term of 15 years. The ‘2030 Agenda for Sustainable Development’3 contains 17 goals and 169 targets that are universal in its coverage and are based on the pillars of social and economic development as well as environmental stability. Peace and security are recognized as essential elements for securing sustainable development (UNGA 2015). A fundamental pillar of the AD strategy is to address the root causes of the emergence and persistence of illicit drug economies in marginalized rural regions, which is complementary contributing to the achievement of the SDGs (UNODC 2016b). Only if social development measures are successful, communities can reduce illicit drug crop cultivation on the long-term and build sustainable economic alternatives. The linkages to the SDG system are obvious: The key element of AD targets SDG 1: ‘End poverty in all its forms everywhere’. Food security and licit livelihood opportunities are accomplished by the principles of non-conditionality (BMZ 2012: 29–31) and the rejection of eradication before alternative sources of income are established – proper sequencing, as endorsed by the UN Plan of Action 2009 (§47f) and the UN Guiding Principles 2013 (§A9). Household food security is today a top priority in AD programming and is a key element contributing to SDG 2: ‘End hunger, achieve food security and improved nutrition and promote sustainable agriculture’. Also, SDG 5, ‘Achieve gender equality and empower women and girls’, is considered by contemporary AD strategies due to the high level of gender-sensitivity of the global drug problem (UNODC 2015: 13–18; UNODC 2016a: 66–68).

Yet the links between global drug policies and the SDGs may be taken even further. It is only until recently that the negative effects of (rural) drug economies on the environment and climate have come to international attention. Illegal drug crop cultivation is one of the main drivers of deforestation in several major illicit drug crop growing regions, a nexus that has been ignored for very long (UNODC 2016a: 86–94). Replacing monoculture coca cultivation through sustainable agroforestry models strengthens the biosphere, protects against soil erosion and desertification (GIZ 2014; GPDPD 2017) and adds to the indicators of SDG 13, ‘Climate Action’, and SDG 15, ‘Life on Land’. AD is a crucial element to tackle the nexus of drugs and development, which is highly interrelated with the relationship of drugs and conflict. SDG 16, on ‘Peace, Justice and Strong Institutions’, acknowledges that peace and stability are necessary conditions for an inclusive and sustainable development (IEGDPM 2018: 13–15). Communities that pursue a drugs-based livelihood system are often located in rural conflict zones and experience fragility, violence as well as the presence of armed groups and organized crime. AD aims to build trust between state institutions and local communities by integrating them in broader rural development strategies, including through the improvement of social services like health and education. Colombia is a current example of a peace process interlinked with the illegal drug economy. In order to achieve a long-lasting and stable peace, the agreement between the government and former FARC guerrilla includes the formalization of land rights and a large scale substitution programme for illegal crops to end decades of internal armed conflict that was partially financed by coca cultivation and cocaine trafficking (OACP 2016: 104–123).

The above-listed direct contributions to the SDGs are a sample of the main targets that can be addressed through a development-oriented drug policy approach. It reveals the potential of innovative drug policy: By measuring the impact of drug control through SDG indicators and not through a mere symptom assessment like hectares of drug crops, its impact on vulnerable populations, human rights, development as well as conflict and peace can be analysed. Global drug policy has the potential to have a mutually reinforcing impact on the SDG framework. For example, the interconnection of AD and the SDGs in the fight against poverty, rural development, environmental sustainability, food security and climate change addresses at the same time the goals of sustainable development and the root causes for illicit drug crop cultivation (UNODC 2015; Alimi 2016a; Alimi 2016b; IEGDPM 2018).

Despite the potential of development-oriented drug policies in contributing to the 2030 Agenda for Sustainable Development and the SDGs, a gap between the high expectations and the actual funding situation for AD is visible. From 1998 to 2013, only 0.2 percent of Official Development Assistance was spent on AD programmes (UNODC 2015: 83–85; Alimi 2016a: 4). The currently quite broad political support for AD at the international level does not reveal itself in a properly funded implementation agenda. Rather, AD can still be considered as a niche of policy intervention. However, recent funding trends seem to move towards broader AD portfolios with long-term AD interventions and diversification of the financial burden. A small number of donor countries and organizations – such as the European Union (EU) – stands out and revitalizes the support by mainstreaming AD into a broader development framework. Given the complementary link between AD and the achievement of the SDGs, embedding the AD approach into the 2030 Sustainable Development Agenda reveals potential for innovative funding mechanisms by ‘taking the risk of sustainability’ (Alimi 2016a: 22).


UNGASS 2016 was the preliminary result of an impressive conceptual evolvement and political emancipation of the role of development within the international drug control system and its consensually approved guiding norms. In the post-UNGASS world, development-oriented drug policies – or drugs-oriented development policies – have acquired a role that is more relevant in scope and recognition than at any other stage of the history of international drug control since the Shanghai Opium Protocol. The UNGASS 2016 Outcome Document exhibits the evolution of drug control towards the emancipation of development as an independent element of the guiding norms addressing the world drug problem, emerging from an assistant role in drug crop eradication efforts towards a narrative that covers the whole supply side spectrum.

Nevertheless, the enhanced leeway to integrate development-oriented responses is rather poorly defined in conceptual terms, currently creating more confusion than guidance. How should effective development interventions in urban drug markets be designed? How could development interventions possibly take place in highly violent drug markets? What should be the target group of development interventions in drug trafficking situations? And how should the contributions of the plethora of potential AD and related interventions to the SDG indicators be credibly measured without losing sight of drug control targets? These are just some of the critical questions currently at stake, to be considered by the international drug policy and development community. The UNGASS Outcome Document does not give any conclusive answers to these pressing issues. At the same time, and beyond these conceptual concerns, the funding situation for AD remains to be worrisome. The gradual but steady enhancement of the development issue within the UN drug control system between the 1988 Convention and UNGASS has created expectations that cannot be fulfilled with the amount of funds invested for AD and related interventions.

The resilient orientation of the global public on short-term reduction in drug crops, seizures and other easy-to-grasp indicators remains a major challenge for an increased funding and piloting of innovative approaches on the ground that seek change in the mid- and long-term. Nonetheless, this challenge is not new. It has existed since the very first AD projects decades ago and not been a decisive obstacle in making development a universally accepted element in global drug control – against great odds.