International Journal of Drug Policy 23 (2012) 488–494 Contents lists available at SciVerse ScienceDirect International Journal of Drug Policy journa l h o me pa ge: www.elsevier.com/locate/drugpo Policy analysis Supply-side harm reduction strategies: Bolivia’s experiment with social control  Linda Farthing a , Benjamin Kohl b,* a c/o Buckley, 1137 S. 8th St., Philadelphia, PA, USA b Geography and Urban Studies, Temple University, Philadephia, PA 19122, USA a r t i c l e i n f o Article history: Received 12 March 2012 Received in revised form 8 June 2012 Accepted 11 June 2012 Keywords: Coca Drug policy War on drugs Harm reduction Social control Bolivia a b s t r a c t Harm reduction approaches to drug control have almost exclusively focussed on consumers in northern countries. This article supports recent analysis that indicates that such policies also hold relevance for producer countries by drawing on recent policy innovations in Bolivia. When Evo Morales, the president of the national coca grower confederation, was elected the country’s first indigenous president in 2005, he promised to fundamentally change 25 years of the U.S.-funded “drug war” that had generated repeated human rights violations. The new policy, which implicitly incorporates harm reduction principles com- bined with respect for human rights, recognizes coca leaf’s traditional use and cultural importance and relies on vigorous local organizations to implement a community-based programme called social con- trol. Results to date indicate that Bolivia’s social control experience has reduced violence in coca growing communities, ensured small farmers a subsistence income from coca and increased sovereignty, while making a modest contribution to containing expansion of coca cultivation. The programme has regis- tered 50,000 farmers who are allowed to cultivate limited quantities of coca to supply traditional users and helped them gain secure title to their land. This registration is combined with satellite surveillance to guarantee that farmers do not exceed limits established by law. To date, the programme’s reach is incomplete and coca is still diverted to the drug trade. Nonetheless, the approach may offer lessons for other drug producer countries, particularly where strong socio-political organizations are found in combination with closeknit communities holding shared cultural values. © 2012 Elsevier B.V. All rights reserved. Over the past 20 years, diminishing the social and economic problems associated with the consumption of illegal drugs through harm reduction has become an accepted part of drug policy dis- course in international as well as national programmes, particularly in Europe, although defining the exact parameters of the concept has been complicated (Ball, 2007, pp. 684–685; Cook, Bridge, & Stimson, 2010, p. 43; EMCDDA, 2010; Greenfield & Paoli, 2012; Lenton & Single, 1998; Marlatt & Witkiewitz, 2010). In general terms, harm reduction’s evidence-based and pragmatic orientation shifts the conceptual focus of drug policy away from criminalization and measuring quantities of drugs confiscated and the numbers of people arrested to a comprehensive perspective on the impacts of drug-related activities and policies on societies as a whole. It places the harms from drug use and drug control policies within a wider context that considers a broad range of social, cultural, and  Some material for this paper comes from interviews conducted as part of the 2009 production of “Cocaine Unwrapped” for Dartmouth Films. The authors thank Kathryn Ledebur of the Andean Information Network, Carol Conzelman, Univer- sity of Colorado, and Diego Giocaman for their assistance. B. Kohl thanks Temple University for research support. * Corresponding author. Tel.: +1 215 554 2557. E-mail address: bkohl@temple.edu (B. Kohl). URL: http://www.temple.edu/gus/kohl/index.htm (B. Kohl). economic factors that includes a more complete conception of the social and geographic distribution of harm. A recurring challenge facing the harm reduction approach has been the choice of measurement indicators. The fundamental nor- mative nature of approximating drug- and drug policy-related harms and benefits, and how these are balanced in policy decisions, makes it unlikely that agreement on these issues will be reached any time soon. As harms and benefits vary across societies, com- paring them either quantitatively or qualitatively faces problems of incommensurability, causality, and subjectivity that result from inherently political rather than empirical issues (Greenfield & Paoli, 2012; Weatherburn, 2009). The general emphasis on scientific results-driven evidence has tended to obscure harm reduction’s normative, value-driven underpinnings, which Fry, Treloar, and Maher (2005) argue undercuts its capacity to successfully engage its critics. Recently discussion has surfaced proposing uncoupling harm reduction principles from related concrete programmes—such as needle exchange and HIV testing for users—in order to apply the approach to the supply-side of drug policy (Greenfield & Paoli, 2012; Jelsma, 2012), although Barrett (2012, p. 18) cautions against broadening the focus so wide that it dilutes harm reduction’s prior- itization of human-rights. With this caveat, we characterize harm reduction, adapting Harm Reduction Coalition’s definition (nd), as 0955-3959/$ – see front matter © 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.drugpo.2012.06.004