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Three Decades of Drug Policy Reform Work

Over the past three decades, the Open Society Foundations have been the largest philanthropic supporter of efforts to reform drug policy and promote harm reduction around the world, investing more than $300 million. George Soros, the Foundations’ founder and chair, recognized early on that a just approach to drugs was critical to building an open society. Together with grantees and partners, the Foundations have supported front-line work to promote an alternative approach to drug policy—one focusing on access to health care and social support, rather than on punishment and prohibition.


1994: Building the Foundations of Drug Policy Reform

George Soros and Ethan Nadelmann started the Lindesmith Center to conduct research related to drug policy reform and harm reduction. The center merged with the Drug Policy Foundation to become the Drug Policy Alliance in 2000, the largest organization in the world working to end the war on drugs. An early success: California’s “Prop 36,” which established a landmark treatment-instead-of-incarceration program and doubled the amount of state funds available for drug treatment.

George Soros, Ethan Nadelmann, and Tony Papa
George Soros, Ethan Nadelmann, and Tony Papa attend an art auction for the Drug Policy Alliance in New York City. © David X. Prutting/Patrick McMullan/Getty


1995: Preventing HIV Among People Who Inject Drugs

Open Society, through its newly established International Harm Reduction Development program, supported the establishment of the first efforts to distribute sterile needles and syringes to people who inject drugs, working in countries facing spiking cases of HIV related to injection drug use—including Albania, Russia, and Ukraine, among others.

Two women lean in close to a plexiglass window where needles are displayed
A woman visits a bus that provides HIV testing, a needle exchange, and prevention information in Saint Petersburg, Russia. © Samuel Bollendorff/Agence VU/Redux


1996: Supporting the Legalization of Marijuana for Medical Use in the U.S.

George Soros personally funded advocacy efforts to legalize medical marijuana in California. The effort was successful. Two years later, Oregon, Alaska, and Washington followed suit.

People holding flags and signs in front of the Health and Human Services Department
A man holds a flag that reads “Cannabis is Medicine” during a rally calling for the legalization of medical marijuana in Washington, D.C. © Mark Wilson/Getty


1998: Establishing U.S. Field Office

Open Society opened its first U.S. field office in Baltimore, investing more than $20 million to establish harm reduction services in Maryland. These efforts increased community access to naloxone, enhanced legislative protections, introduced medically assisted treatment, and built political acceptance for overdose prevention sites.

A man holding up a Naloxone dispenser
A health educator shows a man how to administer Naloxone, an antidote for heroin and opiate overdoses, in a Baltimore City Health Department needle exchange van in Baltimore, Maryland. © Jabin Botsford/Washington Post/Getty


2002: Securing International Funding for Harm Reduction

Open Society and its grantees urged the newly established Global Fund to Fight AIDS, Tuberculosis, and Malaria to invest in needle and syringe distribution programs and methadone prescription. The Global Fund would go on to contribute over $800 million to harm reduction efforts worldwide.

A woman sitting in the front seat of a blue car with a bucket for used needles hanging from the door
A nurse runs a needle exchange from her car as part of an HIV-prevention campaign in Tallinn, Estonia. © Raigo Pajula/AFP/Getty


2003: Reforming Drug Laws in Russia

Open Society and its grantees pressed for reform of Russian law, ending imprisonment for possession of tiny amounts of drugs and securing release or reduced sentences for 40,000 people incarcerated for drug offenses.

A man offers supplies to another from a bag in a parking lot
An outreach worker and a law student offer medical support and information to people who use drugs on the outskirts of Moscow, Russia. © Guy Martin/Panos for the Open Society Foundations


2005: Expanding Access to Treatment

Open Society and its partners successfully advocated for the World Health Organization (WHO) to add two medications used to treat opioid use disorder—methadone and buprenorphine—to the list of essential medicines and include people who use drugs in the agency’s guidelines on antiretroviral treatment for HIV. This helped spur treatment innovations in China, Ukraine, Malaysia, and Vietnam, among other countries.

A woman in a blue medical coat stands with a woman in a small office
A client receives Methadone at clinic that offers buprenorphine and methadone in Mexico City, Mexico. © Janet Jarman for the Open Society Foundations


2006: Building International Solidarity

Open Society helped fund the first International Drug Users Congress in Canada. Participants issued the Vancouver Declaration, which called for universal access to harm reduction, evidence-based and voluntary treatment, and the end of incarceration and discrimination against people who use drugs.

Several adults gather in a living room with a nurse
A nurse provides medicine, food, and psychological support to a family living with tuberculosis, HIV, and hepatitis as part of a harm reduction program in Kiev, Ukraine. © Jean-Luc Luyssen/GAMMA-RAPHO/Getty


2007: Reducing the Impact of Incarceration in the U.S.

Open Society led a coalition to advocate for the federal Second Chance Act, which authorized up to $165 million in federal grants for re-entry initiatives to assist those released from prisons and jails. The Act became law the following year.

President George W. Bush surrounded by advocates and lawmakers
U.S. President George W. Bush signs H.R. 1593, the Second Chance Act of 2007, in Washington, D.C. © Roger L. Wollenberg/Getty


2009: Former Presidents and Small-Scale Cultivators Call for Change

With Open Society’s support, three former presidents convened the Latin American Commission on Drugs and Democracy to evaluate the impact of the war on drugs in the region.

Open Society funded the First World Forum of Producers of Crops Declared Illicit. Groups from Africa, Asia, and Latin America issued the Barcelona Declaration, voicing the concerns of small-scale cultivators and calling for legal recognition of traditional uses of coca leaf, cannabis, and opium poppy, an end to forced eradication, and meaningful participation in the policies that impact their lives.

An elderly woman wearing a bowler hat spreads out coca leaves with a broom
An indigenous coca farmer dries coca leaves in Huancane, Bolivia © Aizar Raldes/AFP/Getty


2010: Reforming Racist Drug Laws

Open Society led a coalition to build political support for the Fair Sentencing Act, which reduced disparities in prison penalties for possession of powder cocaine versus crack cocaine and eliminated the mandatory minimum sentence for possession of crack. The measure was enacted in August 2010.

People holding signs that read "war on drugs is a war on us"
Activists call for an end to the racist war on drugs during a rally in Washington, D.C. © Alex Wong/Getty


2011: Establishing the Global Commission on Drug Policy

The Foundations’ support helped establish the Global Commission on Drug Policy, comprised of former heads of state, senior diplomats, and prominent media personalities. Their first report brought senior world leaders together on the need for better drug policies. 

People sitting a conference table
Former presidents attend a meeting of the Global Commission on Drug Policy in Warsaw, Poland. © Leszek Szymanski/EPA/Shutterstock


2012: Confronting Abuses in Drug Detention

Open Society research and publications helped focus attention on pervasive human rights violations occurring in drug detention facilities and moved the Global Fund to end support for work inside these centers. Twelve United Nations agencies called for the closure of these centers. In Vietnam, thousands were spared detention, and centers were closed.  

An instructor at the front of a meeting room
People who use drugs learn life and health skills at a group meeting in Ho Chi Minh, Vietnam. © Chau Doan/LightRocket/Getty


2016: Lifting U.S. Federal Ban on Funding Syringe Service Programs

Following years of advocacy by groups supported by Open Society, the U.S. Congress lifted its ban on funding syringe service programs, allowing federal dollars to support these services, except for the procurement of needles themselves.

A woman at a podium holding up a card promoting a supervised consumption site
Representatives of a supervised consumption site proposed for South Philadelphia speak during a press conference after a federal judge approved the plan. © Bastiaan Slabbers/NurPhoto/Newscom


2018: Advancing Right to the City

Open Society brought together activists from Brazil, Colombia, and Mexico working to enhance community safety and resilience in the Latin American war on drugs. Members of this network planned the launch of the first-ever community space for homeless people who smoke crack in Rio de Janeiro, Brazil, and won a landmark constitutional case in Colombia protecting the right of homeless people to access public restrooms.

People wearing ATITUDE T-shirts smiling with a man
Members of the harm reduction program ATITUDE speak to a man in Recife, Brazil. © Lianne Milton/Panos for the Open Society Foundations


2019: Establishing Supervised Consumption Sites

With seed funding and technical assistance from Open Society, civil society groups in Ukraine and Mexico opened their first-ever drug consumption sites. These sites—where people can use drugs safely, without fear of arrest, and under the supervision of trained staff—were the first of their kind opened outside of resource-rich countries.

In Ohio, to reduce skyrocketing overdose deaths, funding from Open Society allowed our grantees to distribute naloxone—the life saving overdose antidote—and fentanyl test strips, to check the quality of the drug supply.

A congregant collects Naloxone during a church service in Columbus, Ohio.
A congregant collects Naloxone during a Naloxone Saves church service held by Faith in Public Life in Columbus, Ohio. © Kristin Lieb/Redux for the Open Society Foundations


2020: Winning Decriminalization Worldwide

Open Society grantee the Drug Policy Alliance and its partners sought and won a ballot initiative making Oregon the first U.S. state to decriminalize personal possession of all drugs and to use tax revenue from legal cannabis sales to fund treatment, recovery, and harm reduction services. In Ghana, advocates supported by the Foundations secured passage of the Narcotic Control Commission Bill, de-penalizing drug possession and use, legalizing harm reduction services, and offering alternatives to incarceration.

A close-up view of a man's hands lighting a joint
A man who has paid exorbitant fines for marijuana possession to the police lights a joint in Accra, Ghana. © Nana Kofi Acquah for the Open Society Foundations

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