A public health intervention for violence across the Americas

A deadly public health crisis has been with us for much longer than the once in a lifetime COVID-19 pandemic. A worldwide violence epidemic has impacted communities across the globe though nowhere more seriously than in our own hemisphere.

Ironically, while we make significant advances with COVID-19 vaccinations, our attempts to inoculate against violence have been woeful. The Americas have 47 of the world’s 50 most murderous cities and illegal gun flows are a major problem. Homicides across major U.S. cities were 30 percent higher in 2020 than in 2019, while communities in Central America, Mexico, Colombia, Venezuela and the Caribbean are consistently victimized by criminal organizations, street gangs and political violence — making this the most homicidal region in the world. 

To make matters worse, insecurity has contributed to increased irregular migration as mostly Central Americans and Mexicans seek entry to the United States during the first months of 2021. The reasons for these arrivals are multiple and complex and the priority in Washington policy circles is to address the root causes of migration. The Biden administration has rightly made addressing corruption, security and economic stabilization in the Northern Triangle its main strategy for mitigating migration. But this strategy must also be effective in addressing the epidemic of drugs, homicides, gender-based violence and disappearances in concentrated hotspots that is fueling the mass exodus. Creating economic stabilization and sustaining hope without improved security is a difficult proposition.

What specific steps can the Biden administration undertake to effectively address the epidemic of violence in the region? First, it must ensure its new drug policy is robustly funded and implemented and must recognize its potential to also reduce violence and irregular migration. Then it must implement evidence-based programs with proven track records for reducing violence at the community and household level. 

For decades, the United States has conducted the “drug war” during various administrations in a failed attempt to end the scourge of illicit drugs. But the drug war was based on a faulty strategy that promised success by eradicating and intercepting drugs south of the border, and incarcerating consumers and those engaged in the business.  Instead, it has mainly exacerbated violence in poor white, Latino, and African American communities in the United States, and destroyed Indigenous, Afro-descendent, and poor rural communities throughout the Americas. Additionally, in 2020, overdoses in the U.S. might have exceeded 90,000 deaths. The Biden administration’s new strategy embraces much of what has been recommended by the drug policy reform community and so does the congressionally mandated report of the Western Hemisphere Drug Policy Commission.

The commission report recognizes that U.S.-supported counter narcotics policies sometimes cause considerable harm and goes on to suggest a number of new approaches to dealing with illicit drugs in the Americas by proposing a public health approach to the harm caused by them. Rather than forcing countries to adopt the traditional drug war approach through the national “naming and shaming” exercise known as the certification process, the commission suggests the U.S. seek to reach bilateral compacts with each country on issues related to harm reduction and citizen security. And in the midst of a public health and economic crisis caused by COVID-19, it becomes more important than ever to use resources wisely when dealing with violence. That begins with funding effective treatment programs, strengthening security and justice institutions and investing in marginalized communities across the Americas. This is how we begin to get at the root causes of violence and irregular migration.

The White House Office of National Drug Control Policy is in a prime position to evaluate domestic and international efforts around drug policy and citizen security while also championing best practices in law enforcement and community violence prevention initiatives. This requires new partnerships seeking security arrangements that protect human rights and emphasize a public health approach to violence prevention and drug policy. This begins with a careful diagnosis of citizens in violence hotspots, targeted interventions to interrupt transmission of violence, preventive measures to protect those at risk from violence and confronting the intersection of violence and the unrelenting drug epidemic. Now is the time to bring together all the knowledge and resources across the Western Hemisphere that suggest a harm reduction, community violence prevention and smarter law enforcement approach can be effective. There is a rich body of evidence that uses the Centers for Disease Control epidemiological approach to address community violence and campaigns like Peace in our Cities have made an audacious goal of halving homicides globally by 2030. We do not need to reinvent the wheel; we just need to focus on what we know works and set ambitious targets.

We are at an inflection point with President Biden proposing $5 billion for community violence prevention programs in the U.S., $4 billion for Central America to address the root causes of migration and a proposed holistic approach to security and counter narcotics strategy throughout the region. This major investment presents an historic opportunity to vaccinate against violence and would be a welcome U.S. policy shift — if we get it right. The pandemic of violence needs to end now with real herd immunity. We can and must get this done for the future of the region.

Enrique Roig is a citizen security specialist at Creative Associates International and former coordinator for the USAID Central America Regional Security Initiative. Eric L. Olson is a Wilson Center global fellow.