WHO Director-General's opening remarks at the International Forum on Countering Transnational Drug Threats to Public Health and Security – 20 April 2026

Ms Saida Mirziyoyeva, Head of the Presidential Administration,

Excellencies, honourable ministers, dear colleagues and friends,

Assalomu alaykum.

It is an honour to join you today in this historic city of Samarkand. I thank the Government of Uzbekistan for its hospitality, and for organizing this important forum, in partnership with the United Nations Office on Drugs and Crime.

I would like to take this opportunity to congratulate His Excellency President Shavkat Mirziyoyev for his leadership in instituting health reforms in Uzbekistan, especially by strengthening primary health care.

I was also honoured to meet Her Excellency the First Lady in New York last year, where we discussed her efforts on childhood cancer.

I look forward to meeting His Excellency the President and Her Excellency the First Lady in Tashkent tomorrow.

I also thank Ms Saida Mirziyoyeva for her leadership in drawing attention to transnational drug threats to public health and security.

Drugs are often seen primarily as a criminal issue and a threat to security.

But they are also profound public health challenges, affecting individuals, families, communities, and health systems in every region of the world.

Globally, there are an estimated 300 million drug users, and around 64 million people live with drug use disorders. That is very staggering and of course on the increase.

Each year, hundreds of thousands of lives are lost to preventable harms linked to drug use - most commonly from viral hepatitis, overdose, HIV, and other treatable conditions.

These lives can be saved, with effective, evidence-based interventions for prevention, treatment, and harm reduction.

Yet only a small fraction of those who would benefit from treatment actually receive it.

Women, young people, migrants, and people living with infectious diseases or mental health and other substance use conditions face particularly high barriers.

Stigma, discrimination, criminalization of people using drugs, and fear of punishment continue to push people away from care and away from the health systems that should protect them.

Making things even harder, new types of highly potent synthetic drugs are emerging every year, presenting significant risks to public health. As earlier said, there is a shift from the traditional to synthetic drugs, which makes the fight even more difficult.

In recent years, the most prevalent synthetic opioids, including a number of fentanyl derivatives, have all been brought under international control.

However, at the country level, funding and other resources for the public health response to synthetic opioids is inadequate.

In many countries, health system responses to drug-related problems were developed in response to the threats of heroin, cocaine and amphetamines.

It is time to update our health system response to address the complex challenges presented by a mix of factors, including synthetic drugs, the use of multiple substances at once, and the role of pharmaceutical manufacturers and distributors.

Strengthening responses to drug-related harms requires stronger, more resilient health systems:

Systems that integrate services for mental health and substance use with services to prevent communicable diseases, at the primary health care level;

Systems that engage communities and civil society as outlined by Ms Saida;

And systems that support families, protect children, and reach people in prisons, in humanitarian crises, and on the margins of society.

Ultimately, substance use disorders are health disorders.

And people who suffer from these disorders need access to evidence-based health services.

Treatment and care must be voluntary, evidence based and ethical.

Compulsory detention and punitive approaches do not represent good clinical practice, do not reduce drug dependence, and do not protect communities.

The launch by the president of the national drug help line is commendable.

WHO is supporting countries to address drug-related harms with evidence-based policy and clinical guidance.

We work closely with Member States, UNODC, civil society and many other partners to implement this guidance and save lives.

For example, we are now updating our guidelines on the treatment of opioid use disorder and community management of opioid overdose;

And we are working with UNODC on the "ScaleUp" initiative to address stimulant dependence.

At the World Health Assembly next month, I will report to WHO Member States on the public health dimension of the world drug problem.

WHO remains committed to working closely with our friends at UNODC, Member States, regional partners, and civil society to advance people-centred approaches grounded in science, human rights, and compassion.

This Forum offers a critical opportunity to advance a balanced, evidence based approach; and I agree with the five priorities that Ms Saida proposed earlier.

An approach that recognizes the links between public health and security, addresses root causes, and invests in prevention and care.

One message must remain clear: health is a human right, including access to prevention, treatment, harm reduction and essential medicines for all who need them, without fear or discrimination.

Thank you all for your leadership and partnership, and I wish you a successful forum.

Katta Rahmat.