Q & A: Gino Vumbaca

This is the third in a series of Q & A's for people who have some relationship or interest in illicit drugs.


Name: Gino Vumbaca

Role: Executive Director of the Australian National Council on Drugs
Date: January 2009


Gino Vumbaca has one of the hardest jobs in Australia. Although he is part of the core advisory group for drug policy to the Australian government, he also strongly supports Harm Minimisation which sometimes can put him in a precarious position. As we saw with the Inquiry into the Impact of Illicit Drug Use on Families aka The Bishop Report: “The Winnable War on Drugs”, Gino was called in to defend Harm Minimisation against a hostile, heavily biased and trumped up panel of twits led by Bronwyn Bishop. In his typical diplomatic style, Gino stood his ground whilst being bombarded with farcical and ludicrous questions aimed at discrediting Harm Minimisation. Someone as well grounded and knowledgeable as Gino Vumbaca was never going to be an easy target for them and was grossly underestimated.

I have never met Gino but his reputation speaks volumes about the man. Someone who is dedicated to the well being of others and one of Australia’s top experts on drug policy. A tireless and dedicated supporter of a better future for the addicted and society in general. The fact that Gino took the time out of his extremely busy schedule to be part of this Q & A is evidence of his commitment to the drug issue. Read on to get an insight into the personal views of maybe the most important person shaping our drug policy.

NOTE: Gino’s answers are his own personal opinions and not those of the ANCD, its members or the government.

About Gino Vumbaca
Mr Vumbaca has extensive experience in the HIV/AIDS and drug and alcohol fields both in Australia and internationally. He is a Churchill Fellow and has completed a Social Work degree and a Master of Business Administration at the University of Sydney. He has worked as the Manager of HIV/AIDS and related services with the NSW Department of Corrective Services, in a variety of drug and alcohol centres as a counsellor and was responsible for coordinating the establishment of the NSW network of needle and syringe exchange programs for the NSW Health Department. Mr Vumbaca also continues to provide advice on prisons, HIV and drug issues for international organisations such as the UN and WHO.
Source: ANCD


QUESTIONS:

The Australian National Council on Drugs (ANCD) has no official decision making role for our drug policy and is an advisory group only. Do you feel you should this is sufficient?
Yes - it is the role of government (elected) to make decisions for which they can be held accountable to the community - certainly the ANCD has a role to provide independent evidence based advice and to inform public debate and thinking on drug policy but in the end it is governments, on behalf of and taking into account the needs and views of the whole community, that need to make the decisions.

Do you think the public understands what the ANCD actually do and should their profile be raised?
Some of the public will understand and some will not, but I think that the public profile of the ANCD over the last 5 years in particular has been raised considerably - it could always be better but I think many people continue to learn and understand its role. Certainly, the level of government and media requests for advice from the ANCD has increased markedly over the years. In the end however it is not the public knowledge profile of the ANCD that it is most important but rather the quality and timeliness of its advice for the public and policy makers.

Does the press help or hinder your job at the ANCD?
Both, but it helps far more than it hinders. I would say that in the overwhelming majority of cases the media has been good at reporting on ANCD commissioned research and announcements, as well as general drug and alcohol matters of concern, certainly in regard to alcohol policy in recent times the media have been very helpful in raising issues and maintaining pressure for change - reflecting the community view. There are of course media reports that are unhelpful and if I were to single some out it would be those that promote so called 'miracle' cures without checking or reference to any real evidence, and those media reports that imply drug users are somehow not entitled to humane care and support. I also think we don't help the media enough such as being able to provide a single national helpline number that could be listed at the end of every relevant story on drug and alcohol use.

There is now more evidence than ever before that drug addiction is a physical condition and some people are more susceptible to becoming drug addicts than others. Do you think the public understands this?
It is true that there is increasing work being done on the genetic disposition to dependence and I think the public understands this somewhat but many would still see dependence as a matter of personal choice or via a disease model approach - this is not a rejection of the theories and research within the biosciences fields but rather a reflection of the long standing complexity surrounding nature and nurture. Suffice to say, it is an area that requires far more research particularly in Australia.

Politicians are often labelled as being “soft on drugs” when they suggest that a “tough on drugs” policy is not the answer. Do these types of politic stunts make your job harder?
I don't think they make it easier - many people in the sector are rightly tired of this type of rhetoric although to be fair it is often others that attach such labels rather than politicians. The reality is that Australia has a balanced and pragmatic drug policy and has done so for many years. It should not be about being soft or tough it should be about being effective. However, we should not underestimate the power of language at times. The recent proposal by the NSW Opposition for a greater focus on rehabilitation of prisoners was met with positive coverage and this is encouraging for many of us that have been advocating for an end to increasing incarceration as an answer to the problems of drug use and associated harms.

Australia appears to be following the US and placing more emphasis on religion in politics. Do you feel this effects our drug policy?
Not that I am aware of - I think it would be fair to say that faith based services have a long history in providing services for disadvantaged groups, but they also compete for their funding with all other services. People representing faith based services also sit on advisory bodies at times, again this is a reflection of their role in providing treatment and other services. I don't think anyone should ever be appointed to a position of influence on drug policy (or any public health policy) as a result of their religious beliefs.

Does religion have any place in drug policy or treatment?
see above

The US is infamous for it’s drug policy and opposition to Harm Reduction. Though the US has about 10 times the number of HIV/AIDS sufferers amongst injecting drug users compared to Australia, only recently has federal funding been allowed for needle exchange programs. Is this a sign that Harm Minimisation is becoming more accepted in the US?
I am not sure about the level of acceptance in the USA - it is certainly encouraging that pragmatic and humane responses taken here over the past 20 years are starting to also gain greater traction in the USA - it is unfortunate that so many people have had to suffer in the interim. President Elect Obama has made some statements in the recent past that would seem to signal a change in approach, but I guess time will tell.

Bronwyn Bishop chaired an enquiry into illicit drugs last year and produced a report called “The Winnable War on Drugs” which you were asked to participate in. Do you think Harm Minimisation was unfairly criticised?
Yes - I think the report fell into the trap of arguing about language and ideology rather than evidence and that, in my opinion, is something that Australians are generally wary of and sceptical towards. A lot of people understand that drug users are people just like them with real lives, families and friends and they deserve to be the primary focus rather than used as a proxy in a battle of ideologies.

John Howard wanted to remove Harm Minimisation as Australia’s primary drug strategy and implement a policy of Zero Tolerance. Do you think most Australians understand what Harm Minimisation really is?
I am not sure that the premise of the question is accurate but I understand that is a perception for some - as to public understanding of HM, I think it could be a lot better. There is confusion at times between harm minimisation and harm reduction - but again we can get too caught up in arguing about language when it is the quality and effectiveness of the responses to drug use issues that needs to be debated.

South Australia recently banned drug paraphernalia and rejected a call to test MDMA for Post Traumatic Stress Disorder. Is this a good move in your opinion?
I think that in reality these decisions often sit at the margin of what constitutes effective drug policy. I am not aware of the evidence underpinning these policy decisions so don't feel in a position to comment further.

Are anti-drug advertisements using scare tactics effective?
I know some people will disagree but they can be - the ANCD has assisted in many campaigns for Governments and the goal has been effectiveness via thorough research and focus testing of concepts with the target audience, be they young people or parents. I understand that some people believe that somewhat dispassionate information on drug use is the most effective approach but I think that is not supported by what target audiences say and fell, it also seems to be undermined somewhat by the campaigns associated with anti-smoking which have been very effective and haven't shied away from showing people some of the graphic consequences of smoking. The issue is not so much scare campaigns but effective campaigns that need to be supported by a range of other strategies (as we also see with anti-smoking which includes a range of public policy changes) and the need for campaigns to be ongoing so they can evolve and develop even more sophisticated approaches to inform and educate the public.

Kevin Rudd said in an interview that his policies would be evidenced based if he won the election. Do you think this will encompass our drug policy?
The ANCD has had the privilege of meeting with the Prime Minister and many of his senior cabinet colleagues, including the Deputy Prime Minister and Health Minister and have no doubt that evidence based policies will include drug policy.

A report was published in the medical journal, The Lancet, where psychiatrists who specialise in addiction and legal/police officials with medical expertise were asked to rank the most dangerous 20 drugs. The factors used were physical harm to the user, addictive potential of the drug and the drug's overall impact on society. Cannabis, LSD and ecstasy didn’t even make the top 10, alcohol came in at number 5 and tobacco came number 9. Should this effect how the government approaches the rating of drugs?
It is an interesting approach - there of course is still a level of subjectivity within the approach but it does seem to be a way of promoting greater public awareness and debate on drug and alcohol issues.

Should the drinking age be raised to 21?
There is evidence that in some countries there have been some benefits from a higher drinking age but I think in Australia we have problems with underage drinking despite there being a legal limit in place and I would be wary of placing so many more people in illegal situations, particularly given the associated problems that could cause - it is the culture and patterns of alcohol consumption that need to be addressed. Alcohol is available and consumed by many here and we need to be wiser and more aware of the potential consequences of alcohol misuse, particularly for young people.

Should well known sportsmen and sportswomen be tested for non performance enhancing drugs?
This is not an area of expertise for me but if testing regimes are to be in place they need to be done within the context of a comprehensive program that also provides assistance and addresses alcohol misuse.

Do you have any first hand experience with someone you know being addicted to drugs?
Yes - both personally and professionally

Methadone is just as addictive as heroin and some people argue that methadone simply replaces one addiction for another. Do you have an opinion on this?
Methadone and other pharmacotherpies allow people to get some control back over their lives. The evidence is quite clear on their effectiveness. It is a legitimate treatment that deserves support.

Some members of Drug Free Australia (DFA) say ex addicts especially those on medication like methadone don’t have a place discussing addiction treatment. Are they correct.
I am not aware of that comment specifically but I think we should all be very careful about trying to exclude people from a debate. It should be the merit of the argument that determines its worth not the opinion of mine or others on the person that delivers the argument.

Australia was to have a heroin trial but it was vetoed by John Howard because it “sent the wrong message about drugs”. Was he right?
This was a decision made by the government of the day - I am unclear as to how the impact of the messages that could have be sent by its introduction were assessed and decided. Trend data from the National Drug Strategy Household Survey shows increasing support for controversial programs such as injecting rooms and prescription programs. As I said earlier the final judgement that balances the evidence and community wishes rest with the government of the day, as it should.

Other Opiate Maintenance Treatments(OMT) are in use or on trial in Europe, Canada and the U.K and have great success. Should other forms of OMT be trailed in Australia like slow release oral morphine, injectible hydromorphone, dihydrocodeine and prescription heroin?
Evidence from these programs should be assessed and inform policy debate and thinking in Australia. We should never be afraid to look at options and alternatives.

Finally, if you were Prime Minister Gino Vumbaca and you could change one law relating to illicit drugs or drug treatment, what would it be?
No restrictions for treatment, that is, when someone wants help they should be assessed and have the best treatment made available to them without delay. Seeking treatment is a significant and somewhat scary step for many people to take and it should be met with positive professional assistance as quickly as possible.


RELATED ARTICLES:
Q and A: Kerry Wolf - Certified Methadone Advocate (USA)
Q and A: Dr. James Rowe - Lecturer at RMIT, School of Global Studies, Social Science & Planning
Q and A: Sandra Kanck - Former South Australian MLC. South Australia spokesperson for Families and Friends for Drug Law Reform (FFDLR)
Q and A: Tony Trimingham - Chief Executive Officer, Family Drug Support

John Herron, NGOs and Signs of Change

As the internet helps spread the truth about the damage caused from current drug policies worldwide, many people are changing their minds about the approach we take with the issue of drug use. Harm Minimisation is starting to become better understood and misconceptions about legalisation and encouraging drug use are fading. Bronwyn Bishop’s attempt last year at destroying Harm Minimisation is slowly slipping into the dark depths of John Howard’s undie draw. The heavily criticised report, “The Winnable War on Drugs” is barely mentioned now except that it was fundamentally flawed and offered nothing to society except pain, misery and a false sense of security. This was at the height of the Zero Tolerance push by John Howard and his moral crusaders (as opposed to Kevin Rudd’s moral crusaders). That dark era may well be behind us if Kevin Rudd follows through with his promise of evidence based policy. Some much needed changes have taken place since then. For example, NGOs are no longer threatened with funding withdrawal or losing their tax-deductable status for donations if they became critical of government policy.

In 1991, just five years before the Howard Government came to power, the House of Representatives Standing Committee on Community Affairs brought down a report in which it commented on the role of non-government groups. The Committee said: An integral part of the consultative and lobbying role of these organisations is to disagree with government policy where this is necessary in order to represent the interests of their constituents. Note that they said non-government organisations should ‘disagree’ with Government where necessary. Contrast this Parliamentary Committee statement with John Howard’s Menzies Lecture, delivered in 1996, the year he came to power. The lecture was entitled, ‘The Liberal Tradition: The Beliefs and Values Which Guide the Federal Government’. In it, Howard referred to the NGO sector as ‘single-issue groups’, ‘special interests’ and ‘elites’ and he promised that his government would be ‘owned by no special interests, defending no special privileges and accountable only to the Australian people’. [...] De-funding has shut down many voices, but it is only a small part of the picture. At the same time, forced amalgamations have silenced alternative views, purchaser-provider contracts bring NGOs closer to being an arm of Government and confidentiality clauses are explicit restraints upon freedom of expression. -Joan Staples Report - NGOs out in the Cold: Howard government policy towards NGOs University of New South Wales Faculty of Law Research Series

NGO’s no longer have a clause in their contracts that prohibit them from speaking to the media or releasing any report before seeking the approval of the federal government.

Thirdly, confidentiality clauses appeared at the same time that purchaser-provider contracts became the norm. They now appear in some form in most contracts that NGOs have with the Federal Government. These clauses have requirements that the organisation not speak to the media without first obtaining the approval of the appropriate department or minister. Some appear to forbid any public activity. Apart from the direct censorship involved, voices are likely to be silenced, even if a media release is approved, because delay risks lack of relevance with the speed of media stories today. Even groups working on habitat rehabilitation and feeding the homeless are now finding that any relationship with Government results in confidentiality clauses being imposed on them.

It seems, one important organisation in particular has also changed, The Australian National Council on Drugs (ANCD). Although the changes are small, there appears to be a move away from Howard’s Zero Tolerance. The ANCD was originally chaired by Brian Watters, who was hand picked by Howard for his like minded, black and white approach to drugs. Over the years, there have always been members like Watters who have no interest in HM or evidence based policies. Ann Bressington, Craig Thompson and currently Jo Baxter, who along with Watters are all members of Drug Free Australia (DFA). The one constant has been Secretariat, Mr Gino Vumbaca. Reading through the transcripts from Bronwyn Bishop enquiry, Gino Vumbaca was continually attacked by Bishop for stating the simple truth. Bishop desperately tried to tie HM with failure but Gino stood his ground. This is a man with principles. It seems that current chairman, Dr John Herron, is also changing since the Rudd government. Maybe the pressure to mislead the public is off since the change of government. Who knows? An opinion piece by Dr. Herron in The Australian last week is a clear sign that finally evidence based strategies are replacing the mumbo jumbo that for so long was called drug policy.

Battle Against Drugs Needs Realistic Approach Dr. John Herron The Australian - August 23, 2008 IN 1998, the United Nations held a general assembly special session on drugs and set 2008 as the target date to eliminate, or significantly reduce, the world's drug production and use. Well, here we are in 2008, and while we've certainly come a long way, drugs still remain a worldwide problem. The elimination of drugs is an ideal many would like to see achieved, but we need to approach drug issues in a realistic and pragmatic manner. Fortunately, the next UN initiative sees the potential to formulate realistic goals and some positive changes for the future, including to the drug control conventions which govern global drug control, and to which many countries (including Australia) are signatories. Why do we need to make changes to our global drug control efforts? To start with, the three drug control conventions currently have a heavy law enforcement focus. While this is a key aspect of any comprehensive drug control effort, law enforcement is just one of many areas that need to be engaged when tackling drug problems. Even the executive director of the United Nations Office on Drugs and Crime, Antonio Maria Costa, has himself said that "tighter controls in one region, or on one product, produce a swelling of activity elsewhere. As a result of this balloon effect, the problem is displaced, but not solved." In addition, it is quite concerning to me and many others that human rights, and their protection, are only referred to once across all three drug control conventions. Frankly, this is not good enough, especially when considering that those with drug problems are often subjected to severe stigmatisation and discrimination in communities across the world. To put it simply, we have to update the conventions to reflect our most modern and effective approaches of tackling the world's drug problem. Both Australia and New Zealand have balanced and pragmatic drug policies compared with many other regions in the world. Why do we do this? Because it works: our national drug strategies are also among the few that are subjected to comprehensive evaluations, and as a result we have long had an evidence-based approach to formulating our drug strategies. This had led to declining levels of drug use and overdoses, and the maintenance of one of the lowest rates of HIV amongst injecting drug users. We have a global responsibility to share our knowledge and success with other countries and to learn from the approaches of other nations in areas they have done better. In our region, non-government organisations (NGOs) provide many services within the alcohol and other drug sector. Inevitably, NGOs are confronted with many challenges from being under-resourced and overworked -- which makes attracting and keeping staff a difficult task for many agencies. Despite this, or perhaps because of these circumstances, many NGOs often offer the most innovative treatment approaches. It has therefore been very unfortunate that NGOs and their invaluable experience has not been utilised more in important decisions made at the UN level on drug issues. This time, however, a historic achievement was made recently when the UN actively sought input from NGOs in a review on drug control since 1998. NGOs across the globe reflected on what has been achieved in the past 10 years and provided recommendations on how to improve and strengthen these conventions, but also for enhancing NGO involvement in drug policy at the government and UN level. In Australia, the Australian National Council on Drugs worked with our colleagues at the New Zealand Drug Foundation to develop a report outlining the response from our region. Our regional report confirmed what many of us already knew: NGOs have much to offer including frontline experience, independent perspectives and innovative strategies for how to make our drug policy even more effective. I was very pleased and impressed that so many NGOs across the sector participated in this project in the face of such great time and resource limitations. Why did they do this? For the greater good. It is something which drives the NGOs in this sector, and they wanted the opportunity to influence global decision making and to promote the successes of our region in the hope of achieving better outcomes for others in the world. In July, regional representatives, including a delegation from Australia and New Zealand, met at an international forum in Vienna to propose new drug policy resolutions. This meeting concluded that equal weighting should be given to supply and demand reduction across the three drug control conventions. Furthermore, that each country should consider drug misuse primarily as a health issue. The importance of such resolutions should not be underestimated -- they have the potential to change the face of drug issues on a global scale. There seem to be so few opportunities to celebrate our success within the drug sector -- numerous challenges will always be apparent. However, what we have seen recently has been no small feat, and I congratulate the UN and most of all the NGOs, which gave their time and resources to participate. I now wait in anticipation for March next year when a high-level UN meeting of government delegates will meet to discuss the last 10 years of drug issues, including a very important NGO perspective. I urge them to adopt a realistic and ground-breaking approach to battling the world's drug problem, to ensure that the many victims of some current drug control strategies are helped to overcome problems rather than be further harmed. Dr John Herron is the chairman of the Australian National Council on Drugs