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Parallel with trends in the wider East Africa region, there has been an increase in the number of women involved in drug use, trafficking and drug-related crime in Kenya (Beckerleg, Telfer, & Hundt, 2005 ). Vulnerable populations, such as domestic labourers, ethnic minorities, those living in slums, bar attendants, sex workers and refugees, are recruited into criminal organisations and assigned roles that expose them to negative health outcomes, human rights violations and incarceration (NACADA, 2016 ). In cases where women do not directly participate in drug use or the drug trade, they often are responsible for mitigating the risks arising from drug use by family members and the community. This reflects their triple burden of care and support when family and social life deteriorates (Mburu, Limmer, & Holland 2019).

The Kenya Narcotic Drugs and Psychotropic Substances Control Act of 1994, criminalises possession and trafficking of illicit drugs. The enforcement of this legislation has led to an increase in the number of women incarcerated in Kenya for drug, but also (and mainly) alcohol offences. This goes against the recommendation of the UN Commission on Narcotic Drugs in 2005 that States should adopt innovative measures and policies that prioritise treatment and rehabilitation as opposed to incarceration. In Kenya, prisons have adopted the Mandela and Bangkok Rules, enabling a paradigm shift in the provision of correctional services for women offenders, including remote parenting, family open days and linkages to aftercare services. However, these policies need to be anchored in the legal framework, with adequate resources to hasten the realisation of goals for the care and treatment of female drug and criminal offenders.

Over the past decade, an increase in the numbers of women prosecuted, sentenced and imprisoned for drug-related offences has prompted concern and debate amongst criminal justice practitioners and policymakers. The female prison population in Southeast Asian countries is high compared to other regions. The direction of national drug policies and law enforcement are critical determinants of this situation. This chapter discusses the trends in the illicit drug market, the different types of policy responses, and the impacts on correctional services in the region. It provides an overview of women prisoners’ profiles, their backgrounds and their involvement in drug-related crimes. Key issues relating to the treatment of women in Southeast Asian prisons are analysed and addressed through the lens of the relevant provisions of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders.

This chapter addresses the differential impact of drug policy enforcement on women and the interactions of these processes with other sources of social marginalisation. It explores how broader processes of stigmatisation and exclusion play out in the context of global drug policy enforcement, limiting women’s access to effective voice and representation. The author illustrates the increasing salience of this issue through an exploration of global rightwing pushbacks and the intersectional impacts on those whose voices and identities are increasingly criminalised. The framing of women who interact with drugs or drug markets as deviant and anomalous by policy actors is constrictive of their rights, and it is crucial that reform agendas be advanced.

This chapter paints a picture of the war on drugs, and the structures of prohibition and punishment that drive it, as extensions of broader systems of state and interpersonal violence. I outline the failures of prohibition through the criminalisation of drug-related activities and put forward a framework for harm reduction that has as its foundation a radical critique of punishment in all spheres of our lives. This chapter urges those who advocate for drug policy reform to build broader alliances with the many communities around the world that organise against the continuation of the prison industrial complex (PIC) as a whole, including: people in prison, gendered, racialised and LGBTQI+ communities, sex workers and prison abolitionists. I conclude by offering a vision for abolitionist drug policy, whose ultimate goal is to resist the expansion of the PIC globally and in doing so, to foster greater community resilience both across difference and beyond our increasingly siloed fields of expertise. As drug policy experts, the author can choose to situate the millions of people who use drugs worldwide within global contexts of ongoing state violence and control, so that the reforms the author advocate for match the fullness and complexity of the people and worlds the author are fighting for and tackle the root causes of the many harms our communities face.

Women across the world are being incarcerated at an alarming rate. Between 2000 and 2017, the female incarceration rate worldwide increased by 53.3%, whereas the male incarceration rate increased by only 19.6%. In Latin America, drug offences are the first or second cause of female incarceration. The excessive use of pre-trial detention, mandatory minimum sentences, and disproportionate penalties characterise the region’s drug policies. Recent data compiled by the Washington Office on Latin America show that between 35% and 70% of incarcerated women, depending on the country, are behind bars due to a drug offence, while for men the rate is much lower. In other words, harsh drug laws disproportionately impact women.

Qualitative research on female prisoners accused of drug-related offences shows how gender roles, gender-based violence and social exclusion are often triggering factors for women’s participation in the drug trade. Agency and victimisation co-exist in these women’s stories, and while drug trafficking becomes a means to cope with adversity, it also further enhances previous vulnerabilities, and incarceration can have a devastating impact on their families. These women are engaged in high-risk activities but represent a low risk to society. Drug law reforms and the use of alternatives to incarceration could reduce the number of women behind bars for low-level drug offences.

A policy of surveillance which interferes with the fundamental right to a private life requires credible justification and a supportive evidence base. The authority for such interference should be clearly detailed in law, overseen by a transparent process and not left to the vagaries of administrative discretion. If a state surveils those it governs and claims the interference to be in the public interest, then the evidence base on which that claim stands and the operative conception of public interest should be subject to critical examination. Unfortunately, there is an inconsistency in the regulatory burden associated with access to confidential patient information for non-health-related surveillance purposes and access for health-related surveillance or research purposes. This inconsistency represents a systemic weakness to inform or challenge an evidence-based policy of non-health-related surveillance. This inconsistency is unjustified and undermines the qualities recognised to be necessary to maintain a trustworthy confidential public health service. Taking the withdrawn Memorandum of Understanding (MoU) between NHS Digital and the Home Office as a worked example, this chapter demonstrates how the capacity of the law to constrain the arbitrary or unwarranted exercise of power through judicial review is not sufficient to level the playing field. The authors recommend ‘levelling up’ in procedural oversight, and adopting independent mechanisms equivalent to those adopted for establishing the operative conceptions of public interest in the context of health research to non-health-related surveillance purposes.

The Russian Federation has taken a harsh, punitive approach towards drug policy. There are limited health and social services available to people who use drugs and widespread, documented discrimination within the criminal justice system. Amongst those who use drugs, the proportion of women who use injection drugs is estimated to be approximately 30 per cent. While a minority, women who use drugs are often disproportionately impacted by drug policy enforcement and remain underrepresented within research. Moreover, women who use drugs experience specific gender-based forms of discrimination within social, health and criminal justice systems, which result in particular vulnerabilities. This chapter examines policing and sentencing practices within the Russian criminal justice system and their gendered impacts, especially concerning women who use drugs. Human rights reports and court cases as well as interviews from civil society organisation (CSO) workers are analysed in order to understand how gender roles, gender-based discrimination and gender-based violence shape these interactions and result in disproportionate negative impacts on the lives of women who use drugs. This analysis also highlights key areas that need greater involvement and attention from researchers, policymakers and advocates.