Global health. The current scenario and future perspectives

198 problems in the countries, even though their relationship presents a major concern at global level. The drug problem, although shared by all, has a different scope in each country. This was very well described in the report “The Drug Problem in the Americas” by the Organization of American States (OAS) in 2013 (Insulza J.M., 2013), which concludes that diversity is what best reflects the drug situation globally as well as in the American region. Therefore, “the drug problem needs to be dealt with in a flexible, differentiated fashion and countries should adopt an approach tailored to the particular ways in which they are affected.”. There is no doubt that this statement made almost a decade ago remains fully relevant today. There are two major areas of problems that have been identified in countries, which are certainly not mutually exclusive and therefore both can be present in a country: on the one hand, there are consequences associated with health and social well-being and, on the other, there are problems related to security and governance (including transnational organized crime and corruption). These dimensions of the phenomenon have been addressed based on two main premises: policies regarding drug supply reduction, aiming to control and limit access, and policies regarding demand reduction. However, in general, funding for these policies has been primarily focused on controlling production and distribution of illicit substances based on the paradigm of the “war on drugs”, with limited funding for interventions aimed at health policies including research and evaluation. Based on this background, we encounter major problems and challenges when considering a new approach to drug policies. The first element is the need to understand that, while there are global issues, solutions must contain a significant local component not only at national level but also at territorial level within countries. This is a political decision adequately supported by various reports. A second issue relates to overcoming the dominant model of the “war on drugs” and moving towards policies focused on individuals (and not on substance), which, guided by solid scientific evidence, lead us towards successful interventions to reduce levels of drug consumption and achieve responsible drug use. This is crucial: policies have been “behind” drugs. However, today more and more diverse drugs are available on the market, with an increasing prominence of synthetic drugs and so-called new psychoactive substances (NPS). This comes along with a serious lack of knowledge about substance adulteration processes, as well as uncontrolled increases in the use of prescription medications, mainly synthetic opioids. Therefore, continuing with imbalanced priorities favoring drug control does