Progressive Harm Reduction in Iran, China Shines Spotlight on Hypocrisy of Death Penalty Use

The widening gap between the increasing provision of harm reduction services in China and Iran and their use of the death penalty for non-violent drug offences highlights a worrying moral paradox in the value these countries place on human life.

China and Iran are the world’s biggest state killers, according to Amnesty International. Although the number executed by China remains a state secret, the number of executions is believed to be the highest in the world. Approximately 5,000 people were executed in 2010, a significant number of these for drug crimes, estimates the Dui Hua Foundation. Though this number is reportedly falling, it still remains in the thousands.

Iran’s 289 officially announced executions are dwarfed by the estimated  total of 743 executions last year, making Iran the second most prolific enforcer of the death penalty. NGO Iran Human Rights estimated that 367 of these executions were for drug offences, only 123 of which were announced by official sources.

Worryingly the number of executions in Iran is on the rise, from 580 in 2012 to 753 in 2014 report Iran Human Rights and the 2015 figures are alarming. The European Union estimates that by 15 July 2015 Iran had already surpassed the total number of executions for 2014 and over half of executions were for drug offences.

International law only permits the death penalty for the "most serious crimes" which does not include drug offences. In spite of Iran’s shocking breach of human rights law, the United Nations Office on Drugs and Crime (UNODC) continues to fund anti-drug trafficking programmes in the country.

By financially supporting these programmes, this UN body confers legitimacy on these violations of the very principles of peace, security, and respect for human rights that the United Nations was formed to enforce. Responding to this alarming situation, many organisations have urged the UNODC to stop funding Iran’s anti-drugs programmes.  

Campaigners and experts allege that the commitment to this excessive and violent enforcement of drug laws can be attributed to political manoeuvring. Faraz Sanei, researcher at Human Rights Watch has stated in an interview with The World Post that “some activists suspect that Iranian authorities may be using drug prosecutions in part to target and execute political dissidents or others who speak out against the government”.

Note to the reader: the graph is provided as a rough illustration of the last year's trends. The data should be carefully analysed as they come from different sources and result from different methods of collecting.
We don’t have for the first 6 months of 2015 a precise estimate of the number of executions for drug offences.
- Amnesty International provides information about officially acknowledged executions as well as providing its own estimates.
- Estimated executions for drug offences come from the NGO Iran Human Rights.


In both countries, not only is drug trafficking and distribution punishable by death but even simple drug possession can incur the death penalty. In Iran, “the death sentence is often carried out without a fair trial and without any serious opportunity for appeal and clemency” say academics Ota Hlinomaz, Scott Sheeran and Catherine Bevilacqua.

The violent execution faced by those prosecuted for drug offenses stands in sharp contrast to the relatively good harm reduction policy in China and Iran (compared to their geographical neighbours), highlighted by Harm Reduction International (HRI).

In China, methadone maintenance treatment was launched in 2003 in response to the spread of HIV infection around 31 provinces in 2002 and the number of sites offering opioid substitution therapy (OST) increased from 738 to 763 between 2012 and 2014.

In terms of harm reduction policy, Iran is more progressive still. With less people who inject drugs (185,000 vs 2.58 million in China), Iran lists more centres offering OST (4,275, 902 more centres compared to 2012), according to HRI.

Along with Morocco and Israel, Iran is the only country from Middle East and North Africa offering both needle and syringe exchange programmes (NSP) and OST. Iran is also one of the only countries in the region offering OST without a detoxification or rehabilitation condition and the only one providing OST inside prisons, HRI reports.

An explanation for this surprising paradox could lie in in the way that public health is prioritised at the expense of individual life. China and Iran use harm reduction as an effective means to prevent and control the spread of HIV.

China has one of the highest estimated population of people who inject drugs 2.58 million and Iran a high prevalence rate of HIV  in the region (15 percent among people who inject drugs). In recognition of the fact that people who inject drugs are the most affected, China and Iran have developed harm reduction policies to protect the health of the wider population.

Sadly it seems that neither of these countries have developed a strong regard for the driving principle behind harm reduction: that individuals’ needs should be supported and that every life has value.