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We found over 300 million young people had experienced online sexual abuse and exploitation over the course of our  meta-study

Professor of International Child Protection Research and Director of Data at the Childlight Global Child Safety Institute , The University of Edinburgh

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Deborah Fry receives funding from the Human Dignity Foundation.

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It takes a lot to shock Kelvin Lay. My friend and colleague was responsible for setting up Africa’s first dedicated child exploitation and human trafficking units, and for many years he was a senior investigating officer for the Child Exploitation Online Protection Centre at the UK’s National Crime Agency, specialising in extra territorial prosecutions on child exploitation across the globe.

But what happened when he recently volunteered for a demonstration of cutting-edge identification software left him speechless. Within seconds of being fed with an image of how Lay looks today, the AI app sourced a dizzying array of online photos of him that he had never seen before – including in the background of someone else’s photographs from a British Lions rugby match in Auckland eight years earlier.

“It was mind-blowing,” Lay told me. “And then the demonstrator scrolled down to two more pictures, taken on two separate beaches – one in Turkey and another in Spain – probably harvested from social media. They were of another family but with me, my wife and two kids in the background. The kids would have been six or seven; they’re now 20 and 22.”

The AI in question was one of an arsenal of new tools deployed in Quito, Ecuador, in March when Lay worked with a ten-country taskforce to rapidly identify and locate perpetrators and victims of online child sexual exploitation and abuse – a hidden pandemic with over 300 million victims around the world every year.

That is where the work of the Childlight Global Child Safety Institute , based at the University of Edinburgh, comes in. Launched a little over a year ago in March 2023 with the financial support of the Human Dignity Foundation , Childlight’s vision is to use the illuminating power of data and insight to better understand the nature and extent of child sexual exploitation and abuse.

This article is part of Conversation Insights The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.

I am a professor of international child protection research and Childlight’s director of data, and for nearly 20 years I have been researching sexual abuse and child maltreatment, including with the New York City Alliance Against Sexual Assault and Unicef.

The fight to keep our young people safe and secure from harm has been hampered by a data disconnect – data differs in quality and consistency around the world, definitions differ and, frankly, transparency isn’t what it should be. Our aim is to work in partnership with many others to help join up the system, close the data gaps and shine a light on some of the world’s darkest crimes.

302 million victims in one year

Our new report, Into The Light , has produced the world’s first estimates of the scale of the problem in terms of victims and perpetrators.

Our estimates are based on a meta-analysis of 125 representative studies published between 2011 and 2023, and highlight that one in eight children – 302 million young people – have experienced online sexual abuse and exploitation in a one year period preceding the national surveys.

Additionally, we analysed tens of millions of reports to the five main global watchdog and policing organisations – the Internet Watch Foundation (IWF), the National Centre for Missing and Exploited Children (NCMEC), the Canadian Centre for Child Protection (C3P), the International Association of Internet Hotlines (INHOPE), and Interpol’s International Child Sexual Exploitation database (ICSE). This helped us better understand the nature of child sexual abuse images and videos online.

While huge data gaps mean this is only a starting point, and far from a definitive figure, the numbers we have uncovered are shocking.

We found that nearly 13% of the world’s children have been victims of non-consensual taking, sharing and exposure to sexual images and videos.

In addition, just over 12% of children globally are estimated to have been subject to online solicitation, such as unwanted sexual talk which can include non-consensual sexting, unwanted sexual questions and unwanted sexual act requests by adults or other youths.

Cases have soared since COVID changed the online habits of the world. For example, the Internet Watch Foundation (IWF) reported in 2023 that child sexual abuse material featuring primary school children aged seven to ten being coached to perform sexual acts online had risen by more than 1,000% since the UK went into lockdown.

The charity pointed out that during the pandemic, thousands of children became more reliant on the internet to learn, socialise, and play and that this was something which internet predators exploited to coerce more children into sexual activities – sometimes even including friends or siblings over webcams and smartphones.

There has also been a sharp rise in reports of “financial sextortion”, with children blackmailed over sexual imagery that abusers have tricked them into providing – often with tragic results, with a spate of suicides across the world .

This abuse can also utilise AI deepfake technology – notoriously used recently to generate false sexual images of the singer Taylor Swift.

Our estimates indicate that just over 3% of children globally experienced sexual extortion in the past year.

A child sexual exploitation pandemic

This child sexual exploitation and abuse pandemic affects pupils in every classroom, in every school, in every country, and it needs to be tackled urgently as a public health emergency. As with all pandemics, such as COVID and AIDS, the world must come together and provide an immediate and comprehensive public health response.

Our report also highlights a survey which examines a representative sample of 4,918 men aged over 18 living in Australia , the UK and the US. It has produced some startling findings. In terms of perpetrators:

One in nine men in the US (equating to almost 14 million men) admitted online sexual offending against children at some point in their lives – enough offenders to form a line stretching from California on the west coast to North Carolina in the east or to fill a Super Bowl stadium more than 200 times over.

The surveys found that 7% of men in the UK had admitted the same – equating to 1.8 million offenders, or enough to fill the O2 area 90 times over and by 7.5% of men in Australia (nearly 700,000).

Meanwhile, millions across all three countries said they would also seek to commit contact sexual offences against children if they knew no one would find out, a finding that should be considered in tandem with other research indicating that those who watch child sexual abuse material are at high risk of going on to contact or abuse a child physically.

The internet has enabled communities of sex offenders to easily and rapidly share child abuse and exploitation images on a staggering scale, and this in turn, increases demand for such content among new users and increases rates of abuse of children, shattering countless lives.

In fact, more than 36 million reports of online sexual images of children who fell victim to all forms form of sexual exploitation and abuse were filed in 2023 to watchdogs by companies such as X, Facebook, Instagram, Google, WhatsApp and members of the public. That equates to one report every single second.

Quito operation

Like everywhere in the world, Ecuador is in the grip of this modern, transnational problem: the rapid spread of child sexual exploitation and abuse online. It can see an abuser in, say, London, pay another abuser in somewhere like the Philippines to produce images of atrocities against a child that are in turn hosted by a data centre in the Netherlands and dispersed instantly across multiple other countries.

When Lay – who is also Childlight’s director of engagement and risk – was in Quito in 2024, martial law meant a large hotel normally busy with tourists flocking for the delights of the Galápagos Islands, was eerily quiet, save for a group of 40 law enforcement analysts, researchers and prosecutors who had more than 15,000 child sexual abuse images and videos to analyse.

The cache of files included material logged with authorities annually, content from seized devices, and from Interpol’s International Child Sexual Exploitation (ICSE) database database. The files were potentially linked to perpetrators in ten Latin American and Caribbean countries: Argentina, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Honduras, Guatemala, Peru and the Dominican Republic.

Child exploitation exists in every part of the world but, based on intelligence from multiple partners in the field, we estimate that a majority of Interpol member countries lack the training and resources to properly respond to evidence of child sexual abuse material shared with them by organisations like the National Center for Missing and Exploited Children (NCMEC). NCMEC is a body created by US Congress to log and process evidence of child sexual abuse material uploaded around the world and spotted, largely, by tech giants. However, we believe this lack of capacity means that millions of reports alerting law enforcement to abuse material are not even opened.

The Ecuador operation, in conjunction with the International Center for Missing and Exploited Children (ICMEC) and US Homeland Security, aimed to help change that by supporting authorities to develop further skills and confidence to identify and locate sex offenders and rescue child victims.

Central to the Quito operation was Interpol’s database database that contains around five million images and videos that specialised investigators from more than 68 countries use to share data and co-operate on cases.

Using image and video comparison software – essentially photo ID work that instantly recognises the digital fingerprint of images – investigators can quickly compare images they have uncovered with images contained in the database. The software can instantly make connections between victims, abusers and places. It also avoids duplication of effort and saves precious time by letting investigators know whether images have already been discovered or identified in another country. So far, it has helped identify more than 37,900 victims worldwide.

Lay has significant field experience using these resources to help Childlight turn data into action – recently providing technical advice to law enforcement in Kenya where successes included using data to arrest paedophile Thomas Scheller. In 2023, Scheller, 74, was given an 81-year jail sentence . The German national was found guilty by a Nairobi court of three counts of trafficking, indecent acts with minors and possession of child sexual abuse material.

But despite these data strides, there are concerns about the inability of law enforcement to keep pace with a problem too large for officers to arrest their way out of. It is one enabled by emerging technological advances, including AI-generated abuse images, which threaten to overwhelm authorities with their scale.

In Quito, over a warming rainy season meal of encocado de pescado, a tasty regional dish of fish in a coconut sauce served with white rice, Lay explained:

This certainly isn’t to single out Latin America but it’s become clear that there’s an imbalance in the way countries around the world deal with data. There are some that deal with pretty much every referral that comes in, and if it’s not dealt with and something happens, people can lose their jobs. On the opposite side of the coin, some countries are receiving thousands of email referrals a day that don’t even get opened.

Now, we are seeing evidence that advances in technology can also be utilised to fight online sexual predators. But the use of such technology raises ethical questions.

Contentious AI tool draws on 40 billion online images

The powerful, but contentious AI tool, that left Lay speechless was a case in point: one of multiple AI facial recognition tools that have come onto the market, and with multiple applications. The technology can help identify people using billions of images scraped from the internet, including social media.

AI facial recognition software like this has reportedly been used by Ukraine to debunk false social media posts, enhance safety at check points and identify Russian infiltrators, as well as dead soldiers. It was also reportedly used to help identify rioters who stormed the US capital in 2021.

The New York Times magazine reported on another remarkable case. In May 2019, an internet provider alerted authorities after a user received images depicting the sexual abuse of a young girl.

One grainy image held a vital clue: an adult face visible in the background that the facial recognition company was able to match to an image on an Instagram account featuring the same man, again in the background. This was in spite of the fact that the image of his face would have appeared about half the size of a human fingernail when viewing it. It helped investigators pinpoint his identity and the Las Vegas location where he was found to be creating the child sexual abuse material to sell on the dark web. That led to the rescue of a seven-year-old girl and to him being sentenced to 35 years in jail.

Meanwhile, for its part, the UK government recently argued that facial recognition software can allow police to “stay one step ahead of criminals” and make Britain’s streets safer. Although, at the moment, the use of such software is not allowed in the UK.

When Lay volunteered to allow his own features to be analysed, he was stunned that within seconds the app produced a wealth of images, including one that captured him in the background of a photo taken at the rugby match years before. Think about how investigators can equally match a distinctive tattoo or unusual wallpaper where abuse has occurred and the potential of this as a crime-fighting tool is easy to appreciate.

Of course, it is also easy to appreciate the concerns some people have on civil liberties grounds which have limited the use of such technology across Europe. In the wrong hands, what might such technology mean for a political dissident in hiding for instance? One Chinese facial recognition startup has come under scrutiny by the US government for its alleged role in the surveillance of the Uyghur minority group, for example.

Role of big tech

Similar points are sometimes made by big tech proponents of end-to-end encryption on popular apps: apps which are also used to share child abuse and exploitation files on an industrial scale – effectively turning the lights off on some of the world’s darkest crimes.

Why – ask the privacy purists – should anyone else have the right to know about their private content?

And so, it may seem to some that we have reached a Kafkaesque point where the right to privacy of abusers risks trumping the privacy and safety rights of the children they are abusing.

Clearly then, if encryption of popular file sharing apps is to be the norm, a balance must be struck that meets the desire for privacy for all users, with the proactive detection of child sexual abuse material online.

Meta has shown recently that there is potential for a compromise that could improve child safety, at least to some extent. Instagram, described by the NSPCC recently as the platform most used for grooming , has developed a new tool aimed at blocking the sending of sexual images to children – albeit, notably, authorities will not be alerted about those sending the material.

This would involve so-called client-side scanning which Meta believes undermines the chief privacy protecting feature of encryption – that only the sender and recipient know about the contents of messages. Meta has said it does report all apparent instances of child exploitation appearing on its site from anywhere in the world to NCMEC.

One compromise with the use of AI to detect offenders, suggests Lay, is a simple one: to ensure it can only be used under strict licence of child protection professionals with appropriate controls in place. It is not “a silver bullet”, he explained to me. AI-based ID will always need to be followed up by old fashioned police work but anything that can “achieve in 15 seconds what we used to spend hours and hours trying to get” is worthy of careful consideration, he believes.

The Ecuador operation, combining AI with traditional work, had an immediate impact in March. ICMEC reports that it led to a total of 115 victims (mainly girls and mostly aged six-12 and 13-15) and 37 offenders (mainly adult men) positively identified worldwide. Within three weeks, ICMEC said 18 international interventions had taken place, with 45 victims rescued and seven abusers arrested.

One way or another, a compromise needs to be struck to deal with this pandemic.

Child sexual abuse is a global public health crisis that is steadily worsening thanks to advancing technologies which enable instantaneous production and limitless distribution of child exploitation material, as well as unregulated access to children online.

These are the words of Tasmanian, Grace Tame: a remarkable survivor of childhood abuse and executive director of the Grace Tame Foundation which works to combat the sexual abuse of children.

“Like countless child sexual abuse victim-survivors, my life was completely upended by the lasting impacts of trauma, shame, public humiliation, ignorance and stigma. I moved overseas at 18 because I became a pariah in my hometown, didn’t pursue tertiary education as hoped, misused alcohol and drugs, self-harmed, and worked several minimum wage jobs”. Tame believes that “a centralised global research database is essential to safeguarding children”.

If the internet and technology brought us to where we are today, the AI used in Quito to save 45 children is a powerful demonstration of the power of technology for good. Moreover, the work of the ten-country taskforce is testament to the potential of global responses to a global problem on an internet that knows no national boundaries.

Greater collaboration, education, and in some cases regulation and legislation can all help, and they are needed without delay because, as Childlight’s mantra goes, children can’t wait.

For you: more from our Insights series :

Why people self-injure: ‘You have no other voice – and no one would listen anyway’

Mr Bates vs The Post Office depicts one of the UK’s worst miscarriages of justice: here’s why so many victims didn’t speak out

GP crisis: how did things go so wrong, and what needs to change?

‘It’s like being in a warzone’ – A&E nurses open up about the emotional cost of working on the NHS frontline

To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. Subscribe to our newsletter .

• Artificial intelligence (AI)
• Online safety
• End-to-end encryption
• Child sexual exploitation
• Insights series
• Online Safety Act

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Over 300 million young people have experienced online sexual abuse, exploitation, finds metastudy

by Deborah Fry, The Conversation

It takes a lot to shock Kelvin Lay. My friend and colleague was responsible for setting up Africa's first dedicated child exploitation and human trafficking units, and for many years he was a senior investigating officer for the Child Exploitation Online Protection Center at the UK's National Crime Agency, specializing in extra territorial prosecutions on child exploitation across the globe.

But what happened when he recently volunteered for a demonstration of cutting-edge identification software left him speechless. Within seconds of being fed with an image of how Lay looks today, the AI app sourced a dizzying array of online photos of him that he had never seen before—including in the background of someone else's photographs from a British Lions rugby match in Auckland eight years earlier.

"It was mind-blowing," Lay told me. "And then the demonstrator scrolled down to two more pictures, taken on two separate beaches—one in Turkey and another in Spain—probably harvested from social media. They were of another family but with me, my wife and two kids in the background. The kids would have been six or seven; they're now 20 and 22."

The AI in question was one of an arsenal of new tools deployed in Quito, Ecuador, in March when Lay worked with a ten-country taskforce to rapidly identify and locate perpetrators and victims of online child sexual exploitation and abuse—a hidden pandemic with over 300 million victims around the world every year.

That is where the work of the Childlight Global Child Safety Institute , based at the University of Edinburgh, comes in. Launched a little over a year ago in March 2023 with the financial support of the Human Dignity Foundation , Childlight's vision is to use the illuminating power of data and insight to better understand the nature and extent of child sexual exploitation and abuse.

I am a professor of international child protection research and Childlight's director of data, and for nearly 20 years I have been researching sexual abuse and child maltreatment, including with the New York City Alliance Against Sexual Assault and Unicef.

The fight to keep our young people safe and secure from harm has been hampered by a data disconnect—data differs in quality and consistency around the world, definitions differ and, frankly, transparency isn't what it should be. Our aim is to work in partnership with many others to help join up the system, close the data gaps and shine a light on some of the world's darkest crimes.

302 million victims in one year

Our new report, Into The Light , has produced the world's first estimates of the scale of the problem in terms of victims and perpetrators.

Our estimates are based on a meta-analysis of 125 representative studies published between 2011 and 2023, and highlight that one in eight children—302 million young people—have experienced online sexual abuse and exploitation in a one year period preceding the national surveys.

Additionally, we analyzed tens of millions of reports to the five main global watchdog and policing organizations—the Internet Watch Foundation (IWF), the National Center for Missing and Exploited Children (NCMEC), the Canadian Center for Child Protection (C3P), the International Association of Internet Hotlines (INHOPE), and Interpol's International Child Sexual Exploitation database (ICSE). This helped us better understand the nature of child sexual abuse images and videos online.

While huge data gaps mean this is only a starting point, and far from a definitive figure, the numbers we have uncovered are shocking.

We found that nearly 13% of the world's children have been victims of non-consensual taking, sharing and exposure to sexual images and videos.

In addition, just over 12% of children globally are estimated to have been subject to online solicitation, such as unwanted sexual talk which can include non-consensual sexting, unwanted sexual questions and unwanted sexual act requests by adults or other youths.

Cases have soared since COVID changed the online habits of the world. For example, the Internet Watch Foundation (IWF) reported in 2023 that child sexual abuse material featuring primary school children aged seven to ten being coached to perform sexual acts online had risen by more than 1,000% since the UK went into lockdown.

The charity pointed out that during the pandemic, thousands of children became more reliant on the internet to learn, socialize, and play and that this was something which internet predators exploited to coerce more children into sexual activities—sometimes even including friends or siblings over webcams and smartphones.

There has also been a sharp rise in reports of "financial sextortion," with children blackmailed over sexual imagery that abusers have tricked them into providing—often with tragic results, with a spate of suicides across the world .

This abuse can also utilize AI deepfake technology—notoriously used recently to generate false sexual images of the singer Taylor Swift.

Our estimates indicate that just over 3% of children globally experienced sexual extortion in the past year.

A child sexual exploitation pandemic

This child sexual exploitation and abuse pandemic affects pupils in every classroom, in every school, in every country, and it needs to be tackled urgently as a public health emergency. As with all pandemics, such as COVID and AIDS, the world must come together and provide an immediate and comprehensive public health response.

Our report also highlights a survey which examines a representative sample of 4,918 men aged over 18 living in Australia , the UK and the US. It has produced some startling findings. In terms of perpetrators:

• One in nine men in the US (equating to almost 14 million men) admitted online sexual offending against children at some point in their lives—enough offenders to form a line stretching from California on the west coast to North Carolina in the east or to fill a Super Bowl stadium more than 200 times over.
• The surveys found that 7% of men in the UK had admitted the same—equating to 1.8 million offenders, or enough to fill the O 2 area 90 times over and by 7.5% of men in Australia (nearly 700,000).
• Meanwhile, millions across all three countries said they would also seek to commit contact sexual offenses against children if they knew no one would find out, a finding that should be considered in tandem with other research indicating that those who watch child sexual abuse material are at high risk of going on to contact or abuse a child physically.

The internet has enabled communities of sex offenders to easily and rapidly share child abuse and exploitation images on a staggering scale, and this in turn, increases demand for such content among new users and increases rates of abuse of children, shattering countless lives.

In fact, more than 36 million reports of online sexual images of children who fell victim to all forms form of sexual exploitation and abuse were filed in 2023 to watchdogs by companies such as X, Facebook, Instagram, Google, WhatsApp and members of the public. That equates to one report every single second.

Quito operation

Like everywhere in the world, Ecuador is in the grip of this modern, transnational problem: the rapid spread of child sexual exploitation and abuse online. It can see an abuser in, say, London, pay another abuser in somewhere like the Philippines to produce images of atrocities against a child that are in turn hosted by a data center in the Netherlands and dispersed instantly across multiple other countries.

When Lay—who is also Childlight's director of engagement and risk—was in Quito in 2024, martial law meant a large hotel normally busy with tourists flocking for the delights of the Galápagos Islands, was eerily quiet, save for a group of 40 law enforcement analysts, researchers and prosecutors who had more than 15,000 child sexual abuse images and videos to analyze.

The cache of files included material logged with authorities annually, content from seized devices, and from Interpol's International Child Sexual Exploitation (ICSE) database database. The files were potentially linked to perpetrators in ten Latin American and Caribbean countries: Argentina, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Honduras, Guatemala, Peru and the Dominican Republic.

Child exploitation exists in every part of the world but, based on intelligence from multiple partners in the field, we estimate that a majority of Interpol member countries lack the training and resources to properly respond to evidence of child sexual abuse material shared with them by organizations like the National Center for Missing and Exploited Children (NCMEC). NCMEC is a body created by US Congress to log and process evidence of child sexual abuse material uploaded around the world and spotted, largely, by tech giants. However, we believe this lack of capacity means that millions of reports alerting law enforcement to abuse material are not even opened.

The Ecuador operation, in conjunction with the International Center for Missing and Exploited Children (ICMEC) and US Homeland Security, aimed to help change that by supporting authorities to develop further skills and confidence to identify and locate sex offenders and rescue child victims.

Central to the Quito operation was Interpol's database database that contains around five million images and videos that specialized investigators from more than 68 countries use to share data and co-operate on cases.

Using image and video comparison software—essentially photo ID work that instantly recognizes the digital fingerprint of images—investigators can quickly compare images they have uncovered with images contained in the database. The software can instantly make connections between victims, abusers and places. It also avoids duplication of effort and saves precious time by letting investigators know whether images have already been discovered or identified in another country. So far, it has helped identify more than 37,900 victims worldwide.

Lay has significant field experience using these resources to help Childlight turn data into action—recently providing technical advice to law enforcement in Kenya where successes included using data to arrest pedophile Thomas Scheller. In 2023, Scheller, 74, was given an 81-year jail sentence . The German national was found guilty by a Nairobi court of three counts of trafficking, indecent acts with minors and possession of child sexual abuse material.

But despite these data strides, there are concerns about the inability of law enforcement to keep pace with a problem too large for officers to arrest their way out of. It is one enabled by emerging technological advances, including AI-generated abuse images, which threaten to overwhelm authorities with their scale.

In Quito, over a warming rainy season meal of encocado de pescado, a tasty regional dish of fish in a coconut sauce served with white rice, Lay explained: "This certainly isn't to single out Latin America but it's become clear that there's an imbalance in the way countries around the world deal with data. There are some that deal with pretty much every referral that comes in, and if it's not dealt with and something happens, people can lose their jobs. On the opposite side of the coin, some countries are receiving thousands of email referrals a day that don't even get opened."

Now, we are seeing evidence that advances in technology can also be utilized to fight online sexual predators. But the use of such technology raises ethical questions.

Contentious AI tool draws on 40 billion online images

The powerful, but contentious AI tool, that left Lay speechless was a case in point: one of multiple AI facial recognition tools that have come onto the market, and with multiple applications. The technology can help identify people using billions of images scraped from the internet, including social media.

AI facial recognition software like this has reportedly been used by Ukraine to debunk false social media posts, enhance safety at check points and identify Russian infiltrators, as well as dead soldiers. It was also reportedly used to help identify rioters who stormed the US capital in 2021.

The New York Times magazine reported on another remarkable case. In May 2019, an internet provider alerted authorities after a user received images depicting the sexual abuse of a young girl.

One grainy image held a vital clue: an adult face visible in the background that the facial recognition company was able to match to an image on an Instagram account featuring the same man, again in the background. This was in spite of the fact that the image of his face would have appeared about half the size of a human fingernail when viewing it. It helped investigators pinpoint his identity and the Las Vegas location where he was found to be creating the child sexual abuse material to sell on the dark web. That led to the rescue of a seven-year-old girl and to him being sentenced to 35 years in jail.

Meanwhile, for its part, the UK government recently argued that facial recognition software can allow police to "stay one step ahead of criminals" and make Britain's streets safer. Although, at the moment, the use of such software is not allowed in the UK.

When Lay volunteered to allow his own features to be analyzed, he was stunned that within seconds the app produced a wealth of images, including one that captured him in the background of a photo taken at the rugby match years before. Think about how investigators can equally match a distinctive tattoo or unusual wallpaper where abuse has occurred and the potential of this as a crime-fighting tool is easy to appreciate.

Of course, it is also easy to appreciate the concerns some people have on civil liberties grounds which have limited the use of such technology across Europe. In the wrong hands, what might such technology mean for a political dissident in hiding for instance? One Chinese facial recognition startup has come under scrutiny by the US government for its alleged role in the surveillance of the Uyghur minority group, for example.

Role of big tech

Similar points are sometimes made by big tech proponents of end-to-end encryption on popular apps: apps which are also used to share child abuse and exploitation files on an industrial scale —effectively turning the lights off on some of the world's darkest crimes.

Why—ask the privacy purists—should anyone else have the right to know about their private content?

And so, it may seem to some that we have reached a Kafkaesque point where the right to privacy of abusers risks trumping the privacy and safety rights of the children they are abusing.

Clearly then, if encryption of popular file sharing apps is to be the norm, a balance must be struck that meets the desire for privacy for all users, with the proactive detection of child sexual abuse material online.

Meta has shown recently that there is potential for a compromise that could improve child safety, at least to some extent. Instagram, described by the NSPCC recently as the platform most used for grooming , has developed a new tool aimed at blocking the sending of sexual images to children—albeit, notably, authorities will not be alerted about those sending the material.

This would involve so-called client-side scanning which Meta believes undermines the chief privacy protecting feature of encryption—that only the sender and recipient know about the contents of messages. Meta has said it does report all apparent instances of child exploitation appearing on its site from anywhere in the world to NCMEC.

One compromise with the use of AI to detect offenders, suggests Lay, is a simple one: to ensure it can only be used under strict license of child protection professionals with appropriate controls in place. It is not "a silver bullet," he explained to me. AI-based ID will always need to be followed up by old fashioned police work but anything that can "achieve in 15 seconds what we used to spend hours and hours trying to get" is worthy of careful consideration, he believes.

The Ecuador operation, combining AI with traditional work, had an immediate impact in March. ICMEC reports that it led to a total of 115 victims (mainly girls and mostly aged six-12 and 13-15) and 37 offenders (mainly adult men) positively identified worldwide. Within three weeks, ICMEC said 18 international interventions had taken place, with 45 victims rescued and seven abusers arrested.

One way or another, a compromise needs to be struck to deal with this pandemic. "Child sexual abuse is a global public health crisis that is steadily worsening thanks to advancing technologies which enable instantaneous production and limitless distribution of child exploitation material, as well as unregulated access to children online."

These are the words of Tasmanian, Grace Tame: a remarkable survivor of childhood abuse and executive director of the Grace Tame Foundation which works to combat the sexual abuse of children.

"Like countless child sexual abuse victim-survivors, my life was completely upended by the lasting impacts of trauma, shame, public humiliation, ignorance and stigma. I moved overseas at 18 because I became a pariah in my hometown, didn't pursue tertiary education as hoped, misused alcohol and drugs, self-harmed, and worked several minimum wage jobs." Tame believes that "a centralized global research database is essential to safeguarding children."

If the internet and technology brought us to where we are today, the AI used in Quito to save 45 children is a powerful demonstration of the power of technology for good. Moreover, the work of the ten-country taskforce is testament to the potential of global responses to a global problem on an internet that knows no national boundaries.

Greater collaboration, education, and in some cases regulation and legislation can all help, and they are needed without delay because, as Childlight's mantra goes, children can't wait.

Provided by The Conversation

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The Politics of Drug Rehabilitation in the Philippines

Volume 24/1, June 2022, pp. 147-158 |  PDF

Gideon Lasco and Lee Edson Yarcia

The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the “war on drugs.” In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is possible by capitalizing on the reforms that are, unwittingly, the result of the “war on drugs.”

This paper analyzes the Philippines as a case study of how politics and populism have framed the understanding and implementation of drug rehabilitation, particularly in an unstable democracy with a long history of authoritarianism and oligarchic patrimonialism. [1] The Philippines has taken global center stage since the Duterte administration’s launch of a “war on drugs” in 2016, with much attention and concern focused on extrajudicial killings—numbering at least several thousand—in connection with this campaign. [2]

Less critically examined, however, is how this period—during which drugs have been at the forefront of political and public discourse—has shaped compulsory drug interventions in the country. Compulsory treatment in the Philippines occurs inside spectacular “mega rehabilitation centers” and in the context of a growing number of public and private drug treatment facilities. [3] During the height of the “war on drugs,” the police conducted door-to-door searches in order to compel people who use drugs to “surrender”—effectively a form of forced apprehension—and undergo “voluntary” rehabilitation. [4] Philippine drug courts continued ordering people who use drugs to undergo rehabilitation in government centers or inside jails, with rehabilitation considered a penalty under the national drug law. [5] In recent years, promising community-based programs have operated in parallel with compulsory detention and involuntary treatment, but difficulties have arisen in implementing a fully autonomy-respecting system given the punitive legal environment for people whose lives include drugs. [6]

In this case study, we argue that long-standing perceptions on drugs in the Philippines have created an uncritical acceptance that people who use drugs require “rehab” and, consequently, a permissive political environment for compulsory detention and involuntary treatment. Moreover, we argue that the punitive drug regime has reinforced similarly pernicious attitudes by presenting forced “rehab” as the humane and acceptable alternative to extrajudicial killings. To support our findings, we present figurations of “rehab” in the country over the past six years, from the Duterte administration’s statements and programs to the policy pronouncements of those who are running to succeed him in the 2022 elections. We explain this fixation on treating people who use drugs as either criminals or patients—in both cases deemed as without full autonomy to make informed and moral personal decisions—as a product of exploited populism in a predominantly Catholic country. Drawing from international human rights obligations in relation to drug policy, we conclude by identifying critical leverage points and structural factors that drug policy reformists in unstable democracies can maneuver toward a public health-centered framework that respects full patient autonomy and human dignity.

The drug rehabilitation landscape in the Philippines

Duterte’s election to the highest post in the country was premised on a relentless and sustained fight against criminality, illegal drugs, and corruption. [7] On his first day in office, Duterte appointed his former city police chief Ronald dela Rosa to implement his “war on drugs” to fulfill his campaign promise of eliminating illegal drugs in three to six months. [8] As noted by the Office of the United Nations High Commissioner for Human Rights, between July 1, 2016, and November 27, 2017, there was a staggering average of nearly 40 deaths per day as a result of drug operations by the police and from homicides perpetrated by unidentified persons. [9] The prosecutor of the International Criminal Court subsequently requested authorization to open an investigation in the Philippines after finding reasonable basis to believe that the crime against humanity of murder was being committed in the context of the government’s “war on drugs.” [10]

Against the backdrop of extrajudicial killings apparently perpetrated pursuant to an official state policy of the Philippines, the drug rehabilitation landscape in the Philippines was changing in light of the threat to life and liberty of people who use drugs. [11] The 2016 statistics of the Philippine Dangerous Drugs Board (DDB) showed that 6,079 individuals were admitted to residential and outpatient facilities nationwide for rehabilitation. [12] A year later, the data showed a decrease in admission to 4,045 individuals, equivalent to a 33% reduction. [13] This substantial drop in admissions is understandable in light of the threat to life and liberty of people who are identified to be using drugs. In 2018, a significant 34.55% increase in admission was reported, largely due to a court-directed policy that allowed for plea bargaining by persons charged with criminal cases, which made up 24.89% of the 5,447 admissions for the year. [14] The 2019 data showed increasing admissions due to plea bargaining agreements, but an overall slight decrease of 4.04% in total admissions was observed, attributed to individuals’ “voluntary submission” to community-based drug rehabilitation. [15] Figure 1 shows the number of persons who use drugs who were admitted to rehabilitation facilities from 2016 to 2019. Close to the end of Duterte’s term, a total of 55 treatment and rehabilitation facilities were operating, up from 31 centers before the start of his presidency. [16]

In November 2016, Duterte inaugurated a 10-hectare compound, dubbed a “mega rehab center,” designed to house as many as 10,000 persons who “surrendered” and would undergo treatment. [17] According to the compound’s chief medical officer, Nelson Dancel, a typical day in the center starts at 5:30 a.m., when residents are required to do a series of physical exercises similar to those required in the army, followed by activities meant to teach the concepts of self-acceptance, self-development, and self-formation. [18] For recreation, the mega rehab center boasts basketball and volleyball courts, chess boards, and musical instruments, with television reserved as a privilege for more senior residents. [19] Dancel explains that escapes are a natural occurrence since some residents feel homesick or worry about their families; individuals who attempt to escape but fail are segregated from other residents, but Dancel is quick to clarify that they are not in solitary confinement. [20] If violations are severe, residents receive extra physical work, such as exercises or additional chores. [21]

A year after the center’s inauguration, the DDB described it as a mistake. [22] Only 400 people were treated in the 75,000-hectare property, leading the DDB chief to push for community-based interventions. [23]

Nevertheless, the protocols in the mega rehab center reflect typical programs in drug treatment and rehabilitation centers nationwide. Guided by the Manual of Operations for Drug Abuse Treatment and Rehabilitation Centers , which sets the minimum standards for this type of facility, the Department of Health accredits rehabilitation centers—both government and nongovernment owned or operated—based on their compliance with these prescribed uniform standards. [24] Notably, the manual enumerates the prescribed services, which are replicated here for a fuller appreciation of the mandated programs in rehabilitation centers:

• Medical service provides comprehensive health care services ranging from routine physical examination and screening procedure for diagnosis, treatment and follow-up of illnesses and other medical problems.
• Psychiatric service provides therapy to drug abusers with behavioural and psychiatric disorders through, among others, chemotherapy, individual and group psychotherapy, family therapy and occupational therapy conducted by a psychiatric team. A psychiatric team shall include a psychiatrist, psychologist and social worker. This may include an occupational therapist and para-professional worker.
• Psychological service assists the team in the assessment, diagnosis and management of drug dependents through psychological testing and evaluation as well as in conducting therapy/counselling to patients and their families.
• Social service assists the drug dependents help themselves cope [with] their problems, facilitate and/or promote their interpersonal relationship and adjustment to the demands of a treatment program with the end view of helping the drug dependents’ physical, social, moral and spiritual development.
• Spiritual and religious services include the development of moral and spiritual values of the drug dependent. It has been noted that the spiritual foundation of patients has been very weak that this could not provide support to them to enable them to cope with their problems and conflicts. Strengthening the spiritual foundation would involve, among others, reorientation of moral values, spiritual renewal, bible study and other charismatic sessions. It aims to bring them closer to God and better relate to their fellowmen. Various religious and civic organizations can be contacted to provide services. Spiritual counselling shall be helpful in aiding and resolution of individual and family problems.
• Referral service involves the process of identifying accurately the problems of the patient and sending him to the agency that can provide the appropriate services.
• Sports and recreation services provide facilities for sports and recreation to offer patients the opportunity to engage in constructive activities and to establish peer relationship as an alternative to drug abuse. The emphasis in all activities should be on developing the discipline necessary to improve skills and on gaining respect for good physical health.
• Residential/house care service includes provision of basic foods, clothing and shelter.
• Aftercare and follow-up services provided to the patient after the primary rehabilitation program. Aftercare activities can be viewed as the first line of defence against relapse. The activities include attending self-help programs like Narcotics Anonymous (NA) / Alcoholic Anonymous (AA) meetings, regular follow-up at treatment Center, individual and group counsellings sponsor/sponsee meetings, alumni association meetings, etc. This is for a period not exceeding eighteen (18) months and should be undertaken by the appropriate Center personnel. [25]

The manual further provides optional additional services, which may include placement service for work opportunities, volunteer service opportunities to assist the rehabilitation center, and educational opportunities. [26] Centers are mandated to contribute effectively to the goals of the Comprehensive Dangerous Drugs Act of 2002, which expresses the state policy of pursuing “an intensive and unrelenting campaign against the trafficking and use of dangerous drugs and other similar substances [including provision of] effective mechanisms or measures to re-integrate into society individuals who have fallen victims to drug abuse or dangerous drugs through sustainable programs of treatment and rehabilitation.” [27]

Presently, people who use drugs undergo drug treatment and rehabilitation programs and services following the guidelines set under Board Regulation No. 7 of 2019 by the DDB. Under this regulation, a verified application must be filed to the DDB to access a treatment and rehabilitation program. The application may be made by the person who uses drugs or by parents, spouses, guardians, or relatives within the fourth degree of consanguinity. [28] Upon recommendation by an accredited physician, “taking into consideration his/her level of drug dependency and the potential danger he/she may pose to himself/herself, his/her family and the community,” the DDB shall file a petition to the appropriate court for the confinement of the person for treatment and rehabilitation. [29] The court shall then order the person to undergo a drug dependency examination by an accredited physician, and, if certified to be drug dependent, “he/she shall be ordered by the court to undergo treatment and rehabilitation in a center designated by the Board for a period of not less than six (6) months.” Notably, the examination is conducted by physicians accredited by the Department of Health, with reference to the clinical parameters of drug dependency under the International Classification of Diseases, 10th revision. [30]

Modes of compulsion in drug treatment and rehabilitation during Duterte’s administration

Under the Duterte administration, persons who use drugs may be compelled to undergo drug rehabilitation through three major modes: first, through a police and law enforcement-directed door-to-door search and “request to surrender” campaign known as Oplan Tokhang; second, through court-mandated rehabilitation of people arrested for drug use; and third, through family-initiated admission without the consent of the person who uses drugs. The second and third modes are not unique to the Duterte administration, but a significant increase in arrests have been noted in the past six years, leading to congestion in jails. [31]

On the day of his appointment as chief of the Philippine National Police, dela Rosa issued a circular entitled PNP Anti-Illegal Drugs Campaign Plan – Project “Double Barrel,” where he ordered the police “to clear all drug affected barangays across the country.” [32] The international community was shocked by this policy’s aftermath, with the Office of the United Nations High Commissioner for Human Rights reporting 5,601 killed based on information from the Philippine Drug Enforcement Agency; government data mentions 16,355 “homicide cases under investigation” as accomplishments in the fight against illegal drugs, while 20,322 deaths are reported from drug operations by police and homicides perpetrated by unidentified persons. [33] Less visible in the international public discourse is the plight of 223,780 persons arrested for drug-related cases, which led to massive congestion in jails—85% to 90% of those incarcerated are there for drug-related offenses. [34]

The police have also conducted house-to-house visitations, which do not require search or arrest warrants, to “encourage voluntary surrender” to the government for drug-related acts. [35] Refusal leads to an immediate case build-up and “negation,” a term appearing in the aforementioned circular that could be interpreted by the police as permission to kill. [36] The DDB has noted “unprecedented responses from both law enforcement and the public,” including “voluntary surrender of self-confessed drug personalities nationwide.” [37] Under Board Regulation No. 3 of 2016, a “surrenderer” shall subscribe to an affidavit of undertaking and waiver that authorizes a medical examination and drug test; and if the individual in question is not engaged in trafficking or sale and is just using drugs, they shall state in the affidavit that “he/she shall undergo voluntary treatment and rehabilitation.” [38]

According to the most recent data from the Bureau of Jail Management and Penology, there are now 80,162 persons deprived of liberty detained for violation of the national drug law. [39] On November 8, 2021, the bureau signed a memorandum of agreement with the DDB so that such persons who have signed a plea bargain and who are classified as “low risk” or “moderate risk” for drug dependence may undergo court-mandated treatment and rehabilitation while in jail. [40]

Long-standing perception on drug rehabilitation: “Save the user, jail the pusher”

The above policies and programs cannot be disentangled from the long-standing perception—characterized by some scholars as a “moral panic”—that people who use drugs are “addicts” and societal villains. [41] This prohibitionist paradigm, which is perhaps best summed up by the popular slogan “save the user, jail the pusher,” has been reflected in various institutions throughout past half century, from the Catholic Church to broadcast and print media. [42] Essentially, this part-moralistic, part-medicalized view forges divisions between “pushers” and “addicts” who are a menace to society and “users” (often depicted as young people) who need to be “saved.” As the Catholic Bishops’ Conference of the Philippines wrote in a pastoral letter that coincided with Ferdinand Marcos’ ascendancy:

A country whose youths are mental and physical wrecks will be hopelessly doomed to ignominy unredeemable until, if that is possible, a new and strong breed will rise up from the ruins. These are the worst saboteurs and are worthy of the highest punishments. For they destroy the youth, the hope of the land. [43]

Rehabilitation centers figure in this narrative as sites where this “salvation” and “healing” can take place. In the words of a Catholic leader touting the church’s rehabilitation program, “Everybody needs healing. These drug addicts, they’ve been wounded very much and what they need is someone who can help them.” [44] Indeed, many such programs are affiliated with religious organizations; those who are not nonetheless orient themselves around the same themes of healing, redemption, and salvation. [45]

Duterte’s punitive approach to drugs has arguably made rehabilitation an even more socially and politically viable position—an alternative to the extrajudicial killings that allows individuals and institutions to continue being seen as “tough” on drugs while also satisfying civil society’s clamor for human rights.

Notably, however, drug treatment and rehabilitation remains largely compulsory in the Philippines, with evidence-based initiatives in some communities seen as the exception to general forced treatments that often have little or no scientific basis. As reported by the United Nations Office on Drugs and Crime and UNAIDS, the Philippines continues to detain people who use drugs in closed settings, often against their will, without sufficient human rights safeguards and forces them to undergo rehabilitation for an average duration of ten months. [46] Government data show severe overcrowding and substandard compulsory facilities, as well as little evidence supporting the use of spiritual or religious interventions. [47] People who use drugs are coerced to undergo treatment in order to “cure” themselves of their addiction.

A number of episodes during the Duterte administration are illustrative. In response to the first few months of Duterte’s drug war, for instance, the Catholic bishops remonstrated in another pastoral letter:

Our hearts reach out in love and compassion to our sons and daughters suffering from drug dependence and addiction. Drug addicts are children of God equal in dignity with the sober ones. Drug addicts are sick brethren in need of healing deserving of new life. They are patients begging for recovery. They may have behaved as scum and rubbish but the saving love of Jesus Christ is first and foremost for them. No man or woman is ever so unworthy of God’s love. [48]

As criticism mounted, including from the political opposition, Duterte at one point appointed Vice President Leni Robredo—the highest-ranking member of the opposition—as chair of the Inter-Agency Committee on Anti-Illegal Drugs. Although her tenure was short-lived—17 days—her report, which she published months after, is reflective of her view. [49]

Finally, the campaign for Duterte’s successor in the May 2022 elections—still underway at the time of writing—is also reflective of the same view. Virtually all the major candidates have expressed support for an “intensified” anti-drug campaign while vowing to respect human rights and promote a “public health” approach. Invariably, however, their idea of what constitutes “public health” includes scaling up the same rehabilitation paradigm that dichotomizes between killing and “rehab.”

Tellingly, when the leading candidate—Ferdinand Marcos Jr.—was accused by Duterte as using cocaine, his opponents lost no time in calling out the contradictions in Duterte’s drug war—while also calling on Marcos to be punished, as expressed in this tweet by Leody de Guzman, standard-bearer of the progressive left:

Tiyak, kilalang kilala ni Duterte kung sino ang supplier ng kandidatong ‘yan na nagpapasok ng cocaine sa bansa. ‘Yan dapat ang pokusan para mahuli at matigil na. Kaysa itsismis lang, ipahuli na ang kandidatong ‘yan para ipa-rehab. [For sure, Duterte knows who the supplier is of that candidate who trafficks cocaine in the country. That should be the focus so that he can be arrested and stopped. Instead of rumor-mongering, the candidate should be arrested and placed in rehab.] [50]

For her part, Robredo has hewed close to the same discourse she raised as chair of the Inter-Agency Committee on Anti-Illegal Drugs:

In my belief, once DDB sits as the chair of DDB, its plan will not be just “kill, kill, kill” but the plan will be more comprehensive—heavy on prevention, heavy on rehabilitation. [51]

These political discourses reflect and reinforce the moral panic on drugs that sees rehabilitation as the humane (and only) way to “save the user,” precluding other initiatives such as harm reduction and decriminalization, which—notably—none of the candidates have mentioned.

Drug rehabilitation and populism

What can explain the subscription to the “save the user” narrative that has led to uncritical support for “rehabilitation” as it is (mis)understood by the Philippine public?

As discussed above, previous scholars have used the literature on “moral panic” to explain the long-standing vilification of drugs in the country. Drawing on the literature on penal and medical populisms, more recent scholarship has implicated political actors in reflecting and reinforcing public attitudes about drugs, portraying these actors as “moral entrepreneurs” who simplify, spectularize, and forge divisions between “addicts” and the virtuous public. [52]

Missing in these accounts, however, is the nuance regarding what people view as the rightful solution to the “problem.” Survey after survey has shown that Filipinos favor a strong approach to drugs—even approving of the “drug war”—despite the fact that they disapprove of the killings, suggestive that far from a monolithic dichotomy between supporting or opposing a draconian approach to drugs, people are divided on what particular draconian approach to take: either drug addicts deserve to be killed or drug addicts should be sent to compulsory rehabilitation.

Less emphasized in the scholarship is how Philippine drug policy has followed global drug policy flows; most notably, as Christopher Hobson notes, “among all the possible wrongdoing and bad things that exist in the world, it is slightly counterintuitive that drugs are the only one to be labelled as ‘evil’ in international law.” [53] Indeed, the first drug war in the 1970s coincided with the Nixon-era war on drugs and global commitments to the “drug problem,” leading to the establishment of DDB in 1972 and inaugurating a trend of increasingly punitive drug laws. The parallels in high incarceration rates in the United States and the Philippines and similar institutional configurations (e.g., a Philippine Drug Enforcement Agency patterned after a similarly named agency in the United States) speak of how this international—and particularly American—influence continues to have an impact on drug policy in the country. [54]

However, it must be pointed out that even as “Western democracies” and even international organizations are moving away from this approach, the Philippines and other countries in the region have steadfastly adhered to it (with notable exceptions such as Malaysia), suggesting that such an approach has been indigenized, likely enabled by a cultural environment that emphasizes “Asian values” such as conformity and social control, as well as the enduring valance of drugs as a populist trope in the region. [55]

Because they do not specifically address the question of why a particular form of rehabilitation has gained uncritical popular and political acceptance, these explanations are at best partial and would require corroboration through cultural histories and contemporary ethnographic accounts of rehabilitation today. However, they suffice to furnish a historical context to the figurations of rehabilitation in today’s political discourse that in turn perpetuate popular perceptions.

Compulsory rehabilitation in the Philippines an urgent human rights issue

There is a dangerous tendency for reform advocates to condemn extrajudicial killings and due process rights violations as human rights concerns, while supporting rehabilitation as an acceptable alternative. As we have observed, the motivations behind gross human rights violations and forcing people to treatment are the same: the dehumanization of people who use drugs and the removal of their autonomy to decide on the treatment approaches that respond to their felt needs. Drug policies in the Philippines remain to be “substance-centric, moralistic, and medicalized.” [56] Present drug policy from the Department of Health does not recognize non-pathological use, as substance use is classified as mild, moderate, or severe and, in any case, as requiring medical or psychological interventions. [57] Because treatments are compulsory in nature, the right to health, which includes access to voluntary and evidence-based services, is breached. [58]

Relatedly, drug testing has been transformed into a diagnostic and prosecutorial tool for treating people who use drugs. [59] A positive random drug test is enough justification to remove students from school or to terminate employment of otherwise productive employees and to force them to undergo rehabilitation. [60] Notably, random drug testing in schools violate students’ right to privacy and is inconsistent with international guidelines on the rights of children in relation to obligations arising from the human rights of particular groups. [61]

As a result, in 2015, countries from Asia and the Pacific committed to facilitate the transition away from compulsory centers toward an “evidence-informed system of voluntary community-based treatment and services that are aligned with international guidelines and principles of drug dependence treatment, drug use and human rights.” [62] Seven years after, however, the transition has yet to happen.

Moving forward: Transitioning to voluntary alternatives

Despite the problematics of drug rehabilitation in the Philippines being strongly determined by political and popular approaches to drug issues, recent developments suggest that a changing paradigm is not beyond the range of possibilities.

In the first place, the DDB has recognized the failures of closed settings in its approach to rehabilitation. The public admission that the mega rehab center was a mistake because it uproots people who use drugs from their families and the policy shift toward more community-based interventions are important concessions made as the country transitions to a more public health-based framework. More citations on community-based approaches appear in the DDB’s recent issuances that provide guidance to local government units on general interventions and programs. [63] Prior to Duterte’s time, rehabilitation programs were effectively available only in closed settings. Notably, the country has not closed down compulsory rehabilitation facilities and appears to be far from doing so. Nevertheless, at the close of Duterte’s term, we note a promising dent in the number of admissions in closed settings in favor of community-based programs.

This palpable shift in policy can be attributed largely to the work of civil society organizations, human rights groups, and academic institutions that are more sensitized to drug issues and more critical of the political discourses employed in the wake of Duterte’s war on drugs. Many of these groups still embrace a decidedly “drug-free” paradigm, but they can nonetheless serve as entry points for interrogating rehabilitation as it is practiced and understood in the Philippines today. Policy officials, too, have learned important lessons from the drug war, leading them to revise the national guidelines on rehabilitation.

Similarly, as one of the authors notes in another work, “there has been a proliferation of drug war-related researches, from the documentation of its ‘lived experiences’ to policy analyses.” [64] The academic interest in drug issues has included narratives of rehabilitation and case studies on community rehabilitation, all of which can contribute to a local evidence base for alternative interventions. Academic networks have been formed, and publications that problematize the drug war have allowed for dialogues nudging policy makers toward reform.

Second, although, as mentioned above, presidential politics have largely embraced the killings-versus-rehabilitation binary, lawmakers have in fact filed harm reduction bills and similar initiatives. [65] These legislative initiatives—though still unlikely to prosper at this stage—nonetheless represent a sea change from previous times and may signal more openness in the future. This is an important step to challenge the binary framework and to introduce a genuine option that promotes autonomy, human dignity, and health.

Nevertheless, legislative change is necessary. We can no longer avoid and delay the conversation on decriminalization of drug use, as it is apparent that the courts—supposedly the champions of human dignity—have become agents for compulsory rehabilitation. In the Philippines, people are ordered to undergo rehabilitation or face imprisonment. People arrested for drug-related offenses bargain for a lesser penalty, which includes rehabilitation. Jails are now formally considered centers for rehabilitation, putting into question the capacity of these institutions to provide the standards necessary for genuine health programs. [66]

Third, despite the defiant tone that government officials have struck in terms of Duterte’s possible trial before the International Criminal Court, international pressure has been effective in forcing government officials to reform policies that address drug-related concerns. For example, the United Nations Joint Programme for Human Rights in the Philippines has become an important platform for introducing human rights-based approaches to drug control. Among other things, it calls for the improvement of prison conditions and development of community-based programs. If it is to make further progress in the country, however, the joint program must implement the international consensus on ending compulsory rehabilitation and invest in a transition toward voluntary services, following the consensus from the Third Regional Consultation on Compulsory Centres for Drug Users in Asia and the Pacific, and further accommodating the recommendations from the United Nations Office on Drugs and Crime and UNAIDS on adopting voluntary community-based services as the framework for drug-related programs and interventions. [67]

One caveat about international pressure, though, is that it might perpetuate policies that can be framed by populist politicians as “colonial interventions,” especially given the backdrop of how human rights and concerns over the drug war were cast by local politicians as “Western” or “colonial” impositions. [68] This goes to show that beyond “decolonizing drug policy,” drug reform must also move toward decolonizing harm reduction. [69] It is important that attempts to reshape rehabilitation be based on the perspectives of people who use drugs. Thus, international support must not be merely a transplantation of practices from abroad but a genuine privileging of the voices of the communities whose lives involve drugs. Crucial to this project is empowering local actors (e.g., academics and advocates) who can then provide local scholarship and offer localized, culturally sensitive communications efforts that can be more difficult to delegitimize. [70]

Finally, the long-standing support for forced rehabilitation ultimately rests on how people who use drugs are perceived by the public and leaders, both political and religious. Thus, any attempt to reform must involve careful thinking as to how public attitudes can be changed. The narratives that inform policies negatively portray people who use drugs, and moral leaders (predominantly Catholic) have provided the justifications for a draconian approach to drugs, including the removal of personal autonomy in decisions affecting one’s life and health. Admittedly, this sociocultural foundation that supports compulsory rehabilitation is the hardest to break. However, cultural values such as the importance of family can be important themes in counter-narratives that can support family- and community-based approaches. Similarly, amplifying narratives from people who use drugs themselves can illuminate the lived realities of drug rehabilitation for the general public. More fundamentally, however, we need to deepen our understanding of the paradigms that inform the rigid binary to be able to transition to a framework that fully embraces human rights and public health.

In the Philippines, owing to a long history of penal populism, moral panic around drugs, and long-standing moralistic views of people who use them, “drug rehabilitation” is seen as a humane and acceptable alternative to the “drug problem,” and this has been reflected in (and reinforced by) contemporary political discourse. However, as we have shown in this paper, there is very little difference between jails and rehabilitation centers in terms of both philosophy and practice; in fact, jails are now centers for compulsory treatment. Those who seek to reform this untenable status quo need to capitalize on recent policy reforms, informed by a vibrant civil society and supported by the international community, to end the era of forced rehabilitation, with local actors and stakeholders empowered to take the lead.

As the Philippines undertakes a change of leadership, advocates in the country and elsewhere must recognize the need to go beyond addressing killings and insist on a discussion about what kind of rehabilitation should exist—and for whom—and about how to genuinely expand our responses to drug-related issues in a way that goes beyond criminal and medical frameworks. Institutions that have been sensitized to what is at stake with drug policy in the country can be potential allies in this move, but it must be accompanied by international attention beyond the killings—as well as a recognition that “decolonizing drug policy” also entails decolonizing the ways we have sought to reform it. [71] Lessons learned from the Philippines are likely relevant for neighboring countries and thus for drug policy and human rights advocacy around the world.

Gideon Lasco, MD, PhD, is a senior lecturer in the Department of Anthropology, University of the Philippines Diliman, and a research fellow at the Ateneo de Manila University’s Development Studies Program, Quezon City, Philippines.

Lee Edson Yarcia, MD, JD, is a senior lecturer in medical jurisprudence and constitutional law at the College of Law, University of the Philippines Diliman, Manila, Philippines, and a drug policy expert at the United Nations Joint Programme for the Protection and Promotion of Human Rights in the Philippines.

Please address correspondence to Gideon Lasco. Email: [email protected].

Competing interests: None declared.

Copyright © 2022 Lasco and Yarcia. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction.

[1] L. Escresa and N. Garoupa, “Judicial politics in unstable democracies: The case of the Philippine Supreme Court, an empirical analysis 1986–2010,” Asian Journal of Law and Economics 3/1 (2012), p. 1; R. Juan-Bautista, Readings in Philippine legal history (Quezon City: University of the Philippines College of Law, 2017), pp. 143–281; N. Quimpo, “Review: Oligarchic patrimonialism, bossism, electoral clientelism, and contested democracy in the Philippines,” Comparative Politics 37/2 (2005), pp. 229–250.

[2] Office of the United Nations High Commissioner on Human Rights, Situation of Human Rights in the Philippines, UN Doc. A/HRC/44/22 (2020).

[3] A. Abando, Mega rehab gives hope to lost souls (December 2017) . Available at https://www.pna.gov.ph/articles/1013310.

[4] Office of the Prosecutor or the International Criminal Court, Situation in the Republic of the Philippines, ICC-01/21 (2021).

[5] Republic Act No. 9165 (2002).

[6] United Nations Office on Drugs and Crime and Joint United Nations Programme on HIV/AIDS, Compulsory drug treatment and rehabilitation in East and Southeast Asia (January 2022). Available at: https://unaidsapnew.files.wordpress.com/2022/01/booklet-3-12th-jan-2022.pdf.

[7] R. Duterte, Inaugural address of President Rodrigo Roa Duterte (June 2016). Available at https://www.officialgazette.gov.ph/2016/06/30/inaugural-address-of-president-rodrigo-roa-duterte-june-30-2016/ .

[8] A. Tejada, Duterte vows to end criminality in 3 months (February 2016). Available at https://www.philstar.com/headlines/2016/02/20/1555349/duterte-vows-end-criminality-3-months .

[9] Office of the United Nations High Commissioner for Human Rights (see note 2).

[10] Office of the Prosecutor of the International Criminal Court (see note 4).

[12] Dangerous Drugs Board, Reported cases by type of admission and sex (facility based) CY 2016 (June 2017). Available at https://www.ddb.gov.ph/research-statistics/statistics/45-research-and-statistics/329-2016-statistics .

[13] Dangerous Drugs Board, Reported cases by type of admission and sex (facility based) CY 2017 (February 2019). Available at https://www.ddb.gov.ph/research-statistics/statistics/45-research-and-statistics/396-2017-statistics .

[14] Dangerous Drugs Board, 2018 statistics (October 2019). Available at https://www.ddb.gov.ph/research-statistics/statistics/45-research-and-statistics/434-2018-statistics ; Estipona v. People of the Philippines , Philippine Supreme Court, G.R. No. 226679, August 15, 2017.

[15] Dangerous Drugs Board, Statistical analysis CY 2019 (September 2020). Available at https://www.ddb.gov.ph/research-statistics/statistics/45-research-and-statistics/499-2019-statistics .

[16] Ibid.; compare with Dangerous Drugs Board, Reported cases by type of admission and sex (facility based) CY 2015 (August 2016). Available at https://www.ddb.gov.ph/research-statistics/statistics/45-research-and-statistics/287-2015-statistics .

[17] Abando (see note 3).

[22] A. Carbonell, Mega drug rehab center in Ecija a mistake—DDB (November 2, 2017). Available at https://www.manilatimes.net/2017/11/02/todays-headline-photos/top-stories/mega-drug-rehab-center-ecija-mistake-ddb/360157.

[24] Dangerous Drugs Board, Manual of operations for drug abuse treatment and rehabilitation centers . Available at https://www.ddb.gov.ph/images/MANUAL%20OF%20OPERATIONS%20-%20DRUG%20REHAB.pdf .

[27] Republic Act No. 9165 (2002).

[28] Dangerous Drugs Board, Regulation no. 3 series of 2007 .

[30] Dangerous Drugs Board, Regulation no. 2 series of 2019 .

[31] L. Yarcia and J. Bernandas, “Articulating key obligations of states to persons deprived of liberty under a right to health framework: The Philippine case study,” International Journal of Human Rights in Healthcare (2021).

[32] Philippine National Police, Command memorandum circular no. 16-2016 . Available at https://didm.pnp.gov.ph/images/Command%20Memorandum%20Circulars/CMC%202016-16%20PNP%20ANTI-ILLEGAL%20DRUGS%20CAMPAIGN%20PLAN%20%20PROJECT%20DOUBLE%20BARREL.pdf.

[33] Office of the United Nations High Commissioner for Human Rights (see note 2).

[37] Dangerous Drugs Board, Regulation no. 3 series of 2016 .

[39] Bureau of Jail Management and Penology, Data on number of PDL with drug cases (as of May 31, 2021) . Available at https://www.bjmp.gov.ph/images/data_and_stats/Data_on_Number_of_PDL_with_Drug_Cases.jpg .

[40] Dangerous Drugs Board, Regulation no. 8 series of 2021 .

[41] G. Lasco, “Drugs and drug wars as populist tropes in Asia: Illustrative examples and implications for drug policy,” International Journal of Drug Policy 77 (2020); M. Tan, “The construction of drug abuse in the Philippines,” in G. Lasco (ed), Drugs and Philippine society (Quezon City: Ateneo de Manila University Press, 2021), pp. 47–70.

[42] J. Cornelio and G. Lasco, “Morality politics: Drug use and the Catholic Church in the Philippines,” Open Theology 6/1 (2020), pp. 327–341; C. R. Soriano, C. C. David, and J. M. Atun, “Crystallising the official narrative: News discourses about the killings from the Philippine government’s campaign against illegal drugs,” Journalism 22/9 (2021), pp. 2386–2403.

[43] Catholic Bishops’ Conference of the Philippines, Statement on drug abuse . Available at https://cbcponline.net/statement-on-drug-abuse/.

[44] Catholic Bishops’ Conference of the Philippines, Church’s rehab program, a concrete response. Available at https://cbcpnews.net/cbcpnews/churchs-rehab-program-a-concrete-response/.

[45] See, for example, Bridges of Hope, Easter and addiction recovery: Redemption and renewal. Available at http://bridgesofhope.com.ph/index.php/easter-and-addiction-recovery-redemption-and-renewal/.

[46] United Nations Office on Drugs and Crime and UNAIDS (see note 6).

[48] Sangguniang Laiko ng Pilipinas, I will turn their mourning into joy. Available at https://www.cbcplaiko.org/documents/i-will-turn-their-mourning-into-joy/; see also Cornelio and Lasco (see note 42).

[49] Office of the Vice President, Vice President Leni Robredo’s report as co-chairperson of the Inter-Agency Committee on Anti-Illegal Drugs (ICAD). Available at https://ovp.gov.ph/post/vice-president-leni-robredos-report-co-chairperson-inter-agency-committee-anti-illegal-drugs-icad.html.

[50] R. Noriega, “De Guzman: Put cocaine-using presidential bet in rehab,” GMA News (November 19, 2021). Available at https://www.gmanetwork.com/news/topstories/nation/811583/de-guzman-put-cocaine-using-presidential-bet-in-rehab/story/.

[51] J. E. Mendoza, “Robredo to set a ‘drug war’ that focuses on rehab and prevention than ‘kill, kill, kill,’” Inquirer.net (October 30, 2021). Available at  https://newsinfo.inquirer.net/1508254/robredo-to-set-a-drug-war-thats-more-on-rehab-and-prevention-than-kill-kill-kill.

[52] G. Lasco and N. Curato, “Medical populism,” Social Science and Medicine 221 (2019), pp. 1–8; J. Pratt, Penal Populism (London: Routledge, 2007).

[53] C. Hobson,  “Challenging ‘evil’: Continuity and change in the drug prohibition regime,” International Politics 51 (2014), pp. 525–542.

[54] G. Lasco, “Introduction: Redefining drugs and the people who use them,” in G. Lasco (ed), Drugs and Philippine society (Quezon City: Ateneo de Manila University Press, 2021), pp. 1–26.

[55] Lasco (2020, see note 41); see, for example, United Nations, Joint Statement: compulsory drug detention and rehabilitation centers (2012) . Available at https://files.unaids.org/en/media/unaids/contentassets/documents/document/2012/JC2310_Joint%20Statement6March12FINAL_en.pdf; United Nations, Joint statement on compulsory drug detention and rehabilitation centres in Asia and the Pacific in the context of COVID-19 (2020). Available at https://unaidsapnew.files.wordpress.com/2020/05/unjointstatement1june2020.pdf; United Nations Office on Drugs and Crime, Guidance for community-based treatment and care services for people affected by drug use and dependence in Southeast Asia . Available at www.unodc.org/documents/drug-treatment/UNODC_cbtx_guidance_EN.pdf; United Nations Office on Drugs and Crime and World Health Organization, Principles of drug dependence treatment (2018) . Available at www.unodc.org/documents/drug-treatment/UNODC-WHO-Principles-of-Drug-Dependence-Treatment-March08.pdf.

[56] L. Yarcia, “It’s time to decriminalize drug use: Insights from the legal history of prohibition in the Philippines,” in G. Lasco (ed), Drugs and Philippine society (Quezon City: Ateneo de Manila University Press, 2021), pp. 298–319.

[57] Dangerous Drugs Board, Regulation no. 7, series of 2019 .

[58] International Centre on Human Rights and Drug Policy, UNAIDS, World Health Organization, and United Nations Development Programme, International guidelines on human rights and drug policy (2019).

[59] Yarcia (see note 56).

[61] International Centre on Human Rights and Drug Policy et al. (see note 58).

[62] United Nations Office on Drugs and Crime, United Nations Economic and Social Commission for Asia and the Pacific, and UNAIDS, Report of the third regional consultation on compulsory centres for drug users in Asia and the Pacific (2015). Available at https://unaidsapnew.files.wordpress.com/2015/12/report-of-the-third-regional-consultation-on-ccdus-in-asia-and-the-pacific-21-23-september-2015.pdf.

[63] See, for example, Dangerous Drugs Board, Regulation no. 4 series of 2020 .

[64] Lasco (2021, see note 54).

[65] See, for example, House Bill No. 5567, Harm Reduction Act of 2016 , filed by Representative Jose Christopher Y. Belmonte.

[66] Dangerous Drugs Board, Regulation no. 8 series of 2021 .

[67] United Nations Office on Drugs and Crime and UNAIDS (see note 6).

[68] Lasco (2020, see note 41).

[69] C. Daniels, A. Aluso, N. Burke-Shyne, et al, “Decolonizing drug policy,” Harm Reduction Journal 18 (2021); G. Lasco, “Decolonizing harm reduction,” Harm Reduction Journal 19 (2022).

[70] Lasco (2020, see note 41).

[71]   Ibid.

United Nations

Office on drugs and crime, 8 facts you need to know about human trafficking in the 21st century.

Human trafficking is a pressing global problem that continues to affect millions of people, despite widespread efforts to combat it. 

To shed light on this pervasive issue, here are eight key facts about human trafficking in the 21st century that help to better understand why this crime occurs, how victims are recruited and exploited, and the links between human trafficking and migration, climate change or conflict. 

1. Human trafficking occurs in all regions of the world 

Human trafficking occurs everywhere, but people are mainly trafficked from lower-income to higher-income countries.  

Most victims, or 60 per cent, are detected domestically, while victims of cross-border trafficking are mainly found within the same region (18 per cent) or in nearby regions (6 per cent). Only 16 per cent are detected in transnational flows and end up in distant regions. 

Most victims of cross-border trafficking come from Africa, especially sub-Saharan Africa, and from South and East Asia. 

2. Human trafficking is a widespread crime and a lucrative business  

Human trafficking is the recruitment, transportation, transfer, harbouring or receipt of people by force, fraud or deception to exploit them for profit. 

The true extent of the crime is difficult to ascertain. While about 50,000 cases were reported to the United Nations Office on Drugs and Crime (UNODC) in 2020 by 141 countries, as many as 50 million people globally – the equivalent of the populations of South Korea or Uganda – may be subject to various forms of exploitation. 

Human trafficking is one of the fastest-growing crimes , along with drugs and arms trafficking, and a highly profitable business, generating an estimated $150 billion in profits each year.  

3. Human trafficking thrives on poverty, conflict and climate change 

Human trafficking is driven by a complex interplay of social, economic and political factors. 

Conflict and persecution, poverty and political instability, lack of access to education and jobs, migration and displacement, gender inequality and discrimination, natural disasters and climate change all create conditions that fuel human trafficking.  

With nearly half of the world's population living on less than $6.85 per person per day, or with at least three billion people worldwid e living in areas severely affected by climate change and non-climatic environmental degradation, millions of individuals have become vulnerable to exploitation. 

Traffickers capitalize on this desperation, disparity and deficiency, targeting people who are vulnerable, marginalized or in difficult situations, including irregular or smuggled migrants and those in urgent need of work. 

4. Traffickers use everything from deception to violence to recruit and exploit their victims 

Because human trafficking is often under-reported and under-prosecuted, it is characterized by high rewards and low risks for its perpetrators, who reap substantial profits with little fear of punishment. 

Taking advantage of the high demand for cheap labour, commercial sex or other services, criminals exploit shortcomings in legislation and its enforcement, as well as corrupt actors and weak governance, to carry out their illegal activities. 

They fraudulently promise a better life in a new country, offer exciting jobs with great benefits, or use outright violence against vulnerable people to coerce them into exploitative practices, such as sexual exploitation or forced labour.  

5. Escaping exploitation can be extremely difficult 

Victims often endure inhumane conditions and find it difficult to escape from the hands of their exploiters, who utilize a range of mechanisms and manipulations to control them. 

Victims can be beaten, threatened and blackmailed. They can be humiliated, abused or have nowhere else to go. Their passports and other documents can be taken away. Many might not even identify themselves as victims – which is often the case when they are manipulated by a partner or relative.  

Fear of reprisals often prevents victims from seeking help, and they are more likely to self-rescue than be rescued by authorities . While 41 per cent of victims self-report to authorities, in only 28 per cent of the cases does the investigation start with proactive police activity. 

6. The most common forms of human trafficking are sexual exploitation and forced labour 

Human trafficking manifests in many forms . UNODC's latest research shows that 38.7 per cent of victims are trafficked for sexual exploitation, which takes place on the streets, in brothels, massage centres, hotels or bars. The victims – mainly women and girls – often experience extreme violence and abuse. 

A further 38.8 per cent are exploited for forced labour. Some people work long hours in factories, for minimal or no pay, producing clothes, computers or phones. Others work on fields, plantations or fishing boats – often in harsh weather – cultivating corn, rice or wheat, harvesting coffee and cocoa beans or catching fish and seafood. 

Around 10 per cent are compelled to engage in illegal activities, such as pickpocketing, bag snatching, begging or drug selling. Other forms of exploitation include forced marriage, organ removal and domestic servitude. 

7. Women are the most detected victims of human trafficking 

No one is immune to trafficking. People of all genders, ages, backgrounds and in all regions of the world fall prey to traffickers, who resort to a variety of means to recruit and exploit their victims.  

Women and girls make up the majority of victims, accounting for 42 and 18 per cent, respectively. They are mainly trafficked for sexual exploitation and are three times more likely to suffer physical or extreme violence than men and boys. 

At the same time, the number of detected male victims has increased over the last years: 23 per cent of victims are men and 17 per cent are boys. They are mainly trafficked for forced labour. 

In the past 15 years, the proportion of children among identified victims of trafficking has tripled to 35 per cent, or one third of all victims. 

8. Traffickers can be anyone from members of an organized crime group to the victim´s own family

UNODC’s data shows that 58 per cent of those convicted for human trafficking are men. At the same time, the involvement of women in this crime is higher than in other crimes – female offenders account for 40 per cent of those convicted. 

People who engage in trafficking range from organized criminal groups to opportunistic individuals operating alone or in small groups.  

In addition to trafficking in persons, criminal organizations are frequently involved in other serious crimes, including drugs or arms trafficking, as well as corruption and the bribery of public officials. Such groups exploit more victims, often for longer periods, over greater distances and with more violence than non-organized criminals. 

However, traffickers can also be the victim's family members, parents, intimate partners or acquaintances. 

Further information

UNODC is the leading entity within the United Nations (UN) system to address human trafficking. It provides expertise and knowledge to countries and helps them ratify and implement the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children , the main international legal instrument to combat the crime.  

UNODC's experts support the development of national laws and policies on human trafficking and train public officials, including police officers, border control guards, labour inspectors and victim support specialists.  

With the guidance provided by UNODC, countries are better equipped to investigate and prosecute cases of human trafficking, dismantle the criminal networks behind this crime, trace the illegal proceeds and protect and assist victims. 

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