21st Century Healthcare
Over the past decade Turkey has implemented remarkable healthcare reforms – achieving universal health coverage in 2003 – and dramatically expanding access to care for the population. Accompanied by significant investment in the hospital sector and the establishment of a family physician system, the Health Transformation Programme (HTP), Turkey has delivered a high level of activity in the health system.
The quality of healthcare provision has improved over time, but not at the same rate as their European neighbours. In fact, Turkey had the lowest expenditure on healthcare in Europe in 2015, a mere 6.4% of Gross domestic product, according to OECD reports.
Turkey must now focus on improving the quality and efficiency of its primary care after making huge strides in decreasing maternal and infant mortality rates. The use of medical cannabis should be welcome news to medical groups across the country but as further investigation has proved – Turkey’s move to legalise cannabis cultivation was not necessarily borne out of healthcare reform.
Black markets and Harsh Penalties
For decades, Turkey has grappled with serious challenges related to the trade and use of illicit drugs. Drug cultivation itself subsided in the 1970s, when poppy production was effectively licensed for the production of medical opiates.
Today, illegal drug production in Turkey is limited to cannabis, cultivated mainly for domestic consumption. But it’s drug trafficking in Turkey that’s the real problem today.
The trafficking has a very transnational flavor—a fact that’s hardly surprising given Turkey’s proximity to key demand markets in Europe and the Middle East, as well as its location as a land bridge from supply countries like Afghanistan.
Beyond criminality and corruption, drug trafficking in Turkey is a matter of national security. The drug trade has been a key source of terrorism financing in Turkey. The Kurdistan Workers’ Party (PKK), for example, is partly funded through drug trafficking.
Last year, The Turkish Human Rights Association (IHD) and Cumhuriyet newspaper accused Turkey’s Interior Minister Suleyman Soylu of incitement to commit a crime after he spoke at a public security meeting in Ankara demonstrating a harsh and violent approach to drug use.
For the moment, Turkey does not have the liberty to view cannabis via a healthcare lens as illicit trade is continuously linked to the funding of terrorism.
Research and Development in Turkey cannabis cultivation
On the bright side, medical cannabis research is now legal, which is good news for Turkish patients regardless of the states intentions.
Turkey’s Ministry of Food, Agriculture and Livestock announced in October 2016 that they would allow government controlled cannabis production across 19 provinces for medical and scientific purposes. However, cultivation is limited to plants with a limited THC content (under 0.2%).
Under the new law, ‘Hemp Cultivation and Control of Regulations’ growers in 19 of the country’s 81 provinces will have the opportunity to obtain permission from the Turkish government to grow cannabis for a three-year period. Growers interested in participating in the program are required to submit a warrant that proves they have not been previously been involved in the production of illegal cannabis or other narcotics.
International control and quality standards apply to the new cannabis crops, that will undergo government inspection on a monthly basis for Turkey cannabis cultivation to be a success.
Other provinces may be able to join in on the program, but they must provide proof that their crops are for scientific purposes only. Cannabis that does not meet the requirements will be considered illegal and will be subject to the corresponding punishment, which can lead to 10 years of jail time.
These new measures allow the government to take some form of control over domestic drug cultivation. President Recep Erdogan hopes that these changes will help develop systems and incentives to monitor and track illegal cannabis trades.
In February 2017, the Turkish Ministry of Health added Sativex – an oromucosal spray containing tetrahydrocannabinol and cannabidiol – to its list of “importable medicines.” Patients acquire an authorisation of use by a doctor with a prescription.
Turkey has demonstrated an ability to turn illicit drug production into a legal market before. As described in a new short briefing paper by Transform Drug Policy Foundation, Turkey successfully navigated a shift from illicit to legal poppy production in the 1970s. Once used for the production of illegal drugs, poppies are now the key ingredient in the lucrative opioid industry, a staple of global pharmaceutical markets.
In 1967, when the country ratified the UN convention which is the foundation of the prohibitionist global drug control system, Turkey was permitted to claim the status of a “traditional opium producing country”.
Turkey was initially struggling with the unregulated export of opium, reportedly supplying 80% of the heroin used in the US. To get a handle on the problem, a ban on all opium production was introduced in 1972. The ban lasted just two years, by which time the ministry of agriculture had taken the necessary steps to properly license and monitor the growing operations.
Alternative measures needed for Turkey cannabis cultivation
The Turkish medical program will be rolled out slowly and under heavy government supervision. The country is still in the grips of an international drug war with Isis and Afghan drug and terror cartels using Turkey as a key conduit into Europe.
Furthermore, profits from illicit drugs have been directly linked to terrorism across Europe. As the country remains in the middle of these accusations, the authorities will act accordingly harshly to the majority of cannabis users.
However, Turkey has begun to follow alternative measures in their attempt to crack down on the black market. Erdogan’s government have legalised medical programs in order to help regulate and control cannabis production which has previously been under the control of outlaws.
Turkey has historically championed the production of opium after successfully transitioning from illicit production to a highly regulated market. Though there are few reasons to replicate the opioid industry, Turkey has demonstrated an ability to develop a highly regulated bio-pharmaceutical market before and there is no reason they could not profit from a similar move with cannabis.
As the current war on drugs remains a blight on Turkeys reputation as a European ally, we may see an increase in Turkey cannabis cultivation. For now however, Erdogan’s government remain focused on the immediate fight at hand.