Open letter from academics, clinicians, public health experts, researchers, and professionals calling on the Prime Minister of the Czech Republic to preserve the country’s successful drug policy model

Dear Prime Minister,

We, the undersigned academics, clinicians, public health experts, researchers, and professionals working in the fields of drug policy, addiction medicine, mental health, and social care, wish to express our deep concern regarding the ongoing discussions about restructuring the system of drug policy coordination in the Czech Republic, including proposals to transfer this agenda fully under the Ministry of Health.

We have followed with great interest the recent public debate in the Czech Republic, involving the current national drug coordinator Pavel Bém, former national drug coordinators, addiction specialists, and representatives of the expert community, many of whom have publicly warned against weakening the independent coordination of drug policy. We note that these voices do not represent partisan interests; rather, they reflect decades of research evidence, practical experience, and internationally recognised expertise.

For more than three decades, the Czech Republic has been internationally recognised as one of Europe’s most successful and evidence-based models of drug policy governance. The Czech approach has earned global respect precisely because it has never reduced drug policy solely to a matter of healthcare or criminal justice [1]. Instead, it has consistently maintained a balanced, interdisciplinary, and interministerial framework integrating public health, social policy, prevention, harm reduction, treatment, research, and human rights [2].

This model — coordinated through the Government Council for Drug Policy Coordination and supported by the National Monitoring Centre for Drugs and Addiction — has enabled the Czech Republic to achieve some of the best public health outcomes related to drug use in Europe [3,4,5]. Importantly, these outcomes have been achieved while maintaining social stability, comparatively low levels of infectious disease transmission, and a pragmatic, humane approach toward people who use drugs.

The success of the Czech drug policy system has long relied on its institutional independence and its ability to coordinate actions across ministries and sectors. Locating drug policy coordination at the Office of the Government has ensured that decisions are informed not only by healthcare priorities, but also by social services, regional administration, education, justice, research, and civil society expertise.

We are therefore concerned that proposals to centralise the agenda exclusively under one particular ministry could weaken this balanced governance structure and unintentionally narrow drug policy to a predominantly medical framework. Such a shift risks undermining the integrated nature of the Czech model and could threaten the long-term stability and quality of harm reduction programs, low-threshold services, prevention initiatives, outreach work, and community-based social support — much of which is currently delivered by specialised non-governmental organisations [6,7,8].

We also acknowledge ongoing discussions concerning the potential establishment of a dedicated national agency for addiction and drug policy coordination which may, as is currently the case under the Office of Government, have competencies for cross-ministerial coordination. In our view, any future institutional arrangement should preserve — and ideally strengthen — the essential principles that have made the Czech model successful:

• interministerial coordination
• evidence-based policymaking
• independence from narrow political cycles
• strong epidemiological monitoring
• stable support for harm reduction and prevention
• meaningful cooperation with civil society and regional services

According to recent European Union Drugs Agency (EUDA) data, the Czech Republic continues to demonstrate exceptionally favourable public health indicators in comparison with many European countries, including low rates of HIV transmission among people who inject drugs [9], comparatively low levels of drug-related mortality [10], and a strong network of accessible harm reduction services [11], including recent development of safer consumption programmes [12] or safer supply control regimes [13]. These outcomes are not accidental; they are the direct result of long-term, coherent, and interdisciplinary policy coordination at local, regional, and international level.

At a time when many countries across Europe are struggling with rising overdose deaths, synthetic opioids, increasing social vulnerability, and pressure on mental health systems [14], the Czech Republic should be seen as a valuable example of a rational and effective approach — not as a model to be weakened through administrative fragmentation or institutional downgrading.

We respectfully urge the Government of the Czech Republic to preserve the independence, interdisciplinary character, and strategic capacity of its drug policy coordination system. Any reform should protect the internationally respected foundations of the Czech drug policy model and avoid steps that could unintentionally compromise decades of successful public health and social policy development.

By doing so, the Czech Republic can continue to serve as a European leader in pragmatic and evidence-based drug policy. We sincerely hope that this leadership will endure and continue to inspire evidence-informed policymaking across Europe, and internationally.

Respectfully,

Prof. David Nutt DM FRCP FRCPsych FBPhS FMedSci DLaws, Edmond J. Safra Professor of Neuropsychopharmacology and Director of the Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College London (UK)

Alexis Goosdeel, Former Executive Director of the European Union Drug Agency (EUDA) 2024-2025, Former Director European Monitoring Centre for Drug and Drug Addiction (EMCDDA) 2016-2024 (BE and EU).

Martin Jelsma, Director Drugs & Democracy programme, Transnational Institute (NL)

Professor Gary Potter, Professor of Critical Criminology, Lancaster University, and President of the European Society of Social Drug Research (UK).

Professor Alex Stevens, Professor of Criminology, School of Law, University of Sheffield (UK)