The United States put out a “Global Call to Action on the World Drug Problem” ahead of the annual United Nations General Assembly meeting, but several countries, including some prominent allies, declined to sign on, suggesting the role of the US as a global leader on drug policy is in decline.

The document was officially released on September 24 at an event at the UN headquarters in New York attended by President Donald Trump and representatives of the signatory nations.

It calls on countries to develop “national action plans based on a four-pronged strategy” focused on reducing drug demand, boosting treatment for drug abuse, deepening multinational law enforcement cooperation, and reducing drug supply.

Trump administration officials sought UN member countries’ endorsement for the action plan ahead of the event, telling them it was “a final document and is not open for negotiation,” The Intercept reported, noting that this is an unusual move since UN drug policy is typically decided by deliberation and consensus.

While many major Latin American countries, like Colombia and Mexico, gave their support to the action plan, there were some notable exceptions.

The largest country in the region, Brazil, did not appear on the list of signatories. Brazilian President Michael Temer did not address the reason why in his opening remarks at the General Assembly.

Some countries with generally rocky relations with the United States, including Cuba, Bolivia and Venezuela, declined to sign. But others with generally positive relations with the United States, like Ecuador, El Salvador, Jamaica and Uruguay, also declined to lend their support to the document.

While these countries have not publicly discussed the reasons why they did not sign on to the action plan, others, including New Zealand, expressed concern that the strategy lacked a sufficient focus on treating drug abuse as a public health issue.

“We have a number of challenges that are quite specific to New Zealand and the particular drugs that are present, but also on taking a health approach,” a New Zealand official told Reuters. “We want to do what works, and so we’re using a strong evidence base to do that.”

The Global Commission on Drug Policy, a non-governmental organization that supports reforming the global drug control regime, strongly criticized the US-led initiative.

The call to action “signals the continuation of inefficient, costly and harmful policies,” the group said in a statement. “These policies result in punitive law enforcement, militarization, mass incarceration, forced treatment, and broken families and communities.”

“The Global Call to Action represents an attempt to demonstrate a consensus that no longer exists, including among a number of the signatories,” the commission added.

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While many countries in Latin America — including some that declined to endorse the action plan — still adhere to traditional, US-backed anti-drug policies, developments in recent years point to the erosion of the United States’ role as a leader on global drug policy.

In the mid-2000s, Bolivia legalized the cultivation of coca for traditional purposes and expelled the US Drug Enforcement Administration from the country. In the 2010s, it briefly withdrew from the UN’s main international drug treaty before being re-admitted without changing its laws on coca, despite objections by the United States and others.

More recently, Uruguay became the first country in the world to establish a legalized and regulated marketplace for marijuana — again, despite strong objections from the United States.

In October, Canada will follow suit, becoming the second and largest country to legalize marijuana. Moreover, almost a fifth of US states have bucked the federal government’s total prohibition and legalized marijuana.

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Indeed, Colombia, the world’s largest cocaine producer, signed on to the US-backed action plan ahead of a meeting between Trump and his recently inaugurated Colombian counterpart Iván Duque, who has signaled a strong commitment to traditional drug control policies. But even though Mexico endorsed the plan, President-elect Andrés Manuel López Obrador has expressed a desire to reorient the country’s drug policy in a more progressive direction when he takes office later this year.

Although the United States, particularly under the Trump administration, maintains a preference for treating drug control primarily as a law enforcement issue, international authorities are increasingly calling on governments to address the drug trade by emphasizing prevention and treatment of drug abuse.

The reaction to the recently unveiled action plan suggests many countries are taking note.