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Of the world’s 50 most dangerous cities, 43 are located in Latin America and the Caribbean. InSight Crime looks at some of the factors driving the violence.

Business Insider revived the list in a recent publication, based on a report from the Mexican Citizens’ Council for Public Security and Criminal Justice that came out earlier this year, ranking cities around the world by their homicide rates. With the exception of Cape Town, South Africa, the 20 most violent cities are in Latin America and the Caribbean.

Of the 50 urban areas with the highest homicide rates, 16 are located in Brazil, nine in Mexico, six in Colombia, and five in Venezuela (see map below). San Pedro Sula in Honduras was ranked as the most violent city in the world for the third consecutive year, followed by Caracas, Venezuela and Acapulco, Mexico.

InSight Crime has identified the top five criminal dynamics that have helped make Latin America’s cities the most violent in the world:

1. Booming Domestic Drug Markets

Various Latin American countries have seen a substantial increase in the size of their domestic drug markets, spurring the rise of local criminal groups. Brazil is now the world’s second largest market for cocaine and its derivatives, after the United States, while Argentina, Peru and Colombia have also seen significant growth in their domestic markets in recent years.

As local criminal groups emerge to supply local markets, turf wars over transport and sales territory can lead to spikes in murder rates. This is one of the factors driving homicides in Brazil, which has seen the domestic drug trade expand beyond Rio de Janeiro and São Paulo and into the rest of the country. Gangs have spread to the northern and northeastern regions of Brazil, home to several of the cities on the list including Salvador (#13), Natal (#12), João Pessoa (#9) and Fortaleza (#7). The same dynamic is seen with larger criminal organizations, like the First Capital Command (PCC), which originated in São Paulo and now has a presence in 24 of Brazil’s 27 states.

2. The Fragmentation of Organized Crime

Latin America has seen the fall of many major drug kingpins in recent years, causing criminal organizations to splinter into smaller factions. Without the manpower to carry out large-scale transnational drug trafficking operations, these smaller groups typically turn to more localized — and often more violent — criminal activities, like kidnapping and extortion. Splinter groups often fight among themselves for control of local criminal businesses.

This is particularly true in Mexico, where the security forces have dealt heavy blows to criminal groups. The Zetas have lost several high-ranking members in recent years, which has led to the cartel’s fragmentation into semi-independent cells. At least three of the Mexican cities on the list — Nuevo Laredo (#30), Victoria (#22), and Torreon (#18) — are situated in states with a significant Zetas presence.

The Beltran Leyva Organization (BLO) has also suffered a loss of leadership and split into several rival factions, including criminal groups the Guerreros Unidos and Los Rojos, which are engaged in a bloody turf war. These groups are fighting over territory in the states of Guerrero and Morelos, home to two of the cities on the list: Acapulco (#3) and Cuernavaca (#43).

In Guatemala, a 2013 spike in murders coincided with the deaths and arrests of criminal leaders. Anti-narcotics prosecutors told local media that the power vacuum had spawned splinter groups engaged in battles for control of the criminal underworld. Guatemala City is number eight on the list.

3. Drug Transit Nations Become Crime Hubs

Countries that serve as drug transit nations tend to see high rates of violence and crime. To facilitate drug shipments through a country, transnational criminal organizations typically hire local groups to guard and transport the shipments, and sometimes pay them in drugs. This can spur the development and increased sophistication of local gangs, as well as the growth of domestic drug markets. Transnational criminal organizations also set up operations in transit nations to oversee drug trafficking, and bring violence with them.

One example of this phenomenon is Venezuela, home to five of the world’s most violent cities, including Caracas, which is ranked as number two. Venezuela is a major transshipment point for Colombian cocaine and has seen Colombian criminal groups battle for control of drug trafficking routes. Four of the five Venezuelan cities on the list are near the coast, and may serve as transit points for drug shipments headed to the United States and Europe via maritime routes.

Honduras has also seen violence surge and street gangs grow more sophisticated as the country has become a major drug transit hub. Honduras is home to the world’s most violent city, San Pedro Sula, which is located near the border with Guatemala and close to Puerto Cortes, Honduras’ main port. The city also has a major gang problem, with the Mara Salvatrucha (MS13) and Barrio 18 battling for control of the local drug trade, and the presence of the Sinaloa Cartel.

4. Conflict and the Legacy of Civil War

Civil wars in El Salvador, Guatemala, and Nicaragua helped give birth to Central America’s ruthless gangs. The MS13, one of the region’s largest and most powerful street gangs, was founded in Los Angeles in the 1980s by Central American refugees fleeing armed conflict. When the US government deported these refugees in the late 1990s and early 2000s, those involved in criminal groups transformed the war-torn Northern Triangle region — made up of Guatemala, El Salvador, and Honduras — into a hub for gang activity.

Armed conflict has also led to considerable violence in Colombia, where guerrilla organizations have battled the state for the last 50 years. The paramilitary groups that purportedly formed to defend against the guerrillas have now morphed into criminal syndicates known as BACRIM (a name derived from the Spanish “bandas criminales” or “criminal bands”), which are involved in turf wars over drug trafficking routes in major cities including Cali (#4), Medellin (#35), and Cucuta (#33).

5. Corruption and the Criminalization of Local Government

Ties between criminal groups and public officials play a crucial role in facilitating criminal activity and creating a culture of impunity. Corrupt security forces can keep criminal groups informed, shield them from law enforcement operations, and facilitate drug shipments, while ties to politicians and local elites lend criminals a façade of legitimacy.

This dynamic was made painfully clear by a recent case involving the disappearance of 43 student protesters in Guerrero, Mexico. The mayor and his wife in the town where the students went missing allegedly ordered the attacks, which authorities believe were carried out by the Guerreros Unidos criminal group. Following the attacks, intelligence reports indicated that 12 mayors from the state of Guerrero may have links to organized crime.