Jenna Valleriani is director, Canadian Students for Sensible Drug Policy; Donald MacPherson is executive director, Canadian Drug Policy Coalition

Prime Minister Stephen Harper's statement about the failures of our existing drug policy is mostly on point. It's just the last bit he gets wrong: "I think what everyone believes and agrees with, and to be frank myself, is that the current approach is not working, but it is not clear what we should do."

He's wrong, because we know what we should do: Supervised injection sites; prescription heroin; medical cannabis dispensaries; crack pipe distribution; drug testing kits; Naloxone for reversing opioid overdose.

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We know these innovative health services reduce the harms of drugs and save lives, and we all agree "the current approach is not working." And yet, access to these important innovations is unequal across Canada because of a lack of leadership at the federal level, and a failure to collaborate across all jurisdictions – local, provincial, national and international.

We don't need to look far to start. Vancouver is known internationally for its innovation in drug policy reform – it houses North America's first supervised injection site and prescription heroin program, and has recently seen a proliferation of medical cannabis dispensaries. The city's drug policy is based on an evidence-based four pillar approach: harm reduction, prevention, treatment and enforcement. This approach has been adopted around the world, but also here in Canada, officially forming the basis for the Toronto's drug strategy.

Unfortunately, the federal government is out of step with international dialogue and doesn't believe in the four pillars – it dropped harm reduction in 2007 when it changed the National Drug Strategy to the National Anti-Drug Strategy. While countries like Portugal have moved towards decriminalization and a more health-focussed approach, Canada has instead pursued a more punitive, conventional "war on drugs" approach – epitomized by the introduction of mandatory minimum sentencing for low level drug offenses. Recently Health Canada spent $7-million of our precious tax dollars on a fear-based anti-cannabis ad blitz that the country's top physician groups suggested was politically motivated.

The lack of vision at the top means that in a country known internationally for its innovation in harm reduction, many of our best public health interventions only exist in isolated local cases. This is not entirely unexpected. The story of drug policy reform is often one of grassroots change lead by users, local authorities, politicians, drug policy experts, service workers, and organizations. In Europe, for example, cannabis social clubs are driving much of the pressure for cannabis reform. Harm reduction services in countries like Germany, Switzerland, and the Netherlands started as trials in innovative cities before being scaled up nationally.

In Canada, this bottom-up drive for change is exemplified by the current explosion of medical cannabis dispensaries in Vancouver. Dispensaries have always operated outside the federal access program, in a type of quasi-legal status, or as an act of 'civil disobedience.' But the city's recent explosion of these storefronts has underscored the disconnect between local and national. Although the federal government projects a $1-billion free market medical cannabis industry in the future, currently it's a notoriously slow, selective, bureaucratic process with little approvals and many rejections.

The result is a void that "unofficial" dispensaries have been happy to fill. One Vancouver city councillor recently pegged the number of dispensaries at 61. Because of shifting of cultural norms around the acceptance of cannabis – polling shows that Canadian attitudes on cannabis are well ahead of the laws – the city and the police aren't entirely sure what to do. But they are on record saying they will not bother dispensaries that follow best practice dispensing.

This is fine for Vancouver, but we need a comprehensive national drug policy, so that essential healthcare innovations like medical cannabis – and prescription heroin, harm reduction kits, and product testing – are available consistently, throughout the country.

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Instead, Canada heads backwards, no longer an international drug policy leader, and our reputation on the international stage suffers for it. Innovation at the municipal level is essential, but it needs to be backed by federal support. Canada needs to stop criminalizing people and instead address the health needs of Canadians. The current approach is not working.