Raymond Yans, INCB. Ensuring the availability of controlled drugs for medical and scientific purposes has always been a major goal of the treaties. IN 2010, the INCB issued a special report on the issue to provide a global overview of consumption and availability and impediments and recommendations to improve availability. Since then, the international community has continued to show interest in the issue. The CND has adopted Resolution 53/4 and 54/6 on this issue. We have also established this separate agenda item to ensure that debates are devoted to this issue.

We have decided to publish a supplement of the report in 2015 on the issue. We have an important role to play in the supply of raw materials for medications containing opiates. But we work to maintain a balance between supply and demand. The analysis of data by member states shows that the amount of raw materials for pain relief is more than sufficient to satisfy demand. Global stocks are increasing. However, despite this, consumption for pain relief is concentrated in a limited number of countries. Access continues to be uneven in West America, Western Europe, Oceania. 90% of the world’s morphine is consumed by 17% of the population. Access is restricted in low and middle income countries. We need change in patterns of availability. Pain treatment is required for cancer and other contexts. Methadone and buprenorphine are used for the management of opioid substitution treatment and are limited as well. Some drugs, such as pain killers, are difficult to access.

INCB’s 2010 special report highlights impediments such as regulatory, attitudinal, knowledge related and economic and procurement-related factors, for availability. Impediments were also concerns on addiction, reluctance to stock, and sufficient training for health professionals. Unduly restricted laws were also perceived as factors for reducing availability of opioids. The high costs of opioids was also a barrier. The INCB is committed to address the issue. We provided training to 12 African countries in Addis Ababa in 2013, to increase compliance with the drugs treaties while preventing diversion.

Psychotropic substances for medical use are also not available in many countries and regions. Voluntary information and data is very important to assess availability of substances for medical and scientific purposes. We hope that more of you will report data to us. The goal will be to establish well functioning national and international systems to ensure the availability of drugs to alleviate pain and suffering for patients all over the world.

Gilberto Gerra, UNODC.
UNODC has worked on building a new programme about accesses to essential medicines. We have to adopt rigorous medical standards. We are not here to allow anyone to get morphine etc, pain is a complex isssue with respect for them. We are thinking about the management of personal suffering.

GLOK67 
A joint programme between UICC, UNODC, WHO. Piloting in Ghana. Three areas of focus policy and enforcement medical and science, advocacy. Community involvement is important.

24 million people, 30% of population are below the poverty. 188,00 deaths each year. one study suggest 90% of patients experienced moderate to severe pain. There has been a lot of palliative care training.

First stakeholders meeting. focussed on drug availability, policy, education, and implementation.

Ready to expand the programme.