Director of Mental Health and Substance Abuse WHO on behalf of Margaret Chan

The World Health Organization as the directing and coordinating authority for health within the UN system, promotes public health approaches to the problems of drug use and drug use disorders. In doing so, the WHO acts within its core functions which  include setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

Worldwide the disease burden attributable to use of psychoactive substances, including alcohol, tobacco and drugs,– by far exceeds the disease burden attributable to any other risk factor. And drug use disorders have the highest impact on young people at the age from 15 to 29 years old – the key age group for sustainable development in any country.
From a public health perspective drug use disorders are first and foremost health conditions associated with substantial mortality and morbidity. And, as such, all principles of prevention, treatment and care should apply.  However, resources available in countries for prevention and treatment of drug use disorders are scarce, and treatment is often not eligible for coverage by existing funding and insurance reimbursement schemes. As a result, treatment and rehabilitation of affected family members can drive their families into poverty by catastrophic out of pocket payments.
The international drug conventions mandate WHO to evaluate substances for international control. The science of substance evaluation carried out by the WHO Expert Committee on Drug Dependence, evolved over time, but  the rapid evolution of new psychoactive substances is challenging the system. Capacity for generating better data on harm caused by these substances needs to be developed in many parts of the world.

From the WHO perspective it is essential that all the efforts to address the world drug problem do not compromise fundamental aspects of the international drug control system – protection of public health. For example, the access to controlled medicines for the relief of pain and suffering should be ensured in all cases while preventing diversion and abuse. It is estimated that worldwide 5.6 billion people live in countries with low to non-existent access to controlled medicines. The Political Declaration of the High-level Meeting of the UN General Assembly and the WHO global action plan for the prevention and control of noncommunicable diseases 2013-2020 put particular emphasis on access to controlled medicines for pain management in palliative care. Equally, despite strong evidence of efficacy, treatment of opioid dependence with long-acting opioid agonists is frequently unavailable.
In 2012 an estimated 230 000 new HIV infections were caused by injecting drug use. Even greater numbers are thought to have contracted hepatitis B and C through drug injection practices.  And still, infected drug users have low rates of treatment for HIV/AIDS and hepatitis despite the mounting evidence that good treatment outcomes can be achieved in this population.
Health care services are the cornerstone of a public health response to drug problems. Strengthening health service response to drug problems is one of the key objectives of the collaborative program of WHO and UNODC on drug dependence treatment and care.
Ensuring access to treatment for drug use disorders and associated conditions worldwide means rebalancing of the international policy on drugs with increased focus on public health, prevention, treatment, harm reduction and social determinants of drug use.
In conclusion, Mister Chair, WHO is committed to strengthen its contribution to implementation of the Political Declaration and Plan of Action on International Cooperation towards an integrated and balanced strategy to counter the world drug problem by addressing the following key areas:

• Promoting and supporting implementation and evaluation of public health oriented policies aimed at reducing drug-related harm
• Strengthening WHO review processes of psychoactive substances for international control;
• Ensuring access to controlled medicines for medical and scientific purposes;
• Improving coverage and quality of evidence based prevention and treatment  of drug use disorders and associated health conditions;
• And, finally, developing and strengthening public health oriented surveillance and monitoring systems for drug use and resources for prevention and treatment of drug use disorders.
The World Health Organization looks forward to applying its expertise and commitment in our collective efforts towards achieving these objectives.
Thank you.

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