IDPC speech at CND Intersessional – 5th December 2014

Thank you for giving me the floor Mr. Chairman, esteemed delegates.  My intervention on behalf of International Drug Policy Consortium will be in two sections, procedural and substantive, although I believe as the Uruguay representative said yesterday that the procedural is substantive.

I thank the Chair and Secretariat for facilitating civil society involvement in the UNGASS process and welcome the many statements from member states on the importance of civil society in the UNGASS process. 

Meaningful engagement will not be achieved if debates and preparatory workshops remain structured according to CND rules so we need to find different ways of structuring debates so engagement is interactive and meaningful. 

IDPC is clearly calling for an open UNGASS, inclusive of all voices, accepting all perspectives and not pre-judging outcomes.  We look forward to promoting this through upcoming procedures.

Now for the substantive part: My organisation is advocating for the people — most of whom live in your countries — more than 83% of the world — who have no access to pain medicine stronger than aspirin for late stage cancer, AIDS, surgery, and other  treatable suffering. 

Medicines such as morphine are controlled under the conventions because your countries fear it will be misused and diverted into the illegal market.  We now know that the illegal market is already supplied from multiple other sources.  It doesn’t need controlled medicines to function properly! The only people who get hurt from the laws that restrict medicines are patients themselves.

CND can greatly improve this situation by speaking publicly with one passionate voice on the convention priority to ensure access to opioids to treat pain and suffering from war wounds, cancer, AIDS, surgery, etc..  By supporting this priority and insisting that the 5.5 billion people who live in countries with no access are guaranteed not to suffer unnecessarily, you will restore some of the credibility the conventions have lost in recent years.

Promoting increased access to controlled medicines for the treatment of pain within the framework of the conventions supports the sovereignty and territorial integrity of States, the principle of non-intervention, the human right to the highest attainable standard of health, the fundamental freedom to earn a living and be with family, the inherent dignity of all individuals.  The other UN agencies such as WHO and treaty bodies such as the Human Rights Council are standing by to work with you to make this happen.
 
People often bring up religion as a reason not to use opioids to relieve pain and suffering, in the mistaken belief that excruciating pain elevates the soul. As a person of faith and as someone who has studied theology, I can tell you that all the major world religions support the medical use of opioids to alleviate preventable suffering, and in fact say that it is a physician’s religious duty to do so. Indeed, early physicians called morphine “a gift from God”. Excruciating pain prevents people from praying at the end of life and spending quality time with their families.  Pain relief allows them to pray, to work if they are still able, and to spend time with their families.
 
The upcoming UNGASS is a tremendous opportunity for the CND to fix this unintended consequence of over-interpreting the enforcement provisions of the conventions at the expense of the Single Convention’s mandate to member states to use opioid medications to relieve pain and suffering.  This must be a priority agenda item of UNGASS, not a subheading under demand reduction. 
 
Countries where consumption of opioids is low to inadequate according to INCB need to increase demand and supply of controlled opioid medicines at least six-fold according to the data you were given yesterday at the working group meeting. Clearly this mandate does not fit under demand or supply reduction.  CND needs to schedule a stand-alone UNGASS preparatory workshop on increasing access to medicines as a way to promote a core aim of the Conventions.  Of course, it is difficult to add a fifth workshop to the   CND 2015, so an alternative could be scheduling it for later in 2015 attached to one of the intersessionals.  (aim for production of an EM action plan — need an explanatory note — draft action plan UNGASS could sign off on).
 
Under the principle of mutual and shared responsibility, CND can urge member states with developed healthcare systems and adequate access to provide educational, technical, and legal support to countries with inadequate access.  This is not an expensive proposition.  It requires very few resources, and I know that you already have the solidarity and political will to make it work.

Morphine is what the WHO calls an essential medicine — which means it must be available, affordable, and accessible in every UN member state. It is cheap to produce, less than $I a day for treatment, and is not patented. According to WHO and physicians since ancient times, it is the gold standard of pain control.  Member states that grow poppy can manufacture it under regulated conditions — India, Turkey, Hungary, Slovakia, among others are traditional producers for medical use that can show the way. 
 

I beg you, on behalf of the millions of vulnerable patients and their families around the world that my organisation represents, to use your voice as the pre-eminent UN agency on the world drug problem to make OUR drug problem, which is lack of access to controlled medicines for the relief of pain and suffering, YOUR priority.

 
Speaker: Dr. Katherine Pettus, Advocacy Officer, for International Association for Hospice and Palliative Care  (htto://www.hospicecare.comkpettus@iahpc.com

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