CND Intersessional – 23 February 2015 (Morning session)

The main discussions this morning were held around the scheduling of ketamine proposed by China. 

The Chair opens the session.

1 – Agenda for the special segment of CND focused on the UNGASS
In the last CND interssesional of 29th January, member-states discussed the agenda for the Special Session on the UNGASS at this year CND.  The work at the 58th session of the CND, including the work of the Committee of the Whole, will be available in the website of the CND. The revised of work of the Special Session, including the decisions taken at the 29th January inter-sessional will be available at the website of the Commission. The African representative for the extended meeting will be the delegate of  Nigeria (Mr. Mohamed Sh.). Eastern European states need to nominate their candidate for the Vice Chair position.
 
2- UNGASS BOARD and the composition of the UNGASS Board
The nomitation on behalf of the Asian pacific group for the first- vice-chair have been the delegates of the Islamic Republic of Iran and Afghanistan
The composition is now the following:

  • Hungary representing the East European estates
  • Portugal representing West countries
  • Colombia and El Salvador representing Latin American countries and GRULAC.
  • Iran and Afghanistan

Now, there are 6 members at a 4 members board, so we might need to consider this.
 
3- Opening of the 58th session of the commission

After the adoption of the provisional agenda, it is agreed that the at the opening session of CND in the morning of 9th March, there will be:

  • A statement by the president of the UNOCD and a statement by the president of the INCB
  • GRULAC and Afghanistan have confirmed that they will deliver an statement at the opening of the session

Other states confirm their participation:

  • Latvia on behalf of The EU will also deliver an statement
  • Chile will also deliver an statement
  • Nigeria on behalf of the African Group
  • Iran will deliver a statement
  • Colombia – minister of Justice will take the floor at the opening session
  • Bolivia – minister will be deliver a statement
  • (Another LA country ) State Prossecutor will deliver a statement
  • Russian Federation – The director of the federal service against drugs will deliver a statement

For those who want to deliver statements at the opening of the session the deadline is the 2th of March. We expect that there will be a high level of minister delegates. The speaking time for the minister and the chair of regional groups will be between 5 and 10 minutes.
11 draft resolutions and 1 draft decision have been submitted and are available at the CND website

The English texts of the resolution will be placed in a secured website only for the member states, that can submit tracked changes. Once the texts have been translated to the 11 official languages they will be placed in the public website.

If member states have input that they want to offer to the CND for the ECOSOC meeting 2015 they can contact the secretariat.

The final programme of the side events will be placed at the 58th CND on due curse

Operational segment: A draft resolution to extend the mandate of the working group have been presented, as well as an additional item of composition of UNODC.

Agenda for the inter-sessional of 23rd February: 
Morning – discussion of organizational matters and some substantial matters
In the afternoon – presentation by the WHO at 3pm.
Discussions on the scheduling of ketamine
 
The commission this year is expecting to take decisions of scheduling 31 substances. This decision will be made on 13th of March after the operational segment.

Discussions will take place in the order the scheduling of substances placed by:

  1. UK  – Mephredone
  2. China – Ketamine

The Secretariat has requested legal advice to the legal affairs of the legal council to know if the CND can schedule substances against the scientific advice of WHO.
 
Representative of the Legal Affairs section of the legal council: On 18th February,  the principal legal officer in charge of the office of the legal council responded:

The secretariat of the CND asked the legal council “Can the CND schedule a substance under the Convention 1961 if there is legal advise by the WHO against it?”

The response: We are aware that sometimes the advices [of different UN bodies] are different. None of them is a definite view. In our view the Commission can legally schedule ketamine… Even if there is  a recommendation by the WHO, other reasons can be considered.

The response is available online.

Chair: The secretariat has received the report of the Expert Committee of Drug Dependence of the WHO, and some responses by member states. They will be posted online as soon as language versions are available. Those members that don’t want to have their responses published under the secure website, please inform the secretariat.

Discussion on the scheduling of mephredone
 
UK: Mephredone is one of the most harmful substances, it has not recognized medical used and is trafficked by the international crime. In January 2014, the UK notified the secretariat its petition to be place mephredone under the Scheduled I.
The Expert Committee on Drug of the WHO – recommended to place it in the Scheduled II. And UK agrees with changing the scheduling proposal from I to II.
 
Canada:  support the UK position. In Canada mephredone is scheduled under schedule I.
 
Chair: I don’t think we have divergent views on the scheduling of mephredone.
 
Discussion on the scheduling of  ketamine proposed by China
 
China: My delegation would like to reiterate. Ketamine posses a great abuse around the world. We pay attention to the Expert Committee advice, however the most important issue is to find a balance between the prevention of abuse and the health uses.
China appreciates the legal opinion of the Legal Council. The legal opinion serves as a term of reference. The reasoning of the legal opinion is very logical and reasonable. The legal opinion is a very good document to serve as a good basis of deliberation of all on this use.
According to the latest annual reports by the UNODC, Ketamine has been abused, trafficked and intercepted in many places of the word. This phenomena is severe in Asian countries, although it also happens in other regions. More than 40 countries have already put this substance under control.
In ketamine is not controlled in Europe, America, and Africa, there is not international cooperation; the Asian countries cannot control it neither.
China quotes the preamble of the First UN drug Convention where there is language on international cooperation around substances control. The convention calls for the cooperation among member –states to control substances, only in this way substances can be controlled.
The medical value of ketamine is true also in China, so we need to find an appropriate way to control the substance. Although we have not been made any final decision, we are not going to insist in placing the scheduling I, but we are seriously considered in putting it under other scheduling. We will notified member states and the secretariat.
 
Norway: Norway is not against the scheduling of ketamine because it is use in our country, but because we are worried that by scheduling the ketamine we will restrict it for those poorer countries, particularly in rural areas. The 1971 convention requires the WHO to make recommendations to CND on scheduling.

Many countries that use ketamine (particularly some African and some of Asian countries) as a medical substance are not represented at CND, and we hope that we have chance to listen at them, to properly ensure the balance and have their views represented.
 
France: The delegation thanks the legal council in NY, it is very important to have all the elements in place to have a complete opinion. French countries is guided on what would happen with the scheduling of ketamine under I, II or III.
We have a national capacity and have received requests by member states to seriously consider the impacts of ketamine scheduling.  We still have time to analyse the potential consequences of scheduling and find tune with it. (France has not yet a position)
 
The Netherlands: If the WHO communicates that the substance has not so serious impact in health to justify its scheduling we should consider this scientific advise. The commission should not authorized to place it under control

I don’t understand why the lawyers did not took into account two key paragraphs under the conventions (paragraph 22 and 24 of the 1971 Convention), that state that is the responsibility of the WHO to advise on scheduling…I would appreciate that the legal committee reviews their consideration.

The INCB report also states that hundred countries replied to the questions by INCB, and more than 50 of them had not scheduled ketamine nor had measures to do it.  If we schedule ketamine, we will force more than 50 to implement import and export measures, that will restrict ketamine.
The schedules are not a menus in a restaurant, the schedules have wide implications. My advice and request would be not to vote on this matter.
International control and availability morphine is the most powerful example of the impacts of the scheduling of health.

A recent study of Uganda show that morphine is extremely limited in the hospitals of the country, and – because it is not scheduled 77% of the hospitals in Uganda have access to ketamine.
 
UK:  we have controlled ketamine as a class B drug, we do not however that scheduling ketamine under the international convention is appropriate because of the impacts it would have in third countries. The schedule I restricts ketamine for very limited medical and scientific purposes. The other scheduling place bureaucratic barriers to its use. Applying this to the scheduling of ketamine will have disproportionate impacts on health in countries.
Switzerland – WHO underlined value of Ketamine as a widely used anaesthetic. It is an Essential medicine for both adults and children. Every year more than 2 million surgery’s interventions are conducted with ketamine. Obstructed liver, birth defects, cancer, acute abdominal conditions, burns, injuries industries, and traffic accidents are among the most common.  We should be extremely cautious when we consider scheduling substances with health and anesthetic purposes.  Switzerland has a stock pile of ketamine for humanitarian purposes. It is important that medical supplies are taken into effected area as soon as possible. Scheduling will delay the delivery of this essential drug. It will render its use and we are grateful to China for withdrawing proposal. Would mean lengthy procedures to get access to it because of the Import authorisation and export authorisation and licensing procedures. We call upon states parties to take into account humanitarian consequences. Must be available to those who need it urgently. Uncomfortable if CND overrules ECDD advice. Very hard to replace an EM. Not in favour of any scheduling.

Belgium –  Opinion on WHO committee. Consider humanitarian nature, it would limit access to essential and emergency medical needs. It would especially affect Sub-Saharan Africa. Belgium humanitarian aid providers have seen importance of ketamine in the field. Belgium is not in favour of scheduling ketamine and join other Europeans in being against scheduling.

Mexico – In Mexico Ketamine is a schedule 3. Our authorities believe scheduling it under 3 is important. Mexico position doesn’t need to be adopted by other countries.

Thank you china for continuing discussion.

IFRC –  IFCR has 199 societies and it edicated promoter of healthy lifestyles. Acknowledges drugs and drug related crime.  There is no alternative other than ketamine to provide safe anesthesia. Has an importance in vulnerable countries, its medical use far outweighs the risk. Defined by 1971 schedules. We urge the members of the CND to look at humanitarian aspects.

KATHERINE PETTUS – Challenged the legal opinion, ketamine abuse going down in Asia, CND must fully examine all aspects under the Convention section 2(5) and clearly hasn’t done so yet, ECDD opinion repeated and clear 3 times, CND should not override it. The World drug report UNODC states that  ketamine use declining is in favour of other psychoactive substances. Fail to quote part of preamble, medical and psychotropic use. Its use is indispensable.

There are procedural issues. Opinion paragraph 3 of the annex. 21st Feb aimed at preventing abuse and illicit traffic of Ketamine, should take into consideration health and welfare of mankind.
Assessment of WHO- determinative. Unless the CND takes into account administrative, legal and other factors, scheduling shouldn’t happen. Big mistake to sideline WHO, when its’ committee has reviewed (Ketamine) 3 times.

India – Thank you Chair. Ketamine included in the Act of India as a psychotropic substance, not in favour of schedule 1, but open to other schedules.

China – Thanked all for comments (‘some of which were from a serious perspective’). Said that, while WHO opinion must be taken into account, so should opinions of UNODC and INCB.

The authorities in Beijing are discussing what should be done. We believe that it has medical value. Not denying risk of being abuse. Highly risky business. Guideline from WHO. We should not ignore comments from INCB or UNODC.

Representative of IDPC/IAHPC, mentioned in 2014 the decline in ketamine use, I think it is a very minor decline. As a member of Asian countries, we have evidence of ketamine impact on individuals and society and INCB backs it up. We do not deny medical use,we are talking about scheduling not extermination. Mentions 1971 Convention.

We have noticed that we need to find a balance between the abuse of the substance and the availability of the substance. It will prevent very abusive risk and abusive use.  We think we need to find appropriate, serious and responsible discussion. Thank you for other countries contributions.

Chair: Other delegation that wishes to take the floor on ketamine? Already discussed Methadone and Ketamine. Look at some of the substances recommended by WHO. Secretariat doc. E/ …..
WHO considerations.

HIGHLIGHT: GBL, 1,4 butanodol

Interestingly, the ketamine discussion was followed by one on 2 of the other substances proposed for international control by the ECDD (GBL and 1.4 Butanodol) where the dominant view was to resist scheduling, as it would impose too much restriction on legitimate trade. That seems a real change of mood – not protecting essential medicines, but protecting free trade.

US:  Still in process of deciding position. Serious concerns. Used on a very widespread basis, production and trade very high, any scheduling will put a burden on legitimate industries.
2015/A – documented US views on this,circulated by secretariat.
 
Belgium: Serious health risks. Widely used industrial chemicals, solvent, pharmaceutical, high technology. Trade of substances, referred to Article 7 (1971) Would result in prohibition of all use. At the moment no alternative. Scheduling would not be best way to prevent misuse.
EU VOLUNTARY SURVEILLANCE RISK- not scheduled in Belgium
Belgium cannot support scheduling.
 
Canada: of the 12 substances, AH- 7921, NN something Drug. Canada supports 10/12 substances to schedule. Too restrictive, no readily substitute alternative.
Class A precursors, licensed by health ministry and licences. Canada could not support, much too limiting.
 
Mexico: Concerns for scheduling.
 
UK: We recognise the harms. Nationally we have controlled them. We don’t support them scheduling them internationally. Disproportionate effect on legitimate trade.
Chemicals trading in such large quantities.
 
Japan: the same views.
 
France: Haven’t finalised position. Still discussing with authorities in France. We have strong reservations. We will come back to you later. We understand the reason WHO has suggested scheduling.
 
Czech Republic: Does not support scheduling. Used as Industrial chemicals every year. Would mean, changing production process and modifying industry. Czech Republic including control annex into government, national regulation but not into scheduling.
 
Australia: Strong concern. GBL used in the food industry and nationally controlled. GBL import controlled but not 1,4 Butanediol.
Allow time to assess impact on industrial industry properly.
 
Chair: Floor is now open to discuss other substances, unless everyone agrees with WHO recommendations. 3rd intersessional on 6th March. Will propose way forward with comments/interventions.  This concludes the morning session. At the last meeting the Chair will propose to the CND action on the substances.  This afternoon could we limit ourselves to questions and answers. We will have presentation and intervention by WHO, Agenda item 2 and discussions on preparation for UNGASS.

 

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