CND Intersessional – Friday 6th March 2015

Chair – Thailand: Today we hope to discuss draft resolutions and in the afternoon, scheduling. Also on the agenda are preparations for CND and the UNGASS segment next week.

On the UNGASS segment, the schedule has been revised so that on Tuesday 10 March, segment B will be in the morning and segment A in the afternoon, now reflectedonline.

The normative segment will start on Friday and the Commission will consider 2 substances for scheduling in the morning: mephedrone as proposed by the UK, and ketamine as proposed by China. There will be no CoW on Friday 13 Mar morning in order for the scheduling decisions to be made. Please advise if you plan to nominate any officers for election, as the meeting starts on Monday.

For the opening session on Monday, the non-normative and special segments will be opened in the morning. Before that there will be a video message by the President of UNGA, and messages from Fedotov, G77 and other regional groups. Then statements by high-level speakers: at least 17 ministerial level speakers so please keep to 5 mins each. Hope to finish all these statements on Monday. Statements can be posted online.
CoW will start on Thursday 12 March until Tuesday the following week.

Egypt: Chair, UNGASS Board: on preparations for CND, on Tuesday segment B will be chaired by Iran, segment A in the afternoon will be chaired by Portugal, on Wednesday segment C will be chaired by Hungary, segment D will be chaired by Egypt, segment E on Thursday will be chaired by Colombia. Other chairs are yet to be decided.

Format of each interactive discussion: short intro by Secretariat, inputs by panelists focusing on tools developed, sharing of practical experiences and lessons learned for max 7 minutes each, then comments and questions (no national statements) with max 3 mins each. There will not be a list of speakers, it is incumbent on the chair to decide who will be given the floor next in order to make the discussion truly dynamic and interactive. At the end of the session, the Chair will have a few minutes for wrapping up.

Poland: on earlier issue, what do we do with heads of delegations not at ministerial level and hence do not have speaking slot in opening, is there a chance to include them in another speaking slot?

Chair: there are so many speakers on Monday, their statements might not finish until Tuesday, that’s why we want to limit speeches to 5 mins.

DRAFT RESOLUTIONS

All draft resolutions are available online.

Egypt: resolution and decision on governance and financial situation of UNODC, is based on recommendations of FINGOV includes renewal of mandate of standing intergovernmental working group on governance and financial situation of UNODC.

Chair: on resolution on UNGASS, this is a procedural resolution.

Israel: resolution on young people and drug use disorders – co-sponsored by several other European member states. Calls for scientific based treatment to meet needs of young patients, including catering for their type of drug use, education, social background, and involving parents.

Latvia on behalf of EU: resolution on scientific labs. Working group discussion on Tuesday.

Latvia on behalf of EU: passed on to Italy to present intro: resolution on internet sales. Data from EMCDDA show number of online shops continue to grow in EU, last year an increase of 170 in 2010 to around 700 in 2013. Evidence that young children are highly exposed to this risk.

Peru: resolution on alternative development co-sponsored with Thailand. Wednesday 2 pm informal consultations.

US: resolution on collaboration between justice and public health, to reduce prison overcrowding and health approaches to offenders who need it, and collection of data. Want to stimulate dialogue on this. 10 am Thursday for informal consultation.

Russia:  resolution on blocking financial flows, because current rules not duly followed in practice. Do not seek to start political debate on this topic. Informal consultation on 11 March at 2-3 pm.

Russia: resolution on academia. Under aegis of UNODC, we might set up a scientific method forum that can ultimately make it possible to set up international institutions especially designed to develop international cooperation in this respect, in context of UNGASS, pursuing well-balanced drug strategies informed by scientific knowledge. Informal consultations on 12 March 2-3 pm MOE03.

Brazil: resolution on import export system.

Australia: resolution on synthetic drugs including methamphetamine and NPS, with concern especially for ice. Propose expanding definition of NPS to include methamphetamine. Informal consultation on Thursday at time TBC.

SCHEDULING OF SUBSTANCES

Chair: on scheduling, received submissions from several industrial bodies, Willem Scholten, permanent mission of the Netherlands, Katherine Pettus, IFRC – this is posted on online secure website. Most of questions raised will be addressed by WHO today by video link at 3pm.

UK: expanding on statement on mephedrone from last intersessional. WHO has recommended that the 58th CND schedule mephedrone under 1971 convention. It poses health risks, global challenge of NPS is significant issue for CND. Over 200 NPS have been identified by UNODC across 98 countries. Submission of notification on scheduling was based on prevalence data. Recommended to be scheduled under schedule 1. But WHO recommended control under schedule 2 of 1971 Convention. UK agrees. A note verbale has confirmed this, and a conference room paper has also been disseminated for CND next week. UK will have a side event on NPS on Thursday 1.10 pm to discuss international challenges and health harms.

France: supports UK as the substance is causing problems in France too.

India: support scheduling of mephedrone under 1971 convention. But since it has no therapeutic value at all, we ask that is be under Schedule 1.

Chair: request China to introduce its scheduling measure.

China: after last intersessional meeting, China submitted clarifications. Wants to clarify that this by no way challenges authority of WHO. Our measure balances legal, medical factors etc and respects CND and WHO. On March 4, China sent note verbale modifying its proposal, now proposal ketamine in Schedule 4 instead of Schedule 1, and submitted further materials and clarifications and ask Secretariat to circulate these. By putting under international control, risk of ketamine abuse and trafficking can by controlled while fully recognizing medical value. Decision to modify was made after prudent consideration and respect for ECDD report and views of NGOs. This fully demonstrates the highly serious attitude of China. Our further materials are on abuse and diversion of ketamine spreading beyond China; CND passed resolution noting concerns with ketamine last year ; it is becoming less difficult to synthesise ketamine, and there is more evidence of labs synthesizing ketamine ; Schedule 4 is the least stringent control measure so we are not burdening the import/export of ketamine for medical purposes, diazepam is also in Schedule 4 ; ECDD recommends national controls instead of international scheduling  but despite max efforts by China and affected countries in past decade, risk of abuse and diversion of ketamine continue. Only putting ketamine under international control will prevent diversion.  On scheduling procedure, views of WHO is not determinative nor binding – the ECDD report includes assessment of medical factors, but social, legal, cost benefit etc factors should also be considered  – the ECDD report doesn’t completely deny harm of ketamine and just concerned that scheduling will limit medical use, so this is a cost-benefit analysis; office of legal counsel gives high quality analysis and reasoning; except for clear counter arguments these views should not be negated. Member states are fully able to take account of social, legal etc factors in addition to medical factors. China has no hidden agenda, just wants a reasonable solution. China is willing to have further communications with member states before 13 March. Scheduling of ketamine may be typical dilemma encountered by CND in controlling drugs and preserving medical value. Convention calls for balance between these 2 aspects. It is not easy to apply this principle in practice, and we will work to ensure this on basis of shared responsibility.

Thailand: following resolution last year, supports action on ketamine.

Germany: vote on schedule 1 is not appropriate. Ketamine is used as veterinary and human, especially emergency, medicine. Welcome discussion on this issue. CND is required to take into account medical evidence but also other factors. There will not be time for discussion given UNGASS segment will continue until Thursday and the vote is on Friday morning. Perhaps the vote can be deferred for one year and we can listen to more submissions from experts etc. Would like to hear views of other delegations. Ketamine is mainly produced in Asia, so is a global response necessary or a regional response more appropriate?

Chair: intersessionals are also opportunities for discussion on this.

Switzerland: proposal to schedule ketamine raises question on whether CND may overrule recommendation of WHO. We studied the opinion of the Office of Legal Affairs and note its conclusion rests on the grammatical nature of a specific paragraph of the 1971 convention. It doesn’t deal with the issue of how to deal with a negative recommendation by the WHO. The opinion looks at commentary and past practice. Both the text quoted from commentary and past practice do not support the legal opinion’s conclusions because they suggest CND should and has always followed WHO advice on not scheduling a substance. The 1976 commentary deals with the matter at hand in a more different manner, it confirms the CND has wide discretionary powers and can place a substance under international control even when the WHO recommends otherwise but may only be applied in certain cases. In other cases, CND is bound to act in accordance with the WHO’s recommendation, according to p. 31 of that commentary. This is precisely the case with ketamine, because ketamine cannot lead to dependence.  The ECDD report on p. 44 states that tolerance may occur but there is insufficient evidence to show ketamine can cause withdrawal symptoms – therefore the criteria for disregarding WHO recommendation has not been met. If CND proceeds with scheduling, it will create a dangerous precedent for placing substances under international control based merely on social, economic etc factors. Surely CND does not want to go down that road otherwise in future it will find itself scheduling substances such as antibiotics and flavors of substances that member states do not like. The situation with ketamine may change, if and when sufficient evidence becomes available perhaps we can consider scheduling, but not at the time being.

Netherlands: In the past few weeks, humanitarian and veterinarian associations around the world have made us aware of the medical need for ketamine, e.g. in emergency situations and conflict scenarios. There is no alternative available for ketamine, refer INCB report from 2010 on access to essential medicines, because of insufficient training, distribution etc.  The World Drug Report 2014 also says that ketamine misuse is stabilizing or declining. Decline might not be large but the case for controlling ketamine is nevertheless weak. WHO has recommended against it. The OLA’s opinion misses out reference to several crucial commentary paragraphs. China says schedule 4 is the least stringent one but the substance phenyl-barbital under schedule 4 is not available in many developing countries because of restrictions brought by scheduling.

Russia: would like to include ketamine in schedule 4 as that is a flexible and suitable compromise. Ketamine is in schedule 2 of our national legislation. Believe we should have serious debate and consideration to find the most widely acceptable solution because of specific nature of ketamine. We need to have a very cautious approach on this item and thank Chinese for their flexibility.

Ecuador: pay tribute to China for flexibility, also value their openness of mind but we do have reservations for inclusion in Schedule 4. It would have impact in my country because of economic and health factors as ketamine is used widely for veterinarian purposes. My delegation next week can discuss with the Chinese the effects of this. Fine with deferring vote to next year to allow more time.

India: no one is denying medical value of ketamine but there are also other issues with misuse, so that even if declining, it is of concern regarding trafficking, misuse and diversion. Some kind of international control will be useful. Appreciate China’s flexibility. I am not competent on legal aspects on this matter to comment.

Belgium: against international control, even Schedule 4, as it will be a major obstacle to access for low and middle income countries; support WHO recommendation.

Norway: skeptical of any scheduling of ketamine because of its importance in emergency situations as described by the NL with no alternative available, and WHO has spoken against any international control, supported by commentary. We are concerned with consequences for CND, acting against clear recommendations of WHO.

China: on substantive issues of scheduling, we will not repeat our statement.  In response to the Netherlands and Switzerland comments, e.g. Switzerland referring to ECDD report saying that ketamine has no dangerous effects, on this question we have different opinion. In accordance with Article 2 of 1971 Convention, if WHO believes substance has possibility of causing dependence, or it has negative effect of causing dependence, WHO will consider all these issues – as said in ECDD report. ECDD has confirmed concerns raised by many countries and international organisations and in addition, it has compared K with PCP. We believe ECDD opinion is just different in terms of degree of harms of ketamine, it hasn’t rejected completely its harms. The NL says schedule 4 will still cause problems, but I believe China has pointed out that Schedule 4 has only very light controls. It was proposed that more time was needed. China is very open to such suggestions. If majority of countries believe they need more time, we will in spirit of shared responsibility, discuss all these issues, based on balance and consultative approach.

Guatemala: we should consider this proposal in greater depth given WHO’s recommendation, it could have economic and legal impact.

Canada: at last intersessional, it was mentioned there could be report on difference between schedules 1 and IV.

Chair: asked Secretariat for paper on this, and it will be distributed this afternoon.

WHO INPUT BY VIDEO LINK (response to 16 questions submitted by member states)

WHO: of the 20 million people in need of palliative care, only 15% people get it because of controls. In INCB reports, consumption in Africa is particularly inadequate. Clearly scheduling is a problem. Phenyl-barbital, a medical treatment for epilepsy, scheduled under Schedule IV is an example, where 75% of people who need treatment don’t get it because of controls. For emergency personnel, they have stopped putting morphine into their kits because it is so difficult to bring in morphine into the country; phenyl-barbital needs to be shipped separately and it takes at least 4 months for it to be shipped.

In terms of ketamine in high income countries, it is used for veterinary and human anaesthesia. It has important features such as not increasing blood pressure and can be used outside of hospital settings. Ketamine went on the market in 1974 and has been relied on by physicians for a while.

In terms of research and development, always looking for medicines that are cheap and effective.

Welcome offer from China to provide more information about ketamine.

In terms of similarity between PCP (already controlled) ketamine, asked by China, there are significant differences. Eg. ketamine is significantly less potent, doesn’t induce convulsions, doesn’t induce allergic reactions as frequently. They are far from identical.

Research on dependence of ketamine: no sufficient evidence of withdrawal symptoms hence there is not likely to be strong physiological dependence on ketamine.

Scheduling ketamine will certainly restrict access for medical purposes, with negative impacts for vulnerable populations.

Additional questions to WHO:

Spain: welcome your role, especially in CND. Encourage WHO to strengthen collaboration with CND and work of UNODC. Question on mephedrone, proposal was initially for Schedule I then WHO advice was for Schedule II. We thought structure of mephedrone was similar to Schedule I substances such as MDMA, can you please advise on difference.

China: most of the 16 questions addressed by WHO were raised by China. Next week we have experts from Beijing so there can be further discussion between experts. ECDD report. Does WHO acknowledge dangerous properties of ketamine, recognized by several other countries which already control ketamine? Can we have written response to questions?

India: echo question from Spain ; why is mephedrone not scheduled under Schedule I?

FURTHER COMMENTS ON SCHEDULING

Brazil: on scheduling of GBL and BDO, we cannot support due to the known and very relevant industrial use for both substances.

India: we are not in favor of scheduling GBL and BDO as well.

WHO: because ketamine is a psychotropic substance, there will be abuse – that is a reality. We have a careful process of balancing medical use with abuse; also the purpose of the drug conventions. Yes we can provide written responses before 13 March, where scheduling will be decided.

On mephedrone, there was not enough data on dependency, although it included data on deaths, to warrant recommendation for schedule 1.

SCHEDULING PROCEDURE FOR FRIDAY 13 MARCH

Chair – Thailand: proposed course of action for scenario and voting on 13 March, under agenda item 6 (b) where ‘taking action’ also means deliberating, not just voting. Before moving to a vote on each substance, there will be statements from notifying party followed by WHO. For substances recommended by WHO only, only WHO will make statement. Regular procedure is to act by consensus and decide to postpone for debate, or to vote etc. For substances under 1961 Convention a simple majority is required for vote to pass; if under 1971 Convention, 2 thirds majority is required regardless of how many member states are present. If unable to reach consensus, then member states can vote on what to do next by simple majority, according to rule 58 of rules of procedure of functional commission of ECOSOC. Voting is done by show of plates or calling out yes/no/abstain in alphabetical order of member state.

Also need to discuss agenda for 59th CND in 2016 next week, and please submit survey in preparation for 58th CND discussions regarding role and budget for CND secretariat.

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