Side Event (HRC Panel): The right to health: addressing the drug control barriers hindering access to controlled medicines

Ruth Dreifuss (GCDP): HRC can organise adequate response to this problem. Policies building on repression have unintended consequences.  Time has come to recognise that the problem cannot be solved without shift in priorities.  Real aims are not to be reached without deep policy changes.  In this report, the Commission is advocating for scientific evidence. Human rights and health should be the compass. Also take compassion as a compass. Presents Global Crisis of Avoidable Pain.  Crisis has one additional cause — negative impact of drug control makes access to pain relief and substitution therapy even harder than for other medicines. This is the case for morphine, one of the most vital analgesics. ‘Not just a world drug problem, but a world drug opportunity’.

Ricardo Gonzales Arenas (Uruguay): Health and well-being of mankind are at heart of drug conventions and must guide our policies on this sensitive matter. Mentions Uruguay contributions to the zero draft. Has called for adequate financing to establish a program under leadership of the World Health Organization in order to help countries to address obstacles to access.  Has appealed for support to look at scheduling issues.  Uruguay has established stringent standards to prevent diversion of amphetamines, etc.  Should guarantee delivery of medical substances. National plan on palliative care to respond to physical, psychological and spiritual needs of patients in Uruguay.

Kees De Joncheere (WHO): Issue of health central to UN drug control conventions.  They clearly recognise the importance of medical use of narcotic drugs and the need to ensure medical availability.  WHO has a clear mandate in this area. Our DG recently decided on the application and request of a range of MS to put preparations of UNGASS 2016 on the agenda of the WHO Executive Board in 2016.  Also have important mandate on the Expert Committee on Drug Dependence (ECDD) to discuss scheduling.  Also a clear mandate around availability and access on essential medicines. Resolutions in World Health Assembly (WHA). WHO are working with countries to promote access. Using essential medicines lists, promoting guidelines, but particularly to improve policies, governance and health systems that address access to controlled medicines. The Access to Opioid Medication in Europe (ATOME) project looked at the barriers.

Diederik Lohman (HRW): Go and speak with patients who need palliative care, to hear their stories, and difficulties in getting healthcare they need.  Over the years has interviewed hundreds of people.  Their stories are heart rendering and touch a chord with all of us.  All of us know people who have suffered from cancer and have died in very difficult circumstances.  We can all relate to these people.  At the end of life there is a certain amount of suffering that is inevitable. Dying is not a walk in the park. But there is a lot of suffering that is unnecessary. People face symptoms that could be relieved with simple, inexpensive health medications.

First example in Mexico. In a mid-size provincial town, there was 9 year old boy who had advanced throat cancer.  It had invaded his brain, his eye was starting to pop out, huge mass, and he was complaining about increasingly severe pain.  Their physicians did not have the right to prescribe morphine.  Regulations in Mexico are so complicated that physicians outside major metropolitan centres avoided prescription because it was too difficult. Put him in touch with a provider in one of the big cities.

In Senegal, a patient had been receiving adequate pain relief and then stock ran out. He felt that body was breaking.  Sent his nephew to Italy to fill prescription for morphine and bring it back.  When patients are most vulnerable they cannot advocate for their rights.  People are simply forgotten.  Families taking care of them also have no voice, so policy makers do not know they are there.  Make sure that policymakers hear about the suffering they face.  We have a duty to take care of vulnerable people and make sure people do not have to suffer needlessly at the end of life.  In doing so we may also help ourselves and our loved ones.

Colombia: Prescriptions restricted because people fear that they could be addicted afterwards. Very critical to work together with justice ministries and ministries of culture. Work on the demand side to induce demand. When people are suffering we need to understand that pain is not quantified in many cases, and perception cannot be based on who is providing the service.  Needs to be quantified in a more objective manner.

Damon Barrett (HRDP): Due to a number of additional barriers, access to medicines for children is poor, even worse than for adults.

Katherine Pettus (IAHPC): Thanks the Global Commission for the Report.  It is wonderful that this issue has come out of the shadows and will be highlighted at UNGASS 2016, thanks to the efforts of my colleague at Human Rights Watch and other advocates who have been working on this for so many years.  I want to mention the main class of patients that are suffering in the lower and middle income countries, are the most indigent, who are suffering at home, who often never see a health worker, and to highlight the need for training health workers and licensing nurses to prescribe essential medicines, as they do in Uganda.  There is so much work to be done on this issue, and WHO can lead the effort, as Uruguay has suggested, by convening regional training workshops to share best practices such as those in Uganda and Kenya.



Contributions to the Zero draft can be found online.

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