Home » Side event: Public health dimensions of the world drug problem, and WHO activities in addressing them

Side event: Public health dimensions of the world drug problem, and WHO activities in addressing them

Organised by the World Health Organisation.

Annette Verster (HIV Department, WHO)

Thank you everyone for attending.

Dr Oleg Chestnov (Assistant Director General of Non-Communicable Diseases at WHO)

Drug problems are much more broader than WHO. The big member states take this very seriously, our government board is made up of 194. UNGASS involved the health sector, and this was a very important milestone. The public health response should play a more and more important role in the world drug problem. Also interesting from UNGASS – expecting operational recommendation for the role of WHO in the future. Who is present from the member states – we try to take in consideration that more agenda items for WHO are present in New York as part of the UN system. These are two different groups, with different education – we are very comfortable in Geneva. We want to work with governments. We are very active, and have signed an MOU with UNODC. We now have a commitment to work together, Mr Fedetov and Dr Chan are very happy to work together. We will show you how we are going to proceed. Governing process with WHO – in May we have agenda item we’re going to discuss. In each car we have 1 driver, now we have 3 drivers in each car. For us this is a great change. The drug problem, this is business as usual. Everyone criticises UN system, such as Mr Trump. We much continue to work within normative guidelines – sugar control, salt intake etc. What is our additional barrier – we have a network, but UNODC doesn’t. We have 8000 staff working in the field. We can be good for measuring the result and process, and help provide data. This will be done without any force. We have Sustainable Development Goals (SDGs) for 2030. We want to be clear on how many people die and how many people we save. We are always looking for more ways to save lives. The health sectors contribution is not only guidelines – sometimes methadone is successful. We are looking for more innovative ways to save lives. Each country can contribute to this, having health options for people who use drugs.

Annette Verster (HIV Department, WHO)

WHO is UN health agency since 1940s. Map shown of WHO regions. Main functions – technical support, developing norms and standards, strengthening health systems, research agenda and knowledge management. Summary of SDGs that relate to our work – in particular 3.5, but also 3.3. Main activities – treaty/convention based functions – not limited to illicit drugs, but to include other psychoactive substances. Public health is the main mandate of our activities. Brief summary of resolutions related to drugs at the World Health Assembly. Increasing focus on public health – 2009,2016, 2019. We summarise our activities in 5 areas – prevention, treatment, harm reduction, access to controlled medicines, monitoring and evaluation.

UNGASS outcome document quoted many times – springboard for UNODC and WHO to sign MOU together. Very broad MOU – will become available publicly quite soon – it happened a month ago. Main areas of collaboration: share knowledge, second or loan staff, joint missions to member states. More specific – harm reduction – ‘ending the AIDS epidemic and combating hepatitis – developed norms and standards – with UNODC and UNAIDS. Defining what harm reduction contains. Main focus to meet 90% of people who inject drugs with harm reduction services by 2020. ‘Priotities for HIV and viral hepatitis’ aimed to reach 2020 and 2030 targets in line with SDGs – about implementing the right interventions for people who inject drugs. HIV and Hepatitis epidemic – we are continuing to work on, provide technical support to donors, on new ways to deliver services – provide access to harm reduction programs and HIV treatment.

Gilles Forte (Access to Medicine, WHO)

WHO work within the international drug control conventions – The Expert Committee on Drug Dependence (ECDD) to review substances to be placed under international control, held annually. Robust evidence based prioritisation of psychoactive substances to be reviewed by ECDD, with support of UNODC, INCB and Member States. Thorough evidence based analysis of harm to health and therapeutic use of substances to be review by ECDD eg NPS, Cannabis. Mechanism for dissemination of information on ECDD, for raising awareness and understanding of WHO work and rationale for recommendations.

We are trying to engage with member states to collect and promote necessary data. WHO role on access to controlled medicines within the international drug conventions – WHO medal list of essential medicines updated and review of controlled medicines.

Resolutions on pain management, palliative care, epilepsy- urge to push these. Meeting at end of March – will be 3 more medicines reviewed for the management of pain in cancer. We also engage with countries to strengthen pharmaceutical systems and access to controlled medicines in 15 African countries. We are involved with UNODC to improve access to controlled medicines. Also working in Timor Leste with the support of Australia. We have identified the way forward and strategy in those countries.

Vladimir Poznyak (Coordinator, Management of Substance Abuse, WHO)

Hello, I’ve just come from presenting at the SOS Initiative side event regarding opioid overdose and naloxone. Focusing on health systems – demand reduction and related measures. We collect and disseminate good practices, health workforce development, updates on effectiveness of prevention and treatment strategies. We had signitifcant gaps in normative guidance realted to drug use and drug use disorders. We need to fill these gaps, and we hope to fill these after UNGASS. We need to update our guidelines from 2009. As well as guidelines on opioid agonists. We need to update guidance on stimulant use disorders – there are currently no management guidelines.

We are holding many side events at CND – with governments, with UNODC.

Annette Verster (HIV Department, WHO)

Thank you – we now have 10 mins for questions –

From Brazil NGO – in 1999 I was here. I was part of the government at that time – the drug problem comes and goes. We came with harm reduction about injecting drug users. Now it’s not such a problem in Brazil. You said about stimulants – everything you see with stimulants is around injecting drug users – we have lack of investment with non injecting drug users. There is increasing HIV, hepatitis and STIs in drug users in comparison with other communities. Our network is around harm reduction and human rights. Second question – harm reduction in WHO is normal – why is it not for UNODC?

Answer (Verster) – As you say, drugs come and go – the focus has very much been on HIV. 23% of HCV infections is due to injecting drug use. A large proportion of the group is already infected, that is why the rate is slowing down. There is absolutely a need for new pieces of work, especially for stimulants. For UNODC, I can’t speak on behalf – the UNODC do support harm reduction. UNODC – we have been trying forever to get into substitute therapy for stimulant use. We really need some serious studies there – we are always looking for funding.

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