Special Event: Increasing Access to controlled drugs Post-UNGASS

Organized by the Governments of Australia, Belgium, Italy, Lithuania and Norway, the UNODC Prevention, Treatment and Rehabilitation Section, the International Narcotics Control Board, the World Health Organization, the International Atomic Energy Agency, the Union for International Cancer Control, the International Association for Hospice and Palliative Care, Human Rights Watch, and the Vienna and New York NGO Committees on Drugs

Dr. Gilberto Gerra, Chief, Drugs and Health Branch UNODC

Increase of Cancer rates, due to changes in lifestyle etc. Journal of Clinical Oncology – not just availability of all drugs but also compassion.

UNODC, WHO, UICC Program – I hope that in the future that all these groups present can be part of the program.

Welcoming Remarks

H.E. Bente Angell Hansen, Chair 60th Session of the Commission on Narcotic Drugs

UNGASS outcome document a milestone. Deliver on important recommendation.

Children and parents are suffering because there is no pain relief. You can see the difference when you get pain relief and when you don’t. Recommendations from UNGASS Outcome Document are really do-able to implement.

Quotes Dr. Chan,M. – Access to essential medicines as a human right….dignified death and how people are remembered.

Delivery of WHO and UNODC mandate of how countries can access essential medicines.

Prejudice when using these substances but it’s absolutely necessary. Multilateral cooperation needed. Also, to see atomic agency on board is positive. Radio therapy important for pain relief and curative.We have to deliver much better on this because global gaps are really telling and horrific when it comes to coverage.Thanks Civil Society for their enthusiasm.

Aldo Lale-Demoz, UNODC Deputy Executive Director

Pleased UNODC is part of this. During preparatory to UNGASS, CSO’s came out strongly in favour of this. Clearly noted in Outcome Document. Over past 10 years we have been able to identify barriers. Member states need to build capacity. Patients have right to receive highest quality care including access to essential medicines. Ensure affordability. Strong commitment to health care needs, visible due to presence of different stakeholders at this event.

Dr. Wendy Southern PSM, Deputy Secretary, Department of Health Australia

Australia remains concerned on disparity of access to substances for pain relief. We do need to make this a priority. Importance of medical use of narcotic drugs. Conventions have undue barriers. Also, domestic conditions restrict access.

We welcome the UNGASS practical recommendations. Also, highlight social and cultural barriers to access. Tackling stigma and misinformation together with UNODC and WHO. National frameworks supported by Australia, UICC, UNODC and WHO. Analysis for dispensing and accessing controlled drugs for pain relief. Pilot in Ghana- demonstrates possibilities to overcome complex barriers in National settings. Model laws while preventing diversion. We welcome INCB learning project.

Australia encourages all Member States to prioritise access to controlled substances for medical purposes to reduce pain.

Mr. Kurt Doms, Head Drug Unit, Department of Health, Belgium

Cites Universal Declaration of Human Rights – Right to Health. Promoting Health is 1 of 3 main aims of the Conventions. Resolutions and World Health Assembly highlight this. However, accessibility not guaranteed. Causes pain for families and individuals. Crucial recommendations set a Framework for efficient and balanced way to tackle the problem.

There is a focus on Africa as situation is problematic. Worrying rise of Cancer. Democratic Republic of Congo Project – Analysis and improvement of domestic legislation and training for health professionals. We hope to inspire other countries with this project. However, there is still complexity and magnitude of problems. Belgium commends UN Bodies for technical support. INCB 2015 Availability report provides clear guidelines.

Mr.Rokas Bernotas, Ambassador at large of the Ministry of Foreign Affairs of Lithuania

There is an essential need to balance abuse of controlled substances and for that of medical use. Share good practice and good solutions. We have all agreed on Operational Recommendations and how to implement and what is the best solution for our modern society.

Mr. Thor Erik Lindgren, Counsellor, Norwegian Delegation to UN in Geneva

80% of the World’s population has insufficient or no access to controlled medicines. Not available for palliative care and life saving treatment. This is clearly major public health problem. Also a rights problem which is unacceptable. Reiterates promotion of health and wellbeing and ensuring availability of controlled substances- adequate provision and availability for such purposes and likewise for psychotropic substances. We commend WHO and CSO’s for important work they are doing in this area.

Dr Gilles Forte, Essential Medicines and Health Products, WHO

Access to essential medicines one of the 6 leadership priorities. World Health Assembly resolutions endorsed. Reflects member states commitments. Provides WHO with strong mandate. WHO recognises that UNGASS has been a milestone. Supporting countries to achieve these goals. Committed to promote policies, that promote better access but we are aware of misuse and abuse. Cancer pain worrying. WHO is actively contributing with the INCB to the learning project and joint global programme, together with UNODC and CSO’s.

Mr Luca Li Bassi, Acting Director, IAEA

Importance of partnerships to address this challenge. Cancer is increasing, particularly deaths in low and middle income countries. Pressure on health systems due to late diagnosing. Palliative care becomes priority and should be part of integral of health response. Implementation of Cancer control. Identify needed resources for Palliative care.

Statement from INCB

President Werner Sipp, INCB

Ensuring Adequate Access. Various INCB reports; not only special report last year, but our annual reports as well show unbalanced situation of availability. Member states expressed concern of availability – low to non-existing. Operational recommendations adopted on this important issue adopted by UN bodies, CSO’s and some member states already taking action.

Follow-up and Actions taken by Member States:

  • Domestic Legislation, regulatory/administrative mechanisms: New regulations and online platforms/systems to facilitate prescribing and dispensing of controlled substances

All this while still maintaining control regulations. Improving accessibility while controlling prescription drug abuse.

  • National Control systems, domestic assessment mechanisms/programmes: The recommendation refers to the WHO publication for Guidance
  • Import and Export authorizations: Several Countries enrolled in I2ES. More countries need to join. Resources for maintaining the system are needed.
  • Affordability: Several Countries started national morphine production. Importing morphine powder, providing morphine free of charge.
  • National Supply management systems: Computerized pharmaceutical systems to monitor stocks and ensure availability; observatories on palliative care to monitor needs and inform policy.
  • Essential Medicines: WHO and CND work collaboratively on this. Countries need to review the lists at national level.
  • Capacity building and training: Several Member States carried out national training events

INCB Learning Project: (launched April 2016) training seminars, awareness raising workshops and development of e-learning modules. Two regional trainings in East Africa and South and South East Asia and West Africa. Europe and Central America plsnned.

While the issue of availability is of the highest importance, awareness should also be raised on the need for control mechanisms. In particular; attention should be paid to the potential for diversion and abuse of controlled medicines which have created overdose crisis in some countries of the World.

Statement from Civil Society

Dr Katherine Pettus, International Association for Hospice and Palliative Care on behalf of UICC, Human Rights Watch, UICC, World Hospice and Palliative Care Alliance, VNGOC/NYNGOC

Willing partner on implementing the operational recommendations. CSO’s able to implement Chapter 2. Doing the work with affected populations and deprived countries. Advocate for improved access to essential medicines. Urge policymakers to contact local palliative services to see what they are doing with little and no resources to see first hand the work and needs of these people. Further training for health care providers. Opioid over and under use. Member states can support Agenda 2030.

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