Item 5. Implementation of the international drug control treaties (continued)

Chair: Welcome. I would immediately like to resume our consideration of Agenda Item 5: implementation of the international drug control treaties.

We will now consider 5a: changes in the scope of control of substances. Under this item, the Commission is called upon to carry out its treaty functions under the respective provisions of the drug control treaties. Secretariat: give us a brief overview of papers prepared under this sub-agenda item.

Secretary: The Commission has before it a number of documents relating to Agenda Item 5a. The Secretariat prepared pre-session documentation. There are notes from the Secretariat…including on proposed scheduling recommendations on cannabis and cannabis-related substances. These notes are complemented by conference room papers…including on comments submitted by states parties.

Chair: I understand the documents are available online on the Commission’s website. We will proceed with the scheduling under the 1988 Convention, followed by those under the 1961 and 1971 Conventions. I move to number 1. Pursuant to Article 12(2) of the UN Convention 1988, the INCB has recommended that MAPA (Methyl alpha phenylacetoacetate) should be included in table 1 of the 1988 Convention. As mentioned by the secretariat, the information submitted by the INCB has been brought to the Commission’s attention. I would invite the President of the INCB to introduce the Recommendations and propose scheduling of MAPA.

President of INCB: The INCB has the responsibility under Article 12 of the 1988 Convention to assess chemicals used in the illicit manufacture of drugs in order to determine if they should be placed under international control. The INCB submitted this recommendation to put this precursor to methamphetamine and amphetamine in the table 1 of the 1988 Convention. It is known as MAPA. In making its assessment pursuant to para 14 of Article 12, the Board finds that MAPA is a substitute chemical for APAM and APA, and highly suitable for the illicit manufacture of P2P, which are all precursors in Table 1 of the 1988 Convention.

P2P is in turn used in the illicit manufacture of amphetamine and methamphetamine. Incidents involving the illicit manufacture of MAPA began to emerge in 2017, with increases in seizures since 2018. The emergence of MAPA coincides with an increase in scrutiny over APA. MAPA has no known legitimate use, except in small amounts for research, development and laboratory purposes. There is no documented regular trade in MAPA other than for the aforementioned purposes.

It is a designer precursor, similar to APA and APAM. You will recall that the board elaborated on this yesterday under the agenda item 5b. In light of its findings, the board recommends adding MAPA to Table 1 of the 1988 Convention. International control of MAPA will limit its availability for illicit drug manufacturing and subsequently reduce the quantity of amphetamine and methamphetamine manufactured. It will have no negative impact on availability for research, given the relatively limited market. Placement in table 1 will provide governments with the possibility to request pre-export classifications to monitor shipments entering their country.

Chair: If we have no requests for taking the floor, then I invite the Commission to take a vote to place MAPA in Table 1 of the 1988 Convention. I would like to recall that 12(5) of the Convention says that a 2/3 majority is required to place a substance under control. An affirmative vote of at least 36 members is required. I call on only the members of the Commission in favour of the Recommendation to raise their hands:

Afghanistan, Algeria, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Morocco, Nepal, Netherlands, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom, United States, Uruguay

Chair: And those not in favour? We see none. Those who want to abstain? There are no votes against and no abstentions. 47 votes in favour, none against, the remainder are absent. I declare that the Commission has decided to include MAPA in Table 1 of the 1988 Convention. If I see any delegations wishing to make statements on their votes, they can do so. There are no such requests at this stage. We move to the next item: WHO Scheduling Recommendations from the 42nd meeting of the Expert Committee on Drug Dependence. We proceed with scheduling recommendations under 1961 and 1971 Conventions.

Chair: The Commission has a note in the Secretariat with information about the scheduling of substances under the 1961 and 1971 conventions. As well as the assessment and rationale for the recommendations submitted. And comments by Member States. Item A is on crotonylfentanyl


WHO: Crotonylfentanyl is a synthetic analogue of fentanyl, it appears in powder and tablets. It produces typical opioid effects, including analgesia and sedation, with a potency between oxycodone and fentanyl. It has significant potential for dependence and likelihood for abuse. In terms of adverse effects, death by respiratory suppression. Seized in several regions, no therapeutic use. Given the potential for similar abuse and ill effects as many other opioids on Schedule 1 of 1961, like oxycodone and fentanyl, recommendation of Schedule 1 of 1961.

Chair: We proceed to a vote. Under the 1961 convention, we need a simple majority.

Afghanistan, Algeria, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom, United States, Uruguay

Chair: Abstained?

Morocco

Chair: 47 in favour, 1 abstention. The Commission schedules crotofentanyl on Schedule 1 of the Convention.


Chair: I would once again ask WHO to introduce the item.

WHO: DOC is a synthetic hallucinogen, commonly found in blotted paper, liquid and tablet forms. It is commonly misrepresented on the internet as LSD. The action of this on the nervous system are very similar to other hallucinogenic amphetamines such as DOM and other hallucinogens like LSD and psilocybin.

In addition to hallucinations, other features include aggression and hypothermia. Use is associated with a risk of death. It has potential for abuse comparable with other hallucinogens and abuse has been reported in a number of countries. It has no therapeutic use. As it has potential for similar abuse as other hallucinogens in Schedule 1, it is recommended that it is placed in Schedule 1 of the 1971 Convention.

Chair: If there are no comments, I invite the Commission to take a vote. According to 17(3) of the 1971 Convention, a 2/3 majority of the Commission is required. I now call on members of the Commission in favour of the Recommendation to place DOC in Schedule 1 of the 1971 to raise their coutnries’ signs.

Afghanistan, Algeria, Angola, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom, United States, Uruguay.

Chair: And those not in favour? I see no abstentions, we will shortly share the result. It is 48 votes in favour, no votes against, and no abstentions. I see that the Commission has decided to include DOC in 1971 of the Convention.


Chair: Next up AB-FUBINACA. I invite the CND to take action on AB-FUBINACA to place it in Schedule 2 of the 1971 convention.

WHO: AB-FUBINACA is a synthetic cannabinoid smoked with plant material sprayed with the substance. Shares mechanism of action of other synthetic cannabinoids included already in Schedule 2 of the 1971 convention. It’s likely to be abused and has the potential to produce dependence similar to other synthetic cannabinoids. In animal models, similar to other synthetic cannabinoids: suppression of locomotor activity, hypothermia; human use associated with severe adverse effects: confusion, hypertension, tachycardia, deaths. Use has been reported in over 30 countries in all regions. It was no therapeutic use. As it has potential for similar abuse and ill effects as others in Schedule 2 of 1971 convention, we recommend placing it also there

Afghanistan, Algeria, Angola, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom, United States, Uruguay

Chair: 48 votes in favour with no votes against or abstention. I declare the commission has decided to include AB-FUBINACA to Schedule 2 of the 1971 convention.


Chair: We invite the Commission to take action to add to 5F-AMB-PINACA to schedule 2 of 1971 of convention.

Secretariat: 5F-AMB-PINACA is a synthetic cannabinoid known as 5F-AMB. It is used by smoking plant material sprayed with the substance. It shares a common mechanism of action in the central nervous system with other synthetic cannabinoids in schedule 2. It is likely to be abused and has the potential to produce dependence. It is Associated with fatalities included deaths using motor vehicles. It has diverse effects including cognitive impairment and coordination, similar to other synthetic cannabinoids. It has been reported in over 30 countries across different regions. It has no therapeutic use. It has similar potential abuse and similar ill effects as other synthetic cannabinoids in schedule 2. We recommend it also be placed in schedule 2 of convention of 1971.

Chair: As of Article 17 of 1971 convention, a 2/3 majority is required.

Afghanistan, Algeria, Angola, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

Chair: 49 votes in favour, no abstentions. It has been included in Schedule 2 of 1971 convention.


Chair: We move to 54-MDMB-PICA. I would like to invite WHO to introduce the Recommendation.

WHO: This is a synthetic cannabinoid found as a powder, and sprayed on plant material that mimics the appearance of cannabis. It shares a common mechanism of action with other synthetic cannabinoids that are placed in Schedule 2 of the Convention of 1971. Based on this action, it is likely to be abused and has the potential to produce dependence. Its use has been linked to serious adverse effects including impaired mental status, delirium and seizures. Its use has been linked to mass overdose events and deaths. It has been detected in about 20 countries and has no therapeutic use. As it has potential for similar abuse and produces similar ill effects to those under Schedule 2, the Committee recommended that it also be placed in Schedule 2 of the Convention of 1971.

Chair: I invite the Commission to take a vote to add 54-MDMB-PICA to Schedule 2 of the 1971 Convention. A 2/3 majority is required. I request the members of the Commission who are in favour to raise their signs.

Afghanistan, Algeria, Australia, Angola, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom, United States, Uruguay

I now call on the member States not in support to raise their signs. There are none. And I now request abstaining member States to raise their signs. There are none.

The vote is 48 votes in favour, no votes against and no abstentions. I therefore declare that the Commission has decided to include this in Schedule 2 of the 1971 Convention. If there are no requests for the floor, we move to agenda sub-item G, inclusion of 4F-MDMB-BINACA in Schedule 2 of the 1971 Convention.


Chair: We invite the Commission to take action to add to 4F0MDMB-BINACA to schedule 2 of 1971 of convention.

Secretariat: 4F-MDMB-BINACA is a synthetic cannabinoid. It has been detected in powder, liquids used for vaping and a constituent in plant mixtures used for smoking. It shares a common mechanism of action in the central nervous system with other synthetic cannabinoids in schedule 2 of 1971 convention. It is likely to be abused and it has a potential to produce dependence. It has been detected in cases of drug related fatalities and cases of impaired driving. Its adverse effects include paranoia, chest pain and vomiting. It has been detected in a number of countries in a variety of regions. It has potential for similar abuse and effects as others in schedule 2, the committee recommended it be also placed in schedule 2 of 1971.

Chair: According to Art 17, a 2/3 majority is required.

Afghanistan, Algeria, Angola, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

Chair: 49 votes in favour, none against and none abstained. It has been included in schedule 2 of 1971 convention.


Chair: We move to the inclusion of 4CMC in Schedule 2 of the 1971 Convention. (4-chloromethcathinone, clephedrone).

WHO: 4CMC is a synthetic cathinone. It has been detected as a powder that is administered orally, but also nasally or by intravenous injection. It shares a common features with stimulants such as MDMA and other cathinones that are placed under Schedule 2 of the 1971 Convention. It produces adverse effects typical of psychostimulants, including paranoia and tachycardia. Use has been associated with fatalities due to overdose, suicide and traffic accidents. These are similar to that of other substances and psychostimulants, such as MDMA.

It has significant potential for dependence. There  is evidence of use in a number of countries. It has no therapeutic use. As it has potential for similar abuse and produces similar ill effects as other synthetic cathinones placed in Schedule 2 of the 1971 Convention, the Committee recommended that 4CMC also be placed in Schedule 2 of the 1971 Convention.

Chair: We proceed with the vote. A 2/3 majority is required. Those in favour?

Afghanistan, Algeria, Australia, Angola, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

I now call on the states not in support? There are none. I would now request any abstentions? There are none. The vote result is 49 votes in favour, no votes against and no abstentions. I declare the Commission has decided to include 4CMC in Schedule 2 of the 1971 Convention. If there are no requests for the floor, we move to N-Ethylhexedrone.


Chair: I invite the CND to consider the inclusion of N-ethylhexedrone in Schedule 2 of 1971 convention.

WHO: N-ethylhexedrone is a synthetic cathinones detected as a powder administered orally by nasal insufflation or IV injection. It shares a common mechanism of action as other cathinones and stimulants like methamphetamine, included in Schedule 1 of 1971. Adverse effects typical of psychomotor stimulants, hypothermia, tachycardia, seizures. N-ethylhexedrone has been associated with cases of impaired driving and deaths. The effects indicate significant potential for dependence and high likelihood of abuse. Evidence of use in many countries of various regions. It has potential for similar abuse and ill effects as other synthetic cathinones in Schedule 2, we recommend its scheduling there.

Chair: We call on Member States to raise their signs if in favour of scheduling.

Afghanistan, Algeria, Angola, Australia, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

Chair: Not supportive? None

Chair: Abstaining? None. We will share the results soon.

48 votes in favour with no votes against or abstention. I declare the commission has decided to include N-ethylhexedrone to Schedule 2 of the 1971 convention.


Chair: We move to alpha-PHP, in relation to Schedule 2 of the 1971 Convention.

WHO: It has been administered orally, sublingually, vaping, nasally, or by intravenous injection. It shares a mechanism of action with other cathinones and stimulants like methamphetamine which are in Schedule 2 of the 1971 Convention. It produces adverse effects typical of psychostimulants including hallucinations and tachycardia. It has been identified as a cause on multiple fatalities and clinical admissions. It has significant potential for dependence and high likelihood of abuse.

There is evidence of the use of alpha-PHP in a number of countries, it has no therapeutic use. As it has potential for abuse as other cathinones placed in Schedule 2, the Committee recommends that it be also placed in Schedule 2 of the 1971 Convention.

Chair: We move to the vote, a 2/3 majority is required. I call on those in favour of the recommendation to place alpha-PHP in Schedule 2 of the 1971 Convention.

Afghanistan, Algeria, Australia, Angola, Austria, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

I now call on members not in support? There are none. And those abstaining? There are none.

We have 49 votes in favour of the recommendation with no votes against and no abstentions. I declare the Commission has decided to include alpha-PHP in Schedule 2 of the 1971 Convention.


Chair: I  invite the Commission to consider the inclusion of flualprazolam in Schedule IV of 1971 convention.

WHO: flualprazolam is a benzodiazepine with a chemical structure and effect similar to alprazolam and triazolam. It has been found in powder, tablets and liquids. It produces similar effects to other benzodiazepines in the Convention of 1971. Reported adverse effects: loss of consciousness, disinhibition, impairment. It has contributed to cases of fatal and nonfatal intoxication and cases of impaired driving. Significant risk when combined with opioids because it potentiates their respiratory suppressant. Potential of dependence and likelihood of abuse. Evidence in countries in different regions. Not used therapeutically. As it has potential for similar abuse and ill effects as other benzos in Schedule IV of 1971 convention, the Committee recommends its scheduling there.

Chair: We call on Member States to raise their signs if in favour of scheduling.

Afghanistan, Algeria, Angola, Australia, Austria, Bahrain, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

Chair: Not supportive? None

Chair: Abstaining? None. We will share the results soon.

50 votes in favour with no votes against or abstention. I declare the commission has decided to include flualprazolam to Schedule 4 of the 1971 convention.


Chair: We invite the Commission to take action to add Etizolam to schedule 4 of 1971 of convention.

Secretariat: Etizolam is a benzodiazepine that is used therapeutically in a limited number of countries, but is also produced in non-approved forms. It is produced in powder and tablets, and used mainly orally. It produces effects similar to benzodiazepines such as diazepam placed in schedule 4. It has reported adverse effects which include sedation, loss of consciousness and cognitive impairment. It causes a large amount of dead when combined with other drugs. It poses significant risk when combined with opioids and can potentiate the respiratory effects of opiates. The effects indicate it has potential for dependence and likelihood of abuse. It is used in a number of countries across different regions. It was patented in the 1970s and marketed as medicine since early 90s. It has been used for treatment of anxiety disorders and other psychiatric conditions. It has potential for similar abuse and ill effects of benzodiazepines as those in schedule 4, the committee recommended it be placed in schedule 4.

Chair: According to Article 17, para 3 of the convention, a 2/3 majority is required.

Afghanistan, Algeria, Angola, Australia, Austria, Bahrein, Belgium, Brazil, Burkina Faso, Canada, Chile, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Czech Republic, Egypt, El Salvador, France, Germany, Hungary, India, Iraq, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kyrgyzstan, Libya, Mexico, Nepal, Netherlands, Nigeria, Pakistan, Peru, Poland, Russia, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Turkmenistan, Ukraine, United Kingdom, United States, Uruguay

Chair: 50 votes in favour, none against and none abstained. It has been included in schedule 4 of 1971 convention.


Chair: We move to cannabis and cannabis-related substances. The Commission has before it the Recommendations of the WHO. I would like to inform you that I will be introducing this item and then we move to consideration of the draft agreed by individuals as a result of this understanding, and member States will be invited to express any comments or make any statements. If you agree with this, the Commission has a note by the Secretariat a note on this. As well as a summary of the comments submitted by the member States contained in another document.

The WHO recommended a. to delete cannabis and cannabis resin from Schedule 4 of the 1971 Convention; b. to add to Schedule 1 of 1961 Convention and remove it from the 1971 Convention; C. to add THC to Schedule 1 of the 1961 Convention and to delete it from the 1971 Convention; d. To delete extracts and tinctures of cannabis from Schedule 1 of the 1961 Convention; e. to add a footnote to the entry for cannabis and cannabis resin in Schedule 1 of the 1961 Convention to read: “Preparations containing predominantly cannabidiol and not more than 0.2% of Delta9 …are not under international control”; f. To add to Schedule 3 1971 Convention chemicals that are compounded as pharamaceutical preparations with one or more ingredients and in such a way that THC cannot be acquired by readily available means or in a way that contributes risk to public health

The Commission has held intensive discussions, including addressing questions to the WHO and the INCB. A summary of the questions and answers has been brought to the attention of the Commission in a document. During the intensive informal considerations I have held over the last many weeks, it became clear that some delegations do not have a clear understanding on the implications and consequences of the recommendations, while others were prepared to go for a vote. On this basis we have reached a common understanding and after weeks of consultation, that is reflected in the draft decision that I have tabled on behalf of the Commission contained in Document L8. It reads as follows:

The Commission on Narcotic Drugs recalls its mandate to vote on scheduling recommendations as laid out in the international drug control conventions and decides to continue during its current sixty-third session the consideration of the recommendations of the World Health Organization on cannabis and cannabis-related substances, bearing in mind their complexity, in order to clarify the implications and consequences of, as well as the reasoning for, these recommendations, and decides to vote at its reconvened sixty-third session in December 2020, in order to preserve the integrity of the international scheduling system.

It is understood that the voting does not preclude consensus. There can be other administrative social and legal factors in the assessment of the member States. Therefore I have an intention to continue this consultative process in between the intersessional period, with a view to have implementation of this decision in the 63rd reconvened session of the Commission in December.

If I have your understanding and approval, may I now invite the Commission to adopt decision L8. I see approval by the House, Decision is adopted.

European Union (Following countries align with statement – North Macedonia, Montenegro, Serbia, Albania, Bosnia and Herzegovina, Iceland, Ukraine, Moldova and Georgia. Mexico and Uruguay also align with the explanation of vote: We regret majority of countries wasn’t ready. To provide additional time to allay concerns, we do not oppose the postponement of the vote at the Reconvened Session. We will continue discussions. At that moment, we have to assume our responsibilities to preserve the credibility of the system of scheduling. We trust with your guidance, we will be ready to vote then.

Chile: During March 2019, Chile hosted the mission of INCB. In June 2019, we give thanks for cooperation with them. One of the topics which they recommended on was changes on scope of substance control. Government of Chile does not support the legalisation or cultivation of marijuana for medicinal purposes. As a state we will have the point of view how to incorporate this initiative in comparison to drug control treaties. In my country, the work that the CND does with WHO is essential to control new substances derived from fentanyl. These substances have been problematic worldwide due to deaths, and the complexity of regulating these. The relevance of NPS could say that the last WHO recommendations on fentanyl, carried out analysis of global trends. Between 2015 and 2018 we included a total of 161 new substances and are working on legal modification to add precursors used as bulking substances. This approach should be considered an example for all of South America.

Russia: We align ourselves with your postponement decision. We are pleased that as an outcome of the complex consultations all members of the CND shared their commitment to the Vienna spirit of consensus of such a sensitive and delicate issue. At the same time, we would also like to underscore that the adoption of a substantive decision on such a serious problem requires solid evidence basis and comprehensive analysis of medical, scientific, legal, social , administrative and other aspects of these recommendations. This is an issue of prestige, authority and trust in our CND. To date, we have not seen any convincing exhaustive argument to support the proposals that came from the WHO ECDD. We suggest the task of the CND at the time is to analyse what is behind the need to weaken controls on cannabis, which remains the most abused narcotic drug in the world. We hope that we will manage to receive answers to our questions during the intergovernmental meetings planned in Vienna with experts from Ministries of health, law enforcement, legal experts, to look at these recommendations by WHO. We hope this will be open to all Member States of the UN. We are certain the results from this expert format will allow for an objective decision with regard to cannabis. To study this issue in detail, in additional to WHO, we need the opinion of INCB. It will be important to receive the legal conclusions of the Committee with regard to the cannabis control regime, included alleged existence of limitations in the use of this substance to medical and scientific purposes. The precedent in revising other substances form their point of view from excluding substances form Schedules. Russia will participate actively and look forward to constructive cooperation. We hope the dialogue will allow member states to determine their positions at the reconvened 63 session and take a well-considered and objective decision on these issues.

South Africa: We have carefully considered and reviewed the recommendations regarding the proposed changes. WE commend WHO for the scientific evidence based information to assist us formulate drug policy to counter and address the world drug problem. We think the recommendations are sound, balanced and based on a critical review of evidence. These will serve as a solid guide on how to translate commitments to the national level we uphold the conventions as the cornerstone of the system and will continue to oblige to its dispositions.

Jamaica: We view that the approach to postpone the decision does not undermine the WHO ECDD decision. We thank WHO for its contribution. Jamaica acknowledges that this additional time will allow States to further analyse recommendations. We encourage States to address scientific and evidence based. Continued delays will not improve access for patients to palliative care and other forms of illness, such as wasting syndrome, epilepsy. They deserve this alternative where other options have failed.

Chair: Next delegation on our list is the delegation of Indonesia.

Indonesia: Thank you. I would like to reiterate our position concerning the prohibition of cannabis. Also, kratom can only be used for scientific purposes and has high potential. It cannot be used in science or therapy and has a very high potential for addiction. It is currently being grown and includes ingredients. It can cause addiction and respiratory issues.

We would like to discuss consumption of NPSs. As many as 76 types of NPSs have been detected. Despite the progress that has been made, we still feel that more needs to be done. The Committee needs criminal sanctions of NPSs and cross-sector organisation. Indonesia remains committed to supporting the work of the Commission in assessing the valuable information on proper application of scope of controlled substances.

Singapore: Singapore has been engaged in the six recommendations on cannabis and related substances and would like to thank the chair for efforts to retain unity. Singapore respects the ECDDA’s role and to provide recommendations. WE are supportive of measures to ensure the availability and access of controlled substances for medical and scientific uses. However, we would like to reiterate our concerns that the ECDDA’s recommendations will lose the controls over cannabis, leading to a widening public access and cause serious public health and safety issues. Our concerns are: 1. We do not see any strong evidence to substantiate the recommendations – particularly on safety for medical purposes; 2. There have been no compelling reasons to justify that barriers are needed to be reduced for medical purposes – the current regime allows more than adequate access; 3. Widespread and serious effect on public attitudes – the public may think that cannabis is no longer harmful. There could be serious and long-term impact from this. 4. Some recommendations are not well defined and will give rise to the lack of implementation in measures. It will lead to interpretative confusion among state parties and undermine the drug control regime.

These recommendations are complex and not mutually exclusive. Member states should have sufficient time to analyse and consider them from all angles, including societal and administrative perspective. Singapore remains committed to continuing the dialogue on this so that the right decision will be made.

Japan: The recommendations have significant impacts on social, legal and administrative aspects in member states. We should have further elaborated and careful discussion among member states to accompany this. The world drug problem remains serious; the unity of all member states fighting against drugs is the most important thing. We appreciate the CND position to continue discussing during the 63rd CND session. We would like to support further collaboration among member States. Japan is ready to continue to further engage in consultations and has supported INCB to conduct analysis of the impact of the recommendation.

(…)

Switzerland: In January 2018, the ECDD WHO released the outcomes of the critical review of cannabis, including scheduling recommendations. For over a year, States have had the opportunity to use intersessionals to pose questions and decide on the positions. We were prepared to vote and regret some States were not. We accept they need more time to think of implications and recommendations so that they can make the evidence based assessment needed to vote in December at the Reconvened. We need to show the world, beyond CND, that we are ready to assume our responsibilities in scheduling. That the scheduling system still works. And that it’s credible and fit for the future.

Sudan: We appreciate efforts to find compromise to allow necessary considerations of the scientific basis and social, economic, administrative, technical and legal ramifications. Sudan recognises the treaty-mandated role of WHO in recommending changes in the control measures for drugs. The CND has played an important role in implementing scheduling recommendations by WHO. Sudan has expressed concerns about the recommendations by the ECDD, however. WE need a clear justification to social, legal, administrative, legal, ramifications. Cannabis is one of the most abused drugs in my country. We should think of the people in the poor local communities not aware of the process. IN my country, cultivation and high traffic of cannabis and abuse persists. Despite our national cannabis laws. So a hasty decision on the rescheduling of cannabis will have a disastrous consequence. Over 70% of police cases and crimes relate to cannabis. We are also concerned about the use of tramadol, which is trafficked. We are concerned it wasn’t considered for scheduling. There is no doubt that the nonmedical use of cannabis has become a crisis. This challenge should be treated with the seriousness it deserves. The international community should go beyond surveillance and national control measures, inadequate because this is a transnational issue. My country reiterates the need to globally regulate tramadol. We call on WHO to recommend tramadol scheduling.

Egypt: We thank you for the efforts you have made in the past few months in an attempt to obtain consensus in the control of cannabis, and the tabling of a draft resolution that should allow for the postponement of such a decision until December 2020.

These recommendations need to be debated combined – no recommendation should be singled out. It is important to highlight the repercussions on several levels – including health and regulatory – so enough time needs to be given to careful consideration of these recommendations and deciding how they be debated. This needs to take into account domestic legislation and the capacity of member states to take up these recommendations.

Egypt has incessantly endeavoured to highlight the threat of tramadol and to contain its prevalence. Despite international and national measures taken, these have been insufficient. We call on the international community to take further effective measures to doing so, including serious consideration of its inclusion in international control schedules. The substance should be included in Schedules as soon as possible.

USA: We echo the statement of the EU and Canada. We join consensus on the decision to vote on the cannabis recommendations in December in order to allow member states and the Commission to share their views on the impacts. We recognise that there will be a diversity of viewpoints – this is important.

We urge the CND and other states to study these issues throughout the intersessional period so all states are ready to vote in December. Not seeking to undermine the scientific evidence.

The importance of the WHO critical review of cannabis should be put into perspective: this reaffirms the placement of cannabis in Schedule 1. This is a major milestone in our efforts to control narcotic drugs liable to abuse but having some potential therapeutic value. We cannot lose sight that the world drug problem is vast and multi-faceted. Much remains to be done. This cannot be sidelined by other deliberations, so the USA reaffirms its support to use these next 6 months productively so we are ready to vote in December.

China: We welcome the decision of postponing the voting on cannabis. The delegation believes that the adjustment of cannabis is very complex. Last year WHO and UNODC listened extensively to comments and replied to our questions. We hope WHO and ECDD will strengthen knowledge of dangers of risks of cannabis. China supports the continued discussion of cannabis and the management of rescheduling cannabis on public health. China will maintain the stability of 3 UN drug control conventions. China will actively perform its duties of the conventions.

 

Canada: We continue to endorse the treaty mandated role to assess and make recommendations based on expert evidence. The review of the cannabis result in recommendations with complex implications. Over past year, CND members work to gain understanding of the reasoning behind the recommendations and their consequences. We Appreciate answers by WHO and INCB in mandates during the intersessionals. 2 recommendations were ready for vote and could have been adopted today. We are willing to postpone on those items to be defined at a date this year. The legal and technical problem we have will be addressed by further clarification. Further study will allow additional factors. We wil make use of intersessional meetings to hear from exports engage in dialogue and address questions. We protect the integrity of the schedule process and make sure they are based on scientific evidence. We look forward to voting in the reconvened in December.

 

Nigeria: We recognise the  treaty mandated rule. Commission continued to play its role and prompt recommendations by WHO. We express concern about the recommendations by WHO experts on scheduling of cannabis and we believe the reasons offered by ECDD on the recommendations are insufficient. The reasons relate only to scientific basis. No reasons for social and technical ramifications. We are deeply concerned about the global perception about proposal. The shift for support for legalisation of non-medical use of cannabis. There is a growing appetite for legalisation of non-medical use of cannabis is reported in 2019 INCB report. World Drug Report states it is the most abused substance in the world, and is a threat to security, health and global population. Legalisation of non-medical use is a violation on International obligations of drug control treaty. Cultivation and trafficking consist in Nigeria. We prioritise strategy which has resulted in rescheduling cannabis will be counterproductive to drug control efforts. The Linkage between cannabis and rate of crime increases insurgency. The National drug use report launched 2019- 10 million abuse cannabis in Nigeria in one year. The Epidemiology Report of drug use show that over 80% of those that access treatment abuse cannabis. Against this background these recommendations face serious scrutiny. Appreciation for finding compromise to allow consideration of scientific, social, political, technical ramifications. Nigeria is also concerned of tramadol- one of most trafficked in Africa which is not considered for scheduling. In 2019, INCB indicate that abuse is on the rise in Africa and Asia. It has Revealed a dangerous pattern of preparations of 100mg- 1 billion pills have been seized. Non-medical use of tramadol has become a crisis. It is a very serious challenge that must be treated with seriousness it deserves. To rely on national control measures have proved insufficient. We encourage the global regulation of tramadol and the member states collect and share information on non-medial use of it. We call on WHO to consider placing tramadole on next scheduling recommendations.

Mexico: one of the tasks of CND is to take action to amend scheduling. Failing to fulfil this mandate would mean shirking the role of organ to address the world drug problem. Having joined statement delivered by EU, like to convey as Mexico, that postponing recommendations of ECDD of WHO based on scientific analysis, should not mean postponing the date, but should compel us to ramp up efforts to understand technical interpretation and implications to carry out role in drug control system and carry out the mandate. Very different international time compared to 1961, when single convention adopted. Recognised role of WHO in undertaking examination on cannabis, a plant which was included in controlled scheduling without analysis of therapeutic properties of scientific uses. Trusts that with guidance, we will start work bringing up to december 2020 and believe together we could address tasks and identify recommendations which need further study- 5.1 does not need more clarification. Carry out informal consultations to focus on recommendations that are interlinked and other consultations to address pending recommendations.

(…)

United Kingdom: Turning to the recommendation on cannabis and cannabis related substances, we thank WHO on the work of the communications. The UK continues to fully support the WHO. We hope to vote in December, and commit to preserve the integrity of the international scheduling system.

 

Brazil: We review all aspects of administrative, social, political and legal aspects that are part of the mandate of this commission to discharge its responsibilities. These are challenges that have to be undertaken in conformity with the the UN convention on drugs control which provide a clear framework to comply with. Cannabis and related substances are important and we are confident we’ve given ourselves time for better understanding and for clarifying the issues. 

 

Iran: Iran acknowledges the importance of the ECDD’s role. However,  the evidence that ECCD has presented seems inaccurate and inconclusive, some are not well defined and may lead to confusion when implemented on the ground. The recommendations have serious implications and ramifications on public attitudes towards cannabis, protecting public health and commercial use of cannabis. It is not clear how cannabis rescheduling will ensure removal of barriers to use for medical and scientific purpose. The social, economic, administrative, legal and other implications need to be further explored. We welcome to discuss the rescheduling of cannabis and cannabis products to be discussed further in informals. 

Kenya: Thank you for giving more time to discuss the WHO’s recommendations. I wish to reiterate my delegations position: while the WHO report does address some of the logistical difficulties with preventing diversion to illicit markets, our objection is that cannabis is our most problematic drug abuse and accounts for the highest number substance abuse disorders. Approving the WHO  proposal will result in misunderstanding and controlled abuse and misuse of cannabis and cannabis related substances. Member States should reflect on the impact before the next session in December 
Palestine: We respect the recommendation to change measures but we express our serious concerns on the recommendations by the WHO on rescheduling of cannabis and related substances. It didn’t reflect to consider the social, legal, administrative and technical ramifications of such an action. We recall the 2019 world drug report which identified cannabis as the most abused substance in the world, posing a serious threat to the health and wellbeing of the global population. The legalisation of non-medical use of cannabis is a violation of the international obligations under the drug control treaties. We respect the opinion of some members states need to take an action, but we call upon all states to dually consider the serious challenges that will arise if they take such decisions without enough studying of its implications on the social, economic, administrative and legal issues on our societies and communities.  We hope the CND will continue to play a reasonable and responsible role to consider all member states concerns and problems for the common and shared interests of the whole international community.

Community Alliances for Drug Free Youth: In regards to recommendation 5.5, the WHO and its expert committee on drug dependence have recommended that preparations containing predominantly CBD and not more than 0.2% THC be excluded from international control. The use of the term ‘preparation’ will cause significant confusion: 1. That term can apply to finished products, if the ECDD had intended for their recommendation to apply only to active pharmaceutical products – they had other choices, such as the term ‘drug’ which would have caused less confusion. 2. If WHO /ECDD did intend for the recommendation to apply to finished products then the scientific basis they rely on is mistaken; they rely almost exclusively on abuse potential. Epidiolex is the only approved prescription in the US and the EU, however in this the THC content is not 0.2%, but only 0.01%. So, WHO/ECDD are recommending the descheduling of products having 20 times more THC than this. This can be a lot of THC. In addition, owing to poor quality control, there is no proper way of ensuring that products do not contain concerning levels of THC.

Also, it is not true that CBD has no side effects. It can present real safety risks if not used under the supervision of a healthcare professional. For this reasons, we believe that recommendation 5.5 should not be adopted in its current form.

DRC Vet Foundation: We have found cannabis to be a valuable medication, helping us reduce our pill count. As a medical treatment, I know firsthand how well cannabis works. Our current medicinal laws are the result of decades of effort. Patients in my country have waited long enough, but patients in most of the world have suffered for a very long time: in 33 of 55 voting states, the medical use of cannabis is a traditional practice, documented by science and history. The treaty is often the sole reason cited to justify strict control of cannabis for medical use. 59 years after it was scheduled in absence of scientific evidence, the WHO spent many years examining it before releasing recommendations. Although we understand the need for states to understand the recommendations, I ask them: fulfil the mandate of the drug control system to ensure access to medicines capable of relieving human suffering.


Chair: I would like to thank all delegates engaged in me for useful cooperation and constructive spirit. I would underline that more engagement will be required in the intersessional period, involving INCB and WHO for their own expert views to address important aspects resonated by the member States today and with a view to move forward to the implementation of this decision in December. I thank all of you for all the support.

We conclude agenda item 5a and move to open business of item 5c. As we have suspended the COW, so I believe they can now plan to start their work from now on.

Item 5(c) International Narcotics Control Board

Chair: Agenda item 5c: international narcotics control board. The first speaker is Switzerland.

Switzerland: We welcome the annual report of INCB. Despite the general increase in availability for consumption at a global level, inequalities remain striking and lead to serious consequences to health. We must henceforth shoulder our responsibilities in accordance with the Conventions. As member states we should be aware that this is closely linked to the functionality of the system of classification and the effectiveness of the international community in addressing this problem.

Switzerland places health at the heart of its drug policy, which is why we find it intolerable to note the suffering lived through by millions of people not given assistance – even palliative care. INCB supports the efforts undertaken inter alia through the import and export system – I2ES. Swizterland is one of the main contributors to this.

In Switzerland, data analysis has shown that prescription of pain relief has increased in the last decade – in particular for powerful opioids. A 2018 study seeks to interpret these trends by examining use and frequency of use.

With regard to human rights, Switzerland is categorically opposed to extrajudicial executions, torture, and use of the death penalty. Capital punishment does not allow a country to address drug problems. Further, the Human Rights Committee has clearly stated that it may only be used for the most serious crimes – excluding drug offences. We support the principle of proportionality, and support the part of the INCB report which invites states to apply drug policies which protect human rights and are in line with relevant international instruments on these rights.

Venezuela: Chapter 3 of the board’s report of the analysis of the global situation refers to our country as well others, as well as the impact to effectively address the world drugs problem. As part of the unilateral and coercive measures targeting my country, this has served to weaken our government’s ability to respond to these challenges. The strategic and geographic position of Venezuela must be taken into account given the geographically the western part of Venezuela coincides with the highest area of cocaine production. Criminal groups seek to use our country for the illegal transit of drugs to meet demand in the northern hemisphere by ramping up state control actions throughout our national territory. Set forth in the national drugs plan 2019-25 which serves as a framework of our public policies to enhance the efficiency of undertaking against these issues in our country. 7 tonnes of various drugs have been seized in 2019 by Venezuela. This testifies to our resolve to prevent our country from being a transit route for export. In keeping with methodological rigour we ask for scientific evidence. Official date and solid proof provided by the Venezuelan efforts in order to avoid undermining the credibility and impartiality of this body. We object to a number of vague references, lacking scientific rigour and has made it easier for the media to use in a manner  free from proper context for political reasons. We reiterate our committee our commitment to the board’s work. We welcome the board’s interest in a mission to Venezuela this year. My country shall firmly combat drug trafficking within the corresponding multilateral fora and to uphold the international drug control treaties. Fully respecting human rights, fundamental freedoms and sovereignty of states. 

 

Pakistan: We want to highlight some of the points of the report which are contrary to current facts. On page 94 para 6/73 and 95 para 6/82 some references have been made to flow of drugs from Pakistan to neighbouring countries. This is wrong. Pakistan is having a strong anti narcotic cooperation with iran. The root cause does not lie with Pakistan. Pakistan is a victim and target country of drugs used elsewhere. A similar reference has also been made in the report on drug trafficking. It was reported 85% of heroin seized in 2018 was in Iran coming from pakistan and we believe this is disproportionate to the actual situation. We are constantly in contact with the anti-narcotics police of Iran. Pakistan has been wrongly reported as the source country of cannabis resin, we must segregate victim and target countries from the source countries. Such statements may jeopardise our anti-narcotic efforts. No drugs are cultivated or produced in Pakistan. We repeat this. We are a target and victim country. Pakistan is fully cognisant of its responsibility as a member of the community to combat the menace of drug trafficking. 

Netherlands: The Netherlands aligns with Croatia on behalf of the EU. Designer precursors are the biggest challenger as fully recognised by the INCB. Although scheduling doesn’t seem to solve all problems we are pleased that MAPA is recommended for international scheduling.. We welcome the thematic chapter of the annual report for improving prevention and treatment services for young people. We have a strong focus on youth work in the Netherlands. We need to strengthen the evidence base of our drug prevention policy for our young people and need a better understanding of how they engage with substance.s they are not a homogeneous group, we need sanctions centred on each young person’s needs and circumstances. The role of the INCB will be stronger by being more transparent – this will strengthen the data and role of the INCB. 

INCB President: Without the cooperation of countries and the frank dialogue we’re having, we wouldn’t be able to do this work. I thank you for your feedback to the annual report. Also the concrete suggestions on areas we should be further looking at. The critical comments are welcome too. We look forward to continue our dialogue and our work.

Chair: With this we have come to our conclusion of the morning session, we will resume at 3pm – reporting back on the youth forum, followed by consideration of agenda items 5d and 5e.

Secretary: Informal consultations on L2 in room L5 at 1pm. Also at 1pm, informal consultations on L4 convened by Australia and EU in room m2.


WEDNESDAY AFTERNOON SESSION

Chair: I have the pleasure to give the floor to the Youth Forum.

Youth Forum: We are honoured to be here. We are 39 from 39 different countries. Drug use prevention nedes to start as early as infancy, to help parents be better parents and children to grow up. International standards are the foundation for prevention at every level.

We call upon the development of skills. Only knowing about drugs does not change behaviour, but learning skills, stress management and developing self esteem are helpful for development. We call for member states to find solutions for healthier communities. We need a model for youth which encourages them to think critically and take action.

We call on member states to develop a system which promotes healthcare. Youth face inequality, abuse, stigma and discrimination. We may need emotional and psychological support. We call upon civil society to provide genuine support, and safe spaces for youth who use drugs and their families. We are not just the leaders of tomorrow – we’re the leaders of today. You have the power to create a healthy community for everyone – we will tell you to get everyone involved. Come together now to make a better reality, turn our dream into a better reality.

Chair: I thank the youth forum for their message. With this brief presentation, we now revert back to consideration of the Agenda Item 5(d).

Item 5d: International cooperation to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes while preventing their diversion

In the Ministerial Declaration, member States noted concern that concern about availability of substances for medical purposes and resolved to ensure access for medical and scientific purposes, including for relief of pain and suffering, and address existing barriers in this regard – including full availability. I call on Project Coordinator at UNODC.

The speaker needs more time. I give the floor to WHO.

WHO: The WHO seeks to ensure the highest attainable level of public health for all people, by promoting health, keeping the world safe, and serving the vulnerable. Controlled medicines are necessary to resolve suffering including cancer, neurological disorders and mental health conditions. They’re also necessary help recovery, alleviate pain, and for treatment of drug dependence disorders. The WHO is very concerned about the global lack of these medicines.

The vast majority of low and middle income countries have no access to these lifesaving medicines. In line with the international drug control conventions, WHO’s approach is to strive for policies and programmes which balance the need for these while preventing their misuse and diversion. The 2016 UNGASS document recognised the disparities in access to controlled medicines, and called for increased international cooperation to address this. Several WHO resolutions have emphasised the importance of access for health; these reflect the commitment of states and the WHO to address barriers to controlled medicines, in particular for palliative care, anaesthesia, emergency care, and improving transparency of markets for medicines. These commitments also provide WHO with a strong mandate to assist state efforts in addressing barriers.

We review the safety of medicines, and publish guidance. As part of its standard-setting mandate, we recently set guidelines for managing cancer pain in adults. We’re currently revising guidelines on access to controlled medicines – including managing pain of children and ensuring balanced policies for access to controlled medicines. WHO is also updating a guideline on national pricing policies.

WHO collaborates with countries in addressing price, quality and appropriate use of medicines. For the development of balanced policies and implementation of best practices for use of these medicines. WHO and UNODC are implementing the SOS initiative to save lives by promoting access to naloxone and training first responders in overdose management – including peers and family members. We’re also engaged in programmes on pain management.

In May 2018, the World Health Assembly approved our new strategy – 2019-2013, which has at its mission to promote health, keep the world safe and to serve the vulnerable. The WHO is committed to improving access to controlled medicines, towards the achievement of universal health policies, and the achievement of the SDGs. Collaboration is vital. WHO and UNODC have strengthened their commitment to collaboration. WHO will continue to foster collaboration with member states and other partners and civil society to ensure safe medicines are affordable for those who need them.

UNODC: Following the 2016 UNGASS Outcome Document, on access to controlled substances, member states unanimously agreed to several actions. These include capacity building and training for health bodies and professionals. Under the UNODC/WHO/UNICCC joint programme, in 2019 Panama and Nigeria took actions relating to this operational paragraph. With funding from the US, UNODC has been working closely to ensure access. In Panama this is closely tied to professional development in palliative care. There have been 3-day trainings in five provinces. There is a new degree classification in the University of Panama on palliative care. There was also a regional meeting hosted in Panama. …

In the guidelines for the management of pain in Nigeria, in 2019, Nigeria embarked on an ambitious plan to further educate higher education students and current professionals seeking certification. Renewal of certification and other professional development, on access to controlled medicines, with funding form an EU project. During 2019, over a hundred academics and policy makers were trained in access to medicines, using the new training manual. Nurses, pharmacists and physicians across Nigeria were accepted. Over the course of six months, 25 persons became ‘master trainers’.

The work in Timor Leste, funded by Australia, focused on building skills of nursing staff. Work in DRC, funded by Belgium, also helps health workers.

For many years the system has been built on fear: focusing on the rational use of medicines brings the focus back to quality medical standards that at their heart protect the dignity of all persons with medical conditions, reinforcing the highest standards for all. In reality, this provides a strong control system where patients’ needs are protected as well as physicians’ needs.

 

INCB: In 1961 the governments drafting the convention on narcotic drugs recognised the medical use of narcotic drugs and their role in relieving pain. Member States identified needing to make sure these can be used for medical and scientific use. This was extended to psychotropic substances in 1988. The goal of ensuring the availability of and access to narcotic drugs and psychotropic substances for medical and scientific purposes is far from being universally met. People are still suffering. Some people have no access to medication they need and are dying in unnecessary and treatable pain. At the other end is the excessive prescription of medical opioids has led to thousands of deaths, particularly in america. Last year we produced a report on the progress of making drugs available for medical and scientific purposes. A special report presented the findings from a survey for 130 countries where 70% of the world’s population lives. 79% of the world’s population consumed only 13% of the total amount of morphine used in pain management. It is an obstacle for governments in their efforts to achieve sustainable development particularly goal 3. Some governments have been changing the legislation and regulatory system. They have implemented awareness raising initiatives to help doctors and patients in using these medicines, where the consumption of narcotic drugs for medical purposes has risen. The vast majority of morphine produced is converted into other opiates. Morphine has a critical place in pain management and palliative care and is often the more affordable option – a consideration for people of low incomes in low income countries. The board calls on governments to make mechanisms to ensure that opioids such as morphine are made available. Equally important is the availability of psychotropic substances for treatment of medical health conditions. The international community recognised they are indispensable for medical use and should not be unduly restricted. Treatment of mental health disorders is a challenge in all parts of the world. Up to half of people with mental health conditions in high income countries receive no treatment and more than three quarters in middle and low income countries do not get appropriate treatment. INCB calls on member states to take measures to ensure psychotropic substances are made available for the people in their countries and they are appropriately used. 42 substances used for medical reasons are present in the illegal market. There is a global disparity in the availability of these substances . Epilepsy: significant disparity in availability of antiepileptic drugs, there is more availability in high income countries when epilepsy is more prevalent in low and middle income countries. These low and middle income countries also experience a higher proportion of death from suicie – this is almost 80% of suicides in the world. One measure to prevent suicides is to ensure those at risk have timely access to appropriate medical and mental health support which may include psychotropic medicines. INCB further stressed that countries need to ensure the availability and access to these substances and incorporate treatment into these systems. We lack,however, enough data on psychotropic substances to understand how they are distributed in the use of medical conditions. Consumption data enables the board to analyse and assess the global availability of the substances. The board is working on compiling possible methodologies with governments to help collect data. Underresourcead health care systems, few or insufficiently trained health care professionals, weak or inadequate control systems are why access to narcotic drugs and psychotropic substances is limited. INCB works with member states to increase the rational use of internationally controlled drugs. Since 2016, through the INCB learning project, regional seminars have been held.

Indonesia: Indonesia has participated in the ARQ. In December 2019, Indonesia also participated in a seminar conducted by INCB. These projects benefit our countries in our effort to prevent the use of NPS in the free market. Indonesia believes that similar projects and international cooperation could allow for substances to be available for medical and scientific purposes. 

Russian Federation: Access to narcotic drugs and psychotropic substances for those who need them for medical purposes has been established in our country as a government priority. Budget legislation 2019-24 has provided a separate budget line to carry out measures necessary to ensure patients have necessary medical equipment and medicines, this includes pain relievers. Measures taken by administrative bodies along with NGOs has increased the use of medical narcotic drugs and analgesic. In 2018 the amount of people receiving adequate pain relievers increased more than seven fold. Russia is now category four – meaning there is access to morphine and other medicines, such as powerful pain relievers. The Russian Federation has organised for cultivation of opioid poppy for medical purposes in Russia. Opium poppy and obtaining poppy straw is within international conventions to supply Russian medical and food needs. A law banning cultivation on the poppy was lifted, with complete governmental oversight over the whole process. 

USA: No person should suffer unnecessarily from untreated pain or be denied needed medicines. As we work to increase the rate at which intl controls can be placed on deadly substances such as fentanyl analogues. 

Sudan: Within the context of our cooperation with INCB, and with reference to article 30 and article 9 of the convention of 1971, the national council on drugs has adopted proper prescriptions. It has held appropriate meetings with workers and doctors on the ground. We are concerned by the prevalence of a number of drugs that are not scheduled, among wide factions of our society, esp students and youth. Especially tramadol. There are risks that would require us to look at rescheduling these substances according to conventions of 1961 and 1971 to control the raw material as well as the import. Other countries have scheduled these in their national schedules. We see these are not scheduled in other countries, this makes it difficult to control these substances on certain border checkpoints. 

Brazilian Harm Reduction and Human Rights Network: As part of the civil society organisations we convey the voice of many people working for human dignity and working towards sustainable development. The aim to create a drug free world through reduction and abstinence has failed. Instead of resolving the problems the steps taken against narcotic drugs are compounding the problem. The global war on drugs has beget violence and systematic violation of human rights as well as an increase of risks in safety and health of vulnerable populations. We call for a deepening of efforts for reconciliation of justice, peace, and health and putting an end to the war on drugs. For this reason civil society and government responsibility needs to become a multistakeholder issue. It is essential to finance prevention, education and multidisciplinary research creating alternative proposals other than prohibitionism. Psychotropic substances have been legalised over the past century. Today is the best time to gain an awareness of the context and elements involved and thus fina innovative means for improvement on drug policy. We must wage war on the scourge and you in the CND have the opportunity to demonstrate your resolve and commitment.

(e) Other matters arising from the international drug control treaties

Agenda item 5(e)

Brazil: Drugs continue to present a challenge to public health. In relation to substance control, Brazil is fully omitted on modernising our national legislation to respond to the challenge posed by emergence of NPSs. Since June 2016, Brazil is adopting scheduling of controlled substances which is used alongside the individual scheduling approaches. Those already scheduled are synthetic cannabinoids, synthetic cathinones. Despite the new generic scheduling, and in order to improve technical capacity, we developed guidance to implement the new classification.

In May 2019, the Brazilian Health Regulatory agency promoted the second symposium on NPSs. This covered regulatory and forensic aspects. It includes experts from DEA, EMCDDA and UNODC. They discussed trends, identification, and approaches. Brazil has successfully been using the national control system, MDS, in order to provide statistics reports for INCB. Also, Brazil has been actively exchanging international trade information through I2ES system. We continue supporting the widespread utilisation of this relevant tool and encourage member States to use I2ES.

Indonesia: We would like to invite all member States to utilise publications in developing national policies, thank you.

Chair: That is the end of agenda item 5.

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