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Informal Dialogue: INCB President

VNGOC Deputy Secretary Penny Hill: Welcome to the VNGOC’s Informal Dialogue with the INCB President. I’m Penny Hill, Deputy Secretary of the Board of the Vienna NGO Committee. I’d like to welcome you all to this Informal Dialogue with the INCB President today. Mr. Cornelis Pieter De Joncheer is joining us today as the INCB President as he does every year to hear from and respond to questions from civil society. We would also like to welcome Mark Calhoun, the new secretary of the INCB, thank you for taking part in the dialogue. I’d like to acknowledge the ICNBs ongoing support of civil society and the VNGOC, particularly through the issue of the alert presented by the INCB in late 2019 which highlighted the integral role of civil society in the development of drug policies. We are grateful for INCBs continued engagement with civil society through these sessions and through specific civil society hearings organized through the VNGOC and note the ongoing commitment to continuing these discussions in Vienna.

INCB President Cornelis Pieter De Joncheer: One positive side-effect of covid-19 is that we have gotten used to these online meetings and it gives us a higher reach for these international engagements. I am very grateful for the invitation to engage in this dialogue. It is an annual thing here at CND to have an opportunity to engage and discuss issues and we greatly appreciate that opportunity. I understand you have just had elections so congratulations Mr. Bridget on your re-election and the other committee members who have been elected and re-elected and we look forward to continuing this collaboration. In my foreword to the INCB annual report I acknowledged the valuable role played by civil society, particularly in ensuring availability of internationally controlled medicine, providing human rights based approach, and providing prevention, rehabilitation, treatment and other related services. You know the recommendations of the board are in principle directed at governments but of course we also encourage civil society to use these recommendations to plan and implement your work. I note the thematic chapter in this year’s annual report on the hidden epidemic of drug use in older people and I hope you will find those recommendations helpful. We appreciated the written contributions given to us by NGOS in preparing this thematic chapter. We regret we couldn’t have in person meeting with NGOs to discuss this chapter, we had a shorter meeting in September and it was simply impossible to squeeze this in but we do appreciate the contributions to that chapter. I’m pleased to say that during the 131st session planned in May, between 17th and 28th May, we will hold an online meeting with NGOs on the thematic chapter planned for the annual report 2021. That topic will be illicit financial flows through drug trafficking and the impact on development and security. We look forward to hearing the views of civil society as we did in previous years. Given the situation with covid we are still working out modalities of meeting, our board meeting is going to be partly in person as some people can attend in Vienna but the rest are connecting online. Will continue to work with the Vienna NGO Committee on this. I am looking forward to this discussion.

VNGOC Deputy Secretary Penny Hill: Thank you very much and I’m sure there are many members really interested in that opportunity in late May.

VNGOC Deputy Secretary Penny Hill, on behalf of the Slum Child Foundation (Kenya): Because of the Covid-19 situation, I know that country visits have been put on the shelf. What are the plans for when things come back to normal to make sure there is a more frequent visits to civil society in different countries you visit? This is where the real work is done and they can give better and concrete information about implementation.

INCB President Cornelis Pieter De Joncheer: Thanks that is an important topic, as you may know one way the board works within our mandate and in terms of monitoring the compliance of countries within their obligations of the conventions is by organizing country visits. Unfortunately since the  start of the pandemic that has not been possible for obvious reasons. We will surely return to that practice once the pandemic is somewhat under control. We have, over the year before Covid, conducted almost 20 country visits which are always prepared with the authorities of the country, creating an agenda on topics of interest to the country but also of interest to the INCB. It is all done in collaboration with countries, so the number of country visits may fluctuate depending who is ready to receive a mission of the Board. It is normally a visit of one week, with the Board and Secretariat where we meet with government representatives from all the different involved ministries. We also make it a point to meet civil society during that country visit. Together with the VNGOC we identify relevant NGOs in the country that the Board is going to visit and the Board will meet with civil society representatives. We do that without the presence of government officials in order to maintain confidentiality of the dialogue. We greatly appreciate your collaboration on that. The report that the board is writing is also a report between board and country and we keep the sources of this confidential as well. We make a point of discussing with civil society in countries as we see civil society as essential to many aspects of a balanced drug control system, particularly in the area of prevention, treatments, rehabilitation, and social integration. In many countries it is often civil society that is the primary or only provider of these services. Without your presence and active commitment it would be impossible to tackle the multitude of drug control challenges and address negative consequences with drug use. We really value your role and make it a point that when we have country visits that we are totally committed to discuss with civil society.

Penny Hill: I know our membership are very grateful for this engagement and I’m sure you’ll have lots of interesting visits coming up after the pandemic.

Nazlee Maghsoudi of Centre on Drug Policy Evaluation (Canada): What are the next steps for the INCB in relation to medicinal cannabis, following the CND vote on the WHO scheduling recommendations from December 2020? How will you consult civil society in those processes?

INCB President Cornelis Pieter De Joncheer: Over the last couple of years we have been confronted with a growing number of countries engaging in the licit cultivation of cannabis for medical purposes. It became clear in discussions with those countries that the requirements countries need to comply with in engaging in that licit cultivation are not always clear. It also became clear with countries working in that area that there is a bit of diversity around the reporting and the information, what is required under conventions and what we as the Board want to see. At the end of 2019 we had a first meeting with the major cannabis producing countries. We had invited the relevant authorities to come here and we had engaged in that discussion as the first mapping of the issues. This was also done with view of the discussion at CND for the WHO recommendations. We had to pause that process for about a year as the CND took time to come to a vote, and of course we couldn’t move on with that discussion until CND had decided where the various cannabis compounds would land in the conventions. Apart from removing cannabis from schedule 4 there has been no change. We contributed to the process by indicating what the implications would be for rescheduling some cannabis compounds within the 61 or the 71 conventions. The INCB has no formal or official role in the scheduling process. After the vote it became clear where cannabis is scheduled in 61 and 71. Then we continued with an expert meeting in January of this year where we invited a number of countries producing cannabis and experts to discuss with countries and the Board around information and reporting requirements. The next step we had was another meeting with major cannabis producing countries in February to go through issues again. In march this year we had a consultative meeting open to all countries to present the findings of these discussions to come to a shared understanding and agreement at international level on reporting requirements and information. If countries report differently there will be gaps in the overall global situation and information on licit cultivation of cannabis. That is where we are at this time we will continue with consultative meetings with countries. Although we have come a long way there are clearly issues not resolved. There are issues with cannabidiol and CBD, what is industrial use, scientific issues, interpretations on some articles in the conventions, so there is still work to be done. We also want to get input from civil society into the process. Will be preparing a questionnaire to send to civil society and you can disseminate to your networks and we are also looking to do something such as now, to have online meeting. We do want to engage civil society in that process. We want to get feedback from you but the ones taking final decisions are the state parties. Sorry for the long answer but it is good to be clear about how we structure that process in a transparent manner.

Eric Siervo of Community Anti-Drug Coalitions of America (CADCA), (USA): Substance use prevention is a sound investment, with every dollar invested having the potential to result in savings of between $2 and $20. Despite these facts, substance use prevention has been underutilized and under-resourced relative to its ability to reduce population level rates of substance use disorders and related issues. Please explain how INCB will work with UNODC, WHO and others to ensure that substance use prevention is a higher priority for emphasis in designing, developing and implementing responses to the world’s drug problems.

INCB President Cornelis Pieter De Joncheer: Thanks and I’m afraid I have to agree with that assessment there is a lack of investment and commitment in developing real and sound investment in prevention and treatment programs. As you know in the conventions there is no international instrument or tool for this. This is one of the obligations in the conventions that is left to member states to implement so they are the ones that have to do that. In many countries there is not enough priority to this area of prevention, treatment and rehab. There is not enough priority and funding for it, many countries don’t have enough capacity and technical resources to do this and engage in these evidenced based programs. We do urge countries and bring to attention during country visits that this is a really critically important area and we work with partners particularly WHO and UNODC, although the board itself is not involved but we have more of an advocacy role. Whenever we have the opportunity we recommend countries to work within their national environment and also seek international attention and implement international standards on drug use prevention. There is a need for added investment and capacity building and an important role in advocacy to work with the government within national control programs to give priority to this. If you look at the investment into law enforcement and incarceration etc compared to prevention there is clearly a gap. We totally agree with your assessment and will continue to work with our partners, including civil society to give increased attention to this area.

Etienne Fontan of Veterans Action Council, (USA): Referring to the INCB Cannabis Guidelines creation process: why has there been no civil society, patients or medical doctors invited to help create these guidelines? Why has there been so little transparency? It seems that a lot of private industry was chosen to participate – has there been any effort to identify or avoid conflicts of interest?

INCB President Cornelis Pieter De Joncheer: I think I partially answered that question but let me elaborate, the guidelines are about a shared understanding and common base for information and reporting of the data of the licit cultivation of cannabis to the Board. We have been talking with major producing countries and we have invited the national authorities within the composition of these delegations to participate in these guidelines, states are invited to include whoever they want in their delegation. A number of countries have included their industry that have lots of technical knowledge about cultivation, there may be academia there, or medical professionals in their delegation. In first meetings with the countries it is up to the country to establish their delegation. In the expert group meeting we have also invited industry associations and individuals with medical knowledge. The industry has an interest but it is also clear what their interest is. They also have a set of technical knowledge in that area so it is important to engage them. As I explained, in one of the next steps we will reach out to the VNGOC with a questionnaire and an online meeting and that may involve physicians and pharmacists who are working in this area so we do value your input and to have transparency in the whole process to give you an opportunity to contribute. All comments we get need to be processed transparently and not to be put aside, we need to be transparent in that respect. The final decisions on this are lying with state parties and the Board. The states are the contracting parties in this process so the final agreement must be with them but we do seek input from your side into this process as well.

Begüm Özdamar of Turkish Green Crescent Society: We are aware that there is a CND Resolution (57/10) that deals with preventing the diversion of ketamine from legal sources while ensuring its availability for medical use. What kind of state-of-the-art strategies are you planning to implement in order to ensure the prevention of its diversion from legal sources while ensuring its availability of medical use which in itself is extremely critical during the COVID-19 pandemic setting?

INCB President Cornelis Pieter De Joncheer: Thank you for the question and to start with the latter part of it, ketamine is an important medicine, particularly within the context of Covid. In our annual report and in our statements we have called out our concern about the availability of medicine under Covid, particularly in the beginning, but also now with several countries giving messages about lack of sedatives and medicine used for Covid and other patients. We need to address this critical issue. We have outlined a range of measures that we have taken. As you know ketamine is not a substance under international control. It is an important medicine but also a drug used illicitly in a number of countries there has been lots of illicit use in East Asia but also a well known party drug in Western Europe and other countries as well. We are not sure if that is a diversion from licit production and distribution of ketamine or if this is an illicitly produced drug. Looking at the patterns and quantities of illicit use it does look more like production illicit rather than diversion from legal channels. In the past and in response to the resolution on ketamine we have called out countries where there is a problem with ketamine to schedule it nationally and many countries have done so. We have asked countries to inform board what national measures they are taking in controlling and ensuring the safe use of ketamine so countries may be reporting to the Board on national measures they take but they do that on a voluntary basis and we make that information available to state parties. From that information we can see that there are 80 countries that require import authorizations and 70 countries with export authorization for ketamine. Over the years we have provided assistance to countries that require information and shared info with countries so they can have an effective national control of ketamine. We also know from the NGO community who are engaged in emergency relief that very often with import of medicine to emergency areas that there are controlled substances included in medicine kits being sent. We are concerned that because of strict measures that countries have taken that those controlled medicines are taken out of medicine kits. That applies to international controlled medicines as well, such as morphine, but also non internationally controlled medicine and this is a concern. It is not an internationally controlled but there are lots of national controls. It is an important medicine and indeed it is used as a party drug and that is up to countries to take national control measures to ensure safe use of it as a medicine.

Monica Barzanti of San Patrignano Foundation, (Italy): Recently, lawmakers in Mexico approved a bill to legalize recreational use of marijuana.  In past years, INCB has repeatedly expressed its concerns to the Government of Uruguay on the adoption of a similar legislation in 2013, which legalized adult cannabis use and cultivation for non-medical purposes.  In which way is the INCB going to address this issue, in order to favor the compliance with the legal obligations and to achieve the aims of the Conventions?

INCB President Cornelis Pieter De Joncheer: Thanks for the question and I can assure you that cannabis is consuming lots of the time of the board. Clearly developments around non-medical use in a number of counties is of great concern. It is stated that legalization or permission of sale for non-medical or scientific purposes is undermining adherence to drug control conventions and may have adverse effects on compliance with these. We are closely monitoring developments in all state parties and have frequently expressed concern about trends related to non-medical sale in a number of countries. We reiterate in dialogues and in statements that legalization for non-medical purposes is incompatible with article 4c and countries must live up to obligation under the conventions. This issue is widely known, it is in the CND and is all in the public domain, but it is often difficult for those countries engaging in national discussion to know the precise legislative processes that are being followed. You mentioned Uruguay where there is clarity but there are a number of countries where there is a process of developing legislation and that may have to go through congress or a senate depending on the political processes within countries. We do keep a close eye on it and engage in countries as the conventions ask us to do by engaging in closed dialogue to bring adherence to the conventions. The approach of the board is consistent with these conventions and aligns with the UNGASS outcome document and the 2019 ministerial declaration which ensures compliance to and implementation of treaties. We are engaged with countries in dialogue on living up to their obligations under conventions.

Juan Fernandez Ochoa of International Drug Policy Consortium (IDPC), (United Kingdom): In 2017, at an informal dialogue just like this one, your predecessor, former INCB President, Werner Sipp, acknowledged the tensions between some of the obligations enshrined in the Treaties (for instance, in relation to the cultivation and use of plants currently under international control) and the rights of indigenous peoples for whom these plants have medicinal and/or sacred value, as recognized by the UN. What concrete steps can the INCB take to seek to redress these tensions between the Treaties and the rights of indigenous peoples?

INCB President Cornelis Pieter De Joncheer: Thank you for the very pertinent and complex question where we have several treaties involved. Let me start by saying the Board is fully committed to implementing the treaty mandated functions to protect human rights. We have expressed that drug control must respect human rights and any measures taken must be designed to safeguard the health and welfare of all people as well as respecting human rights. We have reiterated this in our annual report and statement at CND. The issue of indigenous people is complex and if you go back to the signing of 1961 conventions. In article 49 there was a possibility for a reservation for countries with regard to traditional indigenous use of drugs, whether coca chewing, opium smoking, or marijuana use, so countries had the chance to apply that reservation which would allow for number of years, I think it was 25, to continue that use of drugs in their society. However, none of the countries actually used that reservation, so time has passed and the obligation of countries to comply with commitment under convention is there. There is clearly an issue with how we look at personal use under convention, but we have called on states to develop balanced approaches to drug control policy to account for the health and medicinal needs of communities. Medical use is allowed under drug control conventions and if states comply with the need to divert from non medical use with licensing and control. Where there is personal cultivation there is a risk of diversion from this. Again, we echo what my predecessor Mr. Sipp has said at that time there may be tensions, but can also see that the Board sees drug control conventions as respecting human rights and no state is exempt from the protection of human rights. We appreciate the question as it reminds us that governments have obligations under drug control treaties and under human rights instruments which must be mutually reinforcing. We see developments of countries through governments or court decisions around personal use of controlled substances and we are very engaged with countries on discussing that but it differs from country to country on what the legal environment is and the arguments being put forward. We are very aware of these points and try to live up to mandates under control conventions and be mindful of obligations countries have under human rights conventions. 

Stig Erik Sørheim Europe for Action on Drugs (EURAD), (Belgium): With the emergence of a commercial cannabis industry in some legalized markets we increasingly see that large, legal cannabis corporations are investing in cannabis businesses in other parts of the world, including Europe. These investments are accompanied by political campaigns to change cannabis laws and regulations. What can the INCB do to support the global drug conventions in the face of this commercial challenge?

INCB President Cornelis Pieter De Joncheer: We have talked already about non-medical commercial cannabis and the growing number of countries engaging in the licit cultivation of cannabis for medical use. As explained around the INCB guidelines, when countries engage in licit cultivation there are a number of controls requirements in particular under articles 23 and 28 of the 1961 convention. For those countries that are moving in the direction of the commercial cannabis industry for non-medical use, there is an issue that countries will need to live up to their obligations under the international conventions. The fact that there is an emerging commercial cannabis industry focusing on non-medical use is a compliance issue that countries must deal with at national level. Countries must comply with articles 23 and 28 and if there is cultivation of cannabis for what is considered an illicit market then countries should take steps to deal with that. We have consistently stated that there is an incompatibility between the commercially influenced actions on non medical cannabis and the legal obligations states have under treaties. The fact there is suddenly big industry players in that area doesn’t exonerate countries from living up to their obligation under the conventions. 

Kelly Beker of Cannabis Education Guild, (Canada): What precautionary measures is INCB taking to ensure that the monitoring of activities related to cannabis include those working in the sector, the supply chain, and the chain of custody, to prevent Member States from allowing human rights violations to unfold?

INCB President Cornelis Pieter De Joncheer: Important question again, we agree on the importance of regulatory standards which state that state parties must protect human rights which are inalienable. We are working with member states on these guiding principles to assist countries on reporting on cultivation of non-medical cannabis. We have no specific mandate under conventions to inspect for human rights violations but we support member states to adhere to the regulatory standards specified in conventions. We have pointed out again that respect and protection of internationally recognized human rights standards are essential conditions to drug control conventions. Member tastes and civil society can monitor this sector to ensure full protection of human rights. You raise important issues and must be clear on the mandate of the board with respect to cannabis issues and human rights so thank you for bringing that on the agenda. 

VNGOC Deputy Secretary Penny Hill on behalf of For Alternative Approaches to Addiction (FAAAT): ECOSOC Resolution 1991/48 (para. 10) says that “confidential material in documents and records of the INCB in the possession of UNODC” are protected from unauthorized disclosure. According to para. 8 of that same Resolution, these confidential communications refer to communications undertaken “directly with Governments and other entities pursuant to the relevant provisions of the Conventions.” But, except for the Annual Report, zero documents of the Board are available. Recognizing that some communications need to remain confidential: will INCB make other materials, such as meeting minutes, available to stakeholders –as is common with all United Nations entities?

INCB President Cornelis Pieter De Joncheer: I don’t have an immediate answer to that, there is a wealth and diversity of correspondence and documentation of reports that we are dealing with. There is correspondence between the Board and state parties, correspondence between the Board and other UN organizations, and the Board and NGOs and other stakeholder organizations. You raise an important issue, we haven’t as such discussed this since I’ve been on the Board in a comprehensive manner. We have over last years decided that every year in the May session of the Board we reserve half a day to engage with civil society and the VNGOC where there is an opportunity for the VNGOC to engage with the full board. We are very committed as a Board to maintain that channel of communication, and to maintain confidentiality. We do the same thing with state parties, before these open discussions there was always time within CND to have an hour but we felt it was important to open up that channel of communication with civil society and state parties where if you see issues of transparency that you can put that forward. We can take that point back to the Board and the secretariat and see what more we can make available, there is already a lot of information available on the website. You can imagine correspondence with state parties is confidential. The extensive information we get on manufacturing and trade of precursors is also confidential because of the commercial importance of that. We get lots of information on commercial streams and who is exporting and importing precursors. This is a very complex but important issue and will take it back to the Board to see what more we can make available and to raise that point. 

VNGOC Deputy Secretary Penny Hill: I know that will be greatly appreciated by the civil society community, thank you for your time and sharing this hour with us on the final busy day of CND. We will wrap up there and VNGOC are very grateful to have more opportunities to engage with you and with the questionnaire it is great to get more opportunities. Thank you everyone for your time and interesting questions and we will wrap up there.

Cornelis Pieter De Joncheer: Thank you for the opportunity and it is always a pleasure to see and speak with you.

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