No Borders Humanity Organization (NBH): How is the INCB addressing challenges in ensuring equitable access to controlled substances for medical purposes while preventing diversion and misuse?

Southeast Asia Harm Reduction Association (AHRA): Considering the proliferation of heroin and ATS substances, increasing drug use and dependency, and concerns about unintended consequences of drug policies in Southeast Asia, how does the INCB reconcile differing perspectives on harm reduction for collaboration towards shared public health goals?

Turkish Green Crescent Society: Does the INCB plan on integrating the root causes of drug use among different vulnerable communities in its treaty-based annual report, for the socio-economic and health determinants of drug addiction to eventually be addressed by the international drug control community?

INCB: We also run monitoring compliance with the international drug control treaties. If you see in the report we released just two weeks ago the board made a series of recommendations in chapter 5 in which we recommend that governments prioritise recollection of data on other interventions, and there are also recommendations on data collection and capacity building. Stigma is one of the social determinants that keep people from seeking treatment. Stigma is very strong in many regions in the world, including for cultural reasons. Working on stigma means working on the main social determinants of drug use. Policies can impact stigma. You see that those social determinants play a role in every step in the process that can lead to drug use disorders.  The role of NGOs is indispensable. They work from the ground. 

International Drug Policy Consortium: The INCB has published important statements at the occasion of International Human Rights Day 2020, 2021 and 2022, but did not do so in 2023. What is the INCB doing – and what could the Board do better – to ensure that human rights are streamlined across your work with Member States?

INCB: All statements by INCB presidents include human rights. Human rights are an important issue. Conventions are treaties, even if they take us back to the 70s and 60s, they are aiming to protect the health and wellbeing of people. IT all comes down to people. We need to keep in mind how the conventions and treaties serve people. Human rights are in the centre of every session we hold in Vienna. Human rights is at the centre of our mandate. We consistently integrate human rights perspectives in our monitoring of policies and practices.We are in contact with human rights organisations and UN agencies to improve that. We also work with civil society to understand better human rights challenges. This is one of the main issues for  the INCb.

International Association for Hospice and Palliative Care: How can INCB support governments or NGOs to take the Pledge to improve availability of essential medicines?

INCB: We are facing a huge gap worldwide when it comes to the availability of medicines. It’s not normal people suffering from pain and not having access to medicines. It’s not normal to have people injecting drugs and not having OAT. 

European Coalition for just and effective drug policies (ENCOD) (Austria) and Fields of Green for ALL (South Africa): In 2021, 200 organizations noted the INCB was the most secretive of all UN bodies, and made 6 recommendations on transparency, prevention of conflicts of interests, and civil society participation. What progress has INCB made in this respect?

INCB: We do a lot on transparency and inclusion, but the dialogue with governments is confidential. Confidentiality builds trust and increases the impact of dialogues with governments. It’s the same as dialogues with NGOs. And this confidentiality is very important to us. NGOs are so close to what goes on in reality, and if we are not in contact with them we will miss a big chunk of the picture. 

Kenzi: We pointed out risks of conflict of interest with corporations. The fact that your answer doesn’t touch on the letter means that you didn’t read it. It’s outrageous. 

INCB replies: I will take this on board.

CADCA (USA): Synthetic and semi-synthetic cannabinoids derived from hemp, have proliferated in the United States of America and across the globe. These substances are totally unregulated, widely available and can be extremely psychoactive. Please explain how the INCB will work with other U.N. agencies and member states to address the proliferation of synthetically derived cannabinoids.

INCB: We have seen several countries authorising the cultivation of the cannabis plant with low THC. These plants are considered to be not under international control. The board believes that any cultivation of the flowering of the fruiting tops requires control. Furthermore, the isomers are also separately under international control. We are also concerned about the proliferation of synthetic cannabinoids. However, these are synthesised quickly, and the scheduling system is not able to catch up with the fast pace. So many countries have adopted national legislation to control. 

Centre on Drug Policy Evaluation (Canada): The INCB has previously shared that it was developing standards for reporting and monitoring of cannabis and cannabis-related substances for medical and scientific purposes. Can you please provide an update on where the process currently stands? In addition, can you please share whether these focus only on reporting per the Single Convention on Narcotic Drugs of 1961, as amended by the 1972 Protocol, as well as the Convention on Psychotropic Substances of 1971, or whether they address guidance on medical cannabis programs more broadly?

INCB: The new reporting criteria have been agreed upon and are being used as of 2024. Cannabis should be interpreted as the flowering of fruiting tops of the cannabis plant. 

Association Proyecto Hombre (Spain), World Federation of Therapeutic Communities (Global): Based on the identified and intertwined challenges such as that drug treatment and health services continue to fall short; that the adverse health consequences of and risks associated with new psychoactive substances have reached alarming levels; and that geographical coverage and availability of reliable data on the various aspects on the world drug problem requires improvement, to what extend should INCB request member states to report more reliable data on the coverage, relevance and effectiveness of prevention, treatment, rehabilitation, recovery and harm reduction services?

INCB: Monitoring and evaluation systems are indispensable to discharge the work of the Board. Data collection is crucial, and the basis of any well-designed care system. In many countries there are so little people qualified in this field that we can’t even do any monitoring. And this also applies to NGOs – NGOs have the enthusiasm and the willingness to change things.We see many people providing prevention services that are not based on science, and this is a complete waste of money. When we meet countries we always encourage them to promote evidence-based interventions.

Students for Sensible Drug Policy Australia: In 2023 the INCB held a consultations hearing, among other, from experts in digital harm reduction education and outreach. How has the INCB integrated these learnings into its understanding of the role and potential of harm reduction approaches in drug education and policy, and how might these learnings influence the INCB’s work going forward?

INCB: The increasing use of social media platforms to make illegal drugs is highlighted in that report. We have also highlighted opportunities such as prevention, awareness raising, social media, etc. but online sharing of information can mitigate the consequences of the use of drugs. It can connect people who use drugs with treatment and care services, this is crucial. The main objective of government action in this area remains the prevention of drug use for young people. So this is a huge opportunity that should be ceased.

Zimbabwe Civil Liberties and Drug Network (Zimbabwe): Not much is being done in terms of adopting harm reduction as an intervention for people who use drugs. Can the INCB help in that regard?

INCB: Harm reduction is a crucial component when it comes to treatment and substance use disorder management. The international drug control conventions do not refer to harm reduction, but we  continue to promote evidence-based approaches, including harm reduction.

Instituto RIA, AC (Mexico): The “Vienna Consensus” appears to fracture more and more at every CND. Is the current framework fit for purpose when countries are moving in such different positions? For example authoritarian models with the death penalty, versus countries with legally regulated cannabis models or psychedelics for therapeutic purposes.

INCB: Whether or not drug control conventions are fit for purpose is a question for state parties, not for the board. The board’s mandate is to monitor the implementation of the conventions as they are, and to work with state parties to ensure that its  objectives are met. Capital punishment is technically within the conventions, although we continue to encourage member states to abolish it. One of the reasons why the conventions have stood the test of time, is because the flexibility they offer to state parties. Parties can have their own drug control policies and each of them can define their goals. The final shape of the conventions is not up to the board, it is to Member States. Although of course there are clear challenges.

Drug Policy Centre in Sweden (NPC): There are at the moment some countries that have started up pilot studies with legalized selling of cannabis with scientific evaluation. Some initiative of selling cocaine is proposed.  How does the INCB view these initiatives in light of the UN drug conventions?

INCB: There is a tension between the conventions and treaties on the one hand, and of course some policies that are put in place in some countries. It’s something that is up to the state parties, it’s up to the countries who are signatories to the convention and treaties. We also have to be aware that are many different approaches to drugs. Some countries have a conservative approach, others have a more progressive approach.