Home » Side event: Taking the Pledge4Action to ensure adequate availability of internationally controlled essential medicines

Side event: Taking the Pledge4Action to ensure adequate availability of internationally controlled essential medicines

The 50-minute side event was sponsored by the Kingdom of Belgium and hosted by the International Association for Hospice and Palliative Care. Co-sponsors were Dianova, CAPSA, INCB, Pallium India, Union for International Cancer Control, Vienna NGO Committee on Drugs, and the Worldwide Hospice Palliative Care Alliance.

Professor Dr Dr Charlotte Colman, Professor Drug Policy and Criminology Ghent University, and National Drug Coordinator – President of the General Drug Policy Cell Belgium welcomed participants to the event, citing Belgium’s record of support for the issue of improving availability of controlled medicines at CND, including the #NoPatientLeftBehind Chair’s initiative of 2024. She also mentioned the resolution Belgium was tabling with Cote d’Ivoire on improving availability, especially for children. The resolution was approved unanimously in the Committee of the Whole and adopted by CND with many co-sponsors.

I (Katherine Pettus) then briefly presented the work of IAHPC and introduced the panelists and the theme of discussion. You can read the IAHPC written statement to CND67 here.

Dr Cesar Arce, first vice-president of the INCB, reviewed INCB’s long history of reminding member states of their treaty obligation to ensure availability and urging governments to improve availability in the face of chronic global inequity. He summarized the main impediments detailed in the 2022 Supplement “No Patient Left Behind” and presented INCB’s recommendations that

Governments consider allocating sufficient resources to ensure the adequate availability of controlled substances and encourages countries to review pricing and production policies of medicines for low- and middle-income countries….Furthermore, the Board also invites countries to increase the amount of morphine destined for palliative care and to give low- and middle-income countries the possibility of purchasing affordable morphine instead of expensive synthetic opioids.

This recommendation supports the agency governments have when they license and negotiate with the pharmaceutical industry, whose business model is to present unaffordable opioids to the market rather than affordable generic oral morphine.

Maria-Goretti Logo, Esq. a human rights lawyer from Ghana with long experience in drug policy and advocacy at CND, presented on Tools/Resources of regional Commissions and Bodies, including the West African Model Drug Law’s recommendations on improving availability, and the efforts Ghana is making in this regard. Article 33 of the Model Law, a key resource, states that “there shall be a Commission on Access to medicines that are controlled drugs, the oversight of which is to be the responsibility of the Minister of Health.”

Anthony Esposti, CEO of CAPSA, a Canadian branch of Dianova comprising  educators, researchers and policy experts  informed by their living experience in their work to dismantle and transform stigma and discrimination, addressed the concept of Substance Use Health. Substance use health can be addressed anywhere on the spectrum from from non-beneficial to beneficial use, which covers availability (or lack thereof) of medicines to relieve severe pain and symptoms, and treat substance use disorder among other conditions.

Dr Heloisa Broggiato-Matter, joining online from China, where she works as an advisor for the Swiss Embassy in Beijing, discussed her doctoral research on availability of internationally controlled essential medicines in Brazil, particularly in the favelas, where pharmacies do not dispense opioids for patients with prescriptions, but where informal sectors can procure high quality medicines and deliver them to the home no questions asked. Her presentation underlined the point that it is often easier to procure medicines, high quality and counterfeit, in the parallel markets, than in the licit pharmaceutical markets, especially when medical opioids are unavailable due to lack of an appropriate regulatory framework and trained health workforce.

Dr. Pablo Estrella MD, originally from Ecuador, and the representative of young doctors at the World Medical Association, reviewed the barriers to availability, including  lack of appropriate training of medical students, and the key role junior doctors can play in improving availability and addressing the risks of dependence, at the local, national, and international levels. Dr. Estrella also addressed the Tuesday afternoon plenary of CND on Agenda Item 5, which covered the topic of availability.

Finally, Dr Elizabeth Saenz, UNODC Technical Officer in the department of Prevention, Treatment and Rehabilitation reviewed the barriers to availability and her ongoing work on and plans for the next five years to expand the network of young doctors to address the attitudes and dismantle the stigma around opioids that is so prevalent in the medical professions.

I urge you to watch the recording of the event to learn more about the topic and to review IAHPC’s website to see how you can become involved and advocate for improved availability of controlled medicines as a member.

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