IAHPC’s statement to the 66th Session of the Commission on Narcotic Drugs

Categories: Policy.

Delivered March 15, 2023 in Vienna.

International cooperation to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes while preventing their diversion; Thank you Chair. The IAHPC congratulates you on Colombia’s Chairmanship of the Commission. We have many
colleagues in Colombia working on improving access to palliative care and availability of controlled medicines. Colombia’s Fondo Nacional de Estupefacientes is a good example for member states aspiring to develop models of public procurement of controlled essential medicines for the treatment of pain, opioid use disorder and palliative care. As everyone in this room knows by now, there are two distinct opioid crises. One is a global pandemic –of lack of medical availability in more than 80% of the world, mostly the global south. The other is an epidemic, which describes the more localized crisis of excess availability for non-medical use, mostly in the global north. The IAHPC and our partner organizations, as well as UNODC, the INCB and WHO now have the audacity to propose that we can solve both crises through good governance and workforce education. We are grateful for the higher profile CND is giving to the availability obligation of the Single Convention.

Despite the Conventions good intentions, modern sciences of governance, supply chain management, addiction medicine, and palliative medicine were non-existent in the mid-20th century. In the 21st century, the science, best practice guidelines, and a few governments and sub-national jurisdictions that are meeting their peoples’ needs, can show us the way. Governments that still have unduly restrictive regulations to prevent diversion and non-medical use can avail themselves of medical education, academic research, and supply chain management tools to estimate their population needs and train their health workforces. Tools include the INCB Learning Program and UNODC guidelines. The normative framework and agreed language include the UNGASS Outcome Document and 2019 Ministerial Declaration, as well as several World Health Assembly resolutions.

Policymakers no longer have to choose between strict control and ensuring availability of essential medicines that contain controlled substances. They can do both once they have educated their workforces and made their supply chains shorter and more resilient by promoting local manufacturing and investing in generics rather than costly bespoke medicines that are more attractive to pharmaceutical companies and traffickers. The science allows them to be merciful and shift gears to balanced drug policies that protect public health and prevent harmful non-medical use of opioids.

The Report of the Stanford Lancet Commission on the NorthAmerican Opioid crisis has some excellent recommendations to avoid the manipulations of the global pharmaceutical industry, to ensure availability and to prevent an overdose crisis. When governments commit to putting the health and welfare of their people first, as the Single Convention mandates, by creating multistakeholder task forces to improve availability, the graphs in the INCB supplements, such as the one just published, will look dramatically different. Latin American availability has improved because of the multistakeholder meetings my organization has sponsored in many countries of the region. Those around the table included the INCB, national competent authorities, health ministers, medical professionals, accredited civil society organizations, the private sector and faith communities. You can do this. We can help. Now is the acceptable time. I thank you.

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