INCB call for “indispensable” controlled medications to be “adequately available and not unduly restricted”

Categories: Policy.

The report, published as a follow-up to the 2010 report: ‘Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes’ deals with the availability of controlled substances for medical and scientific use, an issue that has been historically neglected in the discussions on implementing the Single Convention on Narcotic Drugs of 1961.

As UN Member States prepare for the United Nations General Assembly Special Session on the World Drug Problem to be held in April this year, this report will be an invaluable resource to inform these discussions.

INCB President, Werner Sipp, said: “As the international community prepares for the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem, to take place in April, INCB wants to contribute actively to the global debate.”

In his preface to the report, Mr Sipp said: “Unnecessary suffering resulting from a lack of appropriate medication due to inaction and excessive administrative requirements is a situation that shames us all.

“Inadequate access contradicts the notion of article 25 of the Universal Declaration of Human Rights, including the right to medical care, which also encompasses palliative care.”

The report examined policies and practices at the national level through a questionnaire for UN Member States, which received over 100 responses. It also invited input from other UN agencies, and civil society organisations representing patients, families, health professionals and other stakeholders.

Governments complying with the international drug control conventions set out by the Single Convention have a dual responsibility to make sure that controlled substances are available for the relief of pain and suffering, while also preventing their misuse.

Barriers to accessing these medications include: regulatory barriers such as unduly restrictive laws, attitudinal factors such as concerns about addiction and reluctance to prescribe or stock these medicines, or insufficient training for health professionals. The report notes that a small number of governments reported supply and distribution problems, as well as the cost of medications such as opioids as barriers to making them available.

The analysis points to “significant progress” in the availability of opioid analgesics for medical purposes, despite severe global inequalities, as well as increases in the average amount of opioid analgesics consumed during the 2011-2013 period compared with the 2000-2003 period.

Also, data suggests that concerns about the risk of addiction and legislative impediments are becoming less relevant and that countries believe that it is necessary to address other key impediments such as lack of training and education, streamlining of supply, costs and limited financial resources.

The report concludes that it is possible to improve the availability of controlled substances for medical and scientific use, within the framework of international conventions. The INCB calls for “sensible and rational” national laws and policies to make sure that people have access  to the medications they need while protecting their health, and that health professionals have the knowledge to prescribe these medications while remaining aware of the risks of abuse.

Mr Sipp said: “The Board is presenting this special report to Member States in the hope that the analysis and recommendations presented therein may assist them in the development of national policies and control systems that are capable of achieving the goals of the international drug control conventions in relation to ensuring availability of narcotic drugs and psychotropic substances.”

You can download the report from the INCB website. INCB Board members have also authored an article in The Lancet, drawing on the data published in the report for a more in-depth analysis.