The event was sponsored by Lithuania and Germany and co-sponsored by the International Association for the Study of Pain (IASP).
German Drug Commissioner, Marlene Mortier, opened the meeting, identifying the need to balance policies discouraging misuse of opioids with those that facilitate use for medical and scientific purposes. She identified the recently revised WHO Guidelines for improving access as an excellent tool.
Gediminas Kliukas, First Secretary of the Republic of Lithuania – which has twice sponsored IAHPC side events at CND – joined Ms. Mortier in greeting the guests.
Introducing his countryman Dr Puras, who had flown in from Vilnius especially for the event, he said that it was “past time for Geneva (the Human Rights Council) and Vienna (the Commission on Narcotic Drugs) to join forces on placing drug policy in a human rights perspective… access to palliative care and controlled medicines should be considered as a human right.”
After reflecting on the work of his predecessor, Anand Grover, Dr Puras said that “failure to ensure access to controlled medicines threatens the fundamental right to health and human rights in general. There is no justification or excuse for not ensuring access.”
The keynote address was Dr Willem Scholten’s presentation of the ATOME report, noting that the multi-country, multi-stakeholder participatory project found that “overly restrictive national laws often did not prevent abuse, dependence and diversion but created barriers to medical access.”
Dr Scholten went through the policy review process in each country – the national symposia – which included law enforcement, policy makers, physicians, patients, pharmacists and other stakeholders.
He also highlighted some of the recommendations, which differed for each country and context, the main one being to address restrictions on prescribing, and administrative burdens on providers.
Dr Scholten finished by addressing the issue of language, which is key to de-stigmatising morphine and other opioids. “Use of the word ‘drugs’ to refer to substances of misuse (and) — if you want to promote improved access — is not very useful. It is better to say ‘I want to improve access to medicine’ than ‘increase drug availability’.”
At the Commission on Narcotic Drugs, whose entire raison d’être is to reduce drug availability, it is important to make the distinction between controlled medicines and ‘drugs’.
Dr Anne Merriman, founder of Hospice Africa Uganda and nominee for the 2014 Nobel Peace Prize, put the icing on the cake by discussing how ATOME (Access to Opioid Medicines in Europe) could be adapted to ATOMA (Access to Opioid Medicines in Africa). In typical Anne fashion, she went on to say that it should be ATOMW — the “W” standing for World.
She showed some very detailed (and in some places graphic) slides depicting the work of Hospice Africa Uganda teams who bring compassionate care, as well as essential liquid morphine, to relieve the suffering of patients suffering in remote rural areas.
Dr Merriman identified lack of compassion in the world as the main source of the problem of lack of access to opioid medicines, and said that countries need “a heart transplant” to ensure that their citizens have access to essential pain medicines such as morphine.
It was a great side event for IAHPC at the 58th Commission on Narcotic Drugs, highlighting the benefits of extensive collaboration between UN treaty bodies, member states, regional groups, physicians, providers, and other stakeholders in the ATOME project.
The topic of improved access to controlled medicines is now becoming mainstream at the CND, where human rights experts are making a persuasive case that all drug policy, including access to essential controlled medicines, should conform to the highest human rights standards, which ups the ante considerably for CND.
Read an intervention on the subject of access to controlled medicines, given by Diederik Lohman, senior researcher at Human Rights Watch, at CND.