- Access to controlled medicines
Ensuring appropriate access to internationally controlled substances used for medical purposes is another challenge. About 80 per cent of the world’s population has limited or no access to controlled substances; that means that in most countries many people are suffering unnecessarily. In some countries and regions, however, overconsumption of certain controlled substances is a growing concern, as it may lead to additional health problems. Recently, the international community joined in recognition of the challenge of non-communicable diseases at the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, held in New York in September 2011. As a participant in that meeting, I emphasized the importance of the appropriate availability of internationally controlled substances for the relief of pain and treatment of mental illness. (…)
237. Aware of its dual responsibility under the 1961 Convention and the 1971 Convention to ensure the availability of controlled substances for medical and scientific needs while preventing their illicit production, trafficking and abuse, the Board launched in March 2011 the Report of the International Narcotics Control Board on the Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes14 as a supplement to its annual report for 2010. The special report brought to the attention of Governments and the general public the stark contrast in consumption levels in the different regions of the world. It also contained recommendations on the availability and appropriate use of controlled drugs, national drug control systems and the prevention of diversion and abuse of such drugs. The Board appreciates the positive reactions to the special report. The Board trusts that Governments will implement those recommendations in the report which are relevant to the situation in their countries. The Board will in due time analyse, in cooperation with Governments, the extent to which the recommendations have been implemented.
238. The Board, which is responsible for monitoring the compliance of Governments with the international drug control treaties, administers the international control regime for narcotic drugs and psychotropic substances. An essential component of the control regime is a system under which countries are requested to estimate their annual requirements for internationally controlled substances for legitimate purposes and to limit the use of such substances to those estimates. If applied correctly, the system should promote access to adequate levels of controlled substances and at the same time correct excessive use of such substances. (…)
254. On 4 February 2011, a joint letter signed by the President of the Board, the Director-General of WHO and the chair of the United Nations Development Group was sent to United Nations resident coordinators. In that letter, the issue of the availability of internationally controlled substances for medical use was addressed. The letter referred to the continuing shortfall in many countries with respect to the availability of internationally controlled substances required for the treatment of severe pain, mental illnesses and psychiatric disorders, opioid dependence, epilepsy and birth complications. Resident coordinators were urged to integrate the issue of access to controlled medicines into health programmes. (…)
258. The Board notes the increasing number of non-governmental organizations that are actively involved in promoting the availability of internationally controlled substances for medical purposes and act as advocates for the adequate availability of such substances. Their activities focus mostly on the availability of analgesics, in particular opioids, in the treatment of pain and in palliative care. Data collected and processed by the Board and published in its technical publications have been used by non-governmental organizations and research institutes to study the issue of availability globally as well as in individual countries. At the same time, the Board receives valuable information from non-governmental organizations on the situation of patients lacking adequate pain treatment and palliative care, as well as on activities carried out at the national and international levels to improve health services and access to medications for those in need of them. (…)
304. Concerned by those continuing difficulties, the Commission on Narcotic Drugs adopted resolution 54/3, on ensuring the availability of reference and test samples of controlled substances at drug-testing laboratories for scientific purposes. In the resolution, the Commission requested Member States to review, in consultation with the Board and UNODC, national procedures, in order to facilitate access to internationally controlled substances for use as test and reference samples by drug-testing laboratories. (…)
Recommendation 5. In March 2011, the Board launched a special report entitled Report of the International Narcotics Control Board on the Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes, 32 as a supplement to its annual report for 2010. In its special report, the Board brought to the attention of Governments and the general public the stark contrast in consumption levels in the different regions of the world. The special report also contained recommendations on availability, appropriate use, national control systems and prevention of diversion and abuse of controlled drugs. The Board encourages Governments to implement those recommendations contained in the special report which are relevant to their country. The Board will in due time analyse, in cooperation with Governments and WHO, the level of implementation of those recommendations. (…)
Recommendation 36. The Board calls upon WHO, UNODC and other relevant international organizations to support Governments in their efforts to include substance use disorders and access to internationally controlled medicines in their national strategies for addressing non-communicable diseases (see also recommendation 33 above).