The remarks of Ambassador Pedro Moitinho de Almeida (Post-UNGASS Facilitator) after the Commission on Narcotic Drugs’ thematic discussions on the implementation of the operational recommendations contained in the UNGASS outcome document, held on 10-11 and 27-28 October 2016.
10. The importance of fighting stigmatization and social-exclusion as well as minimizing the adverse consequences of drug abuse was identified by many delegations as one of their priorities. It was underlined that measures aimed at minimizing the adverse consequences of drug abuse, referred to by a number of delegations as harm reduction, needed to be part of a structured comprehensive package of measures from prevention, early intervention, to treatment, social reintegration, rehabilitation and recovery measures. Some delegations reported that measures including opioid substitution treatment, needle exchange programmes, safe injection sites, distribution of foil as well as antiretroviral therapy had proven to be an effective element of a range of measures to prevent the transmission of HIV, viral hepatitis and other blood-borne diseases associated with drug use and delegations referred to the technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users, issued by the World Health Organization, the United Nations Office on Drugs and Crime and the Joint United Nations Programme on HIV/AIDS. The need to promote risk and harm reduction measures directed also to stimulants users was also mentioned. On the challenge of drug overdoses, in particular opioid overdoses, delegations shared information on national prevention and treatment efforts to reduce drug-related mortality, including through the use of opioid receptor antagonists such as naloxone. The important cooperation between UNODC and UNAIDS was highlighted, also in view of the commitment to ending, by 2030, the epidemics of AIDS and tuberculosis.
11. (…) With the availability of internationally controlled drugs for medical and scientific purposes, including for the relief of pain and suffering, remaining low to non-existent in many countries of the world, delegations shared information on the steps taken to enhance national approaches and international cooperation and to address different kinds of existing barriers to the availability and accessibility of controlled substances for medical and scientific purposes.
12. Delegations shared information on measures adopted to ensure that domestic legislation, regulatory and administrative mechanisms as well as procedures to support the availability and access to controlled substances for medical and scientific purposes, including for the relief of pain and suffering, while preventing their diversion, abuse and trafficking. Measures presented covered inter alia the use of electronic prescription systems; increasing the validity of prescriptions; expanding the number of trained health professionals authorized to prescribe controlled substances as well as simplifying the storage and transport requirements.
13. The importance of providing capacity building and targeted trainings for health professionals and competent national authorities was emphasized, covering inter alia the adequate access to and use of controlled substances, including for the relief of pain and suffering. In this regard, many delegations highlighted positive experiences of closely collaborating with civil society to engage at the local level in addressing any social or cultural barriers that might exist to the availability of controlled substances for medical and scientific purposes, as well as of cooperation with the pharmaceutical industries. In this regard, reference was also made to the cooperation between UNODC, WHO and the Union for International Cancer Control (UICC).
14. With the view to enhancing the assessment and reporting capacity as well as ensuring efficient supply management systems, many delegations highlighted the leading roles of UNODC, INCB and WHO and shared information on specific joint programmes, including pilot programmes, addressing the availability of and access to controlled substances for medical and scientific purposes. With a view to strengthening the functioning of national control systems and assessment mechanisms, efforts were shared, including the organization of targeted trainings for competent national authorities on estimating and assessing the need for controlled substances. The participation in the INCB Learning Programme was encouraged by many delegations in this regard. In addition, delegations reported on using early warning and monitoring systems to counter-act increased reliance on just-in-time delivery and production shortages of essential medicines, also in reference to the Model Lists of Essential Medicines of the World Health Organization.
22. Many delegations reported on steps taken to implement recommendations on proportionate and effective policies and responses for drug-related offences, including alternatives to incarceration, by focusing on treatment, education, aftercare, rehabilitation and social reintegration as well as the implementation of age and gender appropriate interventions targeted to the specific needs of vulnerable members of society, in particular women and children. Alternatives to conviction or punishment for drug-related offences in appropriate cases of a minor nature reported by delegations ranged inter alia from referral to treatment, administrative measures, suspension of proceedings conditional on pursuing treatment, substitution of imprisonment for non-custodial measures, suspension of sentences, and referral to so called drug treatment courts, which were operating in some countries, and which were currently under evaluation in others. Approaches designed to deter illicit drug use and promote policies addressing public health concerns were shared by some delegations. Some delegations underscored the importance of proportionality in sentencing, including the need to consider mitigating and aggravating factors. Some shared the view that an over-reliance on criminal justice measures was counterproductive. The need to distinguish between traffickers and users was also highlighted. Delegations referred to the importance of relevant United Nations standards and norms in crime prevention and criminal justice and reported on their use of national guidelines as well as of the UNODC criminal justice handbook series (…)
30. Some delegations shared efforts to counter the growing challenge of non-medical use and misuse of pharmaceuticals, in particular in relation to opioid overdoses. National responses included inter alia targeted interventions, increased awareness raising initiatives on addiction and overdose risks, the supporting of better prescribing practices or the active involvement of pharmaceutical companies in risk management.
39. Delegations highlighted efforts undertaken to promote sustainable crop control strategies that support the empowerment, ownership and responsibility of affected local communities while taking into account their vulnerabilities and special needs. Efforts reported included increasing farmers’ access to financial services, facilitating access to local and international markets and upgrading community infrastructure, promoting gender equity and the empowerment of youth, supporting the development of local citizens’ organizations to interact with local and municipal authorities as well as building transparency and accountability. Law enforcement was highlighted by a number of speakers as a key component of a comprehensive and balanced package of 7 interventions to strengthen sustainable crop control strategies that may include, inter alia, alternative development, eradication as well as law enforcement measures.
40. Delegations expressed support for the inclusion of alternative development strategies in national drug control policies, focused on a broader development perspective, taking into account demographic, cultural, social and geographic considerations. Promoting a holistic approach to alternative development to alleviate poverty and strengthen the rule of law, accountable, effective and inclusive institutions and public service, was underlined by a number of delegations. Delegations underscored the importance of taking into account the United Nations Guiding Principles on Alternative Development, when designing sustainable crop control strategies.
41. Advancing sustainable alternative development initiatives in rural and urban areas, and promoting viable economic alternatives for communities affected by illicit drug-related activities were highlighted as key priorities by a number of delegations. Delegations reported on national and regional strategies to identify and address the root causes of illicit cultivation and drivers for instability as well as foster development at the community level. Delegations also referred to encouraging economic development through investments in and partnerships and innovative cooperation initiatives inter alia with local, national, and international businesses to ensure licit economic development by strengthening for example small-scale producer associations. In this regard, the importance of ensuring long-term and flexible funding for the implementation of comprehensive and balanced alternative development programmes and viable economic alternatives was highlighted.
42. Some delegations highlighted the need to extend the concept of alternative development to urban areas for those affected by the cultivation of illicit crops and drug trafficking. Such programmes included alternative development programmes targeting particular populations in urban settings, not directly involved in the cultivation but affected by the illicit cultivation and trafficking of drugs, who often faced a lack of alternative economic opportunities. Delegations shared information on specific projects such as comprehensive training programmes, including vocational training, that had yielded positive results.
43. Ensuring access to markets for products stemming from alternative development was accentuated by a number of delegations and information on initiatives including certification schemes for alternative development products or trade agreements with producing countries to boost exports was shared. In addition, the need to address the consequences of illicit crop cultivation on the environment was underlined.