Volume 23, Number 4: April 2022
A High-Level Call to Improve Availability of & Access to Controlled Medicines
By Katherine I. Pettus, PhD
IAHPC Senior Advocacy and Partnerships Director
The 65th Commission on Narcotic Drugs (CND), held in March, focused on availability of controlled medicines.
Amid a political atmosphere charged by strong national and regional statements condemning the Russian Federation’s invasion of Ukraine, the commission paid more attention than usual this year to the issue of improving availability of and access to internationally controlled essential medicines listed in the schedules of the drug control conventions supervised by CND. I attend these meetings for IAHPC because these include essential palliative care medicines. The topic is the one thing most member states of all political stripes agree on, even though they don’t quite understand how to reach the goal of optimal availability.
With his high-level side event canceled as a result of explosive geopolitical fractures, the CND Chair, His Excellency Ambassador Ghislain D’Hoop, an ardent champion of the cause of availability, launched his Joint Call to Action to improve availability and access for medical and scientific purposes at noon on the first day. The virtual event included powerful statements from the Executive Director of the UN Office of Drugs and Crime (UNODC), the Director General of the World Health Organization (WHO), and the President of the International Narcotics Control Board (INCB), whose statement can be found here. More than 12,000 viewers attended the virtual event, which kicked off #NoPatientLeftBehind, a social media campaign.
CND videos you can view
As I was privileged to attend CND in person for the first time in two years, UNODC filmmakers interviewed me for a #NoPatientLeftBehind video that included speakers from that high-level event. I also joined the virtual and in-person dialogues organized by the Vienna NGO Committee on Drugs (VNGOC) with INCB President Ms. Jagjit Pavadia and Ambassador D’Hoop.
As one of the few in-person attendees for civil society, I delivered the IAHPC statement on the floor. Dr. Mataa Moses Mataa, IAHPC’s Advocacy Focal Point in Zambia, addressed delegates in a short video about the need to improve access in Africa, which was also broadcast on the event’s webstream.
Side events on access
“The pain was terrible. I couldn’t sit. I couldn’t stand… The patch, I don’t know if it helps the pain; it’s just the same. The morphine is excellent… In less than five minutes I get an effect. You don’t feel the pain anymore.”
— Ms. Taussent Yvonne Lawrence (patient)
There were two side events on access—one convened by the IAHPC, another by the government of El Salvador. The latter event included Dr. Gayatri Palat, from Telengana, who presented on her partnership with the state government to bring palliative care services and morphine to remote villages, and Ms. Rose Kiwanuka who discussed the Palliative Care Association of Uganda and the innovative model of nurse-prescribed oral morphine as a low-cost solution to availability issues. Dr. Milagros Cubilla, a professor of pharmacy at the University of Panama, presented on “Literacy: Secret Tool for Controlled Medicine Access.”
I moderated the IAHPC side event on “Disparities in Access to Controlled Medicines in the Caribbean,” cosponsored by VNGOC, UNODC, the Walther Global Palliative Care Center, and the Caribbean Palliative Care Association. Jamaican Ambassador Her Excellency Ms. Cheryl Spencer opened the online event, which included presentations by three palliative care providers in the Caribbean including IAHPC Board Member Dr. Dingle Spence. Ms. Verna Edwards discussed the steps taken by the Jamaica regulatory agency to improve access, and Sir George Alleyne provided wise closing remarks. The highlight was a short video of a cancer patient discussing the therapeutic and pain-relieving effects of morphine (at the 26-minute point). It’s worth watching! Many thanks to the Walther Center for providing the platform and sharing the recording.
Last but not least, Ms. Joan Marston, founder of PallCHASE, participated in a side event organized by the government of Italy on “The Humanitarian Approach to Drug Policy.” See her five-minute presentation on the need to improve availability of and access to controlled medicines in humanitarian emergencies.
Implementation work continues with plans for a pre-World Health Assembly technical briefing with WHO and an April 29 webinar, "Protecting public health and welfare through balanced opioid governance," sponsored by UNODC and the VNGOC. Panelists include the chairs of the Lancet Commission on Palliative Care and Pain Relief and the Stanford-Lancet Commission on the North American Opioid Crisis, Dr. MR Rajagopal (India), Ms. Maria-Goretti Loglo (Ghana), and Secretariat staff of the INCB, UNODC, and WHO. Read the webinar concept note, or register. Take a look at the 2021 INCB Annual Report released at the meeting with a useful chapter on global consumption data and other information on controlled medicines.
To learn more about Palliative Care Association of Uganda and the Caribbean Palliative Care Association, visit the IAHPC Global Directory of Palliative Care Institutions and Organizations.