2016; Volume 17, No 1, January
Dr. Katherine Pettus speaking at the Non-communicable Diseases Meeting in Geneva
Policy and Advocacy
Policy Advocacy in the Brave New World of the Sustainable Development Goals (SDGs)
Dr. Katherine Irene Pettus, PhD, Advocacy Officer, International Association for Hospice and Palliative Care
The Sustainable Developments (SDGs), are realigning the narratives around the imperative of improving access to controlled medicines. World drug policy is shifting from a criminal justice, supply control paradigm to a public health oriented approach, and controlling non-communicable diseases (NCDs) is seen as central to achieving the SDGs. IAHPC advocacy activity in November and December picked up this thread, as I worked with the World Health Organization (WHO) in Geneva, and the Commission on Narcotic Drugs (CND) in Vienna. In order to learn more about the WHO work, I attended a weeklong Technical Briefing Seminar on Essential Medicines and Health Technologies.
Group members: Technical Briefing Seminar on Essential Medicines and Health Technologies
With colleagues from all over the world, I attended sessions to learn how the WHO ensures delivery of essential medicines and technologies in emergencies, and listened to presentations about how the regulatory section works on health system strengthening; how WHO collaborates with regions and countries, advocates for universal health coverage, and implements World Health Assembly (WHA) resolutions in the field of essential medicines and health products. It was an excellent opportunity to network and meet new partners interested in improving access to controlled medicines for pain and palliative care. I learned about this biannual Technical Briefing from a notice on e-drug. To subscribe, write to [email protected] to learn about all activities and developments around the world regarding medicines.
The Dialogue on NCDs and international cooperation organized by the WHO Global Coordination Mechanism on NCDs (WHO GCM/NCD immediately followed the Technical Briefing. According to the WHO website, the Dialogue “takes place following the adoption of the 2030 Agenda for Sustainable Development and against a backdrop of the huge imbalance between the enormous burden that premature deaths from NCDs represent – 50 percent of the global disease burden – and the disproportionately small scale of resources devoted to their prevention and control in developing countries.” This is the second Dialogue I have attended, where I coordinated interventions on the floor about the importance of palliative care and controlled medicines with Dr. Stephen Connor, Executive Director of the Worldwide Hospice Palliative Care Alliance (WHPCA).
I also contributed to a WHPCA paper on palliative care and the Global Goal for Health.
Most of the discussion around NCDs at the dialogues focuses on prevention, control, and policy ‘best buys’. It is important to remind WHO member states that, even if they succeed in preventing and controlling NCDs, they must still provide palliative care through primary health systems, a commitment they made when they signed up to the Palliative Care Resolution at the World Health Assembly in 2014. The WHO has designed an interactive platform for the NCD dialogue for all who would like to be involved or remain informed about developments. The Global Virtual Discussion Forum will be the starting point of a Community of Practice on the new GCM Web Portal. The theme of this Global Discussion Forum will focus on: ‘How countries can leverage the many dimensions of international cooperation to complement their domestic resources, mobilize and accelerate progress on integrated national NCD responses and fulfill their commitments in the context of the NCD-related SDG targets’. To join in, click here.
There was much discussion among member states during the December Reconvened 59th Session of the Commission on Narcotic Drugs on the topic of how to frame the issue of access to controlled medicines for UNGASS2016 (UN General Assembly Special Sessions), also in the framework of the Sustainable Development Goals. The new turn in global drug policy was evident at a packed, standing room only side event sponsored by Norway, Colombia, and Switzerland. The topic was UNGASS 2016 on the World Drug Problem: focus on people, public health and human rights. The panel included representatives from UNAIDS, the Office of the High Commissioner for Human Rights, the WHO, UNODC (UN Office on Drugs and Crime) and the Colombian Deputy Minister of Justice and Law. Their powerful statements on health, human rights, and drug policy, including controlled medicines, are available here. On the last day of the session, the WHO representatives reported on the scheduling recommendations of the Expert Committee on Drug Dependence (ECDD), which included a decision not to place ketamine, an essential anesthesia medication, under international control. The ECDD also recommended further study and review of the medical efficacy of cannabis, a substance currently under strict international control.
Links
Palliative Care Advocacy Opportunity for the World Health Assembly Executive Board Meeting, January 2016
Diederik Lohman, Associate Director, Health and Human Rights Division at Human Rights Watch
Diederik Lohman
At its next meeting (January 25-30, 2016), the Executive Board of the World Health Organization (WHO) will discuss the public health dimension of the world drug problem. This is an important opportunity for the palliative care and pain communities to get UN Member States to highlight the ongoing challenges with limited access to opioid analgesics in much of the world, and for Member States to encourage WHO to continue its efforts to implement the 2014 World Health Assembly palliative care resolution. We hope you will reach out to health officials in your country to encourage them to speak up about opioid analgesics, palliative care and pain management at the Executive Board meeting.
During the WHO Executive Board meeting, the WHO will present its report on the public health dimension of the world drug problem followed by a discussion among Member States. It is critical that as many countries as possible speak about the importance of access to controlled medicines and pain and palliative care. We hope they will make the following points in particular:
- Express concern about the limited availability of controlled medicines, especially opioid analgesics, in their own countries if applicable, and in much of the world. Countries could refer to the International Narcotics Control Board (INCB) annual report for 2014 that estimates that 75% of the world population does not have adequate access to these medicines.
- Emphasize the need for an UN-wide response to this public health crisis. Ensuring the adequate availability of controlled medicines as well as preventing their misuse and diversion requires a collaboration across numerous government agencies including those involved in the drug control, health, health insurance, pharmaceutical and development sectors.
- Stress the importance of addressing challenges with availability to controlled medicines to achieve the Sustainable Development Goal on health. Goal 3 focuses on “ensur[ing] healthy lives and promot[ing] well-being for all at all ages.” This goal cannot be met if the major gaps in access to controlled medicines persist.
- Call for the UN General Assembly Special Sessions (UNGASS) on Drugs outcome document to mandate a UN-wide effort to address this public health crisis. The UN General Assembly can instruct all UN agencies to work together to solve this problem.
- Call for the recognition of the leading role of the WHO in the global response to drugs.
You can
- Contact health officials in your ministries and find out who will be preparing your country’s intervention on Agenda Item 6.4 of the WHO Executive Board meeting. As this issue will be discussed under the overall heading of non-communicable diseases, it is likely that officials responsible for non-communicable diseases will play a role in deciding what your country will say.
- Request health officials to include the above points in their intervention. Feel free to email me for any questions.