2019; Volume 20, No 7, July
Policy and Advocacy
Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Palliative Care Medicines, with her latest roundup of advocacy news.
Unrelenting Advocacy at the Highest Levels for Patent Pain Relief
June advocacy focused almost entirely on deepening IAHPC’s work to raise awareness about the abyss in access to internationally controlled essential medicines (ICEMs), an abyss that is now deepening in the shadow of the North American ‘opioid epidemic.’ At all my talks this month, I described the access abyss, created and sustained by decades of unduly restrictive global, regional, and national drug policies, which in turn prevent adequate professional training of practitioners.
Speaking at a session during Global Drug Policy Week in Geneva. To my left are fellow panelists Dr. Tammam Aloudat, Médecins Sans Frontières; Ms. Jennifer Hasslegard-Rowe, Geneva Platform; Jason Peat, IFRC; and Dr. Gilles Forte, WHO Essential Medicines.
My advocacy talks included a three-day meeting in Amsterdam at Health Action International, an intersessional meeting of the UN Commission on Narcotic Drugs in Vienna [text of the presentation], meetings with the Justice and Health sections of the UN Office of Drugs on Crime regarding needs of palliative care for prisoners, and the launch of the 2019 World Drug Report in Geneva [see the Drug Policy Week program]. Other very important events were a webinar hosted by the Inter-American Observatory on Drugs of CICAD (Comisión Interamericana Para el Control del Abuso de Drogas) and a panel discussion with colleagues from the World Health Organization, the International Federation of Red Cross and Red Crescent Societies (IFRC), and Médecins Sans Frontières as part of Global Drug Policy Week in Geneva.
Advocacy and international drug policy
For those of you wondering about why IAHPC should be so concerned with international drug policy, these trips must seem like a black box. Yet since more than 20% of you reported in a recent survey that advocacy is the core niche of IAHPC, you will be interested to know that the UN agencies responsible for international drug control, not global health, regulate patient and provider access to internationally controlled essential palliative care medicines, such as morphine. For more information, see here.
Advocacy for internationally controlled essential medicines must take place in two separate, but interlinked, UN domains: international drug control and global health systems!
Our advocacy at international meetings builds political support at the highest levels to urge member states to give practitioners and patients access to the essential medicines they use for palliative care. [Further reading on the subject: INCB’s Progress in ensuring adequate access to internationally controlled substances for medical and scientific purposes, Report of the Lancet Commission on palliative care and pain relief, and my article titled, ‘Improving Access to Internationally Controlled Essential Medicines in the Post-UNGASS, Agenda 2030 Framework.’
CND & the role of IAHPC
At the UN Vienna headquarters during the intersessional meeting, I pointed out at the meeting that there are two crises, not one opioid crisis.
Dear readers, almost all of your countries have permanent missions in Vienna and attend meetings of the UN Commission on Narcotic Drugs (CND). CND oversees national, regional, and global drug policy in both its regular and intersessional gatherings, discussing how to ensure that governments comply with the three drug control conventions. As a nongovernmental organization accredited by the UN Economic and Social Council, IAHPC is allowed to participate in these discussions and make statements regarding the need to increase access to controlled medicines. We have done this actively for years, urging governments to cooperate with palliative care organizations to improve access and providing technical assistance as required.
Little by little, we have succeeded in broadening the mainstream drug control rhetoric beyond traditional supply/control policies, which emphasize crop eradication, unduly strict regulatory control of pharmaceuticals containing opioids, and severe punishment of people who use drugs.
A reflection of our progress
Chapter Two of the 2016 Outcome Document of the UN Special Session on the World Drug Problem reflected this progress. Unfortunately, media and policy attention commanded by the North American opioid crisis, a crisis of nonmedical use of both prescription and non-prescription substances controlled under international law, has overshadowed the issue of lack of access in more than 75% of the world. Much of the airtime in the June meetings, as well as in the CICAD webinar, was taken up by efforts to distinguish betweenthe two opioid crises: the global crisis of lack of access for medical use; and the North American crisis of excessive, problematic access for nonmedical and poly-pharmaceutical use.
Advocacy course for members
We will be offering an advocacy course to members in a few months’ time, following an imminent ‘test drive’ by the IAHPC Board of Directors. We encourage you to join IAHPC if you are not already a member, to renew or contribute if you are, and to look out for notices announcing the course.
This is a critical juncture in international advocacy for improved availability of internationally controlled essential medicines for pain and palliative care, and we need all advocacy hands on deck to build on the progress made in the last decades.
Editor’s note: Read Katherine’s new blog, ‘Palliative Care in Deep Time.’
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