Report from Vienna: Delegates call for new approaches to improve controlled medicines access & availability
IAHPC delegation, left to right: Heloisa Broggiato Matter, Chiara Rambaldi, Tania Pastrana, and Brandon Maser. Photo used with permission.
Although hip replacement surgery rendered me unable (for the first time in 12 years!) to travel to Vienna for the 68th session of the Commission on Narcotic Drugs (CND), I oversaw the intense activity of the IAHPC’s four-person delegation led by Dr. Heloisa Broggiato Matter, PhD. Dr. Tania Pastrana, our education and research advisor, kindly took on some of my presentation commitments as well as her own, including a Belgium-sponsored side event on controlled medicines for children and a lecture to the Young Doctors Network (YDN) meeting of the United Nations Office on Drugs and Crime (UNODC). Dr. Brandon Maser, our delegate from Canada, participated in the YDN meeting as well as giving the YDN plenary intervention. Ms. Chiara Rambaldi, a new IAHPC member who, like Brandon, is working on a doctorate focusing on improved availability of controlled medicines, joined the delegation from Italy.
IAHPC statement on improved global framework
Well before CND68 kicked off, I submitted IAHPC’s 1,500-word written statement, published on UNODC's website for member state review. The statement addresses recommendations to overcome impediments to availability of controlled medicines, particularly opioids used to treat health-related suffering.
IAHPC organized a hybrid side event, “Improving Equitable Global Availability and Affordability of Internationally Controlled Essential Medicines in Africa through Inter-Agency and Other Collaborations,” with panelists from Ghana, Kenya, South Africa, and Uganda. You can watch the recording here, review the presentations here, and read a detailed review of the event in my Substack.
Her Excellency Ambassador Matilda Aku Alomatu Osei-Agyeman delivering Ghana’s proposal. Photo from UN TV recording used with permission.
Proposal on restorative justice for Africa
An unexpected and very gratifying outcome of our side event was Ghana’s proposal for a restorative justice approach to the provision of technical and financial support by former colonial powers to improve access to essential medicines in Africa.
Her Excellency Ambassador Matilda Aku Alomatu Osei-Agyeman's authoritative and feasible recommendation for policymakers in both high- and lower-income countries aims to improve both availability and affordability of controlled medicines in Europe’s former territories. This recommendation reflects suggestions first aired in a Lancet Global Health “Comment” published by IAHPC and APCA in 2024 titled "Analysis of Opioid Analgesic Consumption in Africa."
The IAHPC side event was sponsored by the Permanent Missions of Belgium, Ghana, and South Africa along with many other civil society organizations.
Pain relief is harm reduction
Dr. Heloisa gave my scheduled presentation: “Adequate Availability of Controlled Medicines Is Harm Reduction!” in a side event titled “Clarifying Harm Reduction” organized by the Rome Consensus and other civil society organizations. Healthy systems with strong harm reduction programs grounded in primary care under universal health coverage can balance concerns about dependence and nonmedical use as they improve availability of controlled medicines for palliative care. Moreover, inadequate availability of affordable medicines harms patients who resort to illicit markets for pain medicines they cannot find at the pharmacy.
More delegations than usual intervened on controlled meds
Wednesday's plenary debated Agenda item 5d, focused on availability of controlled medicines, and we were pleased that some new member states intervened on this important topic, including Burkina Faso, Ghana, India, Indonesia, Tanzania, Thailand, and Colombia. The European Union delegation, the Russian Federation, Belgium, and Australia consistently speak up on this agenda item, and IAHPC was the only civil society organization that took the floor to urge member states with inadequate availability to partner with us and the UN secretariats. You can read our statement on 5(d) here.
Correcting misinformation on opioids
Ms. Rambaldi gave IAHPC's other intervention on Agenda item 6. Our statement is titled “Follow-up to the implementation at the national, regional, and international levels of all commitments, as reflected in the Ministerial Declaration of 2019, to address and counter the world drug problem.” The statement took aim at misinformation provided on the previous day that conflated increased availability of opioids for medical purposes with an overdose epidemic. Read our statement here.
'Team Humanity'
Join IAHPC as a Delegate
at the World Health Assembly
Contact me to apply to join our delegation as a self-funded representative of your institution at the 78th World Health Assembly in Geneva, May 19-27. Stay tuned as we develop the program for our planned breakfast side event on Friday, May 23 at the World Council of Churches. Panelists at the event, titled “How global faith communities can exercise a preferential option for the health of children, older persons, and persons with disabilities in the current crisis,” will discuss their work to provide palliative care for the most marginalized communities during these challenging times.
The Geneva-based Union for International Cancer Control (UICC) organized a side event later in the week titled “Giving Voice to Silent Suffering: Revitalizing the Global Call to Action for Access and Availability of Controlled Substances for Medical and Scientific Purposes.” Dr. Barbara Hastie, along with His Excellency Ambassador Ghislain D’Hoop, launched a new initiative called “Team Humanity” to give voice to that suffering. Team Humanity will also have a side event at the World Health Assembly in May, as will IAHPC. We wish them all the best and are delighted to have new allies.
WHO guidelines coming soon
World Health Organization representative Dr. Dilkushi Poovendran presented at plenary panels and side events, reaffirming WHO’s commitment as a treaty body under the drug control conventions to work with CND and the International Narcotics Control Board (INCB). She informed delegates that the long-awaited WHO Guidelines on Balanced National Policies to Ensure Medical Access and Safety will be launched on the margins of the World Health Assembly in May.
Another positive outcome!
Finally, another positive outcome of our CND work came when IAHPC delegate Dr. Brandon Maser asked our pre-submitted question to INCB President Jallal Toufiq during the interactive dialogue organized by the Vienna NGO Committee on Drugs. Dr. Brandon asked if the INCB would consider introducing interactive roundtables with prescribers and all relevant supply chain actors at Learning Programme workshops, to solve what has been called the "wicked problem" of controlled medicines availability.
Dr. Toufiq promised to present our request at the next INCB meeting. I had highlighted this need for more interactive dialogues in my Substack on the INCB Learning Programme meeting in East Africa earlier this year.
Straight from the horse's mouth
You can watch recordings of all the CND sessions on UN TV.
PC rights of older persons in armed conflict
Read IAHPC's submission on the palliative care needs of older persons in armed conflict, sent to the Office of the United Nations High Commissioner for Human Rights in response to its call for input on a report of the Independent Expert on the enjoyment of all human rights by older persons.