Two years ago, I went to my first meeting of the Commission of Narcotic Drugs. Fortunately I went with Dave Joranson, who knew the “ins and outs” of this UN meeting from his previous attendances. What is the COW (Committee of the Whole)?” “Side events?” “When will they discuss access to opioids” A new language and a whole set of protocols to follow. Bottom line was that availability of opioids of analgesia was buried within the INCB report. Not much else. The meeting was largely about the “War on Drugs.”
Despite the fact that the Single Convention states that control should not limit access, and that opioids (the convention talks about narcotics) are essential for the practice of medicine, little was discussed. Yes most of world lack access to pain meds, but over and over again in his attendance at CND, Dave was told that this was a WHO issue, despite the single convention.
My things have changed. In fact this year both the plenary and the Committee of the Whole (that works on resolutions) were discussing availability issues concurrently. Asra Husain was in the plenary, while I was with the Australian Delegation in the COW. Country after country talked about their desire to improve access to opioids and in some cases their efforts to improve availability. The Philippines talked about two opioid availability workshops they had held (led by PPSG with the support of Open Society’s International Palliative Care Initiative) and the governments financing of morphine. The INCB has published a supplement addressing these issues in 2010 (links below).
There are many reasons for this change. Yes IPCI, Human Rights Watch, Union for International Cancer Control and its Global Access to Pain Relief Initiative (GAPRI), International Association for Hospice and Palliative Care, the WHO Access to Controlled Medication Program, our supportive colleagues who promote the science of Opioid Substitution and Harm reduction and, while not the least, the Drug Access and Control of Medications Consortium, funded by the UK governments Department for International Development. Other governments were also strategically involved, including the US government in 2010, and the Australian government who with Mexico led a resolution that significantly advances the availability agenda, calling on both INCB and UNODC to work to improve availability including a revision of Model Laws to guide countries in this process.
So a job well done but really just “the end of the beginning.” Winston Churchill.
2011 CND Resolution on Availability L9/Rev 1
Consporing Countries: Argentina, Australia, Canada, Chile, Colombia, El Salvador, EU, Indonesia, Israel, Kenya, Mexico, New Zealand, Nigeria, Norway, Peru, Philippines, Russian Federation, Sudan, Thailand, Uruguay, US, Venezuela and Zambia
(link is currently down and I didn’t want to delay sending this. I will post links to all 6 UN languages as they become available).
INCB 2010 supplement on availability.