Balance, Pain, Palliative Care

#UNGASS2016 recommendations on Ensuring access to Controlled Substances. #hpmglobal


This week the United Nations General Assembly is considering the World Drug Problem in a Special Session in New York. Through the work of a number of key Member States and Civil Society, access to controlled medicines has gone from not being on the agenda to being a stand alone component on the Final resolution…..

The UNGASS document is available in English at

https://documents-dds-ny.un.org/doc/UNDOC/GEN/N16/105/72/PDF/N1610572.pdf?OpenElement

The sections on the access to controlled medicines:

Operational recommendations on ensuring the availability of and access to controlled substances exclusively for medical and scientific purposes, while preventing their diversion

2. We reiterate our strong commitment to improving access to controlled substances for medical and scientific purposes by appropriately addressing existing barriers in this regard, including those related to legislation, regulatory systems, health-care systems, affordability, the training of health-care professionals, education, awareness-raising, estimates, assessment and reporting, benchmarks for consumption of substances under control, and international cooperation and coordination, while concurrently preventing their diversion, abuse and trafficking, and we recommend the following measures:

(a) Consider reviewing, within the framework of national legal systems, domestic legislation and regulatory and administrative mechanisms, as well as procedures including domestic distribution channels, with the aim of simplifying and streamlining those processes and removing unduly restrictive regulations and impediments, where they exist, to ensure access to controlled substances for medical and scientific purposes, including for the relief of pain and suffering, as required by the three international drug control conventions and defined by national legislation, while preventing their diversion, abuse and trafficking, and encourage the exchange of information, lessons learned and best practices in designing and implementing regulatory, financial, educational, administrative and other related measures;

(b) Strengthen, as appropriate, the proper functioning of national control systems and domestic assessment mechanisms and programmes, in cooperation with the International Narcotics Control Board, the United Nations Office on Drugs and Crime, the World Health Organization and other relevant United Nations system agencies, to identify, analyse and remove impediments to the availability and accessibility of controlled substances for medical and scientific purposes, within appropriate control mechanisms, as required by the three international drug control conventions and taking into account Ensuring Balance in National Policies on Controlled Substances: Guidance for Availability and Accessibility of Controlled Medicines9 and, for that purpose, consider the provision of technical and financial assistance, upon request, to developing countries;

(c) Expedite, in accordance with national legislation, the process of issuing import and export authorizations for controlled substances for medical and scientific purposes by using the above-mentioned guidance and the International Import and Export Authorization System of the International Narcotics Control Board;

(d) Address, at the national and international levels, issues related to the affordability of controlled substances for medical and scientific purposes, while ensuring their quality, safety and efficacy, including limited financial resources and problems in sourcing with regard to these substances, including in cooperation, as appropriate, with the private sector through, inter alia and where needed, expanding the national coverage of distribution networks to rural areas, addressing the link with government regulations, licences and taxation and allowing appropriately trained and qualified professionals to prescribe, dispense and administer controlled medicines based on their general professional licence, as well as, where appropriate, the manufacture of generic pharmaceutical preparations that are bioequivalent and cost-effective;

(e) Take measures, in accordance with national legislation, to provide capacity-building and training, including with the support of relevant United Nations entities such as the World Health Organization and the United Nations Office on Drugs and Crime, targeted at competent national authorities and health- care professionals, including pharmacists, on adequate access to and use of controlled substances for medical and scientific purposes, including the relief of pain and suffering, consider the development and wider implementation of relevant clinical guidelines on the rational use of controlled medicines, and conduct appropriate awareness-raising campaigns under the coordination of relevant national health authorities and in cooperation with other relevant stakeholders;

(f) Develop national supply management systems for controlled substances that comprise selection, quantification, procurement, storage, distribution and use, strengthen the capacity of competent national authorities to adequately estimate and assess the need for controlled substances and paying special attention to essential medicines, as defined by national legislation, taking due note of the Guide on Estimating Requirements for Substances under International Control,10 and enhance domestic data-collection mechanisms in order to present the International Narcotics Control Board with estimates on the consumption of drugs used for medical and scientific purposes;

(g) Continue to regularly update the Model Lists of Essential Medicines of the World Health Organization, enhance collaboration among Member States and the treaty bodies with scheduling responsibilities, leading to informed and coordinated scheduling decisions by the Commission on Narcotic Drugs that take due account of all relevant aspects to ensure that the objectives of the conventions are met, and review national lists of controlled substances and national lists of essential medicines, as appropriate.

We look forward to increasing resources being made available within global health to make these recommendations become a reality!

About Pain policy & palliative care

Improving global pain relief by achieving balanced access to opioids worldwide

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