Dr. Katherine Irene Pettus, PhD, Advocacy Officer, International Association for Hospice and Palliative Care, writes:
Policy advocacy for improved access to controlled medicines is focused on preparations for UNGASS 2016, the UN General Assembly Special Session on the World Drug Problem, to be held in April in New York. Our priorities are ensuring that the text in the ‘outcome document’ to be submitted by the Commission on Narcotic Drugs (CND) to the United Nations, aligns with our policy ‘asks’. This means providing member states with technical support to inform their written and oral interventions at the event itself.
The recently released International Narcotics Control Board (INCB) supplement, Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes, is a helpful resource for this advocacy as it gives member states an idea of their absolute and relative rates of consumption of controlled medicines, and recommends strategies to improve availability. The other key document is the Common Position of the African Union, and the West African Common Position, both of which have good sections on availability of controlled medicines for palliative care.
I attended three of February’s key UNGASS preparatory events held at UN Headquarters: the Interparliamentary Union Hearing on drug policy on February 9, a high level UNAIDS event, and the milestone Informal Interactive Stakeholder Consultation organized by the Civil Society Task Force. All three highlighted lack of access to controlled medicines as a key policy priority. The President of the UN General Assembly, H.E. Mr. Mogens Lykketoft, and UN Secretary-General, Mr. Ban Ki-moon, opened the Informal Multi-Stakeholder meeting, whose purpose was to enable representatives of civil society organizations, as well as the academic and scientific communities, to brief member states and representatives of UN agencies on the view from the coalface. Rose Kiwanuka, Executive Director of the Palliative Care Association of Uganda, flew to New York to represent communities lacking adequate access to controlled medicines in Africa. The Hearing’s Summary Document will be circulated to the delegations of all UN member states, and I presented it at the February 24 Intersessional in Vienna (see below).
The urgent advocacy task is to nourish the seeds planted by means of these narrative interventions and documents so that they will yield policy fruits that feed into both the Sustainable Development Goals (SDGs) and the final UNGASS outcome document. The new SDG global paradigm is already framing drug policy shifts, from the reductionist substance-centered (all drugs are “bad”/addictive) ideology, to holistic person-centered/public health rather than law enforcement approaches; from fear of addiction, and to the courage to provide evidence-based harm reduction and palliative care services where they are needed. IAHPC can support palliative care organizations on the ground to advance these ideas in their own countries and regions. This new, integrated paradigm was on display at an LSE (London School of Economics) Ideas conference, ‘After the Drug Wars’. My panel presentation focused on the importance of civil society participation and advocacy in the high level negotiations on drug policy at both the national and international levels, particularly as countries begin to align health and development policies in the new SDGs framework.
At the Commission on Narcotic Drugs Intersessional on February 24, several member states, most notably Panama, made statements on the floor concerning the need for one outcome of UNGASS to be a specific directive to improve availability of controlled medicines. IAHPC, with Human Rights Watch and many other co-sponsoring palliative care organizations, will be hosting a side event at the regular session of the CND in March. Lithuania, Panama, and Mexico are member state sponsors of this event, which is entitled ‘Resolving the Global Crisis of Untreated Pain by Improving Access to Controlled Medicines within the Framework of the SDGs’. Speakers include Dr. Marie-Paule Kieny, Assistant Director-General, World Health Organization, Dr. Gilberto Gerra, UNODC, Dr. Mabvuto Kango, African Union, Mr. Sergio Chaparro, DeJusticia, Colombia, and Dr. Werner Sipp INCB. I will report on this event in the next IAHPC policy brief, in the May edition of our newsletter.