Katherine I. Pettus, PhD
IAHPC Senior Advocacy & Partnerships Director
Regular readers of my column will know that much of IAHPC’s and our partners’ work to improve global availability of internationally controlled essential medicines started to ripen in 2022, when Ambassador Ghislain D’Hoop chaired the Commission on Narcotic Drugs (CND). Together with the United Nations Office of Drugs and Crime (UNOOC), he initiated the No Patient Left Behind Campaign and led sessions that raised awareness of the topic among member states. However, the campaign has yet to attract sufficient resources from high-income countries to support ongoing work in lower-and middle-income countries, where availability remains a challenge. The November meeting—co-hosted by UNODC and the government of Belgium, incoming chair of the European Union Commission—convened global experts who provided concrete examples of successes and proven methods to address ongoing challenges.
The two-day meeting showcased Belgium’s support for work in the Democratic Republic of Congo, where the government has changed laws and policies that choked availability of controlled medicines. It now allows for local manufacture and targeted training of the health workforce in palliative care and prescribing. IAHPC Research and Academic Advisor Dr. Tania Pastrana took the stage on the second day along with experts from Médecins sans frontières, Health Action International, the Walther Center, and the Institute of Tropical Medicine in Antwerp. His Excellency Ambassador Philibert Johnson, first vice-chair of the 66th Commission on Narcotic Drugs, was present for all sessions and will continue Ambassador D’Hoop’s work to keep the issue of availability front and center during next year’s sessions of CND and the Ministerial Review, which you will hear a lot more about in my 2024 posts.
Read my reflection on how governments that enjoy adequate availability of controlled medicines can cultivate collective gratitude as a first step to support policies in countries where opioids for medical use remain scarce or unavailable.
I will attend the December intersessional thematic meetings of the Commission on Narcotic Drugs in Vienna, where IAHPC will co-host a hybrid side event “No Patient Left Behind: Safe and Affordable Access to Controlled Medicines in Low- & Middle-Income Countries” with El Salvador, Belgium, and Ghana, as well as the CND’s reconvened session, which will prepare for the 67th CND and Ministerial Review in 2024. Stay tuned for a report on the side event, which will include the launch of the Morphine Manifesto.
Advocacy Tip Have your organization endorse the Morphine Manifesto and send it to your policymakers, media contacts, and competent national authority (find yours) with a cover letter about your work. Invite them to come and see what you do or have them accompany you on a home visit.
Start thinking about applying to join the IAHPC delegation to CND in March 2024. This midterm review of progress in the implementation of international drug policy commitments will provide opportunities to make statements on availability of controlled medicines in your country, and to meet your national delegations.
I submitted a report on behalf of IAHPC to the Office of the High Commissioner for Human Rights in response to a call for contributions for an analytical study on key challenges in ensuring access to medicines, vaccines, and other health products. Our submission responded to the Committee on Economic and Social Rights questionnaire that asked about barriers to availability, affordability, and accessibility; legal and regulatory challenges; and concrete recommendations to improve the situation. Controlled medicines are often ignored in these discussions that, especially since COVID-19, tend to focus on vaccines and intellectual property. However, thanks to foundational work by Human Rights Watch, there is now a considerable body of human rights discourse on controlled medicines and authoritative statements by experts. Advocates can use these as leverage to persuade their governments to improve availability.
Advocacy Tip Read the IAHPC submission and consider sending it to your national human rights institution with a note introducing your work and an offer to participate in national consultations. Schedule a webinar where I, and other advocacy experts, join your government officials and frontline prescribers to discuss the issue of human rights and access to medicines.
In November, I was privileged to attend a three-day retreat in Evian, France, titled “At the UN: Civil society in a state of exception—how to free ourselves from the Stockholm syndrome.” It was hosted by the Rosa Luxemburg Foundation and G2H2, a global health network in Geneva comprising civil society organizations working on many different aspects of social justice, peace, and human rights.
After getting to know one another in professionally mediated sessions, the 30 or so participants looked closely at the idea of the state of exception in international law and the role of civil society in the increasingly uneven playing field that has been dominated by corporations. Participants described the impact, or lack thereof, of our work in the various multilateral governance settings where we participate. We unpacked the influence of “multistakeholderism,” or “pay to play,” the trend in global governance that marginalizes the voices of the most disenfranchised, such as people with palliative care needs.
This first meeting set the scene for further retreats where we will hammer out a framework for more effective strategies going forward. We emerged from the meeting with a renewed sense of purpose and solidarity to continue our work in the teeth of powerful and lethal forces that appear to show little regard for the suffering of populations increasingly deprived of their voice, rights, and livelihoods.
Stay tuned for a report in February on December advocacy doings. Please accept my gratitude for your attention to our work this year and my best wishes for your holiday season with family and friends.
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