March Advocacy Advances in Latin America, India & Internationally
By Katherine Pettus, PhD
IAHPC Senior Advocacy and Partnerships Director
Clinicians gain advocacy insights at ALCP
The ALCP Advocacy Committee in Cartagena (from left to right): Doctors Juan Pablo Yeager (Chile), Maria de los Angeles Minatel (Argentina), Maria Adelaida Cordoba (Colombia) with Dr. Tania Pastrana, IAHPC adviser. Photo used with permission.
IAHPC was deeply involved in the Latin American Palliative Care Association’s (ALCP) Congress in Cartagena, Colombia. We participated in several panels, led workshops, and staffed a membership table for new and renewing members.
Regional congresses such as this should be built around strategic goals of policy development and broader education. To this end, I was invited to lecture on “Fundamentos de Cabildeo Internacional, Regional, Nacional” (Fundamentals of International, Regional, and National Advocacy) for a continent-wide group of practitioners eager to learn how to advocate for broader implementation of palliative care services and improved availability of controlled medicines. I covered the theoretical and practical components of palliative care advocacy for those wishing to begin the journey.
Please reach out to me if you would like to arrange such a lecture, in either English or Spanish.
Palliative care ruled ‘part of the right to health’ in India
Switching continents, although staying south and on point, I lectured for a virtual Pallium India master class on “Relevance of International Advocacy” for the Global Fellowship in Palliative Medicine with Tripti Tandon, Esq., of the Lawyers Collective in Delhi. Just the day before, India’s High Court had ruled that palliative care falls under the right to health in the Indian Constitution, putting wind in everyone’s sails.
The court ordered “the Union of India” to “file a comprehensive response indicating the steps taken and the policies in force for administering palliative care to terminally ill patients."
In-person in Vienna at the CND
Virtual became real when I travelled to the 67th Commission on Narcotic Drugs (CND) in Vienna, which began with a High-Level Segment attended by ministers and ministerial level representatives of CND member states. The segment featured 11 high-level side events on each of the challenges identified in the 2019 Ministerial Declaration, one of which is improving availability of controlled medicines.
I was invited to represent civil society at the permanent mission of Belgium’s side event, “Improving Availability of Internationally Controlled Essential Medicines for Medical and Scientific Purposes.” You can view a pdf of my presentation, “Improving rational availability of medical opioids in ordinary and pandemic times.” You can also see a pdf of the online presentation by Professor Julia Downing (executive director, International Children’s Palliative Care Network) about the dismal global situation of availability of controlled medicines for children.
We are very grateful to Belgium for being the lead European country at CND on this issue, and for tabling a draft resolution for approval by CND67, co-sponsored by Côte d’Ivoire, on improving availability of controlled medicines worldwide, with special attention to children.
Pledge4Action gathers steam
On the political front, Belgium, Ghana, and the International Narcotics Control Board all took the Pedge4Action to improve availability of controlled medicines through funded programs, setting a great example for other CND member states. I was able to chat with some representatives of the African group, including at the launch of the East and Southern Africa Commission on Drugs, whose leaders expressed interest in learning more about the topic.
CND adds ‘harm reduction’ to approved language
Most of CND’s focus this year was on assessing progress (or lack thereof) in the global drug control system. The fact that the words “harm reduction” have finally been included in the agreed language marks an inflection point in CND history. The commission voted overwhelmingly to include them.
Other concerns discussed were digital drug markets, and the threat of nonmedical use of synthetic opioids.
More side events on medicines
IAHPC kicked off the regular session of CND the following week with our own side event on Monday morning, “Taking the Pledge4Action to Ensure Adequate Availability of Internationally Controlled Essential Medicines.” The event was co-sponsored by Belgium and six other NGOS in consultative status with the United Nations Economic and Social Council. You can watch a recording and read my report. You can also review a presentation on the model West African Drug law by lawyer Maria-Goretti Loglo.
IAHPC co-sponsored aside event on Friday, April 5, organized by the Union for International Cancer Control, on “Failure is Not an Option: Calling Upon the Global Community to Reignite Effective Collaborative Responses to the 2022 WHO-UN-INCB Joint Call to Action.”
During the plenary discussions, I gave IAHPC’s intervention on the floor when Item 5—implementation of the drug control conventions, access to essential medicines—came up for discussion. Many national delegation statements before mine had endorsed the need to improve availability and invest in their health workforces. Feel free to read and adapt our written submissions to the high-level and regular sessions for your own associations’ advocacy campaigns.
Finally, the CND adopted a resolution on controlled medicines presented by the European Union. The resolution, available in all UN languages, was originally proposed by Belgium and co-sponsored by Côte d’Ivoire. Watch an excellent short film on civil society advocacy for drug policy reform at CND here. I discuss the parallel opioid crises (under-and over-use) towards then end.
Advocacy Tip Use this resolution for advocacy with your government, which probably co-sponsored it, to improve availability in your country. In the next advocacy update, I will provide a finalized list of co-sponsors.
For more information on the global situation, read the newly released 2023 Report of the International Narcotics Control Board. Advocacy must be evidence-based, and this report provides you with the latest data on your country’s consumption and reporting, within global and regional contexts.
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