Ambassador D’Hoop, Chair of the 65th session of the Commission on Narcotic Drugs,
Dear Director General, Dear President,
Distinguished Speakers and Participants,
Excellencies, Dear colleagues,
It is my pleasure to join you today at this special event, to raise awareness on the pressing need to make controlled medicines more available and accessible, as part of the initiative launched this year by the Chair of the CND.
Medicines containing controlled substances are not luxuries.
They are vital to relieve pain for people suffering from serious illnesses.
They have important uses in surgical procedures that can save and preserve lives.
And they are essential in the treatment of drug-use disorders, mental health issues, and neurological conditions.
Many of these medicines are part of the list of essential medicines of the World Health Organization.
And yet more than 80 per cent of people around the world, mostly in low and middle-income countries, do not have access to such controlled medicines.
The international drug control system was established first and foremost to protect and promote people’s health and well-being.
It is meant to safeguard people from the harms of drug abuse, just as it is meant to protect them from the harms that can befall them when they have no access to important medication.
Ensuring that controlled medicines can be accessed by those who need them is very much within the letter, spirit, and purpose of the international drug control system, and its three conventions.
The initiative of the CND Chair presents us with a valuable opportunity to make progress on this often neglected element of international drug policy commitments.
Today’s meeting underlines the scope of this opportunity, with many key players on drug-related issues bringing their mandates and expertise together, to call for improved access to controlled substances with one voice.
It also comes at exactly the right time.
The COVID-19 pandemic has left controlled medicines even further out of reach for many people, even as needs become more dire during emergency responses, and inequalities around the world grow.
Since the beginning of the pandemic, the World Health Organization has identified over 20 medicines with global-level shortages.
Four of them contain controlled substances, and are used in intensive care units for the treatment of severe cases of COVID-19.
Such shortages, as always, impact low- and middle-income countries disproportionately.
The overarching theme of the Chair’s initiative has been to “leave no patient behind”.
It is a sentiment that we all share in principle, but in practice, significant challenges remain.
Throughout the year so far, together with our partners at WHO and INCB, we have used this initiative as a platform to highlight the discrepancy between those who enjoy access to controlled medicines and those who do not.
At various events, we underlined the fact that availability for consumption remains inadequate in most countries in Africa, in Asia, in Central and South America, in the Caribbean, and in Eastern Europe.
Data from 2018 revealed that 86 per cent of morphine used for pain management was concentrated in a few countries, mainly in Europe and North America.
Data from 2019 showed the daily availability of thirty-two thousand standard doses of controlled pain medication for every one million inhabitants in North America, compared with four doses in West and Central Africa.
Those facts should no longer be acceptable. Progress has become a necessity.
It is time to devote our full attention to the urgent action that needs to be taken.
We need frameworks and regulations that facilitate access around the world and across borders, including in emergency situations, pandemics, and climate-related disasters.
Establishing appropriate regulations is often a complex process, particularly in countries that lack the needed regulatory frameworks, and so it is essential to build capacities and provide technical assistance to those countries.
We also need attitudes that match such regulations, understanding and accepting the importance of controlled medicines without undue reservations.
And we need the necessary resources to be invested into ensuring accessibility, and into training healthcare professionals and strengthening their awareness and understanding of the issue, as well as their capacity to prescribe rationally and safely.
Securing supply chains for controlled medicines is also key.
Cooperation between competent national authorities, manufacturers, suppliers and distributors is at the heart of establishing the necessary supply chains for internationally controlled medicines.
Preserving and promoting the rule of law helps protect those supply chains, including by adopting serious anti-corruption measures, as corruption can drain resources, hamper access, and undermine the healthcare sector at large.
The UN Office on Drugs and Crime is a strong advocate for ensuring access to controlled medicines at the global level.
In partnership with WHO and INCB, we engage with Member States to convey the message that it is both possible and necessary to provide patients with controlled medicines, in a manner that is efficient and safe for themselves and their communities.
Our Office also works with health authorities, drug control authorities, regulatory bodies, and representatives of health workers, patients and families, as well as civil society, to address the bottlenecks that might make access difficult, be they legislation and policy, problems in the supply chain, capacity of health workers, or awareness in the general public.
Through our Joint Global Programme on access to controlled substances for medical purposes, which we implement with WHO and the Union for International Cancer Control, we are working to promote patient-centred approaches.
To date, the Programme’s work has benefitted 20 countries in Africa and Latin America, as well as Central and Southeast Asia, expanding palliative care networks, supporting the development of national policy, and improving education curricula for healthcare providers.
UNODC stands proudly with the Chair of the CND, and with all of our partners, to promote health and equality, with our words and with our actions.
I look forward to the One-Day Special Forum that will take place on 10 October to conclude the Chair’s initiative, and will bring together experts to discuss practical steps to take this momentum forward.
Ladies and Gentlemen,
We have a collective obligation to uphold the international drug control system.
Within that obligation, there is a responsibility to prioritize the health and wellbeing of people, particularly those who need it most, and particularly when the help they need is in fact available, feasible, and permitted by our international system.
Let us break down the barriers that are denying equal access to controlled medicines, to make sure that nobody has to suffer needlessly.