Ghada Waly

Director-General/Executive Director

Joint Call on Scaling up Implementation of International Drug Policy Commitments on Ensuring Availability of and Access to Controlled Substances for Medical and Scientific Purposes  

  14 March 2022

Dear Ambassador Ghislain D’Hoop, Chair of the 65th Session of the Commissionon Narcotic Drugs, 

Dear Dr. Tedros,

Dear Madame president of INCB, 

Distinguished delegates,  

Dear colleagues,  

I am pleased to be with you today to join this timely call to action on access to controlled medicines. 

Let me first of all acknowledge His Excellency Ambassador D’Hoop for his leadership and initiative in bringing us together to shed light on this very important topic 

I also want to thank the World Health Organization, and the INCB, for joining this call.  

Access to controlled substances for medical and scientific purposes is a cornerstone of the three drug control conventions, and has been consistently underlined as a priority during the CND’s work.  

But it remains an unrealized goal in many parts of the world, at a time when emergencies are making it both more urgent and more difficult to achieve. 

Practices need to be changed, regulations amended, and resources allocated. 

This 65th Session of the CND is an opportunity to call the international community to action.  

Despite a global increase in the availability of opioid analgesics overall, disparities in such access remains evident, with availability for consumption concentrated in high-income countries. 

Data from 2018 revealed that out of 170 countries surveyed, just 20 countries had enough opioid analgesics available for consumption to cover their pain treatment needs.  

Morphine, for example, was more widely available in two continents than in the rest of the world combined. 86 percent of the morphine used for pain management was concentrated in a small number of countries located mainly in Europe and North America. The rest of the world’s population. 

Overall, availability for consumption of controlled medicines remains inadequate in most countries in Africa, in Asia, in Central and South America, in the Caribbean, and in Eastern Europe.  

In practice, this means that the majority of the world’s population does not enjoy adequate availability. 

A particularly stark comparison from UNODC’s World Drug Report reveals that in 2019, thirty-two thousand standard doses of controlled pain medication were available every day for every one million inhabitants in North America, compared with just four doses in West and Central Africa. 

Behind these statistics there are people who suffer, whose quality of life is greatly diminished because they cannot access things such as anesthesia and palliative care associated with cancer 

Internationally controlled medicines classified as essential by WHO are also vital for surgical care, as well as for the treatment of drug-use disorders, mental health, and neurological conditions. 

Since 2013, the UN Office on Drugs and Crime has been working together with WHO and the Union for International Cancer Control to facilitate access to such medicines 

We remain in need of much greater resources, but we have been able to achieve significant impact with what we have 

Under the joint programme, UNODC has expanded the palliative care network in Panama, developed multiple national policies in Nigeria, strengthened the regulatory system in Timor-Leste, and built a national education curriculum for healthcare providers in the Democratic Republic of Congo. 

Today, I am proud to announce that UNODC is about to embark, together with Australia, on a new journey of cooperation with Fiji, Indonesia, and Timor Leste in addressing the barriers to access in those countries.  

We will be working to bring down barriers in the regulatory system, among health workers ,and in the supply chain.  

Ladies and gentlemen, 

Last year, UNODC joined with WHO and INCB to warn that access to controlled medicines, particularly in emergency settings, was being further curtailed due to climate disasters as well the pandemic and its associated restrictions. 

Now, the state of the world has only become more complicated, with conflict igniting in Europe and growing in other parts of the globe, from Africa to Asia.  

Through our collective efforts since 2013, we have succeeded in raising awareness and taking positive steps on the groundbut the obstacles to equal access remain immense, and global crises are only adding to them 

I once again call on all Member States to take every available measure to facilitate access to medicines containing controlled substances, including by making control measures and solutions as flexible as feasible. 

For our part, UNODC will continue to work with WHO, INCB, and of course our Member States, to provide all the support we can. 

I urge you all to take this session of the Commission as a launching point to expand international cooperation on access to controlled medicines, so that no patient is left behind.

Thank you.