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Text of CSTF Representative Intervention June 12 CND Intersessional

Thank you Chair for giving me the floor. I am the Civil Society Task Force Representative for
Affected Populations living in countries with no or low access to internationally controlled essential
medicines such as morphine and methadone for palliative care and opioid assisted treatment.
With regard to preparations for UNGASS 2016, Resolution 58/8 para 5. requests the Commission
on Narcotic Drugs to produce a short, substantive, concise and action-oriented document
comprising a set of operational recommendations, based upon a review of the implementation of
the Political Declaration and Plan of Action
The regional and national associations of populations affected populations with low or no access to
internationally controlled essential medicines in more than 80% of the world are working hard, with
limited resources, to address this urgent issue. As a start, to prepare for UNGASS, we propose the
following two operational recommendations
1) that CND recognise inadequate reference to the problem of lack of access in the Political
Declaration and Plan of Action; there was one short sentence on this topic.
2) that CND develop a concrete action plan on ensuring the adequate availability of controlled
medicines for the relief of pain and suffering.
A global working committee led by the most affected member states that are already taking
steps to improve the situation on the ground would develop this action plan. Partners would
include states that have expressed concern about the issue at CND, and are providing, or are
interested in providing, funding and technical assistance to support efforts on the ground.
WHO as well as the global, regional, and national palliative care associations striving to
improve access to medicines, would provide technical advice. Currently, although WHO as yet
has no dedicated funding, from any member state, to improve access to internationally
controlled essential medicines, it has staff in many affected countries.
WHO is also in a position to contribute technical resources and guidelines.
We envision one recommendation of this global working group will be the training of healthcare
providers and narcotics police in order to bridge the knowledge gap resulting from decades of
dependence on a supply control model, and over-regulation and suppression of access to opioid
pain relievers in many countries.
A further priority would be to collaborate with national and regional palliative care associations to
determine the appropriate and attainable indicators and targets to be included in the actionoriented report to be presented at UNGASS 2016.
Suggested affected member states to lead the global working group would be incoming CND
members Kenya and Uganda, as well as current members, Benin, Tanzania, and Nigeria in the
African Region. Ministries of Health, working with regional and national associations in these

countries, are pulling out all the stops, have already begun to draft new laws and regulations,
streamline procurement, and train frontline personnel in palliative care coverage. Despite the fact,
however, that morphine consumption in those African countries has doubled in the past year, both
Kenya and Uganda still have less than 10% palliative care coverage, citing the urgent need for
training, mostly of doctors, nurses, and pharmacists.
The Common African Position for UNGASS has already called for greater support to ensure the
provision of opiates and other essential and controlled medicines for palliative care and pain relief,
as enshrined in the international drug conventions, to remove barriers that prevent the import,
distribution and use of these essential medicines. The proposed action plan will generate that
practical support by laying out the precise parameters of the problem in each region and proposing
specific targets and indicators appropriate for each context.
Partners in the Asian region such as India and Malaysia, and in Latin America, are also working
hard to solve this problem that has such a drastic impact on all their citizens. The governments of
Colombia, Bolivia, Argentina, Panama, Peru, and Mexico, to name only a few, are supporting
regulatory and legislative changes to improve opioid consumption.
All the affected states need a lot more support under the principle of mutual and shared
responsibility, however, to to bring consumption levels up to WHO approved standards. The
governments of the US, UK, Ireland, Italy and Denmark, and Australia are already providing
funding for the efforts of national associations and ministries of health in many countries where
consumption is less than optimal. The colleagues in this assembly from Switzerland, Norway,
Lithuania, and the EU collectively have all expressed concern, and would be welcome partners on
the global pre-UNGASS working group.
Speaking as a member of the Civil Society Task Force, I hope that the Board and CND will
consider carefully this suggestion to develop a concrete action plan to improve access, availability,
and affordability of internationally controlled essential medicines for the relief of pain and suffering
as mandated by the preamble of the Single Convention.