News 26 August 2015 UNGASS 2016: mobilisation for the development of an action plan on controlled medicines The UN General Assembly will hold a Special Session (UNGASS) on the World Drug Problem on 19-21 April 2016. A major opportunity to address the issue of limited availability of controlled medicines in much of the world. 5.5 million people in needless pain The World Health Organization (WHO) estimates that each year 5.5 million terminal cancer patients suffer moderate to severe pain that is not managed at all[1]. An absurd number considering that moderate to severe pain can be easily treated with inexpensive, safe and easy to administer opioid analgesics such as morphine. Yet as it currently stands, 92% of the world’s morphine is consumed by 17% of the world’s population, essentially in high-income countries,[2] while low- and middle-income countries, which account for 83% of the global population, consume only 8% of the medical morphine[3]. Global access to pain relief: a public health issue In recent years, the cancer and wider health community have been pressing governments to ensure that access to pain relief and palliative care is prioritised within the world health and development agenda, with efforts being rewarded by UN Member States finally passing a ground-breaking resolution on palliative care at the 2014 World Health Assembly. It is hoped that this resolution, ‘Strengthening of palliative care as a component of comprehensive care throughout the life course’, will help drive national action to reduce barriers to the accessibility and availability of palliative care. Yet despite great step, little progress has been made since, and access to pain medicines remains constrained by several well-known barriers including inadequate training of healthcare workers, misconceptions about pain and its treatment with morphine and other opioids, and overly restrictive laws and regulations. The UN Member States are also facing an important drug control related challenge: ensuring the availability of controlled substances for medical and scientific purposes while preventing their misuse and diversion. To date, however, few countries have achieved this objective. April 2016: time to put words into action UNGASS 2016 is therefore a major opportunity for palliative care advocates to ensure that the availability of controlled medicines gets the attention it needs and deserves and that the international community acts to resolve this longstanding problem that causes millions to experience unnecessary pain each year. Although UN bodies and agencies have repeatedly expressed concern about the limited availability of controlled medicines, a concerted, multi-sectorial response has yet to be implemented[4]. Progress on this issues requires a whole-of-UN response, as it involves regulatory and enforcement infrastructure, health system strengthening, including health worker training, and development-related measures. The international community has decided that the UNGASS will adopt a “short, substantive, concise and action-oriented document comprising a set of operational recommendations…including…ways to address long-standing and emerging challenges in countering the world drug problem[5]”. The Commission on Narcotic Drugs, which is leading the process, has asked countries to submit their priorities for this outcome document by 11th September 2015. The Union for International Cancer Control (UICC) as well as a number of undersigned organisations have therefore put forward their recommendations and call for the outcome document of the UNGASS to include the establishment of an action plan to address the limited availability of controlled medicines in much of the world: To achieve this, it is essential that as many countries as possible list the development of an action plan on controlled medicines as one of their priorities for the UNGASS. How can you help? The palliative care community is highly encouraged to brief government officials and key decision makers who are involved in preparations for the UNGASS. You can contact your health ministry, foreign ministry, drug control agency, interior/home ministry, justice ministry or other relevant authorities, to make sure that your country’s delegation includes the development of the action plan on controlled medicines as one of their priorities. To find out who to approach, you can access this list of delegations to the 2015 session of the Commission on Narcotic Drugs to help determine which ministries and officials from your country are likely to be involved in the UNGASS process. Useful resources and related links The official UNGASS website: http://www.unodc.org/ungass2016 Interactive Opioid Consumption Chart: https://ppsg.medicine.wisc.edu/chart Treat the Pain international program: http://www.treatthepain.org UN World Health Assembly resolution EB134.R7 http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf UICC Global Access to Pain Relief Initiative (GAPRI): http://uicc.org/sites/main/files/atoms/files/UICC_OnePager_GAPRI.pdf Factsheet on global access to pain relief: http://uicc.org/sites/main/files/private/131122_UICC-Palliative_Care_backgrounder_Nov2013_FINAL_SCREEN.pdf ESMO Global Opioid Policy Initiative: http://www.esmo.org/Policy/Global-Opioid-Policy-Initiative The International Drug Policy Consortium’s website: http://idpc.net/policy-advocacy/the-un-general-assembly-special-session-on-drugs-ungass-2016 WHO NCD Global Monitoring Framework: http://www.who.int/nmh/global_monitoring_framework/en/ WHO and INCB Guide on Estimating Requirements for Substances under International Control: https://www.incb.org/documents/Narcotic-Drugs/Guidelines/estimating_requirements/NAR_Guide_on_Estimating_EN_Ebook.pdf Excerpts from UN documents relevant to the UNGASS process: http://www.thewhpca.org/resources/item/excerpts-from-un-documents-relevant-to-the-ungass-process Recommendations and draft language for UNGASS 2016 Outcome Document on Controlled Medicines: http://www.thewhpca.org/resources/item/recommendations-and-draft-language-for-ungass-2016-outcome-document-on-controlled-medicines African Palliative Care Association: http://www.africanpalliativecare.org Asia-Pacific Hospice and Palliative Care Network: http://aphn.org European Association for Palliative Care: http://www.eapcnet.eu Hospice and Palliative Care Association of South Africa: http://www.hpca.co.za Human Rights Watch: https://www.hrw.org International Association for Hospice and Palliative Care: http://hospicecare.com International Association for the Study of Pain: http://www.iasp-pain.org International Children’s Palliative Care Network: http://www.icpcn.org Kenya Hospice and Palliative Care Association: http://kehpca.org Latin American Association for Palliative Care: http://cuidadospaliativos.org Non-Communicable Diseases Alliance: http://www.ncdalliance.org Pain and Policy Studies Group: http://www.painpolicy.wisc.edu Pallium India: http://palliumindia.org Worldwide Hospice Palliative Care Alliance: http://www.thewhpca.org [1] World Health Organisation, Ensuring balance in national policies on controlled substances, Guidance for availability and accessibility of controlled medicines, (2011), p3; available at http://www.who.int/medicines/areas/quality_safety/GLs_Ens_Balance_NOCP_Col_EN_sanend.pdf [2] International Narcotics Control Board (INCB), Report 2014, (2014), p3; available at https://www.incb.org/documents/Publications/AnnualReports/AR2014/English/AR_2014.pdf [3] United Nations Office on Drugs and Crime, World Drug Report 2014, p 30 available at http://www.unodc.org/documents/wdr2014/World_Drug_Report_2014_web.pdf [4] These include the CND, ECOSOC, INCB, UNODC, WHO and the World Health Assembly. [5] United Nations Office on Drugs and Crime, Resolution 58/8, (2015) available at http://www.unodc.org/documents/commissions/CND/CND_Sessions/CND_58/2015_Resolutions/Resolution_58_8.pdf Tags UNGASS UN General Assembly Special Session Palliative Care morphine Opioids Last update Friday 07 June 2019 Share this page