Intervention on the floor of the Commission on Narcotic Drugs Reconvened Session Dec. 5 2014

IMG_4777Civil Society Intervention December 2
ECOSOC Organisation: International Drug Policy Consortium (IDPC Consortium)
Speaker: Dr. Katherine Irene Pettus, PhD

Thank you for giving me the floor Mr. Chairman, esteemed delegates. My intervention on behalf of International Drug Policy Consortium will be in two sections, procedural and substantive, although I believe as the Uruguay representative said yesterday that the procedural is substantive.

I thank the Chair and Secretariat for facilitating civil society involvement in the UNGASS (United Nations General Assembly Special Session on Drugs 2016) process and welcome the many statements from member states on the importance of civil society participation in that process and in the associated preparations.

Since meaningful engagement will not be achieved if debates and preparatory workshops remain structured according to CND rules, we need to find different ways of structuring debates so engagement is interactive and substantive.

IDPC is clearly calling for an open UNGASS, inclusive of all voices, accepting all perspectives, and not pre-judging outcomes. We look forward to promoting this through upcoming procedures.

Now for the substantive part: My organisation is advocating for the people — most of whom live in your countries — more than 83% of the world — who have no access to pain medicine stronger than aspirin, for late stage cancer, AIDS, surgery, and other treatable suffering.

Medicines such as morphine are controlled under the conventions because your countries fear it will be misused and diverted into the illegal market. We now know, sixty years after the Single Convention was drafted, that the illegal market is already supplied from multiple other sources. It doesn’t need controlled medicines to function properly! The only people who get hurt from the laws that restrict medicines are patients themselves.

CND can greatly improve this situation by speaking publicly, with one passionate voice, on the convention priority to ensure access to opioids to treat pain and suffering from war wounds, cancer, AIDS, surgery, etc.. By supporting this priority and insisting that the 5.5 billion people who live in countries with no access are guaranteed not to suffer unnecessarily, you will restore some of the credibility the conventions have lost in recent years.

Promoting increased access to controlled medicines for the treatment of pain within the framework of the conventions supports the sovereignty and territorial integrity of States, the principle of non-intervention, the human right to the highest attainable standard of health, the fundamental freedom to earn a living and be with family, and the inherent dignity of all individuals. Other UN agencies such as the World Health Organisation, and treaty bodies such as the Human Rights Council, are standing by to work with you to make this happen.

People often bring up religion as a reason not to use opioids to relieve pain and suffering, in the mistaken belief that excruciating pain elevates the soul. As a person of faith and as someone who has studied theology, I can tell you that all the major world religions support the medical use of opioids to alleviate preventable suffering, and in fact say that it is a physician’s religious duty to do so. Indeed, early physicians called morphine “a gift from God”. Excruciating pain prevents people from praying at the end of life and spending quality time with their families. Pain relief allows them to do all these things and more.

The upcoming United Nations General Assembly Special Session on Drugs in 2016 is a tremendous opportunity for the CND to fix this unintended consequence of over-interpreting the enforcement provisions of the conventions at the expense of the Single Convention’s intention that member states ensure the availability of opioid medications to relieve pain and suffering.

This must be a priority agenda item of UNGASS, not a subheading under demand reduction.
Countries where consumption of opioids is low to inadequate according to INCB need to increase demand and supply of controlled opioid medicines at least six-fold according, to the data member states were given at the working group meeting. Clearly this mandate does not fit under demand or supply reduction. CND needs to schedule a stand-alone UNGASS preparatory workshop on increasing access to medicines as a way to promote a core aim of the Conventions. Of course, it is difficult to add a fifth workshop to the CND 2015, so an alternative could be scheduling it for later in 2015 attached to one of the intersessionals.

Under the principle of mutual and shared responsibility, CND can urge member states with developed healthcare systems and adequate access to provide educational, technical, and legal support to countries with inadequate access. This is not an expensive proposition. It requires very few resources, and I know that you already have the solidarity and political will to make it work.
Morphine is what the WHO calls an essential medicine — which means it must be available, affordable, and accessible in every UN member state. It is cheap to produce, less than $I a day for treatment, and is not patented.

According to WHO, and physicians since ancient times, morphine is the “gold standard of pain control”. Member states that grow poppy can manufacture it under regulated conditions — India, Turkey, Hungary, Slovakia, among others are traditional producers for medical use that can show the way.

I beg you, on behalf of the millions of vulnerable patients and their families around the world that my organisation represents, to use your voice as the pre-eminent UN agency on the world drug problem to make OUR drug problem, which is lack of access to controlled medicines for the relief of pain and suffering, YOUR priority.


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I am a political theorist, oblate in the Order of St.Benedict, and advocate for universal rational access to essential controlled medicines for pain and palliative care in the lower and middle income countries. I work a lot in Vienna at the Commission on Narcotic Drugs, and in Geneva at the World Health Organisation, and the Human Rights Council representing the International Association for Hospice and Palliative Care.

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