Pain relief on the agenda

Access to opioids for the treatment of cancer pain under the spotlight at the UN Commision of Narcotic Drugs.

The UN’s Commission on Narcotic Drugs held its annual session in Vienna from 11-15 March. UICC was represented by its CEO, Mr Cary Adams, Jonathan Liberman, Director of the McCabe Centre for Law and Cancer, and Dr Jim Cleary and Dr Martha Maurer of the WHO Collaborating Centre, the Pain & Policy Studies Group.

For the fourth consecutive year, starting with the landmark CND resolution of 201, the need to improve the global availability of opioid analgesics was on the Commission’s agenda. 

Dr Gilberto Gerra, Head of the UN Office on Drugs and Crime’s Drug Prevention and Health Branch, and Jonathan Liberman presented to the plenary on proposed revisions to UNODC’s model laws on drug control and availability, designed to ensure the model laws reflect a better balance between ensuring availability and preventing diversion and abuse. The revisions were distributed as a Conference room paper and will be available on UNODC’s website soon. Jonathan had been engaged by UNODC to work on the review and revision of the model laws, work requested of UNODC by a 2011 CND resolution led by the Government of Australia.

In presenting its new Annual Report, the President of the International Narcotics Control Board, Professor Raymond Yans, also underlined the importance of continuing to make progress on availability of controlled drugs for medical use. UICC was pleased that the INCB welcomed our plans for a new joint initiative with UNODC and WHO in its Annual Report: Click here to read the report.

UNODC, WHO and the Union for International Cancer Control have developed plans for a joint initiative to enhance access to internationally controlled drugs for the relief of pain while preventing diversion and abuse. The aim of the initiative is to coordinate activities at the international level and to contribute to in-country progress, beginning with three pilot countries in different regions, with the intention of scaling up the initiative in the years ahead. The initiative will cover various areas of activity, including data collection; regulatory revision and reform; training on estimates and statistics for narcotic drugs; awareness-raising and public education; procurement and distribution; community-based health care; and standards of care in health-care facilities. The objective is to contribute to the implementation of Commission on Narcotic Drugs resolutions 53/4 and 54/6 and the recommendations contained in the 2010 Report of the International Narcotics Control Board on the Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes. The Board welcomes the initiative and invites Governments to support it.

Kees de Joncheere, Director of WHO’s Department of Essential Medicines and Health Products, reaffirmed WHO’s commitment to promote access to essential medicines, which has been conveyed to CND and to the UN Secretary-General by WHO’s Director-General.  He explained that WHO provides technical assistance to countries to improve their policies for medical access without causing increased non-medical use through its Access to Controlled Medicines Programme, and looks forward to collaborating further with other UN agencies, member states and other partners.

Jim Cleary made a statement in plenary on behalf of UICC and our partner NGO, Human Rights Watch, noting that access to controlled substances for medical purposes continues to be a major problem for millions of patients with severe pain and other conditions around the world, and our encouragement by the level of attention in recent years from CND, INCB, UNODC and member states. Jim drew CND’s attention to the inclusion of access to palliative care in the 2011 UN Political Declaration on the Prevention and Control of Non-Communicable Disease and in the associated Global Monitoring Framework, the agreement by WHO member states that consumption of opioid analgesics will be used to measure countries' progress in making palliative care available, and the inclusion of palliative care on the agenda of the WHO’s 2014 Executive Board meeting. He noted the significant progress in improving access that has been made in various countries, including India, Kenya, Panama and Ukraine.

UICC also co-sponsored a successful side event, ‘Access to internationally controlled drugs for medical purposes – meeting a global challenge’ with the Government of Australia, UNODC and the International Atomic Energy Agency (we have pictures). The event, which was well-attended, was hosted and chaired by Australia’s Ambassador in Vienna, David Stuart, and included presentations by:

  • Ambassador Stuart on the commitment of the Australian Government to continuing to make progress globally
  • Cary Adams on UICC’s commitment to enhance global access to pain relief and palliative care through our GAPRI programme
  • Dr Navchaa Gombodorj, Deputy Director in Charge of Medical Services of the  National Cancer Center of Mongolia, on progress made recently in Mongolia through IAEA’s PACT Programme  http://cancer.iaea.org/newsstory.asp?id=126
  • Dr Jim Cleary on the findings of the European Society of Medical Oncology international study of barriers to the availability and accessibility of opioids for the management of cancer pain
    See video

  • Professor Guido Fanelli , Chief of the Italian Minister of Health and Welfare’s Pain and Palliative Care Committee, on major changes made to Italian law to remove barriers to treatment of pain and to put patients’ needs at the centre of the system
  • Dr Gilberto Gerra on UNODC’s commitment to work with UICC, WHO and other partners to enhance the availability of opioids for medical purposes

As you can see, it was another good CND session for UICC and our partners.

Our thanks in particular to the Australian Government for its continued leadership on these issues and to Gilberto Gerra and his team at UNODC for our ongoing collaboration.