Unnecessary pain and suffering for many people

1. Availability of internationally controlled drugs: Ensuring adequate access for medical and scientific purposesCND IntersessionalVienna, Austria4 September 2014Stefano Berterame, ChiefNarcotics Control and Estimates SectionSecretariat of the International Narcotics Control Board

2. Unnecessary pain and suffering for many people • 5.5 million terminal cancer patients • 1 million end-stage HIV/AIDS patients; • 0.8 million patients suffering injuries caused by accidents and violence; • Women in labour (110 million births each year) • Patients with chronic illnesses; recovering from surgery; • WHO estimates that the number of people affected “are the same in magnitude as those afflicted by conditions that are recognized as major contributors to the world’s burden of disease; in particular HIV, malaria and tuberculosis “

3. Main goals of the Conventions

4. Availability for medical purposes • 1961 Convention • Preambular paragraph: “recognizing that the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering”. • Article 9, paragraph 4, 1961 Convention, as amended by the 1972 Protocol . • INCB mandate: “ensuring their availability for such purposes”. • 1971 Convention: • Use of psychotropic substances is indispensable. • Availability for such purposes should not be unduly restricted.

5. Preventing diversion and abuse • 1961 Convention • Preambular paragraph: “Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to manking”. • 1971 Convention: • Preambular paragraph “Noting with concent the public health and social problems resulting from the abuse of certain psychotropic substances” … “Considerng that rigorous measures are necessary to restrict the use of such substances to legitimate purposes”

6. Obstacles to availability

7. Stocks of opiate raw materialsfor the extraction of morphine Tons Tons

8. Supply (stocks + production) ofand demand for opiate raw materials expressed in morphine equivalent

9. Stocks of opiate raw materialsfor the extraction of thebaine Tons Tons

10. Supply (stocks + production) of and demand for opiate raw materialsexpressed in thebaine equivalent

11. Availability of opioids for pain management2000-2002 avg – 2010-2012 avg

12. Availability of opioids for pain management2010-2012 avg

13. Average consumption of benzodiazepines (anxiolytics)1997-1999 and 2007-2009

14. Average consumption of central nervous systemstimulants in Schedule IV, 1997-1999 and 2007-2009

15. Recommendations contained in the 2010 report on Availability

16. Availability of Narcotic Drugs and Psychotropic substances • Correct assessment of the needs; • Geographical distribution of the drugs; • Affordability (coverage by the health system) • Identification of obstacles in various areas (legislation, undue restrictions, etc.); • Information and monitoring.

17. Appropriate use • Training and education of health professionals; • Appropriate prescription practices; • Education of the public on safe use; • Registration system to prevent (doctors shopping, over prescription, etc.); • Encourage the use of better and safer therapeutic agents.

18. National control system • Control and supervision of supply and consumption of internationally controlled drugs; • Improve regulatory system on manufacture, export, import and distribution; • Combat counterfeit drugs;

19. Prevention of diversion and abuse • Measures against illicit manufacture and diversion narcotic drugs and psychotropic substances; • Improvement of information systems and data collection; • Increase regional and inter-regional cooperation.

20. New Report on Availability in 2016 • At its 108th session, in November 2013 the Board decided to prepare a special report to be published in 2016 as a supplement to INCB annual report for 2015. • Focus on the implementation by Governments recommendations contained in the report published in 2010.

21. THANK YOU FOR YOUR ATTENTION ! INCB Secretariat