For information only - not an official document
3 February 2016
INCB calls on countries to ensure worldwide medical access to narcotic drugs and psychotropic substances
VIENNA, 3 February (UN Information Service) - Enough pain relief substances and raw materials are produced to fully cover global demand, yet three out of four people in the world have only limited or no access to pain relief. This is due to various obstacles such as the lack of training and awareness of health care professionals, fear of drug dependence and limited financial resources, according to the Availability Report of the International Narcotics Control Board (INCB) that was published in Vienna today.
In its Report, the Board publishes the findings of a study on the availability of narcotic drugs and psychotropic substances under international control based on global consumption data and information on impediments and barriers at country level. The Availability Report is a supplement to the 2015 INCB Annual Report, which is due to be published on 2 March 2016.
Around 92 per cent of morphine used worldwide is consumed by only 17 per cent of the world population
Just one day ahead of World Cancer Day, the Board highlights that pain relief medications like morphine are indispensable for the treatment of pain caused by cancer, HIV/AIDS, heart disease, diabetes or surgery, among other conditions, as well as childbirth. Despite UN Conventions stipulating that certain essential pain-relief medicines must be made available, 5.5 billion people (75 per cent of the world population) still have limited or no access to essential painkillers, such as codeine or morphine.
What is more, around 92 per cent of morphine used worldwide is consumed by only 17 per cent of the world population - primarily in the United States, Canada, Western Europe, Australia and New Zealand, where consumption has increased significantly since the early 1990s and where there is growing concern about prescription drug abuse.
Ahead of the Special Session of the UN General Assembly on the World Drug Problem (UNGASS), which will take place in New York in April 2016, INCB emphasizes that inadequate access contradicts the notion of article 25 of the Universal Declaration of Human Rights, including the right to medical care, which also encompasses palliative care.
The Report states that the international community made a solemn commitment with the Single Convention on Narcotic Drugs of 1961 and the Convention on Psychotropic Substances of 1971 to make adequate provision to ensure, and not to unduly restrict, the availability of drugs that were considered indispensable for medical and scientific purposes.
Ensuring adequate access to psychotropic substances
Psychotropic substances such as sedatives, hypnotics, anxiolytics, stimulants and antiepileptics are essential for the treatment of several mental health conditions including anxiety, insomnia, epilepsy and attention deficit and hyperactivity disorder (ADHD). However, more than 75 per cent of the population in many low and middle-income countries have no access to such treatment.
INCB remains alert about the disparities for consumption of psychotropic medicines, as levels of their use vary greatly between regions and among countries. Excessive availability of psychotropic substances, as a result of unregulated supply and inappropriate or non-medical use of controlled drugs, is as much of a concern to the Board as inadequate supply.
Barriers and impediments to availability
Compared to the last survey by the Board in 2010 on narcotic drugs, the obstacles to availability of pain relief medications cited by responding countries have shifted in emphasis. In 2015, countries saw the lack of training and awareness among health professionals as the major obstacle to availability of opioid analgesics. The same was true for psychotropic substances.
In the case of opioid analgesics, fear of drug dependence was the second most important reason for a lack of availability, whereas problems in sourcing from industry was seen as the second largest obstacle to availability of psychotropic medicines.
Fear of drug dependence is related to lack of awareness and training, but also to cultural attitudes, whereas lack of sourcing can be the result of pharmaceutical companies not being interested in producing certain medicines because of insufficient market demand in the country. Imports, on the other hand, can often be hindered due to burdensome regulations, causing delays in the supply chain.
INCB therefore calls on countries to close the global pain divide and ensure worldwide access to pain relief medications and to ensure balanced availability of psychotropic substances.
The Board recommends that countries review their laws and regulations to ensure they are not overly restrictive, and improve access by, for example, allowing a larger base of health care professionals to prescribe, in particular, substances under international control. Better training and increased awareness for health care professionals can reduce fears, stigmas and prejudices hindering access to pain relief medications and psychotropic substances.
A study based on the Availability Report was published by The Lancet and is available online.
More information is available at http://www.unis.unvienna.org/unis/en/events/2016/incb_2016.html
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