La Commission globale de politique en matière de drogues a lancé son 3e rapport le 19 octobre dernier lors de la conférence internationale sur la réduction des méfaits à Kuala Lumpur. Ce dernier porte sur l’accès aux médicaments sous contrôle international, comme les analgésiques opiacés.
La Commission propose 10 recommandations dans ce rapport (source : Le rapport, p. 6-7) :
- States and UN bodies must utilize the United Nations General Assembly Special Session (UNGASS) on drugs in 2016, to both acknowledge and begin to forcefully address the major gap in access to controlled medicines, particularly opioids for pain relief. More than 75 percent of the world’s population has little or no access to such medicines, leading to the avoidable pain and suffering of millions. There must be an admission that the international drug control system represents a barrier to accessing controlled medicines.
- States must recognize they have an obligation under international law to ensure access to controlled medicines for their populations. This obligation is implied in the cornerstone treaty of the international drug control system, the Single Convention on Narcotic Drugs, and is firmly rooted in the right to the highest attainable standard of health in international human rights law.
- UN drug control bodies and States must recognize that drug policies at both national and international levels are imbalanced, with emphasis on preventing diversion of controlled substances holding primacy over ensuring their access for medical use. This has profound implications for public health and human rights around the world.
- A high priority must be given to the treatment of physical and mental pain by ensuring access to controlled medicines, including opiates, for pain relief, palliative care, anesthesia, dependency, and all other forms of suffering. While States have the obligation to ensure the production and/or import of sufficient quantities of such medicines—especially those that are on WHO’s Model List of Essential Medicines—WHO, UNODC, and INCB must provide governments with the necessary technical and financial support.
- Governments should provide the necessary funding for a renewed international program to be overseen by WHO, in partnership with UNODC and the INCB, to ensure adequate and affordable access to controlled medicines where they are unavailable.
- Priority must be given to expanding the spectrum of treatment for opioid dependence, while respecting human dignity and offering the possibility of prescription of controlled medicines such as methadone and buprenorphine (included in WHO’s Model List of Essential Medicines) or diamorphine. This can be done in line with the WHO-UNODC-UNAIDS Technical Guide: for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. States and the relevant UN bodies must work together to address the failure of many countries to adequately implement opioid substitution therapy (OST) for opioid-dependent people.
- Governments should establish clear plans to remove the barriers to ensuring access to controlled medicines, including: national drug policies anchored in a criminal justice approach, rather than a public health and human rights approach; burdensome domestic regulatory frameworks; stigmatized societal attitudes driving a fear of prescribing opioids for pain relief and the treatment of opioid dependence; poor knowledge of these medicines by health professionals and regulators; and overpricing.
- The INCB must take more assertive steps in working with countries that consistently fail to ensure adequate access to controlled medicines, and should work increasingly with governments and national health authorities to ensure they provide evidence-based estimates of the need for controlled medicines.
- Governments and UN drug control bodies should acknowledge and address the gaps and lost opportunities in relation to the medical use of, and medical research into, controlled substances, including cannabis. They should review the 1961 and 1971 drug conventions’ schedules in light of scientific evidence and prioritize exploring the medical benefits of controlled substances, based on WHO’s Expert Committee on Drug Dependence recommendations.
- The United Nations and the international community must urgently address inadequate access to controlled medicines as a global health priority. Demand for these medicines is driven not by political expediencies, but by the universal human susceptibility to illness and pain. It is not acceptable to wait for a consensus from States on broader drug policy reform. It is time for action.
Pour en savoir plus, consultez le rapport en ligne sur le site de la Commission globale de politique en matière de drogues (en anglais, 26 pages)