Improving Access to Internationally Controlled Essential Medicines in the Post-UNGASS, Agenda 2030 Framework

Abstract

This chapter discusses the genealogy and development of the ‘access abyss in palliative care and pain relief’ affecting 80 per cent of the world’s people. It argues that the larger context is an epistemic abyss constituted by incomplete information about the need for controlled medicines for pain relief, and that decades of drug policy based on supply control have prevented development of the necessary knowledge base in many countries. Transnational civil society organisations are working to map and bridge this abyss through education, advocacy and action. Deeper (original) systemic and tensions in the original multilateral drug control narrative produced the current epistemic/clinical abysses and now provide space for more participatory civil society involvement. Where the earlier narrative focussed on a fear-based drive to discipline and punish non-medical use of controlled substances, the evolving (and still contested) ‘world drug problem’ narrative foregrounds person centred, human rights based, public health approaches to drug policy that explicitly support improved access to internationally controlled essential medicines. Recommended policies can only be operationalised through a concerted ‘all hands on deck’ effort guided by the international law principle of ‘mutual and shared responsibility’ for improving access within the context of the 2030 Agenda for Sustainable Development. This calls for enhanced communication, concerted advocacy, collaboration and pluralist praxis to fill the often gaping abyss between ‘black letter law’ — what is actually written in the drug control conventions — and how member states learn to interpret and operationalise it.

Citation

Pettus, K.I. (2018), "Improving Access to Internationally Controlled Essential Medicines in the Post-UNGASS, Agenda 2030 Framework", Klein, A. and Stothard, B. (Ed.) Collapse of the Global Order on Drugs: From UNGASS 2016 to Review 2019, Emerald Publishing Limited, Leeds, pp. 85-100. https://doi.org/10.1108/978-1-78756-487-920181004