Changing perceptions around controlled drugs for the benefit of patients

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Published: 21 Apr 2015
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Diederik Lohman - Human Rights Watch, New York, USA

Diederik Lohman, Associate Director of the Health and Human Rights Division at Human Rights Watch, talks to ecancer at IAPCON 2015 about the importance of access to medicines. One of Diederik Lohman's roles is to ensure that past drug regulations are reviewed and amended so that it doesn't interfere with the availability of drugs for medical use such as morphine.

Diedrik also discusses the challenge of procuring medications within India. The efforts of him and his team to change attitudes towards drug regulations resulted in significant changes to the Drug Act where now medications can be accessed more quickly and easily for the patient.

The work around access to medicines and particularly morphine, just as the World Health Assembly is in a meeting of health ministers.

There’s also an annual meeting of drug controllers or drug regulators which is called the UN Commission on Narcotic Drugs which basically their function is to talk about what are the big global challenges related to drugs.

For many years those meetings focussed entirely on drug interdiction, on drug prohibition etc.

In 1998 there was a big global meeting that adopted a vision for how the world should deal with drugs and if you look at that document it declares drugs an evil and a danger to public health without any mention of the fact that there are a number of controlled substances that have critical medical functions and that actually, according to international law, countries have an obligation to make available to patients.

So that whole issue is just not on the radar screen at all.

So, again, we’ve been working with a range of organisations to change that.

In 2016 there’s going to be a special session of the UN General Assembly that is going to focus on the world drug problem, as it’s called.

So we’ve been working very hard to try to make sure that that meeting discusses the importance of controlled substances for medical use.

So the idea is that through that meeting countries will get a very clear signal that they need to review the drug regulations that they have put in place in past years to make sure that they don’t interfere with the availability of medications like morphine.

We’ve been working on this for a number of years and I think we’ve had some very good successes in changing the attitude of drug regulators.

India is actually a very good example where in February 2014 India’s parliament adopted a number of changes to India’s drug act.

In the past the drug act created this very complicated system for hospitals to get medications like morphine.

The pharmacist would have to go and get four or five different licences from different government departments that all had to be valid at the same time.

So, if by the time you got your final licence the first licence had expired you could restart the entire process.

So, as a result, morphine basically disappeared from Indian hospitals.

Now the changes to the law create a one-window licence system where the hospital will be able to go to one government agency, receive a licence and a quota from that agency, and then they’ll be able to procure.

Within their quota they’ll be able to procure all the medications that they need.

So in India we’ve seen a significant shift in how the drug regulators are looking at this issue.

They’re not looking at it solely from the perspective of we need to control, we need to prevent etc.

They’re also looking at it from the perspective of we have a duty to make sure that a patient who is dying from cancer doesn’t have to die in untreated pain because of the regulations that we have put in place.