Ketamine is an essential medicine used for anaesthesia. It is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine will leave these populations with no alternative anaesthesia for essential surgery, and will further deepen the already acute crisis of global surgery.
The UN Commission considers to bring ketamine under the control of the 1971 Convention on Psychotropic Substances contrary to WHO recommendations. The 58th Session of the UN Commission on Narcotic Drugs (CND) in March 2015 has been asked to consider a Chinese proposal to place ketamine – an essential medicine used for anaesthesia – in Schedule I of the 1971 Convention (E/CN.7/2015/7 and E/CN.7/2015/81). Ketamine is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine under any of the 1971 treaty schedules will reduce its availability and further deepen the already acute crisis of global surgery.
A proposal that is about to come before the UN to restrict global access to ketamine, a drug abused in rich countries, would deprive millions of women of lifesaving surgery in poor countries, according to medicines campaigners.
The Commission on Narcotic Drugs (CND) in Vienna will decide next week between two opposite proposals by China and the WHO about international control of ketamine, an essential anaesthetic in human and veterinary medicine. China originally proposed bringing ketamine under the 1971 Convention’s most severe control regime of Schedule I, which would dramatically affect its availability for surgery in poor rural settings and emergency situations. The WHO Expert Committee reviewed all the evidence and advised against any international control of ketamine, arguing it would trigger a public health disaster.
Scheduling ketamine would restrict its availability worldwide, which would lead to harmful impact on animal health and welfare, as well on public health. The World Medical Association is urging its 111 member associations to lobby their governments to oppose scheduling the anaesthetic agent Ketamine as a controlled drug.
In a dispute that pits the war on drugs against global health needs — and one UN agency against another — a pair of Canadian researchers is spearheading a last-ditch bid to keep a widely used anesthetic from being declared an illicit narcotic.
Just over one year away from the 2016 UNGASS, denying the reality that the drug policy landscape has fundamentally changed and that tensions with the UN drug conventions are occuring, is no longer a credible option. Secretary General Ban Ki-moon urged member states to use the 2016 UNGASS on drugs "to conduct a wide-ranging and open debate that considers all options." TNI calls for a special advisory group that should be tasked with recommending how to better deal with the contentious issues following the 2016 UNGASS, in preparation for the next UN high-level review in 2019.
Conditioning Alternative Development (AD) participation to previous eradication should be abandoned as a policy, since it has proved to be counterproductive. As long as the amount of hectares eradicated remains the main indicator for success, sustainable development loses. The voice of the primary stakeholders will be represented in the preparations for UNGASS through the organisation of a Global Forum of Producers of Prohibited Plants. Their participation in the design and implementation of development policies are fundamental.
China is proposing there should be a worldwide ban on ketamine - the drug that can lead to users needing to have their bladders removed. But ketamine is used as an anaesthetic drug in much of Africa, and there are fears further international controls could affect medical usage too. The Chinese say that they are requesting the lowest level of restriction - known as schedule four - which would not affect its use for medical purposes. But Dr Kabwe in Lusaka's main hospital says any restriction will create a level of bureaucracy that will prohibit its use.
China is proposing there should be a worldwide ban on ketamine - the class B drug that can lead to users needing to have their bladders removed. But ketamine is used as an anaesthetic drug in much of Africa, and there are fears further international controls could affect medical usage too.
"There must be no new thinking and no new ideas." This statement is not necessarily one that you might expect from an intergovernmental forum on a hot topic of international policy - except perhaps when that policy is about drugs. This statement sadly, but also neatly, encapsulates the sense of frustration that I can often feel at the UN Commission on Narcotic Drugs (CND) - the annual meeting of the UN on all matters related to drug control, which took place last month in Vienna.
With the 2016 UNGASS on drugs in one year, it is time to recognize the policy landscape is shifting while tensions within the UN drug control system continue to grow. A slowly increasing number of governments is expressing their frustrations with the current international drug control framework, particularly Mexico and Colombia, countries that are suffering from violence related to drug markets, are calling for reflection and analysis in order to consider new options, some of which include regulatory measures.
This March, our video advocacy team attended the 58th session of the Commission on Narcotic Drugs, the largest drug policy gathering in the world, to find out how governments and NGOs feel about the prospects of drug policy reform. We produced a series of short thematic videos, to give you an overview of the current state of political debate on the burning issues of international drug control.
The war on drugs is edging towards a truce. Half of Americans want to lift the ban on cannabis. America’s change of heart has led many to wonder if the UN conventions might be reformed to legalise some drugs and treat the use of others as a problem requiring health measures, not criminal or military ones. But as America has drawn back from prohibition, new drug warriors are stepping up to defend it. Russia is foremost among them. “The Russians have taken over the hard-line role that the US used to play,” says Martin Jelsma of the Transnational Institute.
The international drug control regime is facing the most profound challenge of its existence. Member states have for some time been experimenting with new responses to the ‘world drug problem’; however, the advent of legally regulated cannabis markets has resulted in a ratcheting up of these challenges to expose the system to new levels of strain. With the 2016 UN General Assembly Special Session (UNGASS) on the world drug problem fast approaching, how will the international community make use of the opportunity it provides for a free and open debate?