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.
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.
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 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.
David Bewley-Taylor, Martin Jelsma, Christopher Hallam
16 June 2014
Scheduling is mostly prioritised in its repressive pole, though present debates are increasingly highlighting the need to modify the balance of the system in order to affirm the importance of the principle of health.
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.
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 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?