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.
In March 2014, country delegations will gather at the United Nations Commission on Narcotic Drugs (CND) to review progress and challenges in international drug control since the agreement of a Political Declaration on drugs in 2009. Given that the Political Declaration aims to “eliminate or reduce significantly” the use, supply and demand of controlled drugs by 2019, this meeting represents an important opportunity for honest evaluation and an acknowledgement that these targets are not being achieved. With a United Nations General Assembly Special Session (UNGASS) on drugs just two years away, this is an important time for international drug control policy.
“We will be aiming for no less than securing the inclusion of harm reduction in the political declaration by which member states determine international drugs policy,” the Dutch Minister for Development Cooperation Bert Koenders told the Donor Conference on Harm Reduction that took place on January 28-30, 2009, in Amsterdam. “We will do the same when, in 2010, the honour of chairing the UNAIDS governing board falls to the Netherlands. You can count on that.”
Numerous UN conferences and summits have been devoted to negotiating a harmonized global approach to illicit drugs. Yet more and more cracks are beginning to appear in the supposedly universal model which is based on a highly fragile consensus. The failure to counter the ever-growing problems related to the use of illicit drugs has led countries to question current policies and to experiment with approaches less driven by the US-inspired ideology of "zero tolerance" and more rooted in pragmatism. This has led to increasing acceptance of the concept of harm reduction for consumers, where drug use is treated as a public health rather than a law enforcement problem. On the production side, discussion centers on the need to secure alternative livelihoods for involved farmer communities and how to most effectively promote alternative development.
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?
The year 2012 marks the centenary of the international drug control system and the first instance of a state being moved to denounce formally any of the UN drug control treaties. The 55th session of the Commission on Narcotics Drugs (CND), held in Vienna between 12th and 16th March, therefore looked set to be a fascinating event and did not disappoint. As expected, member states favouring the current regime praised its virtues and ongoing relevance 100 years since The Hague Opium Convention; behaviour that found support in the statements and positions of the United Nations Office on Drugs and Crime (UNODC) and the International Narcotics Control Board (INCB or Board).
Peter Reuter (RAND), Franz Trautmann (Trimbos Institute) (eds.)
15 March 2009
This report commissioned by the European Commission, found no evidence that the global drug problem has been reduced during the period from 1998 to 2007 – the primary target of the 1998 UNGASS, which aimed to significantly reduce the global illicit drugs problem by 2008 through international cooperation and measures in the field of drug supply and drug demand reduction. Broadly speaking the situation has improved a little in some of the richer countries, while for others it worsened, and for some of those it worsened sharply and substantially', among which are a few large developing or transitional countries. Given the limitations of the data, a fair judgment is that the problem became somewhat more severe.
Reflections upon this year’s CND are mixed. On the one hand, some states went further than ever before in openly challenging the current regime on the grounds that, after a century, it needs modernising. That the government of Uruguay is currently considering a domestic policy on cannabis that would put it in breach of the Single Convention shows that, in one instance at least, we have moved beyond rhetoric and posturing.
The most important drug policy event this quarter was undoubtedly the 57th Session of the UN Commission on Narcotic Drugs (CND) in Vienna from 13 to 21 March, the first two days of which were dedicated to a high-level review of the past five years. The winds of drug policy change were clearly felt in the statements made by several Latin American countries – Colombia, Guatemala, Ecuador, Mexico and Uruguay – and some European countries – the Czech Republic, Norway and Switzerland, among others.
As political leaders from around the world gather in Vienna on 11-12 March to review the last decade of international drug control, and set a framework for the next ten years with the signing of a Political Declaration, any hopes for progress or a new pragmatism in approaches to the world drug problem are fading fast.
Meetings of the Commission on Narcotic Drugs (CND) are no forum for debate and change. The author, a former senior officer of the United Nations International Drug Control Programme (UNDCP), shows how CND meetings are manipulated in the interests of 17 developed countries that largely fund UNDCP – the CND’s ‘civil service’. However, these major donors are not united on policy or on how to apply the UN drug Conventions, so CND decisions reflect the lowest level of disagreement, with major splits on policy ignored.
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.
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.
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.
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 US delegation in Vienna continues to block any inclusion of harm reduction in the new Political Declaration – to be approved in March 2009 at the high-level segment of the 52nd session of the Commission on Narcotic Drugs. Three members of the US Congress have written a letter to the new US Ambassador to the UN, Susan Rice, to call for new instructions to be given to the delegation.
The current trend towards legal regulation of the cannabis market has become irreversible and requires an urgent dialogue by UN member states on the best models for protecting people’s health and safety, argues a new report. The question facing the international community today is no longer whether there is a need to revise the UN drug control system, but rather when and how to do it.
An internal United Nations draft document leaked last weekend has offered outsiders a rare look at longstanding disagreements between member states over the course of U.N. drug policy. The document, first publicised by The Guardian and obtained by IPS, contains over 100 specific policy recommendations and proposals from member states, many at odds with the status quo on illicit drug eradication and prohibition.
Change is in the air ... But the pace could be quickened a bit. While the international policymaking body on drugs has long been stuck in neutral, there are signs that alternative voices are finally breaking through. This year's UN Commission on Narcotic Drugs featured some progress though its modest advances are only remarkable by comparison to a dismal past.