This statement is led by the International Association for Hospice and Palliative Care and supported by
● Handicap International Federation
● Help Age International
● International Association for the Study of Pain
● International Federation of Surgical Colleges
● The International Society of Paediatric Oncology
● World Federation of Societies of Anaesthesiologists
●. Worldwide Hospice Palliative Care Alliance
We thank the Secretariat for the draft GPW and the robust inclusion of palliative care, rehabilitation, and assistive technology as essential components of PHC and UHC. We note the lack of explicit reference to availability of internationally controlled essential medicines needed for clinical use in palliative and non-palliative management of acute pain, anesthesia, sedation, surgery, trauma care, obstetrics, treatment of mental health and substance use disorder. These medicines are unavailable in more than 85% of the world. Adequate stockpiles and an uninterrupted safe supply of these medicines is essential for routine clinical care of neonates, children, adults, older persons, persons with disabilities and NCDs, and those caught in humanitarian disasters and war. Our global membership organizations and WHO palliative care collaborating centers can provide health worker training in the safe use of controlled medicines including oral and parenteral morphine formulations. Appropriate training and safe supply chains discourage diversion and harmful non-medical use. People who cannot access these medicines live and die in severe preventable suffering. Our constituents recommend convening health cluster consultations to operationalize the high-level joint statements from INCB, UNODC, and WHO on availability of controlled medicines in emergencies.
Cluster consultations can also operationalise the recent Commission on Narcotic Drugs resolution on essential analgesics, which focused on children. Essential palliative care medicines must be included in WHO emergency and NCD care kits.
We emphasize that non-palliative management of chronic pain requires a multimodal approach, predominantly without opioids, including spiritual care, physical therapy, rehabilitation, and traditional medicine. Safe availability of controlled medicines guaranteed by resilient licit supply chains supports successful achievement of GPW14 outcomes/ targets to promote, provide and protect the health and well-being of all people, everywhere.