The UN General Assembly Special Session on Drugs, starting March 11, 2009, should address the lack of access to pain relief medicines in many countries, which leaves tens of millions of people worldwide suffering from severe but treatable pain, Human Rights Watch said in a report released today.
In the 47-page report, "‘Please, Don't Make Us Suffer Anymore...': Access to Pain Treatment as a Human Right," Human Rights Watch said that countries could significantly improve access to pain medications by addressing the causes of their poor availability. These often include the failure to put in place functioning supply and distribution systems; absence of government policies to ensure their availability; insufficient instruction for healthcare workers; excessively strict drug-control regulations; and fear of legal sanctions among healthcare workers.
"Severe pain can easily be treated with inexpensive medications, so it is inexcusable that millions of people have to live and die in agony," said Diederik Lohman, senior researcher in Human Rights Watch's health and human rights division. "The UN drugs summit provides an opportunity for governments to give real meaning to their commitment to end this unnecessary suffering."
In the report, Human Rights Watch noted that international law requires states to make narcotic drugs available for the treatment of pain while preventing abuse, but that the strong international focus on preventing abuse of such drugs has led many countries to neglect that obligation. The 1961 Convention on Narcotic Drugs states that these drugs are "indispensible" for the relief of pain and suffering.
"The UN drug treaties envisaged a balance between preventing abuse and making sure narcotic drugs are available for medical purposes," said Lohman. "In practice, many governments have implemented strict laws and policies that target drug abuse and ignored their obligation to ensure legitimate access to pain relief medicines."
As a result, almost 50 years after the agreement was adopted, adequate availability of narcotic drugs for pain treatment remains an unfulfilled promise. In February 2009, the World Health Organization estimated that tens of millions of people worldwide suffer from severe pain without access to adequate treatment, including about 5.5 million terminal cancer patients and 1 million end-stage AIDS patients.
At the UN General Assembly Special Session on Drugs, on March 11 and 12 in Vienna, nations will set priorities for the coming 10 years of global drug policy. Preliminary negotiations in advance of the meeting have focused almost exclusively on preventing illicit use of controlled substances while largely ignoring their poor availability for medical purposes.
"The UN summit should set clear, measurable goals for improving access to pain medications," said Lohman. "Being ‘tough on drugs' should not mean that governments refuse to provide pain relief and ignore the suffering of millions of people."
Selected quotes from the report:
"For two days, I had agonizing pain in both the back and front of my body. I thought I was going to die. The doctor said that there was no need to medicate my pain, that it was just a hematoma and that the pain would go away by itself. I was screaming all through the night."
- A Kerala, India, man describing to Human Rights Watch on March 20, 2008, his stay in hospital immediately after a construction site accident in which he sustained spinal cord trauma. His name is withheld to protect his privacy.
"Cancer is killing us. Pain is killing me because for several days I have been unable to find injectable morphine in any place. Please, Mr. Secretary of Health, do not make us suffer any more"
- A classified ad placed in El País newspaper in Cali, Colombia, on September 12, 2008, by the mother of a woman with cervical cancer.
"Physicians are afraid of morphine... Doctors [in Kenya] are so used to patients dying in pain...they think that this is how you must die. They are suspicious if you don't die this way - [and feel] that you died prematurely."
- Dr. John Weru of Nairobi, Kenya, a physician at a hospice, in an interview with Human Rights Watch in June 2007.