United Nations side event to focus on disparities in access to essential medications in the Caribbean.
United Nations side event to focus on disparities in access to essential medications in the Caribbean
The 65th Session of the Commission for Narcotic Drugs takes place from March 14-18, 2022, with Jamaica and Grenada as part of the Commission. Dr. Dingle Spence, President-Elect of the Caribbean Palliative Care Association (CARIPALCA) and co-founder of the Jamaica Cancer Care & Research Institute (JACCRI), will present at a virtual side event on Friday, March 18, at 1:10 - 2 pm CET (7am EST Jamaica), titled, “Disparities in access to internationally controlled essential medicines in the Caribbean.” The side event is sponsored by the International Association for Hospice and Palliative Care (IAHPC), the UN Office of Drugs and Crime, and the Vienna NGO Commission on Drugs.
Essential palliative care medicines are listed in the schedules of the international drug control conventions overseen by the Commission on Narcotic Drugs (CND) in Vienna. The aim of the side event is to highlight the disparities in availability of essential palliative care medicines across the Caribbean region, with a particular focus on opioid availability. “Our goal is to highlight the disparities in access to essential medicines for palliative care and pain relief across the Caribbean region, and to propose solutions.” said Dr. Spence.
H.E. Cheryl Kay Spencer, Jamaican Permanent Representative to the United Nations, is expected to introduce the session.
A high percentage of the cancers diagnosed within the Caribbean population are advanced and incurable, and access to much needed cancer services such as surgery, chemotherapy and radiotherapy is often very challenging. The resources needed to provide timely access to cancer care across the continuum of care, especially access to palliative care and pain relief, are generally limited in the Caribbean.
Even amongst the Caribbean nations themselves, there are clear disparities in access to pain medicines. Whereas some countries have access to all they need, others are managing with intermittent and limited access to morphine, an essential medicine for the management of severe cancer pain. This often leads to prolonged suffering on many levels.
This is especially alarming as the World Health Organization’s (WHO) Model List of essential medicine list recommends access to at least seven analgesics including morphine. Appropriate and effective opioid use in low- and middle-income countries (LMICs) is often impeded by a lack of education and educational opportunities regarding appropriate prescribing, administering and dispensing of opioid medicines. The disparities among the Caribbean nations regarding opioid consumption are extensive. Grenada, which will be part of the Commission for Narcotic Drugs this year, has no published reports on opioid consumption, while Belize, St. Lucia, St. Kitts, Nevis, the Cayman Islands, and Turks and Caicos report their numbers very infrequently to the INCB.
Another example is Haiti, arguably one of the poorest countries in the world, which reported opioid consumption (0-0.2mg/person) that was drastically lower than what was reported in the United States (400 mg/person). Trinidad and Tobago’s reported opioid consumption in 2017 was only 14% of what was estimated to be required. Conversely, Jamaica is one of the only countries in the Caribbean where the 2017 opioid consumption matched as well as surpassed their estimated 2018 requirements.
Unfortunately, due to opioid policy dysphoria, governments are resistant to engaging in developing policies that will improve access and availability of opioids for their own populations, which will in turn make medicine usage safer for those populations.
The conversations and the research will need to continue long after the UN Commission for Narcotic Drugs adjourns, but it is an important step in managing current health disparities.