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CND Chair: Welcome. The World Drug Report is our most comprehensive dataset that is key to combat the world drug problem and contribute to the 2020 agenda and whose importance is recorded in the conventions as MS are required to submit data. In the Ministerial Declaration of 2019, we committed to increase our efforts to strengthen our information and monitoring systems, improve methodologies, data collection. In 2019, the declaration adopted to promote and improve the collection, analysis and sharing of quality and comparable data. CND has been supporting the thematic review of the progress to the SDGs and we continue to provide input to the high-level political form by providing quality data.

Mr. Fedotov, UNODC: We are launching the report simultaneously in New York and Geneva as well as Vienna. Indeed, the findings provide a detailed picture of global drug challenges. Our understanding of such is improving. Health and justice need to go hand-in-hand on our track to achieve the SDGs. The theme of today’s International Day against Drug Abuse and Illicit Trafficking is ‘Health for Justice, Justice for Health’. What is new: India, Nigeria. According to new estimates 25 million people around the world are in need of treatment services. Drug use has caused almost half a million deaths last year, mostly young men and women, mostly preventable. Drug associated disorders are particularly prevalent in prison settings, where treatments are less accessible too. Overdose deaths caused by opioids in the USA are accounting for 68% of total global overdose deaths. Stabilization of the situation has been noted however the presence of synthetic opioids rose by almost 30%. While only 4 countries reported fentanyl in 2016. 16 did so in 2017. The other opioid crisis in Africa concerns Tramadol – it remains outside of international control while presenting a serious health problem. In Asia methamphetamine problems are growing almost 8-fold in the past 10 years. Global opium and cocaine production remain at a record high since 2017.The great effects on law enforcement and international counter-efforts are visible: trafficking from Afghanistan in the Northern route has decreased, 10% of global interception dropped to 1%. International efforts to counter NPS have been effective on the global level our monitoring system keeps MS up to date and provides a platform for information sharing. CND in March put some new substances under international control and confirmed dedication to safeguarding our future and that no one is left behind as per the conventions. UNODC supports countries in this effort with technical assistance via toolkits and research for example. Our global opioid strategy covers early warning systems and we also work with partners to develop international standards for prevention and treatment. Scaling up evidence-based interventions regarding hepatitis and HIV, improving access to treatment for prison populations, promoting alternatives to incarceration, removing barriers for medical use, coordination of collaborations are our recorded priorities – which of course need to paired with action. We pledged to address the connection of the illegal markets to terrorism, investigate the darknet. A balanced, evidence-based approach to the problem is called by CND.

Angela Me, UNODC: I will focus on three aspects today, to give you the impact of the data addition from our new countries; transformation of markets; international cooperation. Nigeria and India have undertaken high-quality surveys with a huge dataset to contribute to our work. Now we can estimate that 35 million people suffer with drug use disorders as opposed to around 30 million last year. In prisons, the annual prevalence is extremely high, much higher than outside of prison. What are the availability of services in prison? In many MS, we have no information but a few number of countries do offer minimal services.
In different regions the drug of concern for treatment admissions is different. In Asia, Cannabis is hardly a concern while in Africa is it prominent, then cocaine is visibly mostly a problem in the Americas. An important message here is that as dynamics change, the responses needs to change. The global cannabis market has also changed, it diversified from herbs to edibles and others while the THC content has increased globally, it now reaches up to 70%. The availability of opioid analgesics is very different in North America to other regions. I am not here to pick on the USA but its important for the international community to understand that it correlates to the addiction phenomena and then the overdose crisis. It is not only an issue in North America, for example in Northern Ireland, the opioid related deaths have increased dramatically. On the supply side, new opioids rapidly come to the market, the quantity of fentanyl seized had increased significantly. Our new survey from Nigeria revealed that 4,6 million people use opioids for non-medical reasons. Other transformations on the market that don’t reach the market are among school students and concerns stimulants. – some countries see as much as 4% of students using stimulants for non-medicinal purposes. For some other countries, tranquilizers are the biggest concern. The challenge is clear. What happens in terms of responses and the results? The manufacturing of cocaine has grown but the rate of seizure has grown faster. Most efforts of law enforcement are from the supply countries. An other noteworthy result of law enforcement efforts is that after the shutdown of AlphaBay and Hansa markets, 10% stopped using the darknet. Internationally controlled NPS on the market has been contained since 2015. In terms of ATS (amphetamine-type stimulants), the market is expanding globally but different regions are affected differently. Just to make a point that if we have the same problem it translates to different challenges on different markets.

Ms. Okeke, Nigeria: As we heard, the world drug problem is still a major challenge to the international community, we still have a long way to go. The topic of today’s International Day against Drug Abuse and Illicit Trafficking is that criminal justice and health are interlinked for the welfare of humankind. We made commitments at the ministerial meeting in 2019 to promote a balanced approach. This year’s report discusses the first nation-wide survey conducted in Nigeria which contributed to the better understanding of the problem in Africa and globally. It indicated that 14 million Nigerians have drug use disorder which helped us to allocate resources addressing the phenomena better. A good understanding of the issue and good data is crucial to advance our work. We resolved to review in 2019 our progress in implementing our commitments. The report confirms that we are on the right track. We thank the statistical bodies and look for an interesting discussion.

Mr. Kitano, Japan: The WDR is the most important evidence we have to base our work on. I would like to share some reflections in my national capacity. The cultivation of illicit crops remains high, the opioid market is expanding increasingly, accompanied with overdose deaths. The prevalence rate of methamphetamine is alarming high. The report had some hopeful findings such seizure increase that reflects that our cooperation have become more effective. The global trends show the persisting and emerging challenges. It serves as a basis for us to rely on for comprehensive balanced, evidence-based measures to protect humanity. This March we adopted the Ministerial declaration that commits to accelerate our joint efforts, now is a good opportunity for us to confirm that.

Ms. Navarette, Chile: The reports shows we lead in the consumption of certain substance. The World Drug Report is important to govern our actions. Regarding prosecution of criminal organizations, we created operational gatherings of authorities, public prosecutors and the police to coordinate our efforts. The most affected area is the Northern border, but we dismantled 2 major organizations this year and have successfully reduced the problem in the area. Cities are often controlled by smaller groups who use fear to control and we launched a program for micro trafficking. Interactive maps were created to identify even street corners. Police officers have been extensively trained and after 3 years of operations this is one of the best evaluated programs. Decrease in demand is one of our greatest challenges, the use of drugs in my country is at its highest level. We launched “chose to live without drugs” for children and students, a national campaign. 1 in 3 students have reported to have used Cannabis in the last year, but they have also used cocaine, cocaine paste. We developed our program based on the Icelandic model. We consider the World Drug Report a highly important body of evidence for our work.

Ms. Sabbatini, Italy:  We hold the WDR in high esteem and welcome the new countries providing data. The growing complexity of the program should advise us to not provide simple responses, there is no easy fix. Illicit cultivation and manufacture are following a long-term upward trend. The number of people who use drugs is 30% higher than 10 years ago, the death-poll is appalling. We should not underestimate our progress as a result of enhanced international cooperation however.  The accelerated scheduling of CND has allowed us to check the emergence of NPS. An increase in our law enforcement efficiency has been reflected in the report. I am reaffirming our commitment but much remains to be done to address the gaps – public health responses continue to fall short of need as only 1 in 7 receive treatment. It is particularly alarming in prison settings. The promotion of a health centered approach is dear to my country where national public health system has a network of about 500 centers and we work towards legal protection and information dissemination at a young age. As we celebrate today, lets remind ourselves that in order to deal with the world drug problem, it is not sufficient to talk about drug only, we have to talk about protecting factors especially with children to promote a heathy lifestyle and protecting them from exploitation as well as provide protection, bringing perspective to their lives, supporting families and communities. If we are to safeguard the future, as we have committed so, addressing these issues is inescapable.

Ms. Markovic, Croatia: The conventions are instruments and are key to the functioning of the international drug control system. While there have been achieves in addressing the world drug report, many remain to be addressed as the report mentions. In our national perspective we are preoccupied with the Balkan route as is mentioned as the world busiest heroin trafficking channel. Incorporating a gender-perspective is also of high priority for us. To undertake our joint commitments we need to cooperate multilaterally. The report will aid our understanding and guide our discussions particularly regarding action-oriented interventions. Data collection and analysis is key to overcome the ever-evolving challenges we are facing.

Mr. Jocheere, INCB: The drug control conventions assign specific mandates to the CND, INCB and WHO and through the SG, to UNODC. I appreciate the UNODC’s role. We continue to be faced with dire challenges, we must ensure we build on our expertise and skills. We have an important contribution to make and coordination is key to optimize our effectiveness. Noting today’s theme, justice for health and health for justice. The board remains concerned that many people affected suffer from a lack of justice and of stigma. We are here to ensure that responses are proportional and are founded on respect for human rights and dignity. The World Drug Report shows the nature and extend of the problem and how far we have yet to go as opium production is at record levels. We urge UN agencies to provide further assistance to address challenges in Afghanistan. We are pleased to see the 2019 report and are concerned by the findings yet we are glad UNODC could make use of our data. We have initiated programs and stand ready to collaborate the growing threats. A holistic approach is needed regarding gender and age – our annual report will have a special chapter on drugs and youth next year. We have a lot to do together. Thank you.

Mr. Bridge, VNGOC: Thank you Mr. Chair, and thanks to UNODC for once again allowing the Vienna NGO Committee on Drugs to make a formal intervention as we mark the UN Day Against Drug Abuse and Trafficking. I want to start by congratulating Angela and her colleagues for the delivery of another rich and engaging World Drug Report. The Report is a huge undertaking, and one that makes an important contribution to the global response to the world drug situation. There are three areas, in particular, I want to focus on today.

Firstly, one number stood out when I first read the Report last week. 585,000 people died as a result of drug use in 2017. Regardless of whether you believe that the answer lies in treatment, or harm reduction, or law enforcement, or rehabilitation – 585,000 deaths is a staggering failure that we all have to face up to. We simply have to bring this number down. The SDGs seek to “leave no one behind”. But we are not doing that. We are leaving lots of people behind – and the Report’s data on deaths, prisons and the unmet treatment need show this to be the case.

My second point is about the alleviation of pain and suffering, which remains a global health imperative. The World Drug Report refers to a, quote, “global paradox of too much and not enough”, unquote. It is an important reminder that we are facing more than one kind of opioid crisis. But the actions, narratives and strategies still do not reflect the necessary balance between rational access and control. Ensuring access to controlled pain medication, including both scheduled and non-scheduled opiates, is essential to meet the SDGs. This cannot be an afterthought. And it cannot continue to be just collateral damage from the control of non-medical use.

My third point today is about the data themselves. The World Drug Report reflects the information harvested through the ARQs, yet the questionnaire is in need of modernisation to reflect the UNGASS, the 2019 Declaration and the UN System Common Position. I appreciate that this is an ongoing process, with a lot of hard work already underway – including through the new UN System Coordination Task Team on drug-related matters. The Task Team, launched earlier this year by the UN Chief Executives Board, aims to promote cooperation and coordination in drug-related research, data collection and analysis across the UN system in the quest for better, more effective drug policies. But I also want to highlight the role that civil society can play in this regard. NGOs on the ground often have access to knowledge, information and evidence which can complement the data being collected from governments and academia. This can help to formulate the most complete picture possible, while civil society can also help to supply the human stories which make the data real. Many NGOs are experts in data collection, monitoring and evaluation – not least because we are constantly having to do it for our own donors! We can help to verify and critique data – as currently happens, for example, for the UNODC, WHO and UNAIDS estimates on injecting drug use each year. And we can also help to plug gaps where the ARQs are not submitted or are incomplete. I encourage you all – member states, the UNODC, and the UN System Coordination Task Team – to better tap into, and nurture, the existing resources that NGOs have to offer.

Chair: Floor is open for questions.

Colombia: Today, on the International Day against Drug Abuse and Illicit Trafficking, I reaffirm Colombia’s commitment to comply with our international commitments. We support UNODC, and welcome the WDR.  We still need to improve research and effective responses to safeguard people and their health. NPS and changes in the cannabis market are important phenomena as well as the increase of cocaine cultivation which we address with AD projects.  It is worth mentioning that we dismantled more laboratories as before and have a leading role for seizing controlled substances. Illicit crop reduction is my governments priority and have put in place a number of mechanisms. The new report mentions Colombia several times and attempts to reflect the complexity of the coca problem – we hope this will prevail in the coming reports as well. Common and shared responsibility is key to counter violence and crime that is fueled by the drug problem. The report shows this is at an unprecedented high. It is necessary to asses the actions of all states. What’s the reason of the extremely high demand? Why is it so easy for users to access? Why does media promote liberality in consumption? What responsibility is taken by those overlooking the [precursor supply chain]?

Iran: Alarming trends and patters can be seen in the report, once again. The illicit crop production is at an all time high. Public health responses continue to fall short while access to medicinal opioids is insufficient. The only way to overcome these challenges is via international cooperation as well as enhancing regional efforts. In our experience, addressing organize crime is necessary to haul illicit drug cultivation. We seized approx. 11 thousand tons of illegal drugs, 76% of opium seizures and ca. 30% of heroin seizure are made in Iran. We shattered hundreds of gangs and seized hundreds of tons of controlled substances, we stopped tons of heroin to cross our borders. Access to controlled substances for medical use is an integral part of our strategy while countering diversion as well as promoting public heath and creation of society free of drug abuse. We seek to prepare the ground for the treatment and social integration of abusers. Illegal sanctions against Iran has dramatically hampered international efforts to counter drug issues which is accountable for diminishing our capacity. Intervention of politics in the development of humanitarian issues is one of the major challenges for us.

Germany: We welcome this landmark document, a treasure of information. I see two key messages: (1) the fight is far from over, we have to re-double our efforts and (2) we have a dire need for international cooperation. We will carefully read and study the report – we contributed 600,000 euros to the creation of the report.

Russia: We welcome this flagship publication and fully share one of the main conclusions: law enforcement constitutes a key response in dealing with the World Drug Problem. We see promising results of such approach, especially along the Northern route. Despite the record cultivation in Afghanistan, we prevented smuggling into Russia thanks to our collective treaty organization and collaboration with Asian countries. We built a K9 unit for Afghanistan aimed to increase interdiction capacities. The report dispels many arguments for cannabis legalization. Commercial companies are trying to seize the profitable opportunity that creates public health problems. The number of patients seeking treatment for cannabis related problems have increased. The report specifically highlighted the balance between the efforts to ensure availability for medicinal use as well as prevention of diversion. President Putin declared the palliative care system as a national priority. We were perplexed by other MS’s responses and that the needle-exchange programs and substitution therapy are mentioned as landmark interventions in the report – we can’t agree to such a selective selection of interventions, we demand a more holistic approach to demand reduction. We launched a month-long awareness campaign aimed at the younger generation. We believe such events both national and UN level help promote a society free of drug abuse. We commend the efforts of UNODC to improve and strengthen data collection tools – more capacity building will be needed.

Pakistan: Thank you so much for this report. We see that comprehensive responses are required to counter this menace. We can also find a manifestation of enhanced international cooperation as we see an increase in seizures. Our region is faced with a series of challenges particularly as our population is mostly young in age. To eliminate the scourge of illicit drugs will remain our focus with border control, education, while taking inspiration from the declarations of 2014, 2016 and 2019. The ministerial declaration and the multi-year work plan are an opportunity to streamline our efforts.

Afghanistan: Thank you for the panelists and the UNODC research team for this most important report next to the EMCDDA, an other excellent source of information. The figures regarding heroin have increased especially on the Balkan route, we hope this is not a political shortcoming but a technical issue. Our assessment shows that Balkan and Northern data is not scientifically sound as most of the heroin smuggled there is cultivated outside of Afghanistan – let me refer to Iran’s contribution to last year’s report. The data is based on seizure, we can reasonably come to the conclusion that our contribution is less than 20% – the Iranian government have confirmed this. The data on southern route lacks scientific judgement, we don’t deny our contribution, we are not accountable for large amounts – what is the UNODC’s data based on? According to this report, we are one of the origin countries, we had the highest amount of seizures globally. According to the INCB report, we are a destination country for precursors. No matter If we are the country of origin or destination, our law enforcement is the most active in the World. In any report, we have to interpret data in a balanced way and we kindly ask UNODC to provide us with an explanation of heroin production in our neighborhood.

Mexico: Thank you and congrats on your work. We reaffirm that international cooperation under the principle of shared responsibility is the best approach to respond to the drug problem. Focusing on public health and human rights is the way forward if we want to have ling standing impact. We see an opportunity in the alignment of drug policies and the 2030 agenda for sustainable development, particularly that illicit markets come with violence. The report represents an invitation to accelerate our discussions and actions. The report must be read as an expression of cooperation and not as finger-pointing as we identify new realities. The UN system plays a primal role in our cooperation, we reaffirm our commitment. We welcome the global vision on health implications. We are undertaking an unprecedented campaign particularly aimed at youth with participation of civil society and the government as well as.

UK: […]

UNODC: Special thanks to the Research and Trend Analysis team.

Chair: Thank you to everyone for coming today and contributing. Meeting adjourned.

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Agenda item 2: Proposed scheduling recommendations by WHO

Chair: Good morning, we have a slight change in the agenda. We are starting with agenda item 2 which is regarding the proposed scheduling recommendations by WHO – no objections. Assistant Secretary General of United Nations Office of Rule of Law and Security, you have the floor.

Alexandre Zouev Alexandre Zouev, Assistant Secretary-General for Rule of Law and Security Institutions: UNODC has been an executive partner of my office, we share good practices on a regular basis, with the inclusion of UNPOL. We operate in regional and global context. We have supported UNODC on operations “open road” with MS such as Zambia, Senegal, etc., a cross-border mechanism addressing cross border trafficking. Two years ago, our entities signed a partnership including the prevention of violent extremism, we cultivate regular exchanges on policy, development, assessment, training – this will continue be our growing are of focus. In particular UNODC chairs the counter terrorism group of UN and it co-chairs the resource mobilization group as well as border management and law enforcement groups. We encourage this collaboration. Serious organized crime is often a product and contributor to conflict in vulnerable states. As a nature of this threats and capacity gaps, we see a need for different skillsets, one is to follow the money. The future will likely bring increased demand, to respond effectively it will be necessary to capitalize on partners inside and outside the UN systems. UNODC and office of counter-terrorism evolves a closed collaboration with various regional and functional groups. Inter-agency mechanism that addresses the rule of law is called a global focal point, a practical field bringing together key actors like OHCR, ONWOMEN, UNODC among others. Thank you for your attention.

Chair: MS were asked to submit their questions to WHO, regarding recommendations to the 61 and 71 conventions regarding Cannabis. We will begin by an introductory presentation then proceed to the questions and answers. There will be a possibility to address questions to INCB after WHO today. Non-state actors, UN entities and NGOs are allowed to make statements afterwards. Now, secretary of ECDD, Gilled Forte, you have the floor.

Gilles Forte, WHO: The body that carries out the assessment is comprised of independent experts selected via a thorough process with a geographical and gender balance. The committee also has observers from INCB and UNODC. The work is guided by a guide developed by MS in 2010. The rationale for reviewing cannabis and related products is to respond to resolutions so WHO has a mandate to review Cannabis including dronabinol. A number of countries requested WHO to collect and analyze evidence as more and more countries are embarking on unregulated medical use. Cannabis has never been a subject to review since its original placement in the schedule. So this process is operating under a stepwise approach since 2014. There has been a progressing in the collection of information and review. Information is central for the work of ECDD and an important objective is that to makes sure that the committee works with appropriate amounts of such so proper decisions are made. Robust information is central to the ECDD review process, we reviewed hundreds of scientific publications that were peer-reviewed. We also take into account MS’s data. Every year we issue a survey about the substances that we review. We do have other sources of data, Early Warning Advisory System of UNODC&INCB, EMCDDA, Uppsala Monitoring Centre on adverse medicines reactions (WHO), Global Surveillance and Monitoring System on Substandard and Falsified Medicines (WHO).
Because the importance and sensitivity of this topic, we paid careful attention of how it is carried out and issued an open call for authors in 2017 in line with UN procurement procedures. We received 31 applications. The consultation process’ reports were posted on our website, comments were received from MS, CSO, private groups and scientific orgs. We held open sessions, consultations with UNODC, INCB regularly, we briefed MS in Geneva and the WHO Executive Board.
The rationale for issuing recommendations on scheduling: We seek to prevent harms and to ensure controlled substances are available when and where they are needed for medical and scientific purposes. We aim to ensure a coherent international control that considers contemporary information. The levels of control should be considered as minimum requirements, it is at the MS discretion to implement locally relevant measures.

Cannabis and cannabis resin: Currently schedule 1 and 4 of 1961 convention. Recommendation: Delete from schedule 4. The rationale is that Cannabis is not similar to other schedule 4 substances, it has proven medically useful.

Dronabinol (delta-9-thc): Currently schedule 2 of 1971 convention. Recommendation: add to schedule 1 of 1961 convention, delete from the 1971 convention. Rationale: delta-9-thc was not known to be the main active component at the time of original scheduling and so placing cannabis and its active component in the same convention schedule makes sense.

Isomers of THC: Currently in the schedule 1 of 1971 convention. Recommendation: add to schedule 1 of 1961 convention and delete from 1971 convention. Rationale: these are not easily differentiated from delta-9-thc, placing them will facilitate international control.

Extracts and tinctures: Currently in schedule 1 of 1961 convention. Recommendation: delete from scheduling. Rationale: it was concluded originally because the original active component was not known but it is covered now as per previous recommendations.

Cannabidiol preparations: Currently schedule 1 and 4 of 1961 convention. Recommendation: Footnote to schedule 1 of 1961. Rationale: childhood epilepsy, not psychoactive, no evidence for dependence or abuse. However, trace amounts of THC can be detected, the proposed change will allow pharmaceutical preparation.

Dronabinol preparation: Currently schedule 2 of 1971 convention. Recommendation: add to schedule 3 of the 1961 convention. Rationale: not liable for abuse when taken orally, lower level of control will increase access to pharmaceutical preparations while protecting from harm.

Thanks.

Chair: Item 2b – we have received questions by state parties and on the alphabetic sequence. I invite the WHO to provide the answers in writing after this session that are in the general interest.

WHO: We are grateful for your questions, we will not respond to them question by question but we prepared a comprehensive response. It is a dense text but you can follow our paper on the screen.
Cannabis has never been subject to a formal review since its original placement within the conventions. CND 52/5 requested the WHO to provide an updated report.
In recent years more robust scientific research has been conducted regarding cannabis and preparations. This clearly identified delta-9-THC to be the main psychoactive compound. We considered this new evidence as the basis for our review. Our recommendations seek to prevent harms and to make sure availability for scientific and medical use. […]

WHO will continue to engage and closely collaborate with all relevant parties, MS, UN agencies, etc to address questions, concerns, comments with regards to our recommendations. We received a question regarding industrial use (hemp) and in food products. These issues are not within the mandate of ECDD, however WHO is prepared to address these issues in other forms. WHO acknowledges the challenges MS in enforcing balanced policies.

Chair: floor is open for questions

EU on behalf of its MS: Thank you for this opportunity. The EU would like to reiterate their commitment of the implementation of international control system at the same time we support WHO’s role and ECDD’s contribution to the system. We recognize that the recommendations are based on scientific evidence We would like to emphasize that drug policy should be based on an evidence-based approach to address the World Drug Situation.
Our specific questions have been submitted. It is key for us all to understand what the follow-up of today will be – will the recommendations will be further clarified? The EU believes that it should take place as soon as the assessment of rescheduling has taken place.

Mexico: We reiterate our full support for the WHO and ECDD’s role, we welcome CND’s opportunity to consider this vast scientific analysis – it is rather a duty to update the conventions. I will submit our questions in writing as well: Do medical and scientific communities have the same tools now as when the conventions were crafted? Is the knowledge about different components the same? Could you confirm if the original concept of cannabis as a single substance is still viable? Is there now a better understanding of the different components well beyond the differentiations captured in the conventions as well as their different characteristics? Is there a different consideration regarding the poppy seed similar to cannabis plant – will this prevail in the recommendations?

Jamaica: The way forward is clearly outlined; we thank the WHO’s work. We covered the Geneva portfolio and had a 360 view on the process and appreciate the transparent and inclusive process adopted by the ECDD. We know all MS were given an opportunity to give input. We regret the delay in the submission to CND but we understand that time was needed to give best recommendations as possible We are of the view that these are the first step in the right direction. International convention can be a barrier to access, they play a dual obligation on governments. To prevent abuse has gained larger importance that access to medical use. We conducted extensive research and continue to be faced with obstacles due to the current placement of cannabis within the current scheduling, therefore we fully support the recommendations of the ECDD that will aid our scientific efforts. We are mindful that implementations will impact the way in which medical practitioners work therefore successful rescheduling will contain re-education and training. Wat are the plans of UNODC, INCB to assist MS in implementation. What is the timeline?

Canada: the ECDD follows the guidance in the conventions as well as the WHO executive boards guidance – could we have a summary of that guidance and how it complements the conventions?

Russia: Cannabis related issues are more and more visible on the CND agenda, according to the World Drug Report, it is the most abused substance worldwide it is most used among youth, increased potency and increased number of people seeking treatment. Some MS chose to legalize non-medical use in violation of their commitment to the conventions. It is a volatile environment, WHO comes up with recommendations – we should be particularly diligent, why after 60 years we are unexpectedly get a proposal to reschedule, what has drastically changed? Th ultimate question is how the international drug control system will be impacted? Will rescheduling allow larger medical access? This doesn’t seem logical. The market has expanded and more and more cannabis medications are visible, nothing in the conventions seems to prevent that. The WHO has repeatedly recognized the therapeutic evidence is weak and not sufficient to support a change, they are never used as a first line medication and can almost always be replaced by a legal substance. As for a harmful effect, WHO is only about to launch an assessment. We intend to conduct our own national research and will share it. Without those results, it is premature to implement these recommendations. The political implications are also something to consider. Even minor changes will be considered by the general public as a blessing for the way towards full legalizations. The number of questions submitted show that we need more clarity on the issue. The CND is now not in a position to take an informed decision.

USA: We take note of the work of the ECCD. We have submitted a number of questions as we are charting a way forward for international scheduling. It is our global responsibility to get it right, we can not rush this. We are in some ways, hampered because the original convention was drafted with limited knowledge. We have to be mindful that we share a universal commitment to the scheduling process and address our overarching concern about the welfare of mankind – prevent abuse but assure access for medical purposes. Does the ECDD has the flexibility to react to the interest of governments in regard to modifying the recommendations to be more specific and stir it in a different direction? Several recommendations are based on findings of others, but this is not written into the recommendation – what would happen if the underlying recommendation is not adopted?

Uruguay: We understand the recommendations are positive step towards a right direction. We request the recommendations to be approved as soon as possible.

Pakistan: We need more detailed assessments as a number of MS have contestations. What was the criteria to include cannabis in schedule 4? What are the findings have compelled WHO to delete Cannabis from schedule 4? Removal will increase the repercussion of legalization? Scientific use is more important the threat of risk? What re the remaining areas that need to be explored to see way forward clearly? This is the most abused rug worldwide, in our view stricter control is needed. We think the removal will increase the threats of Cannabis – it will mark a shift and a further weakening of international control. It may send out negative signals and might be perceived as a promotion of legalization.

China: We have submitted our questions already and hope fir written answers. I would like to echo Russia, Pakistan and US – we need more scientific evidence, this should not be rushed.

WHO: In response to Canada, the guidance document is called “the blue book” internally, it is a 25 page document adopted in 2010. The role of this document is to give procedural guidance and operationalize the rules set out in the conventions. It ensures that WHO review process is on public health and scientific principles and provides clarity to the procedure as a whole – includes a lot of things that Mr. Forte has outlined earlier this morning. It can be found on our website.
Concerning the potential to clarify and refine the recommendations – at this moment, there is no process in place or plan to revisit the recommendations.
Regarding the change in knowledge, in response to Mexico, it is correct that there has been a vast change in our understanding of the plant and substances. There was no attempt at the time of the original scheduling to medically asses Cannabis so there was no information available then. The research on harm and potential for abuse has developed majorly since.
With respect to the question of the EU, this is our first opportunity to engage but we understand that there will be an additional intersessional this year when we can continue. We will share documentation of today’s exchange. We are happy to continue this discussion – we see it as a process where we clarify the rationale and way forward.
Responding to USA and Pakistan, we will address them in the following section.

Chair: Some question were addressing INCB and UNODC, we will give them an opportunity to respond later on so we proceed with our agenda. WHO, please provide answers regarding 5.1.

WHO: Cannabis and Cannabis Resin are currently in 1 and 4 of 1961, we recommend to only have it in 1 based on similarity issues. The drugs in schedule 2 are considered to be weak opioids. We considered the liability to abuse and decided that Cannabis and resin were more similar to schedule 1 as schedule 2. That evidence is outlined in our report. The main points address the effects on mental state, potential for abuse, lethality, impairment of cognitive functions.
Only a small subset of drugs in schedule 1 are also in 4, apart from cannabis these are opioids without therapeutic use, for example the latest addition was carfentanyl. Cannabis did not produce similar ill-effects. In 1961, Cannabis was included as no therapeutic potential was recognized. Today, national regulatory authorities in a number of countries approve cannabis-based medication. We considered that Cannabis was not similar to other substances in schedule 4 and decided it is not appropriate to keep it there.  The impact of this will vary from country to country.
In response to Canada’s submitted question (How does the committee reconcile its recommendation to maintain cannabis under Schedule 1 with the fact that the committee did not consider that cannabis is associated with the same level of risk as most other drugs that are in schedule1) it is important to consider that we noted the high rates of public health problems arising from cannabis use and the global extent of such problems.
There would be no weakening of the international control if Cannabis would only be included in schedule 1. The levels of international control are a minimum requirement.

Chair: Floor is open to comments but please focus on follow-up to 5.1.

Mexico: Regarding from the scientific advancement of the past 60 years – if so is the case, why do we refer to Cannabis as a whole if its only one constituency? Why is delta-9-thc is similar to some other substance where mortality and etc risk is completely different? If the committee did not consider it to be dangerous as much as other schedule 4 substances, why is it recommended that cannabis and resin remains in that schedule? Seems to me as a contradiction. If toxicity and mortality is an issue, what are the other public health problems arising from cannabis use? What is the metric for these other health problems? What would be the difference between these and those arising from the use of other legal such as sugar, caffeine or even work? WHO determined burnout as an occupational hazard and now it is a medical condition – just to reflect on the medical understanding?

Russia: ECDD repeatedly reviewed the health risks of Cannabis and concluded that scientific evidence is insufficient to arrive to a rescheduling decision. What has changed? The evidence for medical efficacy is weak and insufficient. What is the rationale? Cannabis use has a number of adverse effects, safety has never been well documented, medical use is not proved to be safe and beneficial enough. Problems related to other drugs have reached epidemical proportions but no one recommended rescheduling those.

WHO: One of the reasons it is considered as a plant is the 1961 specifically including Cannabis. The second issue is why it is still included in schedule 1 is because it was more similar to substances there with regard to abuse. In this regard it is not just the plant, it is also preparations. The committee was aware of preparations illicitly that have a very high concentration of THC, so we were mindful of those as a recent phenomenon. Nevertheless, we considered it to be different from substances in schedule 2 as previously outlined. Regarding public health problems, the evidence is outlined in our report in more details. The main concerns were abuse and dependence based on epidemiological studies that established that 1 in 10 users do develop a problem. We were also concerned about driving under the influence of Cannabis that increases the number of traffic accidents. We cannot compare this to other types of disorders and unscheduled substances.
Russia, I suggest to take a look at the critical reviews that is a key document in arriving to our decision with regards to empirical research. With regard to the timing, there have been a number of developments as well as the resolutions influenced WHO to conduct the review, including medical use, number of research and increasing potency. With regard to clinical use, this is not our main reason for recommending the removal, the main reason is that it is not similar to the substances it is currently scheduled with. A number of cannabis medications have been approved in some countries which means a recognized medical use.

Canada: We have similar concerns as Mexico – can similarity be seen with Cannabis and alcohol and tobacco. We understand it is not within your mandate yet is an important question. You already answered this question but we do think this is an important comparison especially because you mentioned driving.

Singapore: Did Cannabis resin have similar considerations?

Nigeria: We conducted a survey at home and launched the report in January. It revealed 14million people used drugs and the most used one was Cannabis. Each time our military takes Boko Haram camps, we find a lot of Cannabis and are we are worried […] We raised this issue already at CND. One of the major reasons for the recommendations is the recently uncovered therapeutic use. The INCB noted that therapeutic use of cannabis is not usually the first line of treatment. The growing abuse is also recognized by ECDD. People tend to move away from the technical discussion in fear of giving flexible control to this substance. You noted that schedule 4 means additional measures – don’t ECDD think additional measures are necessary in light of this growing abuse? How do you reconcile the incompatibility between your own conclusions and the reports of the INCB?

WHO: To Singapore; yes but we now recognize a wide range of preparations. Addressing Nigeria, I would make the point that medical use was not the principal reason for removal but that it was not similar to the other substances t was scheduled with in schedule 4. This criterion of similarity was most important. With regard to clinical use, it is true that a number of indications are not first line but have been showed to have several level of interventions – first line doesn’t work for everybody and different types of interventions need to be available. It is still clinically important to have second and third line of medical response. About additional measures, they can still be put in place by MS if they feel necessary in their local context.

UK: We align with the EU. Mr. Forte made a pertinent point that by removing Cannabis from schedule 4, we are not weakening the international control although reading the media reports, I understand the concerns. Are there any communications outside CND to clarify the recommendations that this is not aimed at weakening the international drug control system?

USA: As a follow-up to Mexico’s question, you responded that the scheduling must be as per the treaty – is this a result of a legal opinion? This seems as a pivotal issue.

Russia: We looked at the 41st technical report and found limited list of references, none of them published in international peer-reviewed journals to support rescheduling. We are looking forward to seeing your list of literature.

WHO: With respect to the question from the UK, indeed it is important for us to communicate properly. Misleading statements are visible so we are working on a communication strategy and translatable material. We count on your support for that.
Responding to the US, there is a commentary in the convention regarding the deletion of Cannabis. This is not our recommendation at this time, but we did consider new evidence. The control can only be changed through an amendment and not via recommendations.

Slovenia: THC is in the first group as per this recommendation, but we know that other plants also contain THC other than Cannabis. Will these plants be then scheduled in the future?

WHO: I find it strange that you refer to other plants. Those should be controlled with regard to THC itself.
With respect to Russia, could you please submit a written request so we understand what exactly you are..

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Dave Bewley Taylor (Global Drug Policy Observatory): I plan to discuss the key points made of our report, and the important and pressing issues which are in many ways being overlooked in current policy debates, both regional and international. Our new report ‘Fair(er) Trade options for the cannabis market’ that entails fairer trade is built upon some of the key findings from the hugely successful report produced by the CARICOM regional commission on marijuana. The report was a thorough consultative piece of work in terms of research for the region. Attempting to emulate the good practice of the CARICOM report, the cannabis innovate report is based on mixed methodology, based on research with stakeholders, with a variety of workshops across the globe, and consultations with drug policy and free trade experts.

Fair(er) trade reflects an acknowledgement for the definitional basis around the term fair trade and variations thereof. It demonstrates our belief for the utility of high principles, what we might call the fair trade movement, the rapidly restructuring drug market and how it’s impacting small farmers in what we call the global south. I’d like to run through some key points of the report; Policy change over the past five years significantly reshaped global drug and medical approaches, the change agreed in many quarters looks set to bring a wide range of benefits on health and human rights. There is genuine concern about unfolding market dynamics and particularly the issue for profit companies and threat and exclusion of marginalised farmers from less developed nations. Despite some efforts to assist small scale farmers to transit out to legality, many barriers still exist for entering the market for these communities. We argue for a fairer trade model, built around a rights based, inclusive and environmentally based approach and enables way in which we can frame the debate, and market structuring. Indeed, carefully designed regulatory frameworks can assist farmers to work with or alongside large companies, but importantly can also help achieving the sustainable development goals in these parts of the world where ending poverty remains a significant concern and ‘leaving no one behind’.

We argue that the development of a fairer trade market needs a different approach and a consideration of a range of interconnected frameworks committed to the commodity chain. Within the report these frameworks are designed to better understand the situation and focus our minds. We can organise those in terms of producer, quality standards, consumer and end-user. There are key issues we need to consider, such as empowering producers, quality and standards and manufacturing practices, issues to do with consumers and end users. We can ask questions such as is there a demand for fairer trade? What are the opportunities and challenge in recruiting political consumers? Doing so will avoid the big cannabis complex in well-function supply chains and policy tools to shape markets. It’s important to stress these are initial considerations as opposed to anything definitive, allowing thought and change for a future market. These frameworks are applied in nature, and we must be thinking about now and what can be done on the ground.

Looking at cannabis as a commodity in itself, we can look at experience from other commodity sectors. In order to frame the broader debate, and associated nature of market engagement, we offer up  a more generalised conceptual structure, and while the rapidly expanding landscape is complex, it is fluid and it is possible to establish agreed upon principles in which a cannabis market can be built.

Guiding principles are core inclusions to the commitment to solidarity and social justice. We must build farmer empowerment and view farmers not just as producers but as valued creators. Labour protections also involves fair domestic control and civil society participation in the policy-making process and as a result greater transparency and long term strategies, not immediate, but long-term. Finally social history, foregrounding traditional growing communities and religious and cultural histories as the market develops. It’s important to highlight these are not exhaustive and will be developed over time, we see this project an initial view into the topic, hopefully stimulating further debate and establishing a research agenda as the illicit market evolves. Above all, the guiding principles and report now at the CND and at the national level are a call to policy makers to developments agencies and investors, to take fairer trade seriously and to help to transform a utopia to a reality

Annette Henri (Cannabis licensing Authority, Jamaica): I will be discussing ongoing legislative reforms and deliberate steps Jamaica has been taking to involve traditional ‘grassroots farmers’ in the emerging licit global cannabis market. Importantly, the cannabis licensing authority believes that it is crucial to the Caribbean region to contribute to the debate around cannabis. This side event will be a catalyst for change and greater cohesion, regionally and internationally. At the heart of much change, specific cultural aspects must be involved. Prior to the amendment of the Dangerous Drug Act amendment in 2015 , there were many agitations in the Rastafari community. The Dangerous Drug Act of 1948 spelt many negative consequences for persons prosecuted for small quantities of marijuana from personal to sacramental use. Since, the Cannabis Licensing Authority has gone above and beyond to facilitate the lawful, medical marijuana industry. We went even further by allowing Jamaicans the right to grow five plants, ensuring an individual in possession of two ounces or less can no longer be tried in court as it no longer carries a severe criminal conviction, instead at most a fine. We understand the significant impact of criminal records and favour a system of rehabilitation, which is the way to deal with the matter.

The CARICOM report speaks many things; but an important proponent is having provisions in place to protect children and vulnerable people in possession of cannabis through the likes of counselling and rehabilitation. In terms of provision, the National council of drug abuse is the supporting body in Jamaica by dealing with matters of public education and vulnerable people. At the cannabis licensing authority, we are responsible for Jamaica’s regulatory framework. In 2016 and in conjunction with the ministry of justice, we have established a new framework perspective for Jamaica and we are mindful of cultural activities and the international sphere. Looking to the future, it is important we treat the realities both locally and internationally. Enforcement and monitoring divisions, responsible for carrying out surveillance on industries must ensure licenses are distributed in conformity with those requirements.

Importantly for Jamaica we understand the social reality, the amendments demonstrate Jamaicans are law makers and are aware of their social and economic realities both internationally and locally. We are working with different entities to ensure right testing measures are in place, and to ensure cannabis for medical purpose is of high quality. It is important to maintain good manufacturing practices, good distribution practices, respectful of law and a licensing authority responsibility. The eventual hope is by seeking to put regulation on imports and exports of cannabis and hemp.

There have been persons in the Caribbean who will say years before this 2015 amendment that have gone to prison for small possession. While I also comment on fair trade, the licensing authority Is planning a category or subcategory to support the cultivation of marijuana for medical and scientific purposes. Small farmers will be able to apply for waiver of all fees payable on the regulation. As licensees would be expected to enter this regulatory place and not withstand this tension, a small farmer to apply to the licensing authority, to defer the payment, may enter into part-payment or may ask us to waiver these fees. There are particular group that have been cultivating cannabis for a long time, and especially traditional marijuana farmers and an a move away from an illicit market. There must be alternative development and fair trade principles employed to secure a legitimate place for small farmers in the fast growing cannabis market.

Expect more from Jamaica in the future, come April we will be launching the alternative development programme. Jamaica has also decided be here with a delegation of six, but we hope to be here with many other Caribbean countries and hope to seek a place on the CND in the future.

Rose Marie Antoine: My discussion today will focus on the Caribbean and what we will do in terms of the status of marijuana. It is important to understand that the effects hold great significance beyond the CARICOM region, but at the international sphere. Our exercise to this point has consisted of wide spread consultancy, and since it was launched, Jamaica jumped first at the opportunity of de-factor legalization.

St. Vincent was one of many to pass laws to legalise cannabis, as many countries are willing to engage in reform, following what is clearly the desire for Caribbean people. In terms of policy and legislative change, CARICOM has been a massive success, acknowledging failures of current regime and we look forward to continuous change. Domestic change on the front, there must be policy shift in the international bodies and policies. This is an opportunity for reform on a scientific and evidence based grounding. So permitting medical marijuana as a legal substance in my view is necessary but not a sufficient first step. Incidentally the distinction between medical and recreational is artificial at best, one man’s recreation is another woman’s medicine. The Caribbean has however hit the point of unforeseen roadblock with regards to cannabis as for many years the questions was legalize or decriminalize, or whether to accept cannabis as a status quo harmful substance. A paradigm shift occurred, the medical marijuana industry which appears to be a positive development, albeit the phenomenon presents a dangerous setting to ordinary people and can hijack the international agenda for reform and can even reverse important gains in the cannabis debate. We may have won a battle, but the war is still yet to be won. It is speeding up for medicinal purposes and slowing down for legalisation purposes. Caribbean people want this change and therefore it is a paradox. Cannabis should not be demonized, yet this new threat is emerging, and we are victims of our own success. What caused this?

These are the reasons; change in public opinion that international arrangements prevail. For many years in the Caribbean it was a free substance many have memories of grandparents using it way before prohibition which has severe consequences on people’s cultural traditions and around before ancient times. For the Rastafarian community it has deep religious sacrament and meaning. The current laws that exists in our region are only responses to international treaties and dangerous for our telling value. Harsh penalties operate within a context of strict liability and we accept the benefit of research that has now been proven inaccurate and a lot let harmful than made out to be. There is credible evidence that the acquisition of legal status falls in line with alcohol. The law lacks a rational basis, and therefore we deem it bad law and our people cannot accept it. Prohibition has been ineffective and counterproductive and small amount of persons who continue to use it despite war on drugs.

Instead we look towards a public health and education approach that offers more reward, as we’ve seen the bogey man does not exist. We feel it is unbalanced to regulate and remove prohibition when looking at scientific evidence. In terms of social equality and social justice questions – social justice cannot be ignored as crucial to how to approach the international arena. Against the rule of law, we have jails overflowing with otherwise law-abiding citizens or waste housing, with the likes of 80 years old being incarcerated, with even police authorities telling us about such inefficiency. It’s the poor, the marginalised most vulnerable which in most case translates to race. These social issues in terms of how to address a regime cannot be considered by the medical marijuana exceptions. We have seen an emergence of a rights based approach, the rights to grow a small amount of cannabis.

It is apparent there is big business concern and its bodies continue to support treaties. So I believe this new medical marijuana is creating an escape valve, treating bodies to not address the error which is the classification of marijuana, and to refuse to front the deep social issues. In terms of international law challenges there are some fears about the international paradigm, since international law and treaty instruments they ride their authority for consensus, the fact so many nations and Uruguay, can have already moved from these, it undermines their authority, a theoretical and academic argument.

Small vulnerable developing countries do not have the political clout like Canada, they do not need a fearful treaty to survive, so we recommend CARICOM to form a regional position and have a persuasive voice to part with like-minded companies to have a clear roadmap to lobby for change to these treaties, and an important opportunity for change. For the long term I am convinced treaties must change and, big business interests can no longer be ignored, deja vu a lot longer than I thought. We must protect our hegemony. The emerging trend is for government to be influenced by treaties as well as big business, with wide agenda for reforms turning a blind eye to specific industries. Ultimately we call for a broad approach rather than one narrowly focused on medical marijuana and big business.

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Isabel Perreira (International Drug Policy Consortium): Our law in Colombia includes all services, however there is unmanaged pain for many populations which directly infringes on health and right from torture. We started the research on five core cities which have heroine consumption both small and intermediate, and found minimal palliative care as opposed to the likes of what was evident in Bogota. One programme we have been involved in, consisted of speaking with local and Health authorities who have been working towards methadone programmes so people can access treatment in a safer way. This has been ongoing since 2012, with each city making progress to heroine within the country.

In terms of barriers to accessing methadone, the first issue in Colombia is that we don’t have liquid presentation of methadone. Second in terms of convenience, though the law states opioid should be available 24/7, for people using heroine there are strict schedules as to when people can receive medication. This becomes a burden upon people who have got back into employment and a challenging means to ensure availability to those in need. Some methadone programmes do not allow women for reasons unjustified completely, with data showing that in terms of accessing controlled substances, women are a much smaller population who hardly access treatment at all. For palliative care, we must consider going about demographic transition and what happens when there is a rural inequality in terms of access. In Bogota for example you may find a specialist, then if you go to smaller cities you may not find such. The system means regional authorities have the task of providing OST, and whilst the national regulatory distributes to regional territories, the regional territories lacking institutional capacity do not buy the opioids and therefore for this reason very little or no opioid prescriptions are available.

In terms of palliative care, in homes it is essential for the person or family to have end of life in a secure place, yet due to demanding regulatory frameworks, this is often prohibited and a great issue. We need more presentation available in the country to provide better resources for heroine users. Finally, the role of doctors and health practitioners for both communities of care, it must be addressed how to best engage in conversation about opioids and managing health difficulties of a complex manner, in a way that has a human side. For many populations opioid is central but is not everything. The social services must consider the likes of end of life in order to reach the humanity of people. We must think beyond opioids and how to build these conversations with people suffering.

Helosa Broggato: We must talk about the global situation on access to opioids. The current global situation on global medicines, finds that only 21% of people have access to low medicines, with even less availability in low-economic countries. Pain care is an essential element to health coverage, and opioids are necessary to manage pain with dramatic injury, surgery, opioid agonistic treatments and harm reduction approaches. In terms of the distribution of morphine equivalents, the lack of distribution can be found when comparing the US and Haiti. In Haiti only 5.3MG per capita are available, whereas in the US 55,000 (the lack of availability also a comparable situation in Africa and India), what does this mean for people in pain in LEDC’s?. It is a humanitarian failure, one reason for this situation, public policies focus on health outcomes on extending life and productivity rather than on alleviating pain and ensuring dignity. Currently such approach is reflecting drug policies that show an unbalanced approach to availability of controlled medicines and preventing use of the same medicines. There is also misinformation about opioids which generates fear of prescribing them, and providing adequate amounts to each available country.

A significant barrier to access for pain medication and opioids, are restricted laws and regulation, red tapes, bureaucratic processes and lack of education. There is also a high turnover in people in high government positions and lack of budget resources. A common challenge in all countries is the understaffed teams in local authorities, with many responsibilities such as monitoring not only controlled medicines. It’s true there are improvements and in some countries legislation has seen changes, but changing legislation is important but not enough. We must work to understand the day to day life of individuals. National authority regulators post-research and stakeholders alike demonstrate their views about regulation and opioids. Normally national authorities need to ensure access to pain medication as it is their responsibility. In practice they are concerned that eliminating barriers could lead to diversion, this reflects drug control treaties that are focused on illicit use rather than the balance of good. If countries want to achieve DSG 3.8 (Universal health coverage) they must address this issue.

Marta Ximena Leon (Pain and Palliative Care Group): The number one symptom for medical consultation is pain. We must notice it is important to treat pain in a way that strikes the concept of balance between availability and accessibility to opioid use, and prevention of issue and diversion so that we can have sufficient opioid to treat individuals. The experience in Colombia is of very Low opioid consumption. As of 2006, just 3.6mg per capita of morphine was available, this in comparison to a much greater global average consumption standing at approximately 45mg. The general indicator for a nations ability for effective pain control is in the availability for opioid consumption. We must look for core solutions and diagnose what’s going on.

In terms of solutions, a workshop in 2007 where the WHO and ourselves brought together from different regions, many stakeholders including; physicians, insurance companies, ministry of health, along with many people belonging to pharmacies to understand what was going on in the regions. After there important consultations we had changes in proposals, changes in resolucion 1478 for schedule 24/7, and we worked on these changes and resolutions as a result of working with many stakeholders.

We have witnessed growth in use per capita and opioid big cities (availability) yet very little in rural regions. During another workshop to tackle the issue, we asked why do patients in Colombia have difficulties to access opioids for medical use? We are a country with a wide portfolio of opioids, we have a law to guarantee the distribution 24 hours a day for accessibility and availability, we have low cost opioids that are included in the benefit plan, meaning free for patients.

In terms of other surveys we conducted for physicians and regional authorities around the country, some of the core issues raised were with regards to ; public policies, education, budget, cultural and community and services. Though there is an unequal distribution of opioids in Colombia, it is a lot better than in 2006 which had succumb to much political and economic influence. We must work towards prioritising the concept of balance and a need to cooperate with all the stakeholders and propose solutions. One solution group may not cover the entire perspective and this will make solutions more real for opioids for medical use.

Naomi Burke-Shyne: We also use opioids to treat dependence disorder, as not all drug-use demands treatment. When somebody is in need of medication we look to opioid substitution as a means to avoid hepatitis C and stay healthy, enabling individuals to stabilize their lives through a medical option rather than buying drugs on the street not knowing the substance. There is no universal definition of harm reduction, but we demand a non-discriminatory approach. Opioid substitutions and methadone should be made available and should be produced by national authorities. Methadone is the most prescribed substance around the world, and we have witnessed how heroine assisted therapy is reducing illicit heroine use around the world. From a global perspective, a number of countries in which OST is available is increasing, around the world we identify countries that can provide these services (Vietnam is a great example of political will and scaling up harm therapy) but there are still shortages of data.

Generally we see that it’s 2.5x more costly to put someone in rehab rather than on path to the right support. For every 1 dollar spent on therapy, 4-5 dollars are saved from the Australian expenditure. The middle-east has had the largest increase in OST availability, with now more than 7,000 centres providing to 65,000 people. Latin America however has one of the lowest OST provisions. In terms of barriers you can look at access to medicines, and the severity of regulation that demands a specific qualification in order to prescribe methadone, and generally we are seeing women and migrants around the world struggling to access these resources. There is also a great concern around the worry of addiction which in actuality is instead placing a major barrier to development. When medically prescribed, the risk of dependence is proven to be a great amount lower, with many countries providing OST resources which are government funded. To conclude, we’re looking at a patient based response, a health based response and we urge member states to take these matters seriously.

Q&A

Q) I’m thrilled to see access to medicines involved with harm reduction, Marta could you address the barrier of training physicians? For people who are dependent, does the end of life becomes more complex?

Marta Ximena Leon: In universities around the world training care is not in the curriculum of professionals for pain and palliative care. We are fearful for prescribing substitutions. All curriculum based pain and palliative care should have a place for the many changes and a growing population and much more pain suffered. We need people who are trained to manage pain and all other symptoms. Physicians are afraid as we are not trained and it’s a barrier we must overcome. We do need to use opioids because we need to treat the pain in the patient and ensure a good quality of life. People must be treated by physicians who are trained, and the reason it is so important that it is done is a responsible way. We especially see opioids as important at the end of life, in line with quality of life.

Q) is there any relation between distribution and lack of training?

Marta Ximena Leon: Medicines and training are core. If no one is willing to prescribe them people will not use them. In some places there is strict regulation in terms of who is going to provide, in Colombia it is good because general physicians can provide also, howeber at universities, they are not provided with such curriculum to ensure the competency to do so.

Isabel Perreira: In terms of training; professionals need to know the way to prescribe and when. Currently we see an interpretation of regulation by physicians in the most strict way possible, for example methadone treatment.

Helosa Broggato: Sometimes we look at regulations in different countries, sometimes perfect, but there is a generally varied mentality to prescribe differs across regions. It is a matter of not only changing regulations, but also changing mentalities.

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Dr. Cesar Arce (SENAD): Reflecting on my country Paraguay and a new law for medicinal cannabis along with a research purpose. I wish to start with national policies in deregulation. These are guided by three tools for international control, built by the first planned national control of the drug, along with the three UN documents (Political Declaration 2009, UNGASS 2016 and SDG objectives).

In terms of marijuana in Paraguay, we produce peacefully and do so with the very highest quality of THC. In ensuring our decisions are guided by specialist strategies we can ensure marijuana for research and useful medical purpose. We have treated many people who have diseases, epilepsy and we try to use it especially for these cases. Not only are we considering to lower the level of THC, we are currently conducting research on how to mix low-level THC with CBD, and have so far found that in many cases there is a solution. In terms of national policies we must integrate education, health, social and economic, and justice as a collective of branches and without such it’s impossible to achieve a proposal for drug policies.

We have many specific area objectives including; health, social determinants, communication, prevention, treatment, social research, institutional regulation and coordination with all institutions of the government and NGOs. Our approach to policy is based on applying evidence and we believe this assists in establishing policy focus. We have created a new institution for this purpose, and this institution is working with ministries, the anti-national drug secretary, research institutes, scientists and academia.

An important step to be taken is to have a variety of cannabis that has a low level of THC. We believe this can be done through developing the right industries, and focusing on extracting and concentrating to create a free supply that is available to people who suffer diseases and chronic pain. Now we have started to cultivate this type of cannabis, it for us is very useful. We believe for the future we can continue to create an even more effective product that can replace the type of plant, with emphasis placed on ensuring a role for CBD.

Miguel Candia (Chair): Thank you for demonstrating how countries continue to develop domestic institutions to find a new approach to future drug policy.

Eric Correia (Grand Gueret of France, member of NORML): I am in direct contact with patients, I am also the president of a French community, a real area of a significant proportion of unemployment and elderly. I am another activist to place real importance on protecting the health of the public. In France 0.4% of the population has admitted to making a medical use of cannabis every day, this is what I understood, and what I have understood has urged me further to make a strong commitment to the matter. In agreement in attempts to reduce levels of THC, it cannot account for more than 0.2% of the final product.

As an health professional I urge the call for patients, as an elected official I am calling for economic development. To authorise medical cannabis in France, my country, would be following what many states across the world have done. Cultivating cannabis use has opened up many new business streams which have proven to be greatly successful taking up great profits. Most importantly for patients throughout the world, we discuss a product less harmful than opioid.

Medical use of cannabis can be an economic opportunity, and is an economic opportunity. This common project that we share is demonstrating this crucial work with the public and to elected officials who only know cannabis from a criminal perspective. The French ministry has decided to create a specific committee involving the medical sector in France, and it has delivered its first conclusion for walking today on new turf. I would also like to insist that a medical notion must prevail in this matter when treating an individual. Therapeutic cannabis for human suffering has proven it can treat chronic pains and physical tremor. This is not about opposing a therapeutic proposal of opioid, but an alternative product. Our choice is one of life over pain, it’s because it’s our management of therapists over patients, it’s our duty to help people who are suffering and promote the voice of people who are cured in the healing process. Why should we bear anymore suffering if there are ways to reduce it? It must be available to any citizen, medical practitioner, any elected official, any human.

Miguel Candia (Chair):We always have to ensure that legislation always keeps in mind the human element. The SDG’s themselves place great focus on health and a framework to work within the UN system. Both for enforcing law and evolving law, we should keep human rights in the middle of this, with dialogue essential. One of the core things we can leave the room with is, national regulations are fundamental and the building blocks to a well-oiled response to the problem.

Diego Olivera (National Drug Board of the Republic of Uruguay): On legal terms we were the first country to complete regulation of legal activities of the cannabis plant and product. By law our regulation approved in December 2013, was approved in our parliament and this law established the legal framework to regulate cannabis production by the state who play an important role in this implementation. An approach based on public health, holds great importance and is the core of our approach, with a view for harm reduction. This opposed to use in the illegal market where damage is much higher, and a place for greater impact of narcotic trafficking and organised crime. This legal framework creates a new public institution for regulation and control of cannabis (IRCCA) who hold the ability to implement, move forward matters of regulation market and to have a relationship with the executive branch and say/propose modification in the cannabis implementation with the national drug board related to the presidency. The structure of IRCCA has a national board with the ministry of culture, ministry of public health, ministry of social development, National council with civil society and the academic sector. Our law is initially related to the issue of non-medical use and a policy concern in 2012/13, and includes the medical use and the industrial use as well for; regulating crops, commercialisation of cannabis for scientific purposes, medical purposes and human use relevant. All of these activities need an authorisation, (a license which is impossible without as such) the IRCCA delivered 16 authorisations with crops with more than 1% of THC.

For non-medical use is not the issue of this panel, but it’s important to note that the medical non-use is separate from medical production with a type of authorisation which have different structures and regulatory frameworks. To mandate people who want to access non-medical cannabis, our most important impact are in the well-being and health of non-medical cannabis users that are separate and away from the licit selling’s, education and well-being of society. What is clear, is a prevalent strong communication plan and an approach for health and economic development related to the legal industry in medical and scientific purposes.

Q&A

 Q) What evidence do we have of reduced crime in Uruguay since the change in cannabis legislation?

Diego Olivera (National Drug Board of the Republic of Uruguay): Uruguay thinks it is a very important matter to research the impacts. We have a strong view related to the academic sector approach including public institutions related to policy evaluation, and strong work related to cannabis and policy in our country. We think we need more time to complete implementation to make a strong conclusion, but the current estimation of legal cannabis produced for non-medical use is approximately superior to $22M dollars. Importantly if the legal regulation did not exist we would be buying criminals, yet instead we achieve our very strong objective to an economic impact in terms of dealing with organised crime in our country. The number of persons who incarcerated for drug offences are decreasing in our country, it also is very important to state the decrease of the population in shame, and we have seen in the last three years a decrease in the penalties related to marijuana in Uruguay.

Q) When introducing a system of medical marijuana you should have a national agency that buys all cannabis then distributes it, is this is the way it is done in Paraguay?

Dr. Cesar Arce (SENAD): I set out for this law of medical cannabis a need for a new office and a new authority for law application, it’s a condition to cultivate that it’s legal and a condition to monitor. The second step, is the minister of health has to give license to cultivate the use of oil, and ensure cannabis has a high level CBD, and a low level of THC.

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Vera Strickler (Switzerland): To analyse key trends on the global drug market it is crucial to have reliable and empirical based indicators that are in line with the UNGASS document. In the past, Switzerland has been supportive for the UN systems, and I am glad we can write the topic today.

Isaac Morales (Mexico): On the topic, it’s essential to have such concrete and action oriented debate. Since UNGASS 2016, the government of Mexico has been committed to developing the mechanisms to better data collection, better in statistics and indicators, and international drug policies and programmes. I believe it is so important for the purpose of this recommendation to review the ARQ, and three elements; data collection, statistics, indicators part of a whole chain. For the Government of Mexico, ARQ improvement focuses on UNGASS implementation and SDG’s.

 Over the past two years across seven regions, and as a resultof plural exercise with national authorities, legislators, and experts from civil society and academia, we have created a metric with more than 100 recommendations for the 2016 UNGASS outcome document. To each of those recommendations, we lead an alternative – then find a leading alternative for each recommendation. With the support of the rest of the authorities and sectors, we have developed the level of maturity in the programmes, asking questions such as is it already implemented? Or should it be implemented and at what point in the future? Asking these questions is the best way to capture what we call a comprehensive and balanced approach.

It is important that the ARQ is not enough, the number of eradicated areas, albeit are important, but not solely for the communities affected by illicit cultivation. We have consolidated better data collection processes among sector actors, for example among different authorities and different reporting structures. Regarding the SDG’s, we have spent a great amount of effort and negotiation power for CND documents recognising that drug policy and the complimentary agenda are reinforcing. We do need to go into action in this regard, I can share with you that the new Government in Mexico created a national commission on the implementation of the national agenda. The commission will be in charge in the follow up of the SDG’s, and the commission will adopt a layered approach that will integrate all the national authorities with civil society representatives, the private sector and legislators. All local governments are now obligated to report in a similar formula, also drug policy efforts have to contribute to the efforts to accomplish the SDG’s, this alignment thinks more about sustainable goals and indicators.

We need to further identify key indicators for drug policy and programmes on human rights, poverty etc. It is challenging, as the line is very thin when reporting from drug policy issues to human rights issues, or from poverty to health. Such difference establishes a core need for clear indicators. We need to find a way to also review duplication of efforts, data and report. We are working with the National statistic institution to find this data and shortage. I wish to recommend regional experience through CICAD, the evaluation mechanism, and building to a robust format, more so than the ARQ, and with the support to better evaluate drug policy. I’d like to conclude with stating our close cooperation with Mexico UNODC, we have been bringing to the statistical commission the need for improving data statistics, and of course it has not been an easy process because of politics from our point of view, but this discussion must be more so technical and less political.

Michelle Boudreau (Canada): We must look towards the creation of a data framework, that is effective and reaching into communities. Improvement illustrated in data release with greater finesse, illuminating which populations are most being affected? What age groups? Focus on this population and area of work in which men are most engaged.

Sex, gender and equality in the SDG (Consumption sites) which have been operating with regard to sex and gender, provide consideration of peer injection and concern that women are being isolated from these consumption sites which did not allow peer injection. Women are more affected by peer injection (smaller veins, power imbalance, potential for violence), and there is need for closer scope of what could be done to address such. The pilot project which formed in a data collection process measures multiple components such as gender, and where is the point in which women can gain inclusiveness. I wish to conclude: ARQ, the more we find data, the more we can aggregate it at the national and international level also.

Paul Griffiths (EMCDDA): There is of course importance of a political and ARQ communication, yet it is equally important to understand the differences that lie between the two. The ARQ has been revised twice in the last twenty years, the data isn’t showing a clear result, many countries do not report at all, and some countries that are reporting are weak on demand side of data and responses, the data exists from countries that have developed data systems.

When looking to the future, many issues are suffered in lower-income countries in terms of the retrieval of data. It is therefore very important to create tools to ensure countries are assisted. We seek to streamline practices, and ensure data is less of a burden, yet instead more comprehensive and more additional information is meeting today’s needs. There are of course many issues that are politically sensitive which may affect the willingness of some nations to report. Drug situations changes very dynamically, and we are alike in the process of change.

It is important we do not look to the past and but instead use these new methods that integrate coherence, national reporting across these areas which reduce reporting burden. Lack of resources, and form for proper debate at the union level, how do we technically put things in line and look for coherent approaches? I was inspired by a technical meeting which looked at the start of the ARQ, and what that meeting give out was that we needed an ARQ fit for purpose and fit for all, it needed to represent countries at different levels of development. As an expert from where we have good communications, often the voices we hear are from those in developed systems, we tend to be insensitive and resist the countries which do not have the same structural systems.

What’s the way forward? The ARQ is important, it’s a form, capacity building must be a key element, if a country does not have a capacity to build, you have very little to do with the form. There is a need for Technical and political expertise to be speaking together. Most importantly, sustainability, which will only happen if countries value data collection processes at national up to international level. Responses at the ground must head up. The way forward, a modular approach linked to capacity building, we need to look at the national level and finally incorporation of flexibility and changing circumstances, so for the future ARQ must ensure flexibility to better address future demands.

Marie Nougier (IDPC): In the past couple of years, there has been a lot of discussion in Vienna around the need to review the ARQ. This is also a question that has been very much discussed on the civil society side, including by IDPC, but also other NGOs such as the Global Drug Policy Observatory, the Social Science Research Council, the Centre on Drug Policy Evaluation, CELS and others.

As many of you may already know, IDPC recently produced a Shadow Report entitled ‘Taking stock: A decade of drug policy’. Although the objective of the report was to look back at the past decade of UN drug control, we also took the opportunity to look forward, and to provide recommendations for the next ten years of drug policy. And one of the issues we particularly focused on was that related to data collection and the Annual Report Questionnaire.

When we started working on the IDPC Shadow Report and looked into the data available on global drug policy, we reached two main conclusions. Firstly, most data collected via the current ARQ focuses on measuring the overall scale of the illicit drug market. But there is a need for more thorough research and data collection on the broader impacts of drug policies on protecting health, human rights, security and development. These are the overarching objectives of the United Nations – which have been enshrined in the Sustainable Development Goals – and drug policies should aim to contribute to those key objectives. Although there may be value in measuring the scale of the illicit drug market, evaluating whether there has been a reduction in illicit drug demand and supply is certainly not enough. The new thematic areas of the UNGASS Outcome Document on access to controlled medicines, human rights, women, children and youth, and on development, also require that progress be tracked against these operational recommendations in the revised ARQ.

The identification of better indicators aligned with the 2030 Agenda for Sustainable Development would enable member states to truly measure progress made in drug control to improve the health and wellbeing of humankind.

And this is exactly what we have attempted to do in the IDPC Shadow Report. There, we have taken each chapter of the UNGASS Outcome Document, as well as each target and indicator included in the 17 SDGs, and we have adapted the most relevant SDG targets and indicators to drug policy, linking each and every one of them to a specific operational recommendation of the UNGASS Outcome Document. I will only mention three examples here:

My first example relates to UNGASS Chapter 2 on access to controlled medicines. This is an area that is currently not covered at all in the current ARQ. There, it may be possible to measure progress against SDG Target 3.8 on universal health coverage, access to quality essential healthcare services and access to safe, effective, quality, and affordable essential medicines and vaccines for all. Specific indicators could include:

  • Process indicators whereby Legislation or regulations to improve access to controlled substances for medical and scientific purposes (e.g. making the substances more available, reducing the requirements to prescribe, or for pharmacies to obtain prior licences to dispense medicines)
  • Number of pharmaceutical establishments that can dispense opioids for pain management per 100,000 inhabitants
  • Proportion of medical and nursing schools providing palliative care and pain management training in their curriculum.
  • Also outcome indicators such as the proportion of people suffering from moderate to severe or chronic pain receiving controlled medicines, disaggregated by sex and age.

My second example relates to supply reduction and related measures included in Chapter 3 of the UNGASS OD, in particular the objective of reducing drug-related crime and violence in affected areas (enshrined in para 3.a of UNGASS OD). This is very much linked to the achievement of SDG Target 16.1: ‘Significantly reduce all forms of violence and related death rates everywhere’. Based on SDG indicator 16.1.1, we could consider an indicator focusing on measuring the numbers of victims of intentional homicide per 100,000 population in areas affected by illegal drug cultivation, production, trafficking and sale, disaggregated by sex and age.

My third and final example relates to Chapter 4 of the UNGASS Outcome Document and the achievement of SDG 5 on gender equality. SDG Target 5.1 on ending all forms of discrimination against all women and girls everywhere could be translated into an indicator tracking the number of reported cases of stigma and discrimination in accessing healthcare services by women who use drugs (related to UNGASS para 4.b on non-discriminatory access to healthcare services).

Our second conclusion is related to the fact that the ARQ might not be able to provide a full picture of what is happening on the ground. This is because only half of all member states respond to the ARQ, and of those, only a minority fill in the entirety of the Questionnaire. The resulting gaps in available data inevitably provide an incomplete picture of the drug policy landscape. But in addition to this, collecting data on issues related to human rights may be tricky and require the consideration of supplementary data collected by both civil society and UN agencies such as the OHCHR, UNDP, UN Women, UNICEF and others. These considerations should be taken very seriously into account the ARQ review process, and UN agency cooperation on data collection should be a top priority – especially in light of the implementation of the UN Common Position on drug policy but also to avoid duplication of efforts and available resources.

I would like to conclude by saying that we are acutely aware, as civil society, of the many challenges related to reviewing the ARQ, but also of the capacity building needs for many member states to adequately respond to what can be a complex, costly, and time-consuming tool. However, thisis a key opportunity, and we cannot afford to keep with the current status quo.

In January last year, an expert consultation was held to kick off the ARQ review process. But the event did not provide sufficient opportunities for a discussion on meaningful structural and substantive changes to the ARQ. The space granted to civil society and other UN agencies to feed into the process was also severely limited. Today, we stand ready, as civil society, to contribute to the review process going forward, including at the next expert meeting planned for July 2019. And we look forward to further discussions with you all on this issue in the coming months.

Q) Are gender and morale of harm reduction in Canada, related to the new indicators?

 Michelle Boudreau: Yes, I would say that the gender based analysis is a framework that sits over all of our policies, let me also add that our drug policy (substance) we have a separate framework that we have developed that sits on top of it to ensure that the various pillars (enforcement, treatment) ensure we develop those policies accordingly.

Q)When Canada started to legalise cannabis, has it been different or has it been politically different?

Michelle Boudreau: We have consistently done surveys in Canada on the consumption on drugs, alcohol and tobacco, based on fact and data. The concern was on the consumption patterns in alcohol, a big consumption and based on this. The intention of the public health approach to focus on that population, 15-18 and students who are accessing cannabis.

 Isaac Morales: I’d like to also add,it is necessary to have a whole picture of an illicit market, the whole drug problem not just the consumption, the supply chain etc. it is important to take into account the development issues, and the root causes and violence and crime related to illicit drug market, and by saying so I insist, it is important to identify and develop new indicators to make a better assessment of our national drug policy. Without these, we will not have the whole picture.

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Commission on Science, Technology and Development: Every year our committee has two priorities. The first is focusing on the impact of rapid technological change on sustainable development. The likes of big data, synthetic technology can create great opportunities to address the SDG’s. New technology also poses challenges. These can raise inequalities and facilitate illegal activities. Science and technological change are affecting the strategies taken to drug abuse, new risk and challenges to addressing the trafficking of illicit drugs. Scientific research on drug use and addictions are supporting policy-makers on drug addiction and treatment. Crypto currency and illegal currency important to the illegal trading, approximately 25% of all users and 44% of all bitcoin transfer are related to illegal activity such as illicit drug trading. Policy-makers must develop plans based on technology, one of the main task of the CND is providing such technological foresight. It involves bring together a variety sources of knowledge to shape the future. Distinguished delegates, science, technology and innovation are cross cutting actors that contribute to achieving all the SDG’s, gender is also another core issue. The CSTD and the status of women have developed a strong cooperation, and last January we made a new workshop that examined opportunities for gender Reponses in science technology and innovation, and supporting both commission. Today is the opportunity to discuss cross-cutting plans for the CND and the CSTD and look forward to discussing how the commissions can collaborate in the future.

Austria: We value interagency cooperation and we look forward to enhanced exchange of information and views. We have ls intended to your interventions and see many items where the exact work of your commission can help us to get more the point on the scientific based work we are doing and we look forward to further cooperation in both the CND and official crime prevention.

Women’s Harm Reduction International Network: There is great Importance in aligning the work of the CND with the Sustainable Development Goals. We advocate for drug policies aligned with the 2030 agenda for sustainable development. This ensures upholding the dignity and rights of all women. We call upon member states to respect women’s rights to life, equality and non-discrimination, as these qualities are directly connected to the SDG’s. Women experience greater rights of HIV than men, along with gender-violence and lack of gender-specific services. The UN guide of women who inject drugs can be used by policymakers to understand the intersection of gender, health and the sustainable development goals. We also believe the International Drug Policy Consortium shadow report ‘Taking Stock’ can be used as a review and metric to better evaluate women who use drugs and provide evidence based responses. There must be meaningful involvement of civil society for women who use drugs and we specifically state that we must truly leave no one behind, and to ensure this principle, women who use drugs must be involved in the policy-making process.

Harm Reduction Coalition: Thank you, madam chair. Before I start, I’d like to acknowledge, and pay respect to indigenous and first nations peoples. The world has failed people who use drugs and we must refocus our efforts. To do this, we need leadership on harm reduction. Harm reduction leadership means increasing political support and funding for harm reduction. Harm reduction leadership also means ending the criminalization of people who use drugs. Harm Reduction Coalition welcomes the recent unanimous endorsement by the Chief Executives Board, representing 31 UN agencies, common position on drug policy that endorsed decriminalization of possession and use. People who inject drugs have been left behind in the global response to HIV and viral hepatis. The 2011 target of halving HIV among people who use drugs was missed. It was missed by a staggering 80%! —and there been no decrease in the annual number of new HIV infections among people who inject drugs since. Countless more lives have been lost to overdose, violence, the death penalty, and extrajudicial killings. Moreover, people who use drugs lack access to health care, harm reduction and legal services, both in the community and places of detention, because of stigma and discrimination. Recent research indicates that less than 1% of people who inject drugs live in countries with high coverage of both Needle Syringe Programmes and Opioid Substitution Treatment—two interventions in the WHO/UNODC/UNAIDS ‘comprehensive package’ of interventions to reduce HIV among people who inject drugs. At this time, we urge member states to pledge to intensify meaningful participation of, and provide support, training and funding to, community-based organizations and civil society organizations (including organizations and networks of people who use drugs) in designing and implementing services and advocacy programs for people who use drugs.
Given the explicit endorsement of harm reduction within the UN human rights system, provision of harm reduction services cannot be seen as a policy option at the discretion of States, but must instead be understood as a core obligation of States to meet their international legal obligations. In closing, we need leadership on harm reduction. Leadership means increasing political support and funding for harm reduction. It also means centering the voice of people who use drugs in the global drug policy dialogue. Finally, leadership on harm reduction means ending the criminalization of people who use drugs.

ENCOD: Concern with ongoing process and providing the inputs of civil society. The following issues are core to ensuring protection of human rights to take into consideration the position of the UN. Laws and enforcement of drug control should be central on drugs policies that enhance the rights of people globally. Encouraging the authorities to promote the proportionality of penalties and must ensure basic rights are protected. To endorse a scientific approach to harm reduction and drug dependence, to recognise in the future strategies to increase the overall number of health, should be reoriented in the direction of harm reduction. Adopting a harm reduction approach is key to reducing unintended consequences for society and the well-being of individuals. To community based prevention campaigns which provide the unbiased and real effects of harm and drug consumption must be encouraged. We look must  look to how to address and take control of the scale of drugs. Policies should place people in the centre of drugs and offer flexibility on how adopt policies in different countries. We hope for policies to adopted in line with the SDG’s. United Nations offices should reconsider the correct actions are taken to protecting the rights of people who take drugs.

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Ambassador of Iran, Chair COW: Have finalized and endorsed all 8 resolutions, thanks to all involved for your patience.

Chair: Co-sponsors to be patient

Secretary: Provisions on L2, L5, L6, L7, L8, annotated provisions on L3, L4, L9

L2

Finance: 47000USD required for expert group meeting. No extra.

Chair: Do we agree to adopt? We do. Open the floor.

Co-sponsors: Afghanistan, Belarus, India, Thailand, Nigeria, Colombia

L5

Finance: No financial implications

Co-sponsors: Argentina, El Salvador, New Zealand, Romania (on behalf of EU), Ukraine

Colombia: Would like clarification – when can we be co-sponsors – is it done before or after – we would like to co-sponsor?

Secretary: After the adoption of the resolution, we will read out financial implication, then we invite the adoption, then we open the floor for statements and then we ask for delegations to co-sponsor. So there is an opportunity for everyone to sponsor after the adoption.

Chair: Who wishes to co-sponsor?

Secretary: Afghanistan, Colombia, Belarus, USA, Uruguay, Honduras, Japan, Thailand, Canada Nigeria.

L6 (sponsored by Ecuador, Peru, Philippines, Russia, Thailand)

Chair: I see no comments. Who would like to co-sponsor?

Secretary: Romania on behalf of EU, Honduras, Japan, Indonesia, morocco, Colombia, Nigeria

L7 (sponsored by Canada, Honduras, Paraguay, USA, Argentina, El Salvador, Mexico, NZ, Panama, UK)

Finance: OP2: 1.8 million USD over 3 years within the framework of a global project. OP19: 84K USD to collect national data and share info.

Chair: Adoption? It is so decided. Floor open for statements. Co-sponsors?

Afghanistan, Colombia, Belarus, India, Norway, Poland, Germany

L8 (sponsored by Australia, Ecuador, El Salvador, Russia, Argentina, Panama, Norway, Paraguay, Peru Philippines, Romania on behalf of EU)

Finance: OP5: 683K USD, OP6: 48K USD, OP7: 118K USD, OP9: 713K USD, OP9: 713K USD.

Chair: Adopted.

Co-sponsors: Colombia, Cuba, USA, Indonesia, Dominican Republic, Canada, Thailand, Switzerland, Venezuela

L9 (sponsored by Andorra, Argentina, Jamaica, (…) Mexico, Panama, Portugal, Paraguay)

Andorra, Argentina, Jamaica, (…) Mexico, Panama, Portugal, Paraguay

Secretary: Amendment, last PP, fourth line – ‘while also recognizing different levels of national capacity’

Finance: OP11 – 923000USD for MS to increase capacity for HIV prevention and treatment programs. No extra.

Chair: Do we agree to adopt? We do. Open the floor.

USA: US joins consensus, but takes note by our healthcare – family planning does not include abortion.

Co-sponsors: Australia, Colombia, Uruguay, Canada, Switzerland, NZ, Nigeria, Romania (behalf of EU), Honduras

L4 (sponsored by Australia, Andorra, Armenia, Canada, Egypt, Kenya, NZ, Norway, Ukraine)

Finance: OP5: 1.4 million for 2 years, OP12: 30K USD to inform MS on a yearly basis. Adoption doesn’t entail extra with regards to the regular program.

Chair: Adoption? So decided. Any co-sponsors?

Afghanistan, Colombia, brazil, Switzerland, Uruguay, Romania on behalf of EU.

L3

Finance: OP5: 585K USD to facilitate exchanges of best practices, OP11: 611K USD within the scope of the boards existing projects.

Chair: Adopted. Open for statements.

Russia: The Secretariat in presenting this document indicated the last resolution and I hope this could be put somewhat put differently “last but not least”. The work on the text has been time and human resource consuming. The main issues are to comply with obligations of the conventions and most delegations have spoken against trafficking, in favor of compliance and within the general goals of UN. We have gotten fine results down so I thank all contributions, especially those who co-sponsored. In this fashion, first time speaking on a resolution supporting INCB will prove useful.

Chair: co-sponsors?

Venezuela, Colombia, Cuba, India, Iran, Peru, Japan, El Salvador, Indonesia, Malaysia, Dominican Republic, Nigeria.

Chair: Now to adoption of the report.

Chair: CND shortening reports. Brief summary of deliberations. Also have debates and roundtables. You can find the report outside. Item 15 & 16 will be found later today

Rapporteur: Contained in 9 docs – E/CN.7/2019/L1 and relevant addenda. Admin matters. Includes ministerial segment.

Addendum 2 – Item 8

Addendum 3 – Item 9

Addendum 4 – Item 10

Addendum 5 – Item 11

Addendum 6 – Item 12

Addendum 7 – Item 13

Addendum 8 – Item 14

Agenda 16. The reports will be prepared and finalized under the guidance of Chair and myself after the session. I suggest to begin the adoption with L1 and then proceed one by one.

Chair: Thank you. Any addition and addition of language to be submitted in writing to the Secretary. We proceed with the adoption of the report – alltogether.

E/CN.7/2019/L1 on organization. Any comments? I see none – adopted.

E/CN.7/2019/L.1/ad.1 on ministerial segment. Any comments? I see none – adopted.

E/CN.7/2019/L.1/ad.2 on budget. Any comments? I see none – adopted.

E/CN.7/2019/L.1/ad.3 on treaty implementation. Any comments?

Mexico: We’d like to make an amendment to replace ‘one speaker regretted it’ with ‘some speakers’.

Uruguay: We support the Mexican proposal.

Chair: Thank you, will do.

UAE: During the discussion of item9, we tabled observations concerning INCB’s words and phrases that reflect current situation in the area and so the report followed certain political agendas and didn’t reflect the technical nature of the issue and the efforts of UAE. We would like to put on record our reservations on the report. In order to maintain consensus, we wont object to the adoption but would like this intervention to be reflected on the official records.

Egypt: Para 27 of report – small amendment ‘some speakers’ not ‘one speaker’

Chair: Can we adopted as amended?

E/CN.7/2019/L.1/ad.4

Chair: Any comments? Adopted.

E/CN.7/2019/L.1/ad.5

Pakistan: Para 12 – please insert dates of meeting – and location – Islamabad.

Chair: Any comments? Adopted.

E/CN.7/2019/L.1/ad.6

Mexico: Add para – number 11 – MOU between UNODC and WHO – common position on drug matters and human rights. I will send through the text.

Chair: Any comments? Adopted.

E/CN.7/2019/L.1/ad.7

Chair: Any comments? Adopted.

E/CN.7/2019/L.1/ad.8

Chair: Any comments? Adopted.

Chair: The whole document is now presented for adoption as a whole. I see no objections. It is so decided. Now closing remarks.

Fedotov: Congratulations on the successful session and its ministerial segment. This brought together more high-level officials and regional organizations than ever before. The high level of multilateral engagement clearly illustrates the importance of the issue addressed by this commission and its unique role. The ministerial declaration forges a common path for the next decade in recognition that there is more that unites than divides us. The declaration brings us together on the basis of 2009 and 2016. In charting the course forward, you committed to safeguard our future ensuring no one is left behind as well as placing safety and health of humankind, particularly youth, at the center. I welcome a balanced health and rights-based approach that puts people first. We can’t succeed without shared responsibility. UNODC, as ever, is here to help you to seek innovative solutions and address the ever-evolving drug challenges. Thanks for the extended bureau, Ambassador Okeke, our staff and colleagues. Safe journey home!

Chair: Open the floor

Mexico: Want to convey warm congratulations it’s been a great success, and congrats to COW Chair and people who worked Min Declaration etc

Nigeria: On behalf of African Group, thank you to Chair, you are a proud son of Africa. Professional conduct of COW Chair was great. Thanks to rapporteurs and translators. Thanks everyone

Armenia: Last min amendments to L3 – this is about INCB. Amendments are not relevant. Armenia withdraws as cosponsor and do not believe we fall under its constraints.

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