Shifting the blame: INCB and the global pain medication shortage

The INCB's Newsletter number 20 was recently disseminated, and included some 'highlights from its website'. One of these referred to the INCB's briefing to member states on the availability of drugs for pain relief; it is the Board that is mandated under the 1961 Single Convention on Narcotic Drugs to ensure adequate access to drugs for medical and scientific purposes. In its presentation, the INCB told member states that 'while there is short of raw material for the production of these essential medicines, the consumption of narcotic drugs for pain relief is concentrated in a limited number of countries'. It pointed out, correctly, the inequality of access to pain relief, with 83 per cent of the world's population consuming only 8 per cent of the world's morphine.

However, the Board's presentation is itself problematic. Because it fails to address the structural factors underlying this imbalance, the text reads as though it is the fault of the remaining 17 per cent of people, located in Europe, America and Australasia, who consume the other 92 per cent of global morphine supplies. This is, of course, not the case. At least a part of the problem resides with the INCB itself, in its interpretation of its dual mandate as the monitor of compliance with the conventions: its focus is overwhelmingly on the prevention of what it insists on calling 'drug abuse', although the other aspect of its role is to ensure (in cooperation with signatory countries) adequate access to medicines.

The Board's interpretation and handling of its mandate has contributed to the very over-regulation and exaggerated perception of danger that impedes access and reduces availability, leaving billions of people without the essential medicines they need.

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