World Health Assembly
57th session

May 2004

Statement by Dr. Philip O. Emafo,
International Narcotics Control Board

Item 12.8 Health promotion and healthy lifestyles

Mr. Chairman,

The World Health Organization and its predecessor bodies, the Health Committee of the League of Nations and the Office International d'Hygiene Publique (OIHP), have played very important roles in bringing drugs under international control.

The Single Convention on Narcotic Drugs, 1961 as amended by the 1972 Protocol and the Convention on Psychotropic Substances, 1971, assigned to the World Health Organization the responsibility of assessing and recommending to the Commission on Narcotic Drugs, drugs that should be placed under international control, on the basis of the drugs being able to produce ill effects as to constitute a public health and social problem. The Commission on Narcotic Drugs relies on the recommendations of the World Health Organizations when deciding to place a drug under international control. The Commission on Narcotic Drugs rarely rejects the recommendations of the World Health Organization.

The Conventions require that internationally controlled drugs should only be available for medical and scientific purposes and, in this respect, Parties to the Convention are expected to ensure that possession of these drugs is under legal authority. Drugs should be supplied or dispensed for use by individuals pursuant to medical prescription only, except when individuals may lawfully obtain, use, dispense or administer such substances in the duly authorized exercise of therapeutic or scientific functions.

In practice, however, people use drugs not only for medical purposes but also for non-medical purposes. Cannabis, for example, a substance with no recognized medical use, is frequently abused for recreational purposes. On the other hand, drugs with legitimate uses are used for purposes other than those for which they were intended. Psychoactive drugs, in particular, are often abused to alter moods and ostensibly to enhance performance.  Some of these drugs reduce driving skills and reflexes which could result in serious accidents, and loss of lives and limbs. People abuse appetite suppressants for their stimulant properties. In the process, they often become dependent on the drugs they use illicitly.

Historically, a clear connection can be established between the availability of drugs and their abuse. During the 19 ^th century and prior to the adoption of the international drug control treaties, narcotic drugs were freely available and health problems abounded. The number of opiate dependent persons was higher than it is today. The treaties have been highly successful in reducing the availability of narcotic drugs and psychotropic substances for the illicit market, and, subsequently, their abuse and the impact of their deleterious effects. Nowadays, unregulated substances such as alcohol and nicotine and are causing massive public health and social problems, far in excess of those from substances controlled under the international treaties.

The World Health Organization is well aware of this fact: The World Health Report 2002 addressed the risk of tobacco consumption and the harmful use of alcohol as key risk factors for noncommunicable diseases and a rapidly growing burden for society. And it was in recognition of these risks that the World Health Organization worked so hard for the production of the landmark Framework Convention for the Control of Tobacco.

As has been shown by the example of the international drug control treaties, regulations have facilitated a reduction in drug abuse while ensuring that drugs are available to meet legitimate medical needs.  It is important that these regulations are strictly enforced. However, technological advances in communication have made the enforcement of regulations more difficult.

Unregulated Internet websites advertising controlled prescription medicines for sale pose a significant public health problem for drug control authorities. Controlled pharmaceuticals, which are sold on these sites without a prescription, may not be safe or effective. Internet websites that provide forums for the free exchange of information on illicit drug use are also problematic. Government should, therefore, implement measures to ensure that the Internet is not used for illegal purposes.

Aggressive advertising by pharmaceutical companies may also affect drug consumption. Governments should therefore strictly enforce the treaty provisions that prohibit the advertising of such substances to the general public and encourage the media to promote a more responsible attitude towards their use. The pharmaceutical industry needs to act responsibly by providing objective information about the effects of such drugs.

Mr. Chairman,

Regulation alone is not sufficient to address the problems of drug abuse.  Governments should adopt strategies aimed at the reduction of the demand for illicit drugs which are aimed at preventing drug abuse, treating those who are addicted and reducing the adverse consequences of drug abuse for the addicts.  Demand reduction programmes should encourage the active participation of the public in general and target those at particular risk, regardless of their location or economic conditions. Research has indicated that multidimensional strategies which include general drug abuse prevention measures, especially among young people, access to drug abuse treatment programmes and outreach programmes to engage drug abusers in preventive strategies for themselves, families and partners work best in addressing the problem of drug abuse. The promotion of healthy lifestyles among children and young people, including healthy and safe recreational opportunities should constitute an important element of a drug abuse prevention strategy.  At the same time, demand reduction programmes cannot be successful if they are implemented in isolation and if drugs continue to be readily available for non-medical use.  Only action at both ends of drug supply and drug demand will lead to a sustained reduction of the abuse problem.

Governments should promote healthy lifestyles without drugs. Governments should also promote measures that prevent illicit drug use. It will also be helpful to the international community if the World Health Assembly can recognize in any of its resolutions on health promotion and healthy lifestyles that illicit drug use is a life-style risk factor.

Thank  you for your attention.