Statement by Prof. Jallal Toufiq, President,
International Narcotics Control Board (INCB)
Sixty-eighth session of the Commission on Narcotic Drugs
Item 5 (d) International cooperation to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes while preventing their diversion
11 March 2025, Vienna, Austria
Mr. Chair, Excellencies, ladies and gentlemen,
Ten years ago, I joined the INCB. I remember that year not only for what it meant for me professionally but also because INCB produced a special supplement entitled " Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes - Indispensable, adequately available, and not unduly restricted."
That report marked a turning point. It contributed significantly to the discussions that took place in 2016 at the CND and subsequently at the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem.
The outcome document of the UNGASS included, for the first time, a dedicated section on ensuring availability - an important issue that had often been overlooked. It also set out operational recommendations to guide countries in developing relevant policies and practices.
Since then, international cooperation in this area has strengthened and the issue has been central to multilateral dialogue, reiterated in multiple resolutions, the focus of numerous side events, and strongly advocated for by civil society.
Chapter II of INCB's 2024 Annual Report presents the latest data on global consumption of opioid analgesics and psychotropic substances.
Although that data confirms persistent disparities between regions in the consumption of opioid analgesics for the treatment of pain and the consumption of several psychotropic substances for the treatment of mental and neurological conditions and substance use disorders, there are encouraging signs of progress. In several regions with historically low consumption of opioid analgesics, per capita daily doses have increased. Over the past twenty years, daily doses per million inhabitants have risen in Eastern and South-Eastern Europe, South America, East and South-East Asia, and West Asia. While some of these increases started from a very low baseline - and consumption levels still fall short of fully meeting medical needs - they nevertheless represent steps forward.
However, significant concerns remain for Africa, South Asia, and Central America and the Caribbean. Almost all consumption of opioid analgesics continues to be concentrated in Western Europe, North America, and Oceania. In many other regions, consumption levels are still insufficient to meet medical needs.
One contributing factor is that more than 80 percent of the morphine manufactured globally is not used directly for pain relief. Instead, it is converted into other substances, such as codeine.
INCB urges opioid-manufacturing countries to increase the production of morphine preparations specifically for pain management and palliative care, and to ensure that these medicines are affordable and made broadly available, particularly in low- and middle-income countries.
Likewise, consumption of many psychotropic substances, in particular anti-epileptic drugs such as clonazepam and phenobarbital, are low in Africa, Asia and Oceania.
The rational use of psychotropic substances is a matter of concern for INCB. These substances play a crucial role in managing various mental health and neurological conditions, including ADHD, anxiety, narcolepsy, epilepsy, and sleep disorders.
While online pharmacies and telemedicine have improved access to medications in some cases, they have also contributed to non-rational prescribing practices. Another critical issue is the availability of controlled substances for the treatment of opioid use disorder. Currently, about ten percent of people with opioid use disorder have access to opioid agonist therapy. In some countries with a high prevalence of people who inject drugs, access to methadone, buprenorphine, and opioid agonist therapy services remains limited - or is even non-existent. In view of the increase in non-medical use of opioids and associated negative consequences, INCB encourages countries to develop programmes and services to address the problem, including the use of controlled substances such as methadone and buprenorphine for treatment and opioid agonist therapy services.
Another critical challenge is ensuring access to internationally controlled substances during humanitarian emergencies. The conventions provide for the expedited movement of such substances during emergencies and INCB urges countries to make full use of these provisions.
In closing, I would like to thank Governments for their ongoing cooperation in ensuring the functioning of the international system for licit trade in controlled substances. I am delighted to announce the publication of INCB's 2024 technical publications on narcotic drugs and psychotropic substances. I trust that these reports will be useful for competent national authorities in carrying out their important work to ensure availability for medical and scientific purposes while preventing diversion to illicit channels.
This goal is at the very heart of the international drug control conventions and is also essential for achieving Sustainable Development Goal 3 - ensuring healthy lives and promoting well-being for all. Moreover, it should remain at the core of every country's national drug control policy and practice.
Thank you very much.