Statement regarding Access to Controlled Medicines in Conflict Settings - ICPCN Website

The global palliative care community is deeply concerned for all people experiencing serious health related suffering as a result of the escalating violence in the Middle East and in all other conflict settings across the world.

In humanitarian emergencies, those who are most vulnerable in the civilian population – babies, children, pregnant women, older persons, persons with disabilities, and people of all ages who are seriously injured and chronically ill – are more likely to experience severe untreated physical pain along with psychological, social, and spiritual suffering. Effective therapeutic interventions to relieve such suffering can be delivered as part of humanitarian aid responses.

The goal of palliative care is to relieve serious health related suffering, which includes effective pain relief and symptom management for serious illness as well as traumatic injuries.[1] Appropriately trained health workers can usually relieve severe pain with morphine and other essential palliative care medicines included on the World Health Organization’s (WHO) Model Lists[2]^,[3]

The International Narcotics Control Board (INCB) reminds governments and the international community that the need for pain relief and palliative care, as well as treatment for mental health conditions that require the use of internationally controlled substances, rises during and after emergency situations. The INCB encourages competent authorities in both exporting and recipient countries to exercise the highest degree of flexibility and discretion in their application of control measures on the international trade of controlled substances during emergency situations.[4]

The global palliative care community calls on the WHO and aid agencies providing humanitarian assistance in conflict situations to:

Include adequate supplies of oral and injectable morphine, and other pain-relieving medicines listed in the WHO Model Lists of Essential Medicines in their humanitarian aid response packages.
Ensure an adequate supply of essential medicines for surgery and anaesthesia.
Provide all aid and health care workers with guidelines on the safe use and distribution of these essential medicines.
Work with receiving authorities to ensure that that controlled medicines are not removed from the emergency kits.
Include paediatric formulations of essential medicines for children.

Together as a palliative care community we offer our skills and expertise in pain and symptom management and palliative care as a resource for our colleagues working in humanitarian settings.

Contact details of Palliative Care organisations supporting this statement

1. PallCHASE (Palliative Care in Humanitarian Aid situations and Emergencies)