By Martin Jelsma
The 58th Session of the UN Commission on Narcotic Drugs (CND) in March 2015 has been asked to consider a Chinese proposal to place ketamine – an essential medicine used for anaesthesia – in Schedule I of the 1971 Convention (E/CN.7/2015/7 and E/CN.7/2015/81). Ketamine is the only available anaesthetic for essential surgery in most rural areas of developing countries, home to more than 2 billion of the world’s people. Scheduling ketamine under any of the 1971 treaty schedules will reduce its availability and further deepen the already acute crisis of global surgery.
The WHO has strongly and repeatedly recommended against international control, warning it would constitute a public health crisis in countries where no alternatives are available. The CND is taking place in Vienna on 9-17 March 2015.
On the UNODC website, in the CND section, appears a page under the title "Scheduling procedures" containing incomplete – and therefore misleading – information with regard to the options available to the CND in the case of a decision on ketamine. It says that the Commission “may decide - contrary to a recommendation of WHO - to add a substance to a schedule of the 1971 Convention or refuse to do so, to add a substance to a different schedule than recommended, or to remove a substance from the schedule in which it is listed or refuse to do so. However, the CND has to take into account the assessment from the WHO, which shall be determinative as to medical and scientific matters, and to bear in mind the economic, social, legal, administrative and other factors communicated to it by the Parties.”
The footnote to the paragraph references the Commentary on the 1971 Convention, which indeed talks about the Commission’s "very wide discretionary powers" but it adds that this “does not mean that it may act arbitrarily”. The key procedural question on the table in the case of ketamine is whether the CND "may decide - contrary to a recommendation of WHO - to add a substance to a schedule of the 1971 Convention", a correct direct quote from the Commentary. However, the Commentary also specifies that "there are cases in which the Commission would be bound to act in accordance with recommendations of WHO", cases that unequivocally apply to the current case of ketamine.
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