By Katherine Pettus, for Global Palliative Care

A similar term is odd couple, a pair who share either housing or a business but are very different in most ways.Palliative care advocates, many of whom are seasoned practitioners, and drug policy diplomats make strange bedfellows indeed. The misery that brings them together is the preventable suffering of patients in more than 75% of the world who lack access to essential medicines that are listed in the schedules of the international drug control conventions.

Why? Because international drug control law left these medicines in a legal and policy limbo. Palliative care advocates and practitioners have been working to extract their essential medicines from this legal limbo by raising their visibility in the global, regional, and national drug policy arenas. Although some progress has been made, emphasis on public health harms of the non-medical use of drugs in some regions once again threatens to overshadow our emphasis on the public health harms of the global epidemic of untreated pain.

The Single Convention on Narcotic Drugs, drafted and ratified in the 1960s, before the development of modern palliative care, explicitly instructs all governments to promulgate public health regulations that prevent “diversion and misuse” of essential medications containing controlled substances (aka drugs). This is important. Catastrophically however, the Convention fails to explicitly instruct all governments to promulgate regulations that ensure adequate access to those same medicines. This legal limbo left a policy vacuum that persists and is worsening now, generating untold preventable suffering for millions of palliative care patients worldwide.