The upcoming United Nations General Assembly Special Session on Drugs must examine, as a matter of urgency, why tens of millions of people worldwide have no access to inexpensive painkilling drugs, experts have said.

The UN drugs summit being held next week in New York will provide an opportunity to look at the reasons why so many people continue to suffer from severe but treatable pain when they can be easily treated with low-priced medications, according to the international organisation Human Rights Watch (HRW).

The World Health Organisation (WHO) estimates that around 80% of the world’s population does not have adequate access to pain relief, and a recent HRW examination of the problem concludes that while this is partly due to “over-zealous drug control efforts” and poor training for health care workers, the major problem is failure of leadership. “We know how to treat pain and the key drugs are cheap to produce and distribute. What is lacking is the will and commitment to improve access,” says Diederik Lohman, senior researcher in HRW’s HIV/AIDS programme.

International drug control conventions and human rights treaties oblige nations to ensure that narcotic drugs are available for pain treatment. However, many countries do not recognize palliative care and pain treatment as priorities in health care, have no relevant policies, have never assessed the need for pain treatment or examined how well that need is met and have not examined the barriers to such treatment, the report states. Moreover, the narcotic drug control regulations or enforcement practices of many nations impose unnecessary restrictions that limit access to opioid pain relievers including morphine. They create excessively burdensome procedures for procurement, safekeeping and prescription of these medications, and sometimes discourage health care workers from prescribing narcotic drugs for fear of law enforcement scrutiny, it adds.

95% of people with HIV/AIDS and 50% of cancer patients live in low- and middle-income countries, yet these nations account for only 6% of the worldwide use of morphine – a drug which is safe, inexpensive and necessary for the treatment of severe pain, according to the WHO.

However, HRW notes that several such countries have made considerable progress in making pain treatment available. For example, Romania, Uganda and Vietnam have all developed palliative care policies in recent years, have begun reworking problematic narcotics regulations and enforcement practices and have started training programmes for doctors and nurses.

Their achievements show that, with leadership, low- and middle-income countries can make important progress in closing the pain treatment gap, and other countries should follow their example, said Mr Lohman. “Allowing millions of people to suffer unnecessarily when their pain can be effectively treated violates their right to the best possible health,” he added.

The UN Special Session on Drugs commences on March 11.