Human Rights

Human Rights

Access to pain treatment as a human right.

Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering. Yet, despite the existence of inexpensive and effective pain relief medicines, tens of millions of people around the world continue to suffer from moderate to severe pain each year without treatment. Significant barriers to effective pain treatment include: the failure of many governments to put in place functioning drug supply systems; the failure to enact policies on pain treatment and palliative care; poor training of healthcare workers; the existence of unnecessarily restrictive drug control regulations and practices; fear among healthcare workers of legal sanctions for legitimate medical practice; and the inflated cost of pain treatment. These barriers can be understood not only as a failure to provide essential medicines and relieve suffering but also as human rights abuses. According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.

Editors’ note: Low- and middle-income countries are home to half of all cancer patients and more than 90% of HIV infections, yet they consume only 6% of the morphine used worldwide. Although the International Narcotics Control Board, which monitors the implementation of the UN drug conventions, drew attention in 1995 to the dual drug control obligation to ensure adequate availability of narcotic drugs, including opiates, for medical and scientific purposes, while preventing illicit production, trafficking, and use of such drugs, an estimated 80% of the world’s population has either no access or insufficient access to treatment for moderate to severe pain. Chronic pain, a common symptom of both cancer and HIV disease, has a profound impact on the quality of life, reduces treatment adherence, and influences the course of disease – it is one of the most significant causes of suffering and disability worldwide. Overcoming a vicious cycle of under-treatment requires governments to develop pain management and palliative care policies, reform regulations that impede access, institute health care worker training, and ensure affordability, including through investigating the feasibility of local manufacture.