Follow-up letter to make methadone and buprenorphine widely available

For WHO

1. All WHO regional and country offices should immediately announce the decision to list methadone and buprenorphine on the EDL and develop a communications strategy to ensure that this news is widely disseminated to all stakeholders. Recently, staff at the WHO office in Tajikistan, when asked by a local harm reduction association to host a press conference on the listing of these drugs in the EDL, stated that it was impossible that WHO would list methadone and buprenorphine on the EDL now or in the future. This misinformation needs to be confronted quickly and resolutely.
2. All WHO country offices should meet with national health officials and other policymakers to explain the decision and to suggest how to remove obstacles and change policies to reflect the global standard of care for the treatment of drug users, which now includes these two substitution therapies.
3. All WHO country offices, in partnership with local NGOs, should approach national institutions responsible for medicines control and regulation and discuss the process for inclusion of these two new medicines into National Essential Drug lists.

For WHO and UNAIDS

1. WHO and UNAIDS should work together to ensure that methadone is removed from the list of prohibited drugs in Russia. Restrictions are greatest in this country, which not only has the world’s largest number of IDUs but also holds great influence with other countries in the region.
2. Working with drug users themselves and allied NGOs, WHO and UNAIDS should make IDUs aware of WHO’s decision in simple terms and in local languages, particularly in Eastern Europe, South, Southeast, Central Asia and in the Middle East. Such information could greatly enhance drug users’ ability to lobby their national governments for greater access to substitution therapy and ART.

For GFATM

1. The GFATM must consider methadone and buprenorphine to be an indispensable part of AIDS care and prevention among IDUs. This means that substitution therapy programs must be eligible for GFATM support and applications to the GFATM from countries or organizations where drug use is common must include substitution therapy as a part of a comprehensive HIV prevention and treatment effort. Access to methadone and buprenorphine essential treatment should be considered by the GFATM as one of the critical criteria in judging a country’s success in implementing its grant.

For UNODC

1. Based on a recognition that methadone and buprenorphine are the standard of care for treating opioid dependency and support HIV/AIDS prevention and care for IDUs, UNODC must work to ensure that both agents are reclassified and able to be used without restriction in all countries. This effort will likely require working directly with national law enforcement authorities to assist in identifying and removing policy and other ideologically-based obstacles.

EATG

EATN - European AIDS Treatment News, Volume 14, II – Autumn 2005

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