Belgium managing UN drugs policy

In 2019, an estimated 275 million people worldwide aged between 15 and 64 years old had taken drugs at least once in the last year. In addition to cannabis, heroin and cocaine, this also involved the abuse of medicines and psychoactive substances, such as amphetamines, painkillers and sleeping medication.

Of these 275 million people, around 36.3 million people had developed a drug-related disorder, to the extent that they were addicted and/or in need of treatment. Although cannabis is most commonly used, opioids – powerful, morphine-like painkillers – can often cause the most damage.

The number of deaths relating either directly or indirectly to drug use is rising fast. In 2019, around 497,000 deaths were registered, plus the loss of 30.9 million healthy years of life. Therefore, a need exists for a balanced, well-sustained and human approach that benefits the users and their environment.

At the same time, other parts of the world have inadequate access to substances such as pain medication administered under supervision. This major problem affects vulnerable groups of the population in particular, including children and poorer countries.

Let it be clear, drugs pose a serious threat to the health of the world's population. And being illegal, they are a primary source of revenue for organised crime.

The problem also exists in Belgium, for sure. In fact, together with the Netherlands our country is the world's laboratory for drugs such as ‘ecstasy’. Much of the drugs traffic passes through Belgian and Dutch ports. The customs authorities regularly seize drugs in the port of Antwerp. In 2021, no less than 89.5 tons of cocaine were confiscated.

Belgium is therefore also taking its responsibility. As a dedicated member of the Commission on Narcotic Drugs (CND) (see below), our country is extremely active in international collaboration. Belgium supports a balanced approach which aims to restrict global drugs trafficking, but also which pays more attention to human rights in tackling the drugs problem.

Drugs trafficking and drug use are both great examples of global phenomena. And that means that global legislation and control is necessary. This is why the UN already set up a commission in 1946, dedicated specifically to the problem of drugs: the Commission on Narcotic Drugs (CND). The CND is the governing body of the UNODC – United Nations Office on Drugs and Crime – located in Vienna (see boxes).

The CND defines the global, pioneering policy around the many facets of drugs. Drugs trafficking, drugs production, medical use of drugs, drugs prevention, treatment and rehabilitation of drugs users, to name but a few.

The 53 UN member states of the CND – elected for 4 years, and well distributed across the different regions – are able to propose resolutions. These resolutions are discussed among the CND until, in true Vienna spirit, a consensus is found which is acceptable to each member state. Belgium is a strong believer in striving for consensus. After all, it helps in creating wide support and encourages states to collaborate in a constructive manner.

In addition to this, the member states share good practices, talk to civil society and debate the implementation of their commitments. They also manage the work of UNODC, which implements many programmes in order to benefit the global drugs approach. For example, projects relating to damage limitation, drugs in prison, impact on families and women, support for drugs users and so on.

In December 2021, Belgium took over the one-year chairmanship of the CND, a first. To be more specific, ambassador Ghislain D’hoop from our station in Vienna will be chairing the commission for one year. The chairperson must be impartial. However, that does not stop Belgium from playing a prominent role during its presidency.

Two years ago, together with Australia, our country submitted a resolution on 'controlled medicines'. After its adoption this was sponsored by an overwhelming number of countries. During the present presidency, our country is now keen to work on implementing the commitments made during this resolution. For this reason, with support from the FPS Health, a series of events is planned under the banner #NoPatientLeftBehind.

‘Controlled substances for medical use’ or in short ‘controlled medicines’ concern mainly painkillers, although the problem is comparable with other essential resources. Indeed, in many countries, access remains difficult, although the World Health Organisation (WHO) considers them to be essential medicine.

In countries where access is difficult, painkillers are viewed more as an illegal or dangerous drug, they are not available or the doctors do not know how to administer them. Yet painkillers are often very useful and necessary. For example, in palliative care, but children can need them too. When access is lacking we witness the emergence of a market for alternatives, which are often harmful.

Of course, there is no denying that painkillers, such as opioids, can often cause trouble. In fact, in North America in particular, many people are addicted to them. They are in the midst of a real ‘opioid crisis’.

That is why it is so important to promote scientifically-based and balanced access. While negotiating this resolution there was an intense search for the correct wording which considered both contradictory phenomenon.

Meanwhile, our country is seen as the real advocate of better access to medicine. With the events promoted by the CND chairman under #NoPatientLeftBehind, Belgium hopes to build better awareness, which should help to widen political support.

Belgium is also active in DR Congo. The Belgian Development Co-operation is working to generate awareness relating to pain medication. The FPS Health is also supporting training for health workers, provided locally via UNODC and other organisations. And with great success! The activities are part of a global programme by the WHO and the Union for International Cancer Control.

Other points of attention for Belgium in connection with CND and UNODC are mental health among adolescents and access to high-quality medicine. The latter has become an important item in the Belgian Development Co-operation. During the recent summit by the European and African Union (February 2022) the minister of Development Co-operation Meryame Kitir organised a successful seminar on the subject.

The annual highlight of the CND was held in Vienna between 14 and 18 March. In a normal year, a large Belgian delegations heads off to Vienna for this occasion. In that case, more than 2,000 stakeholders come together. The content-related focus of our delegation lies on Justice, Public Health and the Federal Agency for Medicine and Health Products (FAMHP). Yet Foreign Affairs plays an important role, particularly through our Permanent Representation in Vienna.

It is also worth mentioning that technical UN agencies, such as the CND, are gaining in political importance. Such agencies are used in particular by the superpowers in exercising their influence.

It is therefore of the utmost importance that Belgium and the EU are effective in defending multilateralism. It remains possible to work together and reach an agreement on an international level, even though this takes considerable effort. Our country accepts the challenge, also as part of the CND.

The present international situation puts tremendous pressure on the aforementioned Vienna spirit, which focuses on consensus and constructive dialogue. Therefore, it is up to the Belgium presidency to safeguard this spirit.