A/HRC/22/53
concern about the denial of or conditional access to post-abortion care.50 often for the
impermissible purposes of punishment or to elicit confession. 51 The Human Rights
Committee explicitly stated that breaches of article 7 of the International Covenant on Civil
and Political Rights include forced abortion, as well as denial of access to safe abortions to
women who have become pregnant as a result of rape52 and raised concerns about obstacles
to abortion where it is legal.
C.
Denial of pain treatment
51.
In 2012, WHO estimated that 5.5 billion people live in countries with low or no
access to controlled medicines and have no or insufficient access to treatment for moderate
to severe pain.53 Despite the repeated reminders made by the Commission on Narcotic
Drugs to States of their obligations,54 83 per cent of the world population has either no or
inadequate access to treatment for moderate to severe pain. Tens of millions of people,
including around 5.5 million terminal cancer patients and 1 million end-stage HIV/AIDS
patients, suffer from moderate to severe pain each year without treatment. 55
52.
Many countries fail to make adequate arrangements for the supply of these
medications.56 Low- and middle-income countries account for 6 per cent of morphine use
worldwide while having about half of all cancer patients and 95 per cent of all new HIV
infections.57 Thirty-two countries in Africa have almost no morphine available at all. 58 In
the United States, over a third of patients are not adequately treated for pain. 59 In France, a
study found that doctors underestimated pain in over half of their AIDS patients. 60 In India,
more than half of the country‟s regional cancer centres do not have morphine or doctors
trained in using it. This is despite the fact that 70 per cent or more of their patients have
advanced cancer and are likely to require pain treatment. 61
53.
Although relatively inexpensive and highly effective medications such as morphine
and other narcotic drugs have proven essential “for the relief of pain and suffering” 62, these
types of medications are virtually unavailable in more than 150 countries. 63 Obstacles that
unnecessarily impede access to morphine and adversely affect its availability include overly
restrictive drug control regulations64 and, more frequently, misinterpretation of otherwise
appropriate regulations;65 deficiency in drug supply management; inadequate
infrastructure;66 lack of prioritization of palliative care 67; ingrained prejudices about using
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
12
See CAT/C/CR/32/5, para. 7 (m); A/66/254, para. 30.
CAT/C/CR/32/5, para. 7 (m).
General comment No. 28, para. 11; see also CCPR/CO.70/ARG, para. 14.
WHO, “Access to Controlled Medicines Programme”, briefing note (2012), p. 1.
Resolutions 53/4 (2010) and 54/6 (2011).
WHO, “Access”, p. 1.
See HRW, “Please Do Not Make Us Suffer Any More...”: Access to Pain Treatment as a Human
Right (2009).
Open Society Foundations, “Palliative care as a human right”, Public Health Fact Sheet, 2012.
Ibid.
Ibid.
Ibid.
HRW, Unbearable Pain: India’s Obligation to Ensure Palliative Care (2009), p. 3.
Single Convention on Narcotic Drugs, 1961, preamble.
Joseph Amon and Diederik Lohman, “Denial of pain treatment and the prohibition of torture, cruel,
inhuman or degrading treatment or punishment”, INTERIGHTS Bulletin, vol. 16, No. 4 (2011), p. 172.
See HRW, “Please Do Not Make Us Suffer”.
E/INCB/1999/1, p. 7.
A/65/255, para. 40.
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