Government Policies

Opioid Availability – National Scene

In 1995, Mr David Joranson and his WHO Collaborating Centre at Pain and Policy Studies Group (PPSG) embarked on a partnership with palliative care activists in India to overcome regulatory barriers to opioid access for pain relief. It has been 19 years of hard and sustained work and finally, the amendment of the Narcotic Drugs and Psychotropic Substances (NDPS) Act of India became a reality when on 22 February 2014, the Parliament of India passed it.

We have many people to thank – many individuals and organizations who joined the effort and supported the process. Mr Diederik Lohman and Human Rights Watch. Ms Tripti Tandon and all at Lawyers’ Collective. The Essential Medicines program at World Health Organization. WHO South East Asian Regional Office and WHO (India), Dr Mehanathan, former Deputy Secretary of Department of Revenue who worked on it and made it his subject for doctoral thesis, Mr Subba Rao who followed him and Mr Rajesh Nandan Srivastava who as Director of Narcotics Control made it a reality. And many kind-hearted people all over India and abroad too numerous to name.

The NDPS amendment was published on Government of India’s gazette on 10 March 2014.

The most relevant provisions are:

  1. In section 4 of the Act, the addition of the words, “and for ensuring their medical and scientific use” is a very significant acknowledgement of the purpose of the amendment.
  2. In section 2, the Amendment brings in the term, “Essential Narcotic Drugs” (END), which will include narcotic drugs notified by the Central Government for medical and scientific use.
  3. In section 9, the Amendment transfers the powers for making rules regarding Essential Narcotic Drugs to the Government of India, so that the whole country will now have a uniform system pertaining to these essential opioid medicines.

On 5 May 2015, the Department of Revenue also published two major documents, one (Notification No.923) a notification of the Essential Narcotic Drugs, access to which is being improved under the NDPS Amendment. We are glad to note that among others, all formulations of morphine, fentanyl and methadone are included in them. The other (Notification No. 285) lays down the rules and procedures that every state will be obliged to follow.

Opioid Availability – State Rules

Andhra Pradesh

Kerala

Haryana

West Bengal


National Policies on Palliative Care

During 2012, thanks to the initiative of Government of India’s Secretary of Health, Shri Keshav Desiraju, the Ministry of Health and Family Welfare developed a National Palliative Care Strategy. Dr Nandini Vallath, Pallium India’s honorary consultant (who put in the most effort), trustee Dr Shalini Vallabhan  and chairman Dr Rajagopal, were part of the expert committee which helped create the document. Dr Sudhir Gupta, Deputy Director General of Health Services was the author of the final product. We thank all the officials who contributed to the development of the document, particularly Dr Atreyi Ganguli of WHO (India).

Following the creation of the National Strategy, Pallium India, with support from WHO (India), organized a working group meeting at Trivandrum in January 2013 to develop a framework for implementation of the palliative care strategy. The draft framework created by the working group was submitted to WHO (India) for operational analysis, as decided at the working group meeting. We particularly thank Dr Sudhir Gupta and Shri Rajesh Nandan Srivastava (Director of Narcotics at Department of Revenue).

References:


State Policies on Palliative Care

India has 28 states and 7 Union Territories. Health care is the responsibility of the State Government, each state creating its own policy.

In 2005, Pallium India submitted a proposal for creation of a State Palliative Care Policy. Following numerous discussions and meetings, on April 15, 2008, Kerala announced a State Palliative Care Policy, integrating palliative care into the government’s healthcare system. Kerala State has a decentralised system of government with considerable power of governance given to local self-government institutions (LSGIs). The Government of Kerala also has given instructions to the LSGIs regarding incorporation of palliative care.

Kerala:

Maharashtra:

On 15 June, 2012, Maharashtra State Government also announced a palliative care policy, making it the second state in the country to do so.