Resolution
REGIONAL COMMITTEE FOR THE EM/RC66/R.7
EASTERN MEDITERRANEAN October 2019
Sixty-sixth Session Agenda item 3(f)
Regional framework for action to strengthen the public health response to substance use
The Regional Committee,
Having reviewed the technical paper presenting a draft regional framework for action to strengthen the
public health response to substance use;1
Recalling Resolution A/RES/S-30/1 “Our joint commitment to effectively addressing and countering
the world drug problem”, adopted by the 2016 United Nations General Assembly in its special session
(UNGASS) on the world drug problem;
Taking into account Target 3.5 of SDG 3: “strengthen the prevention and treatment of substance abuse,
including narcotic drug abuse and harmful use of alcohol”;2
Recognizing that substance use poses a large and growing challenge to public health and economic
development in all parts of the world, including the Eastern Mediterranean Region;
Mindful that a number of countries in the Region face complex emergencies which render their
populations – especially adolescents, women and young adults – particularly vulnerable to substance
use problems;
Noting that although cost-effective and evidence-based interventions are available, only one person in
every 13 with a substance use disorder in the Region receives treatment;
Recognizing that there is a need for a framework to operationalize the recommendations made in the
UNGASS 2016 outcome document to strengthen the public health response to substance use;
1. ENDORSES the regional framework for action to strengthen the public health response to
substance use (which is annexed to this resolution);
2. URGES Member States to implement the strategic interventions identified in the regional
framework with special emphasis on:
1 EM/RC66/8. 2 United Nations General Assembly resolution 66/288.
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2.1 Developing, reviewing and updating national policies and legislation through a multisectoral
approach, to minimize the adverse public health and social consequences of substance use;
2.2 Enhancing the availability, coverage and quality of prevention measures and tools, based on
scientific evidence, that target relevant age and risk groups in multiple settings;
2.3 Scaling up coverage through effective drug treatment, care, rehabilitation, recovery and
social reintegration programmes, giving special attention to those in vulnerable situations;
2.4 Developing and strengthening the capacity of health and social care professionals to provide
interventions based on scientific evidence, including appropriate medication-assisted therapy
programmes and other relevant interventions;
2.5 Integrating the core set of indicators within their national health information systems to
enable reporting on the relevant SDG indicator(s);
3. REQUESTS the Regional Director to:
3.1 Provide technical support to Member States to implement and monitor the strategic actions
listed in the regional framework;
3.2 Support Member States to enhance their capacity to undertake and utilize operational
research and generate reliable and comparable data;
3.3 Facilitate the development of regional networks for the regular exchange of information,
good practice and lessons learned among Member States;
3.4 Report on progress made in implementing the regional framework to the 68th and 70th
sessions of the Regional Committee, with a final report to the 72nd session.
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Annex 1. Regional framework for action to strengthen the public health response to substance use
Domain Strategic interventions Indicators
Governance • Include evidence-based, cost-effective interventions in the universal health coverage priority benefit package
• Develop/update evidence-informed national substance use policies with a strong public health component, in consultation with stakeholders from the public, private and civil society sectors
• Develop/update substance use-related legislation(s) in line with international covenants, treaties and conventions, in consultation with stakeholders from the public, private and civil society sectors
• Set up an intersectoral coordination mechanism to facilitate the implementation and monitoring of evidence-based substance use policies and legislation
• Allocate specific budget allocations within the health and welfare sectors to address the prevention, management, rehabilitation, recovery, and monitoring and evaluation of substance use disorders
• Develop programmes offering alternatives to incarceration for drug offenders
• Operational multisectoral public health-oriented substance use policies are endorsed and published
• Relevant national legislation(s) is updated in line with international covenants, treaties and conventions
• Intersectoral (inter-ministerial) coordinating mechanism is in place reflecting public health leadership
• Specified budgetary allocations are in place to cover the prevention, treatment, care and rehabilitation of substance use disorders
• Depenalization/decriminalization of drug use, and drug courts are available in major cities
• Treatment services for substance use disorders and related health problems are available for incarcerated populations across the continuum of care
Health sector response
• Integrate screening and brief interventions for substance use disorders and management of overdose within primary health care and emergency rooms (intervention packages)
• Develop/strengthen specialized services for the holistic and integrated management of substance use disorders, including pharmacological and psychosocial interventions
• Introduce and/or rapidly scale up the comprehensive package of services for harm reduction (needle and syringe exchange schemes, opioid substitution treatment, voluntary counselling and testing for HIV/hepatitis C, hepatitis B vaccination, antiretroviral therapy, tuberculosis care and treatment, sexually transmitted infection diagnosis and management, and overdose prevention and management)
• Ensure that essential medicines for the management of substance use disorders are available
• Develop the capacity of health and social welfare personnel in substance use prevention, treatment, care and rehabilitation by integrating it into pre- and in-service teaching/training and as a part of continuing professional education/recertification processes
• Facilitate and promote the establishment of self-help and mutual aid groups
• Develop/strengthen capacity to conduct and utilize implementation research
• Primary health care and emergency services staff are trained to deliver screening and brief interventions for substance use disorders and to manage opioid overdose
• Multidisciplinary specialist teams are available for out- and inpatient treatment and care of substance use disorders, including the provision of pharmacological and psychosocial interventions
• Referral guidelines and pathways between primary and specialist services are in place
• United Nations Office on Drugs and Crime (UNODC)/WHO treatment standards for ensuring quality are adopted/adapted
• A comprehensive package of services for harm reduction is in place
• Methadone, buprenorphine, naloxone and other medications for detoxification and maintenance treatment are available as a part of a comprehensive package for the management of substance use disorders
• A substance use component is integrated into pre- and in-service education/training programmes for health and social welfare professionals and in continuing professional education/recertification programmes
• Self-help/mutual aid groups are available
• National and regional networks are established to undertake priority implementation research, including a focus on complex emergency situations
Promotion and prevention
• Embed universal substance use prevention programmes within broader health policies and strategies based on rigorous local needs and resource assessment
• Design and implement age-specific substance use prevention programmes in community, education and workplace settings
• Multicomponent community intervention programmes are available, including parenting skills and family strengthening programmes
• Life skills education programmes are integrated into school curricula
• Workplace education and intervention programmes are in place
• Targeted campaigns are developed using multiple media channels to improve literacy about substance use and substance use disorders
• Updated UNODC/WHO prevention standards for ensuring quality are adopted/adapted
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Domain Strategic interventions Indicators
Monitoring and surveillance
• Identify a standard set of comparable core indicators (guided by the Lisbon consensus)* to monitor the substance use situation, including for inclusion in existing surveys
• Develop a national substance use monitoring and surveillance system to collect and report on the core set of indicators using standard data collection tools and methodologies
• National monitoring and surveillance systems are in place
• Regular reports are published and shared with national/international stakeholders and partners using the core set of indicators
• Monitoring and registration systems are in place for prescription drugs
International cooperation
• Promote the active sharing of information and evidence between professionals and civil society organizations from countries of the Region at national and international policy forums on substance use
• A regional network to coordinate the public health response to substance use is activated and facilitated
*United Nations Commission on Narcotic Drugs, United Nations Economic and Social Council. Drug information systems: principles, structures and indicators. Vienna: United Nations
Commission on Narcotic Drugs; 2000 (E/CN.7/2000/CRP.3; https://www.unodc.org/documents/data-and-analysis/statistics/Drugs/lisbon_consensus.pdf, accessed 14 July 2019).