RESPONSE TO

MEDICAL INNOVATION BILL 14 MARCH 2014

BY

In Response To Private member's bill and invitation for public comment on Medical Innovation Bill 3 37349, as published in Government Gazette No. 37349 of 18 February 2014.

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Medical Innovation Bill response

Introduction The Medical Innovation Bill is a tremendous step forward in the realm of a rapidly changing global drug policy regime and paves the way for local drug law reform. By focussingon therightsof the patient instead ofthewillofthepeopleitdepartsfromthe petty politics of the past and the moralisticnature ofconventional discourse. It aims to givedoctorswiderdiscretiontoexplorealternativetreatmentoptions. Briefhistory The prohibition of cannabis is a remnant of colonialism that was founded in an era before human rights. Having few commodities the indigenous people considered valuable the barter of cannabis facilitated trade with indigenous people, allowing settlers to acquire livestock and othernecessarygoods.Colonistscommonlyheldthe belief that localindigenouspeoplewereaddictedtocannabis.Asaresultitbecamean importantmechanismforsocialcontroloftheApartheidstate. Differencebetweendecriminalisationandlegalisation Decriminalisation, in the context of cannabis, refers to removingcriminalpenalties forthepossession of cannabis.Somejurisdictions havereplaceditwithadministrative sanctionsinstead.Under this modelitremainsillegal todealincannabisandoffenders arestillsubjecttocriminalpenalties. Legalisation isa term used to describetheprocessofrepealingprohibition.Itdoes not, however, give any indication ofwhat thealternativefor prohibition is. This has led many people to erroneously believethe alternativewouldentailafreemarketsystem.It is important to reach sensible decisions that are balanced and grounded in reason insteadofbeingvestedineitherextremeofthedebate. Legal regulation is the prefered term as it keeps the endgoal inmind which isan effectivepolicythatensuresminimalharmcomestosociety.

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Policyconsiderations It is important to keep in mind that thisis notjusta medicalmatter but a policy matter thatfalls under the mandateoftheCentralDrugAuthority(CDA).Reviewinaccordance with the National Drug Master Plan 2013/2017 (NDMP) needs to happen before any legal reform can take place. The NDMP requires the CDA toinvestigate the dynamic nature of cannabis in South Africa, entailing rewriting its 2004 and 2010 position statements. The investigation includeslookingintothedecriminalisationandregulation ofcannabis. Publicbenefit One infour South Africansare affected bylife threatening illnesses,someofwhomare faced withtheineffectivenessof conventionaltreatments.Manycancerpatientscannot afford the necessary treatment and need to rely on financial and communal aid. This highlights the need for costeffective palliative treatment in terminally ill patients to reduce the burden on the National Health Care System, their families and the communityasawhole. Antimonopolisationmeasures In the interest of public welfare strong measures need to be taken to prevent uncompetitivepracticesand toprotectthe rights of theconsumer. We have learntfrom the past abuses by the tobacco and alcohol industries. Regulation must be about governmentcontroloverthesupplyofcannabisnotpushinguptheprofitmargins. Advertising Advertising should be banned under threat of criminal sanction. Aggressive commercialisation is already being observed in the United States. It is important to avoid targeted marketing, especially if it is directed at children. It works against the governments control over the supply.Itisrecommendedthatadvertisingandmarketing forcannabisorcannabisderivedproductsbeprohibited.

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Legalreview The prohibition of cannabis has failed when measured against its own goals. The Medical Innovation Bill serves an importantpurposeinbringingtheissueofcannabisto theLegislaturesattentionandinstimulatingnationaldebate. Past legislation created various presumptions of guilt where the burden of proof is placed on theaccused.ItisnowknownthattheselawshaddeeprootsinApartheidand the preservation of whiteminority rule. Thesepresumptionsshouldbereevaluated to determinewhetherornottheystanduptoconstitutionalscrutiny. Patients seeking medical palliative treatment are currently sourcing their cannabis illegally as current legislation does not make provision for legal acquisition. Reform would entail setting up a framework that allows patients to accesscannabis of a safe andconsistentgrade. In the process of review a cost benefit analysis needs to be conducted to determine how much funding is currently being spent on drug law enforcement, how effective currentpoliciesareandwhetherornottheyoffergoodvalueformoney.

Conclusion Thecannabisplant needstobeputontrialsothatitcanbescrutinisedandreevaluated in the public eye. Morally grounded arguments only succeed in polarising the debate andresultinmisunderstandingsandmisinformation.Bothextremesofthedebateshare universal goals,i.e. policies that are costeffective, offer goodvaluefor money, protect childrenandreducecrime. A purely evidencebased approach and goal will serve as common ground for all involved and allow an informed decision to be reached. Collaboration between the public and private sector will factor into the success or failure of future policies and cannotbedismissed.

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1.

Definitions "cannabinoids"[shallmeananypartorchemicalconstituentoftheplant knownascannabis,marijuanaordagga,anygeneticmodification thereof,andanyextractthereoforproductcontainingitorresultingfrom theprocessingthereof]areaclassofdiversechemicalcompoundsfound withinthecannabisplant. "cannabis"shallmeanthenatural,nongeneticallymodifiedplantofthegenus CannabissativaL.,alsoknownashemp,cannabis,marihuana,marijuana, Umya,Matekwane,Ntsangu,Nsangu,Imbanje,Mbanji,Mbhanzheanddagga,as wellasanyvarietyofcannabis,includinganyderivative,extract,flower,leaf, particle,preparation,resin,root,seed,stalk,stem,oranyproductthereof.

2.

3.

Purposes 2.1. Nochange 2.2. Nochange 2.3. Nochange 2.4. Nochange 2.5. Legaliseandregulatetheuseof[cannabinoids]cannabisandits derivativesformedicalpurposesandforbeneficialcommercialand industrialuses. Application 3.1. Nochange 3.2. Nochange Innovationinabsenceofevidencebasedtreatment 4.1. 4.2. Nochange afNochange

4.

5. 6. 7.

LiabilityofmedicalpractitionerNochange InformedconsentNochange Notwithstanding any other law, but subject to the Constitution, no one shall be liable or guilty of any offence for growing, processing, distributing, using, prescribing, [advertising] or otherwise dealing with or promoting [cannabinoid]cannabisoritsderivativesforpurposesof 7.1. Nochange. 7.2. Nochange. 7.3. researchanddevelopment. 7.4. education. 5

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8.

Regulations AfterconsultationwiththeMedicalandDentalCouncilcontemplatedinthe HealthProfessionsAct,No.56of1974,theMinistermaymakeanyregulations aimedatimplementingthisActandpursuingitspurposes,[providedthat whenmakingregulationswithrespecttosection7,theMinistershallact inconsultationwiththeMinisterofTradeandIndustry.]Theseregulations shall: 8.1. bemadeinconsultationwiththeCentralDrugAuthority,theSouthAfrican PoliceService,theSouthAfricanRevenueService,theDepartmentof TradeandIndustry,theDepartmentofHealth,theDepartmentof Agriculture,ForestryandFisheries,theDepartmentofJusticeand ConstitutionalDevelopmentandanyotherrelevantstakeholderand facilitatetheparticipationofcivilsocietyinthemakingofsaidregulations and facilitatethereviewandreformofpoliciesrelatingtocannabis,in accordancewiththegoalsandobjectivesoftheNationalDrugMaster Plan20132017and protectagainstmonopolisationanduncompetitivepracticesand benefitthepublicthroughlocalempowermentand giveeffecttotherightofresearch. makeprovisionfortheabolitionofcriminalsanctionsforthepossession, productionortradeofcannabisunderthetermsofsaidregulations. establishaframeworkthatwillfacilitatetheActsimplementation pardoncannabisrelatedconvictionstotheextentthattheMinistermay proclaimbyGazette. makeprovisionforthetimelyreleaseofinmatesservingtimefor cannabisrelatedconvictions. createascreeningprocessintermsofsection8.10todeterminewhich inmatesareeligibleforrelease. facilitatethelegalreviewandreformofallpresumptionsofguiltthatplace theonusofproofontheaccused.

8.2. 8.3.

8.4. 8.5. 8.6. 8.7. 8.8. 8.9. 8.10. 8.11. 8.12.

9.

Nochange

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