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[SUBMITTED] Access to Effective Medications

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Xanthorrhoea
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Democratic Socialists

[SUBMITTED] Access to Effective Medications

Postby Xanthorrhoea » Tue Sep 14, 2021 3:12 pm

Hey all, I've been doing some reading and have discovered the WHO list of essential medications. I figured the idea probably has merit for use in the World Assembly too.

Here's a first draft of the proposal. I've tried to follow the guidelines as much as I can, but welcome any and all feedback. I'm particularly troubled by section 3 [edit: now secction 4]. I'm not sure whether it violates the "optionality" requirement for proposals, but I also don't want the proposal to be shot down by all the corporate oligarchies, so I figured this was a compromise. Any ideas on how to improve it are welcome, as it's also very short compared to the rest of the proposal.

Otherwise, I've done my best to scan through the most relevant seeming previous resolutions, but I assume I've probably missed one and this proposal either duplicates or contradicts something. Let me know if you spot something and I'll see if I can adjust things.

- Xanthorrhoea.




CURRENT DRAFT (Ver. 6):

Access to Effective Medications
Category: Health (Healthcare)


The General Assembly:

Recognising the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of access to effective medication in maintaining this health and happiness;

Recalling the efforts of resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide;

Noting, despite these efforts, the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, including the significant impact of poverty and income inequality on this access, and noting the lack of a globally accepted standard of medical treatment;

Seeking to reaffirm and strengthen its commitment to improving the health of all peoples, regardless of World Assembly (WA) membership status, hereby enacts the following:


  1. The World Medications Council (henceforth the WMC) is established as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

    1. To assess and record the safety, efficacy, and cost-effectiveness of all known medications, defined as any substance used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In assessing a medication, the WMC must consider:

      1. A medication’s safety, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for that medication safe storage, handling, and administration of the medication;

      2. The impact of patient factors on a medication’s safety, including species, pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors;

      3. A medication’s efficacy for all indications for which it is used, including the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dosing, duration of therapy, and synergistic or adverse effects when used with other medications;

      4. A medication’s relative cost-effectiveness, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes; and

      5. Any other factors it deems relevant.

    2. To, based on this assessment, create and maintain an Effective Medications List (henceforth the EML), containing those medications that are best suited to meet the needs of an effective health system.

    3. To regularly assess and update the EML based upon the current scientific consensus.

    4. To undertake activities to promote access to medications on the EML in all WA member nations (henceforth members).

    5. To promote access to medications on the EML in non-WA member nations, with the consent and according to the laws of those nations.

  2. All members must provide access to all medications included in the EML to all residents of their nation, unless one of the following exceptions applies. Nations are not required to provide access to a medication:

    1. That is illegal, or for purposes that are illegal in that nation, for all of their residents;

    2. For purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that medication has an established clinical use; or

    3. That they cannot provide access to for reasons outside their control. In this case, they must provide access to an available similarly effective alternative, and provide access to the unavailable medication as soon as possible.

  3. Members must ensure that medications are priced in a way that allows all residents to afford all the medications they require while maintaining an adequate standard of living.

  4. Members are encouraged to minimise the cost of medications to patients through all appropriate means, including subsidising common and/or effective medications, standardising prices, enforcing strong anti-trust legislation, and creating special access schemes for vulnerable and disadvantaged groups.


Co-authored by Tinhampton




Edit 1: Expanded on the purpose of the proposal as kindly suggested by Her Excellency Mortimer Wellesley of Imperium Anglorum. Reworded clause 1a to make it less clunky, reworded clauses 2a and 2b to tighten up their application (thanks to the minister of Abacathea for their suggestions).

Edit 2: Re-structured the last sentence of clause 1a to make it less clunky.

Edit 3: Minor spelling/grammar/punctuation etc. Improved formatting.
Clause 1.a.i: "...The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, chronic disease, genetic disease, intercurrent medical and/or psychological conditions, employment, and lifestyle factors."
Clause 3: "Encourages all WA member nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable and disadvantaged groups."

Edit 4: Added a caveat to Clause 2a. Added Clause 4 (Now clause 3 as of Edit 5). Moved edit log below main proposal text.

Edit 5: Updated Clause 1ai to include species as an explicitly noted patient factor. Updated clause 2a ("...the medication or purpose must be illegal..."). Re-worded Clause 2c to be more efficiently worded. Swapped Clauses 3 and 4.

Edit 6: Rephrasing of most clauses and significant improvement to the preamble thanks to verbal Feng Shui From Tinhampton



Access to Effective Medications
Category: Health (Healthcare)

The General Assembly:
Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

Acknowledges the commitment of the World Health Authority to promoting health and wellbeing in all nations both within and outside the jurisdiction of the World Assembly.

Despite these efforts, recognises the ongoing disproportionate lack of access to effective medication between nations, and between residents within nations.

Recognises the significant impact of poverty and income inequality on access to effective medication.


For the reasons stated above, hereby:

1. Establishes the World Medications Council (henceforth referred to as the WMC) as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

a.To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease and/or other medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In examining a medication, the WMC must consider the following criteria. It may also, at its discretion, consider other relevant factors beyond this list.

i. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, chronic disease, genetic disease, employment, and lifestyle factors.

ii. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

iii. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.

b. To, based on this assessment, create and maintain an Effective Medications List (henceforth referred to as the EML), containing those medications that are best suited to meet the needs of an effective health system.

c. To regularly assess and update the EML based upon the current scientific consensus.

d. To undertake activities to promote access to medications on the EML in all World Assembly member nations.

e. To, in nations outside the jurisdiction of the World Assembly, conduct activities to promote access to medications on the EML with the consent and according to the laws of those nations.


2. Requires all WA member states to provide access to all medications included in the EML to all residents of their nation, with the following exceptions:

a. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation.

b. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease and/or other medical and/or psychological conditions.

c. Nations are not required to provide access to medications where for reasons outside of that Nation’s control, they are unable to provide access to that medication. However, in this circumstance, a Nation must make every effort to provide access to that medication as soon as possible.


3. Encourages all WA member Nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable groups.
Access to Effective Medications
Category: Health (Healthcare)

The General Assembly:

Recognises the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of acccess to effective medication in maintaining this health and happiness.

Recognises the significant impact of poverty and income inequality on access to effective medication.

Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

Acknowledges the commitment of the World Health Authority to promoting health and wellbeing in all nations both within and outside the jurisdiction of the World Assembly.

Despite these efforts, recognises the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, and notes the lack of a globally accepted standard of medical treatment.


For the above reasons, and with the goal of improving the health of all nations:

1. Establishes the World Medications Council (henceforth referred to as the WMC) as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

a.To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease and/or other medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In examining a medication, the WMC must consider the following criteria. It may also, at its discretion, consider other relevant factors beyond this list.

i. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, chronic disease, genetic disease, employment, and lifestyle factors.

ii. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

iii. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.

b. To, based on this assessment, create and maintain an Effective Medications List (henceforth referred to as the EML), containing those medications that are best suited to meet the needs of an effective health system.

c. To regularly assess and update the EML based upon the current scientific consensus.

d. To undertake activities to promote access to medications on the EML in all World Assembly member nations.

e. To, in nations outside the jurisdiction of the World Assembly, conduct activities to promote access to medications on the EML with the consent and according to the laws of those nations.


2. Requires all WA member states to provide access to all medications included in the EML to all residents of their nation, with the following exceptions:

a. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation.

b. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease and/or other medical and/or psychological conditions for which that mediction has an establised clinical use.

c. Nations are not required to provide access to medications where for reasons outside of that Nation’s control they are unable to provide access to that medication. However, in this circumstance, a Nation must provide access to a similarly effective alternative, and make every effort to provide access to that medication as soon as possible,.


3. Encourages all WA member Nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable groups.
Access to Effective Medications
Category: Health (Healthcare)


The General Assembly:

Recognises the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of acccess to effective medication in maintaining this health and happiness.

Recognises the significant impact of poverty and income inequality on access to effective medication.

Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

Acknowledges the commitment of the World Health Authority to promoting health and wellbeing in all nations both within and outside the jurisdiction of the World Assembly.

Despite these efforts, recognises the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, and notes the lack of a globally accepted standard of medical treatment.


For the above reasons, and with the goal of improving the health of all nations, hereby:

  1. Establishes the World Medications Council (henceforth referred to as the WMC) as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

    1. To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In examining a medication, the WMC must consider the following criteria, in addition to any other factors it deems relevant.

      1. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors.

      2. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

      3. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.

    2. To, based on this assessment, create and maintain an Effective Medications List (henceforth referred to as the EML), containing those medications that are best suited to meet the needs of an effective health system.

    3. To regularly assess and update the EML based upon the current scientific consensus.

    4. To undertake activities to promote access to medications on the EML in all World Assembly member nations.

    5. To, in nations outside the jurisdiction of the World Assembly, conduct activities to promote access to medications on the EML with the consent and according to the laws of those nations.

  2. Requires all WA member states to provide access to all medications included in the EML to all residents of their nation, with the following exceptions:

    1. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation.

    2. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that mediction has an establised clinical use.

    3. Nations are not required to provide access to medications where for reasons outside of that nation’s control they are unable to provide access to that medication. However, in this circumstance, a nation must provide access to an available similarly effective alternative, and make every effort to provide access to that medication as soon as possible.

  3. Encourages all WA member nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable and disadvantaged groups.
Access to Effective Medications
Category: Health (Healthcare)


The General Assembly:

Recognises the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of access to effective medication in maintaining this health and happiness.

Recognises the significant impact of poverty and income inequality on access to effective medication.

Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

Acknowledges the commitment of the World Health Authority to promoting health and wellbeing in all nations both within and outside the jurisdiction of the World Assembly.

Despite these efforts, recognises the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, and notes the lack of a globally accepted standard of medical treatment.


For the above reasons, and with the goal of improving the health of all nations, hereby:

  1. Establishes the World Medications Council (henceforth referred to as the WMC) as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

    1. To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In examining a medication, the WMC must consider the following criteria, in addition to any other factors it deems relevant.

      1. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors.

      2. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

      3. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.

    2. To, based on this assessment, create and maintain an Effective Medications List (henceforth referred to as the EML), containing those medications that are best suited to meet the needs of an effective health system.

    3. To regularly assess and update the EML based upon the current scientific consensus.

    4. To undertake activities to promote access to medications on the EML in all World Assembly member nations.

    5. To, in nations outside the jurisdiction of the World Assembly, conduct activities to promote access to medications on the EML with the consent and according to the laws of those nations.

  2. Requires all WA member states to provide access to all medications included in the EML to all residents of their nation, with the following exceptions:

    1. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation. For this exception to apply, the medication must be illegal for all people in a nation.

    2. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that medication has an established clinical use.

    3. Nations are not required to provide access to medications where for reasons outside of that nation’s control they are unable to provide access to that medication. However, in this circumstance, a nation must provide access to an available similarly effective alternative and make every effort to provide access to that medication as soon as possible.

  3. Encourages all WA member nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable and disadvantaged groups.

  4. Requires all WA member states to price medications to allow all residents to afford all medications they require and maintain a basic standard of living.
Access to Effective Medications
Category: Health (Healthcare)


The General Assembly:

Recognises the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of access to effective medication in maintaining this health and happiness.

Recognises the significant impact of poverty and income inequality on access to effective medication.

Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

Acknowledges the commitment of the World Health Authority to promoting health and wellbeing in all nations both within and outside the jurisdiction of the World Assembly.

Despite these efforts, recognises the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, and notes the lack of a globally accepted standard of medical treatment.


For the above reasons, and with the goal of improving the health of all nations, hereby:

  1. Establishes the World Medications Council (henceforth referred to as the WMC) as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

    1. To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In examining a medication, the WMC must consider the following criteria, in addition to any other factors it deems relevant.

      1. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including species, pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors.

      2. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

      3. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.

    2. To, based on this assessment, create and maintain an Effective Medications List (henceforth referred to as the EML), containing those medications that are best suited to meet the needs of an effective health system.

    3. To regularly assess and update the EML based upon the current scientific consensus.

    4. To undertake activities to promote access to medications on the EML in all World Assembly member nations.

    5. To, in nations outside the jurisdiction of the World Assembly, conduct activities to promote access to medications on the EML with the consent and according to the laws of those nations.

  2. Requires all WA member states to provide access to all medications included in the EML to all residents of their nation, with the following exceptions:

    1. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation. For this exception to apply, the medication or purpose must be illegal for all people in a nation.

    2. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that medication has an established clinical use.

    3. If a nation is unable to provide access to a medication for reasons outside its control, it must provide access to an available similarly effective alternative, and provide access to the unavailable medication as soon as possible.

  3. Requires all WA member states to price medications to allow all residents to afford all medications they require and maintain a basic standard of living.

  4. Encourages all WA member nations to minimise the cost of medications to patients through all appropriate means, including subsidisation of common and/or effective medication, price standardisation, anti-monopoly legislation, and special access schemes for vulnerable and disadvantaged groups.
Last edited by Xanthorrhoea on Thu Oct 21, 2021 8:41 am, edited 11 times in total.

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Hulldom
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Postby Hulldom » Tue Sep 14, 2021 3:59 pm

Someone may have more detailed feedback than me, but this is a pretty great first attempt! I look forward to seeing where this goes!
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Postby Imperium Anglorum » Tue Sep 14, 2021 7:12 pm

OOC. Re section 3, encouragement or suggestive language does not violate the optionality rule, which applies to proposals (rather than proposal clauses) regardless.

ELSIE MORTIMER WELLESLEY. Could the proposing ambassador clarify as to the actual purpose of this proposal, as something of a precis?

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Postby Abacathea » Wed Sep 15, 2021 7:04 pm

It has been a very long time since I critiqued a draft of anything on the hallowed floors but I shall try my best.

a.To assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease and/or other medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia).


Part of my takes exception to this because I feel this should be done at earlier stages i the process, for example, safety and efficacy you'd imagine would be done at the trial stage of any drug on the market? Just me thinking out loud. Others may not agree.

. In examining a medication, the WMC must consider the following criteria. It may also, at its discretion, consider other relevant factors beyond this list


I feel like the punctuation and grammar is wrong here, I can't put my finger on what it is but it reads super clunky to me. Again, maybe that is just me.

i. The WMC shall examine the safety of assessed medications, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for the safe storage, handling, and administration of the medication. The WMC shall also examine the impact of patient factors on a medication’s safety, including pregnancy, chronic disease, genetic disease, employment, and lifestyle factors.


Again, I feel clinical trials should really sort of address this. You may have some tinpot dictatorship who maybe doesn't do that, but surely any developed nation does?

ii. The WMC shall examine the efficacy of assessed medications for all indications for which they are used. This includes the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications.

iii. The WMC shall examine the relative cost-effectiveness of assessed medications, including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes.


I feel that, and I cannot believe I'm saying this, a universal assembly such as this, really doesn't have much say in, for example, a treatment developed in nowhereistan's manufacturing costs or processes around same.

I'm not going to comment much more on Clause 1 because I don't see any real teeth in any of it or how it would actually impact a nation through the enacting of this legislation.

a. Nations are not required to provide access to a medication that is illegal, or for purposes that are illegal in that nation


This i see as being an issue. If your goal is to ensure access to medication in a nation, what is to stop General Abacathea here stating "all these medications are now illegal in my small nation, up yours WA"?

b. Nations are not required to provide access to a medication for purposes other than the diagnosis, prevention, treatment, or management of disease and/or other medical and/or psychological conditions.


Maybe I'm being ignorant here, but, other than for say, research and development, what other reason would there be to provide access to medication? I assume this was a bid to address recreational concerns, but I feel the point is maybe moot?

c. Nations are not required to provide access to medications where for reasons outside of that Nation’s control, they are unable to provide access to that medication. However, in this circumstance, a Nation must make every effort to provide access to that medication as soon as possible.


Why that particular medication? surely if you have compiled an exhaustive list of medications, a similar and equally effective treatment could be provided rather than ensuring access as soon as possible? Also it reads like "you're not required to, but you are, just at a later date".

I suppose I might just be out of the drafting process too long, and maybe this is a very good resolution and I just can't see it, but overall it reads largely toothless to me and the little teeth it has appear to be baby teeth and waiting to fall out, if this came to vote in its current incarnation I feel I'd have to vote against.
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Xanthorrhoea
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Postby Xanthorrhoea » Thu Sep 16, 2021 12:43 am

Thhanks for the feedback guys, I've read through it and made some adjustments to the proposal based on your suggestions.

Thanks Ms Mortimer Wellesley, I’ve attempted to add more detail to justify the proposal, but suggestions on wording/relevance etc would be great as I’m not fully happy with the introduction. It still feels very stilted and clunky to me.

Thanks to the minister of Abacathea for all your suggestions. You gave an enormous amount of feedback, which I've tried to respond to below.

Role of clinical trials: I would agree that the bulk of the data relied upon by the council would likely be sourced from clinical trials. My initial draft focussed more on the Council acting as a collector and collator of information. However, an unfortunate reality is that many clinical trials are performed (or deliberately not performed) by parties with a vested interest in selling a medication. Thus, I wanted to give the council the power to conduct their own trials if need be. I chose the words “assess” “document” and “examine” to try and reflect this, as I believe they are flexible enough to include both collecting externally produced data such as results clinical trials etc, but also allow running their own trials and investigations.

Regarding clause 1’s “teeth”: On it’s own, it doesn’t really have any. But the “teeth” of clauses 2 & 3 rely on it existing. The point of clause 1 is to create a list of medications that beneficial enough that they should be as easily accessible to as many people as possible. Clauses 2 and 3 aim to enforce that access.

Regarding manufacturing costs/processes: It's true that manufacturing costs and proccesses vary hugely globally. However, certain medications are going to be intrinsically more expensive to deal with than others. e.g. Paracetamol is extremely cheap to manufacture, has few transport requirements, and is safe to handle. Other drugs such as mabs, vacccines, cytotoxics and blood products are inherently more difficult to make, require sterile, temperature controlled transport and storage, have extensive screening and sterility requirements, have a shorter shelf life, or are actively dangerous to people handling them. I would argue that this make panadol tablets overall preferable to a theroetical monoclonal antibody with the same effect, and that this should be accounted for when deciding which medicines make up the EML.

Regarding clauses 2a and 2b: 2a is there so that this proposal doesn’t overstep it’s intended effect. For example, if euthanasia drugs are put on the list, without 2a, all WA nations would be forced by default to provide access to euthanasia, which is (not yet) required by other passed resolutions. 2b is there to address similar concerns about primarily recreational drug use, but also practices such has stockpiling medication for commercial gain or for ‘creative’ medical use a la ivermectin. I’ve actually re-written it to be a bit stricter to reflect this. I would also argue that research purposes would likely fall within the realm of preventing/diagnosing/managing etc. The intent of the proposal is not to force nations into practices they disagree with (no matter how much Xanthorrhoea supports such issues), but to ensure that if an effective medication is legal for use, it is accessible to everyone equally.

Regarding 2c: Good point about providing access to an alternative meds (although in many cases there’s simply no such thing as an equally effective treatment), I’ve expanded the clause to include this. The whole “at a later date” aspect is so that nations aren’t automatically breaking the law in cases of supply chain failures (e.g. IRL Suez canal/natural disasters). The intent is that they are only in breach if they do nothing to address the cause of the failure.

The proposal’s teeth is something I’m still juggling. If you have suggestions for how to make it toothier without giving it overly broad powers or making it so toothy that everyone rejects it please tell me. I don’t have much experience in the WA, so I’m not sure what level to pitch it. For example, I’d personally prefer that clause 3 is a requirement rather than an encouragement, but I get the impression it would get shot down.

Any other feedback is always welcome!

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Postby Bears Armed » Thu Sep 16, 2021 1:59 am

Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

OOC: Even though this proposal doesn't outright depend on any of those earlier resolutions in order to work, that clause is legally iffy under the 'House of Cards' rule. I suggest shortening it to something along the lines of
Acknowledges the efforts of previous resolutions to improve access to safe and effective medication worldwide.
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Postby Imperium Anglorum » Thu Sep 16, 2021 7:23 am

Bears Armed wrote:
Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

OOC: Even though this proposal doesn't outright depend on any of those earlier resolutions in order to work, that clause is legally iffy under the 'House of Cards' rule. I suggest shortening it to something along the lines of
Acknowledges the efforts of previous resolutions to improve access to safe and effective medication worldwide.

I mean under the precedent which you joined, it's just not though. viewtopic.php?p=33109496#p33109496.

The preamble of a draft resolution states the reasons for which the resolution is addressing the topic and highlights past international action on the issue. It does not create an action upon which a resolution might rely. While a repeal might render a referenced resolution inoperative, it does not obliterate the evidence of past action... we cannot see reliance arising from reference in a prefatory introduction.

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Bears Armed
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Postby Bears Armed » Thu Sep 16, 2021 1:10 pm

Imperium Anglorum wrote:
Bears Armed wrote:
Acknowledges the efforts of previous resolutions such as GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide.

OOC: Even though this proposal doesn't outright depend on any of those earlier resolutions in order to work, that clause is legally iffy under the 'House of Cards' rule. I suggest shortening it to something along the lines of
Acknowledges the efforts of previous resolutions to improve access to safe and effective medication worldwide.

I mean under the precedent which you joined, it's just not though. viewtopic.php?p=33109496#p33109496.

The preamble of a draft resolution states the reasons for which the resolution is addressing the topic and highlights past international action on the issue. It does not create an action upon which a resolution might rely. While a repeal might render a referenced resolution inoperative, it does not obliterate the evidence of past action... we cannot see reliance arising from reference in a prefatory introduction.

OOC: Fair comment. I'd forgotten that one, and (this time) was going on a "better safe than sorry" approach.
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Xanthorrhoea
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Postby Xanthorrhoea » Fri Sep 17, 2021 8:54 pm

Rewrote clause 1a to reduce clunkiness.

Anyone have any further changes or suggestions they feel keen on? I’m looking to submit this in the next few days.

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Postby Outer Sparta » Fri Sep 17, 2021 9:06 pm

Xanthorrhoea wrote:Rewrote clause 1a to reduce clunkiness.

Anyone have any further changes or suggestions they feel keen on? I’m looking to submit this in the next few days.

I say you wait a couple of weeks since GA feedback takes time.
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Xanthorrhoea
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Postby Xanthorrhoea » Fri Sep 17, 2021 11:03 pm

Outer Sparta wrote:I say you wait a couple of weeks since GA feedback takes time.



Fair enough. I’m generally an impatient person, but a few weeks sounds reasonable.

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Postby Xanthorrhoea » Tue Sep 21, 2021 12:21 am

Just updated the formatting and added some minor adjustments to wording, as I finally got around to figuring out how to use the forum tools. Hopefully it looks cleaner and is easier to parse.

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Postby Xanthorrhoea » Thu Sep 23, 2021 9:55 am

I know I'm spamming at this point, so sorry about that. However, my most recent edit changes the proposal significantly, so I thought it was worth explaining.

After thinking more about what the minister of Abacathea noted about clause 2a, I wasn't happy with it. The new caveat to the exception should hopefully prevent leaders from outright banning medications without shooting themselves in the foot. The idea is to make people commit to their choices, prevent hypocracy and ensure that if a medication/purpose is legal for one, it's legal for everyone. This should stop "good for me but not for thee" scenarios such as banning abortions for most people, but leaving it legal for politicians and their families. Hopefully this stops General Abacathea from banning all medications, or at least will doom him to suffer syphilis along with everyone else.

The new clause 4 should hopefully give the proposal some more teeth (thanks again Abacathea) and make it more effective in improving access to medications without totally crushing capitalists'/free market proponants' dreams. Given that the entire point of the proposal is to improve people's access to the medications they need, and price is a huge barrier (e.g. people skipping insulin doses to afford rent etc), I thought it needed a stronger pricing requirement. I thought it was best to mandate the desired effect and leave the methods as undefined as possible. The current wording should hopefully give nations the wiggle room to meet the requirement in their own way. I'd appreciate feedback on it, as it's so simply worded at the moment that I'm sure it will have some unintended side effects/loopholes.

I personally believe that special access schemes/subsidisation etc should be encouraged, so I'd like to preserve clause 3, but I'm open to persuasion. I'm also not sure whether clauses 3 and 4 should swap places. I feel like the current order shows the flow of ideas most neatly, but again I'm open to other's opinions.

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Postby Abacathea » Thu Sep 23, 2021 10:36 am

Xanthorrhoea wrote:I know I'm spamming at this point, so sorry about that. However, my most recent edit changes the proposal significantly, so I thought it was worth explaining.

After thinking more about what the minister of Abacathea noted about clause 2a, I wasn't happy with it. The new caveat to the exception should hopefully prevent leaders from outright banning medications without shooting themselves in the foot. The idea is to make people commit to their choices, prevent hypocracy and ensure that if a medication/purpose is legal for one, it's legal for everyone. This should stop "good for me but not for thee" scenarios such as banning abortions for most people, but leaving it legal for politicians and their families. Hopefully this stops General Abacathea from banning all medications, or at least will doom him to suffer syphilis along with everyone else.

The new clause 4 should hopefully give the proposal some more teeth (thanks again Abacathea) and make it more effective in improving access to medications without totally crushing capitalists'/free market proponants' dreams. Given that the entire point of the proposal is to improve people's access to the medications they need, and price is a huge barrier (e.g. people skipping insulin doses to afford rent etc), I thought it needed a stronger pricing requirement. I thought it was best to mandate the desired effect and leave the methods as undefined as possible. The current wording should hopefully give nations the wiggle room to meet the requirement in their own way. I'd appreciate feedback on it, as it's so simply worded at the moment that I'm sure it will have some unintended side effects/loopholes.

I personally believe that special access schemes/subsidisation etc should be encouraged, so I'd like to preserve clause 3, but I'm open to persuasion. I'm also not sure whether clauses 3 and 4 should swap places. I feel like the current order shows the flow of ideas most neatly, but again I'm open to other's opinions.


A telegram baring the official Abacathean seal arrives to the World Assembly, a small and slightly disgruntled gnome enters the drafting floor, more miffed that he has been reduced to a messenger pigeon, approaches the podium and reads aloud;

"His Majesty HRM Pip wishes to clarify the following; In no way is Abacathea run by a General, our contributions to the drafting floor are usuall hypothetical in order to better proposed legislation. The syphilitic status of some of our Ambassadors however is a matter for the Strangers Bar and not something we involve ourselves in."

The gnome gives a discerning middle finger to the floor and leaves.
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Xanthorrhoea
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Postby Xanthorrhoea » Fri Oct 01, 2021 1:34 pm

Hey all, I'm giving this a bump as I'm planning on submitting this in the next week if there are no more suggestions. All feedback is appreciated as always.

May this proposal lead to the eradiccation of hypothetical syphilis.

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Postby Tinhampton » Sat Oct 02, 2021 2:50 am

Alexander Smith, Tinhamptonian Delegate-Ambassador to the World Assembly: I am agreed to this proposal in principle - my support for the idea that everybody should be entitled to seek and use appropriate and essential medications for whatever conditions they may have outweighs my opposition to the woke equity bullshit in this proposal by quite some distance.

In reality, however, it uses ten words to explain things that can be better explained in eight - which is never a good sign in my books. I'd like to ask if the ambassador from Xanthaldiarrhoea or whatever that place's called would be interested in one of the Tinhamptonian delegation's world-famous rewrites, such as... this one. Sorry, I'm 66-and-a-half years old and getting worse with names.
The General Assembly:

Recognising the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of access to effective medication in maintaining this health and happiness (including in reducing poverty and income inequality),

Recalling the efforts of previous resolutions such as GA 333 "Preserving Antimicrobials", GA 429 "Traditional Medicine", and GA 571 "Access to Transgender Hormone Therapy" in improving access to safe and effective medication worldwide,

Noting the ongoing disproportionate distribution of access to effective medications within and between nations - even despite these efforts - as well as the lack of a globally accepted standard of medical treatment, and

Seeking to reaffirm and strengthen its commitment to improve the health and wellbeing of all nations, regardless of WA membership status, hereby enacts as follows.

  1. The World Medications Council (henceforth the WMC) is established as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

    1. to assess and document the safety, efficacy, and cost-effectiveness of all known medications and substances used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In assessing a medication, the WMC must consider:

      1. the safety of assessed medications (including the severity and frequency of known adverse effects, therapeutic range, toxicity, interactions with other medications, and requirements for that medication's safe storage, handling, and administration),

      2. the impact of patient factors on a medication’s safety (including pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors),

      3. the efficacy of assessed medications for all indications for which they are used (including the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dose, duration of therapy, and synergistic or detrimental effects of other medications),

      4. the relative cost-effectiveness of assessed medications (including the medication price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes), and

      5. any other factors it deems relevant.

    2. to, based on the assessment described in Article 1a, create and maintain an Effective Medications List (henceforth the EML), containing those medications that are best suited to meet the needs of an effective health system,

    3. to regularly assess and update the EML based upon the current scientific consensus,

    4. to promote access to medications on the EML in all WA member nations (henceforth members), and

    5. to promote access to medications on the EML in non-members with the consent of, and according to the laws of, those non-members.

  2. All members must provide access to all medications included in the EML to all residents of their nation, except that no member shall be required to provide access to such a medication:

    1. that is illegal for all of their residents, or for purposes that are illegal within their jurisdiction for all of their residents,

    2. for purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that medication has an established clinical use, or

    3. if they cannot provide access to it for reasons outside of their control; in such circumstances, however, that member must make every effort to provide access to an available, similarly effective alternative medication as soon as possible.

  3. Members are encouraged to minimise the cost of medications to patients through all appropriate means, such as by subsidising common and/or effective medications, standardising medication prices, enforcing antitrust law, and applying special access schemes for vulnerable and disadvantaged groups.

  4. Members must ensure that medications are priced at a level that allows all of their residents to afford all of the medications they require while still maintaining an adequate standard of living.
Last edited by Tinhampton on Sat Oct 02, 2021 2:54 am, edited 2 times in total.
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Bears Armed
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Postby Bears Armed » Sat Oct 02, 2021 3:22 am

OOC:[box] You do realise that medications that are effective for members of one sapient species (e.g. humans) might be ineffective -- or even harmful -- for members of some other sapient species (e.g. Ursines, or Ravens), right? Having a single 'EML' would be problematic...
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(includes The Ursine NorthLands) Demonym = Bear[s]; adjective = ‘Urrsish’.
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Xanthorrhoea
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Postby Xanthorrhoea » Tue Oct 05, 2021 11:45 pm

Bears Armed wrote:OOC:[box]You do realise that medications that are effective for members of one sapient species (e.g. humans) might be ineffective -- or even harmful -- for members of some other sapient species (e.g. Ursines, or Ravens), right? Having a single 'EML' would be problematic...


Good point! I've updated the patient factors section of clause 1ai to include species as a relevent patient factor to consider. There is much more physiological difference between a raven and a bear than between pregnant and non-pregnant humans, and that deserves explicit consideration. Re: the rest of the proposal, I'm of a view that clauses 2a and b are sufficient to allow nations to only have to supply medications appropriate for their populations, and only to those species that each medication is appropriate for. I think there's enough room for interpretation in clause 2a to allow providing drugs to one species, but not another if it's unsafe/ineffective.

Tinhampton wrote:Alexander Smith, Tinhamptonian Delegate-Ambassador to the World Assembly: I am agreed to this proposal in principle - my support for the idea that everybody should be entitled to seek and use appropriate and essential medications for whatever conditions they may have outweighs my opposition to the woke equity bullshit in this proposal by quite some distance.

In reality, however, it uses ten words to explain things that can be better explained in eight - which is never a good sign in my books. I'd like to ask if the ambassador from Xanthaldiarrhoea or whatever that place's called would be interested in one of the Tinhamptonian delegation's world-famous rewrites, such as... this one. Sorry, I'm 66-and-a-half years old and getting worse with names.


Thanks for the feedback. Do I have your permission to use some elements of this in my next re-write? (I'm happy to credit you a a co-author of course). If you want to discuss things in more detail I'll send you a telegram so we' don't spam the thread.

Oh, and I understand the confusion about our great nation's name, it does come from the same verbal root. The trick is to remember: One starts with an 'X', the other ends in a mess.

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Tinhampton
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Postby Tinhampton » Wed Oct 06, 2021 2:20 am

Xanthorrhoea wrote:Thanks for the feedback. Do I have your permission to use some elements of this in my next re-write? (I'm happy to credit you a a co-author of course). If you want to discuss things in more detail I'll send you a telegram so we' don't spam the thread.

You're more than welcome to do so (and to carry on this conversation by TG).
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Authorships & co-authorships: SC#250, SC#251, Issue #1115, SC#267, GA#484, GA#491, GA#533, GA#540, GA#549, SC#356, GA#559, GA#562, GA#567, GA#578
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Xanthorrhoea
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Postby Xanthorrhoea » Wed Oct 13, 2021 11:09 am

Version 6 of the proposal is up, featuring new, snappier writing courtesy of the inimicable ambassador for Tinhampton. I'll leave this up for another week, unless there are any more objections, otherwise I'll (finally) submit this.

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Xanthorrhoea
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Postby Xanthorrhoea » Tue Oct 19, 2021 12:56 am

Final call everyone, if there's no further feedback, I'll submit this tomorrow. Thanks for all the help with drafting, the current version is vastly better than the original, and you've all taught me so much about the drafting process and WA legislation. Thanks for being so welocming of a newcomer!

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Xanthorrhoea
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Postby Xanthorrhoea » Thu Oct 21, 2021 8:45 am

Submitted!

Thanks for the feedback and help everyone!


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