Jason Nickerson and Amir Attaran of the University of Ottawa, Canada examine in this week's PLoS Medicine the vast inequities in medical pain relief around the world, arguing that the imbalance has arisen from restrictive drug laws designed to prevent access to illegal substances, and proposing that the global control of licit narcotics be shifted from the International Narcotic Control Board to WHO.

The authors say: "Transferring the public health responsibility for controlled medicines from INCB to WHO would end the impossibly contradictory situation in which INCB is mandated both to restrict and to promote access to controlled medicines...Attention must now shift to creating better legal frameworks that extricate pain treatment from drug prohibition."