July 2, 2026

Moving Toward Age-Friendly Palliative Care 

By Katherine I. Pettus
IAHPC Senior Director of Advocacy and Partnerships

The lofty goal of the World Health Organization’s 3rd World Congress of Age-friendly Cities and Communities in San Sebastian, Spain, was to “set the course for a connected, equitable, and sustainable world for all generations.” 

A program that included pre-congress workshops, plenaries, breakout sessions, and field trips to healthy community sites in the Basque region attracted activists and experts from all over the world, including many I have worked with for more than a decade at the UN Open-Ended Working Group on Ageing. Although it is always hard to choose which parallel session to attend at such engaging conferences, I was particularly interested in the workshops on housing and healthcare, which featured inspiring presentations on how infrastructure-dependent, urban systems are making adjustments at the local level to demographic surges of older populations. 

Dignified ageing must include dignified dying

In a sea of presentations focused on making health systems age-friendly, Dorothy Yeung from the Our Hong Kong Foundation gave the only official presentation on end-of-life care. It emphasized that although 90% of Hong Kong citizens express a preference to die at home, the lack of home care results in hospital deaths for roughly the same percentage. The foundation (like many similar NGOs around the world, including the IAHPC!) is making the case for change. 

It makes the fiscal case with policymakers by sharing evidence of potential savings of HK$91,460 ($11,660 USD, €9,970) per patient by shifting to community-oriented care models that also enhance quality of life. The foundation complements this with “Life-and-Death Education” that normalizes age-appropriate reflection on illness, ageing, and loss and care through lesson plans and multimedia materials, community education, and partnerships with NGOs. 

Our Hong Kong Foundation is also tackling crucial continuity of care issues by setting up a collaboration platform that coordinates referrals, shares medical records, and assesses needs and resources to gather outcome-focused metrics that inform policy. The final slide of the presentation stated unequivocally that “Dignified ageing must include dignified dying,” stipulating that “EOL care is not only a health service issue but a test of whether communities are truly connected, equitable, and sustainable for all.”

Compassion as a cornerstone

The poster I presented, “The Compassionate Charter as a Normative Cornerstone of Healthy Cities and Communities,” also aimed to bridge the conceptual gap between the healthy aging narrative and the universal goal of dignified end-of-life care for persons of all ages. For more than a decade, the movements for age-friendly cities and compassionate cities/communities (which promote palliative care as a public health issue) have been developing in parallel, many in the same sub-national jurisdictions. I proposed (in some conversations at the poster session and at one of the plenaries) that they might start collaborating. That suggestion was well taken, including by WHO officials present, so I hope to be more involved in some of that work going forward. 

I was honored to witness a moving encounter between two delegates who stopped by my poster at the same time to discuss its claim that compassionate communities support grief and bereavement. A university professor whose husband was developing early onset Alzheimer’s disease and another woman whose father had died the previous year shared the ongoing and unsupported grief they were experiencing at their respective workplaces. They ended their brief but deep conversation with a hug and some tears. 

Learn more about the Compassionate Communities movement and check out the new e-book Compassionate Communities in Action: Global Stories of Care, Loss and Connection edited by Emma Hodges and Manjula Patel, available for free online. 

Updated Public Health Palliative Care Textbook

When Dr. Julian Abel invited me to contribute to the Oxford Textbook of Public Health Palliative Care in 2022, I invited Dr. Pati Dzotsenidze to co-author what became a chapter on “The imperative of palliative care advocacy.” It discusses the essential roles of global and national palliative care advocacy in laying the normative, legal, and technical groundwork for sustainable compassionate communities within national and subnational boundaries. The chapter focuses on how evidence-based advocacy can promote the integration of palliative care into primary care to improve quality of life for patients and families in the low-, middle-, and upper-middle-income countries that are the epicenter of the “pandemic of untreated […] pain¹.” Part I of the chapter discusses international law, advocacy, and palliative care praxis; Part II reviews advocacy issues for improved access to essential palliative care medicines; and Part III presents a case study of palliative care development in the former Soviet Republic of Georgia. 

Since a second edition of the textbook is being prepared, I will revise the chapter to include important developments, such as publication of the “WHO Guideline on balanced national controlled medicines policies to ensure medical access and safety.” If you would like to receive a PDF of the chapter please message me through Pallinet.

IAHPC Advocacy Team Engages with the OHCHR

Several times a year I send official IAHPC reports in response to calls from the Office of the High Commissioner for Human Rights (OHCHR) on topics such as access to essential medicines, healthcare in general, older persons, and controlled medicines policy. This year was a first: not only did I submit IAHPC reports on access to medicines and older persons in conditions of dependency, three members of IAHPC’s advocacy committee sent reports: Irena Laska for Albania; Esther Hortense for Cameroon; and Jennifer Hunt for Zimbabwe.

You can read all of these reports on our Advocacy Initiatives page. Keep an eye on Pallinews for OHCHR submission calls. I can help with your report if you need tips! 

Leverage These!

Also, the UN General Assembly approved the Political Declaration on HIV/AIDS: United to End AIDS by 2030, committing “to promote services that integrate prevention, treatment and care of co-occurring conditions, including tuberculosis and viral hepatitis, and improve access to quality, affordable primary healthcare, comprehensive care and support services, including those that address physical, spiritual, psychosocial, socioeconomic and legal aspects of living with HIV, and palliative care services” [italics added]. 

Please Contribute Your Views

The Interfaith Advocacy Network (IFAN) survey is still open if you would like to consider filling it out and letting us know if or how you would like to participate. Survey responses will help us understand how IFAN should take shape, what priorities should guide the first phase of work, what resources are most needed, and how you may wish to be involved. It should take you about 10 to 15 thoughtful minutes. Survey responses to date are helping us envision our practical workplan, priority partners, faith-leader-ready resources, bulletins, and webinars. I will send out our first IFAN Bulletin by the end of the month, so drop me a line on Pallinet if you would like to sign up. 

Please contribute to the WHO Call for Public Consultation on Global Standards for Long-Term Care. Palliative care is a key component of long-term care, which itself is an essential component of all public health services for persons of all ages. Your contributions will be key to the development of standards that WHO will recommend to governments everywhere. The call is open until October 30. 

Reference

European Society for Medical Oncology. Governments failing to address “global pandemic of untreated cancer pain.” Science News, October 1, 2012.