2016; Volume 17, No 7, July
Policy and Advocacy
Improving access to controlled medicines for pediatric and geriatric palliative care
Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Human Rights and Palliative Care, reports on IAHPC advocacy at the ICPCN Conference in Buenos Aires, the WHA, PACE and World Elder Abuse Day in Brussels
IAHPC hosted a workshop at the conference with global experts. Speakers Diederik Lohmann (Human Rights Watch) and Liliana De Lima, (Executive Director of IAHPC) are pictured with Mary Callaway (IAHPC board member, centre)
Buenos Aires
The 2016 International Children's Palliative Care Network (ICPCN) conference, which overflowed with more than 410 enthusiastic providers from all over Latin America and the rest of the world, sparked new advocacy collaborations, including pediatric formulations of controlled essential medicines. IAHPC led a workshop featuring a panel of global experts: Busi Nkosi (ICPCN), Sharon Baxter (Worldwide Hospice Palliative Care Alliance – WHPCA), and Diederik Lohman (Human Rights Watch), to introduce basic advocacy concepts and strategies. Participants expressed the desire for follow-up to include in-depth regional and country workshops to train providers in advocacy. IAHPC is developing a palliative care medicines advocacy hub to be launched in the fall.
Geneva
The key cross-cutting topics of palliative care and controlled medicines were either entirely absent or barely mentioned at the high level panels and debates on resolutions at the World Health Assembly (WHA) and Executive Board meetings. Speakers presenting national work on non-communicable diseases, workforce capacity, migration and health, primary care, and drug policy seemed unaware of the palliative care resolution passed at WHA only two years previously. The WHO Executive Board also took a “Decision” to develop a dementia strategy to be adopted by WHA70 next year.
Only the representatives of non-governmental organizations in formal relations with the World Health Organization (WHO), such as IAHPC, WHPCA, the World Medical Association, The Red Cross and Red Crescent, brought up the topics when we were given the floor after representatives of member states had their say. The long awaited Progress Report on WHA Palliative Care Resolution 67/19 was given a scant couple of minutes at the end of a crowded agenda and had to share the floor with Access to Essential Medicines, a topic most member states remaining in the Committee Room chose to address.
As many WHO member states are now recognizing with alarm, their public health workforces are not equipped to cope with the spread of non-communicable diseases (NCDs), the demographics of ageing, and migration/refugees. Palliative care advocates can leverage the excellent “Global strategy on human resources for health: workforce 2030” A69/B/CONF./4, which recognizes “the mismatch between the supply, demand and population needs for health workers” as “major barriers to achieving universal health coverage as committed to in Sustainable Development Goal 3, Target 3.8.” This workforce deficit clearly undermines countries’ capacity to provide palliative care, especially given projected increases in the number of older persons, persons suffering from dementia and other NCDs.
Brussels
Here, events included Mainstreaming Palliative Care for an Age-friendly Society, the PACE Collective (Palliative Care Europe) a project to study how palliative care is provided in care homes in six countries, and the Joint EU high-level conference on ‘Fighting elder abuse in health and long-term care’ on the occasion of the 11th World Elder Abuse Awareness Day. Unsurprisingly, the PACE project found significant variations in quality and provision of care across countries and facilities. It became clear from attending the two meetings in succession, that the palliative care, human rights, and care home provider and advocacy communities, need more such interactions to strengthen their policy advocacy.
The Independent Expert on the Rights of Older Persons, the Special Rapporteur on the Right to Health have both confirmed a right to palliative care and pain relief, and all WHO member states approved the WHA67 Resolution calling on governments to integrate palliative care into healthcare systems. Advocates in all countries can leverage the statements of these UN human rights experts to make the case for palliative care to their health ministries and deans of medical/nursing/pharmacy/social work schools.
Read more about the ICPCN Conference on the Featured Article page where IAHPC board member Prof. Julia Downing reflects on the conference.