2016; Volume 17, No 10, October
Policy and Advocacy
Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Human Rights and Palliative Care, reports on key advocacy meetings in Copenhagen, Geneva and Vienna.
Policy advocacy in September included a meeting at the Commission on Narcotic Drugs (CND) in Vienna, the World Health Organization (WHO) European Regional meeting in Copenhagen, and the report of the Independent Expert on Ageing at the Human Rights Council in Geneva.
Commission on Narcotic Drugs Intersessional – Vienna
The intersessional meeting in Vienna was the first since the April UNGASS on Drugs and the summer break. This meant there were a lot of new delegates who are not yet familiar with the issues around access to controlled medicines, meaning there is a need for basic education and technical briefings on the topic. The Chair emphasized the importance of Agenda 2030 – the Sustainable Development Goals (SDGs) – as the frame for the work of the CND in coming years.
‘Civil society’ includes national, regional, and global palliative care associations. We are a key part of the ‘roadmap’.
The theme of Agenda 2030 — “Leave no one behind” aligns with palliative care, whose universality makes it the quintessential “leave no one behind” clinical discipline. It is universal because everyone dies, many suffer, and the epidemiological reality of modern public health landscapes means that the vast majority of the world’s people, including those who live in rural areas, slums, and fancy gated communities, will need palliative care at some point, if only at the end of life. Palliative care also embodies the ultimate multi-sectoral, trans-disciplinary approach required by the SDGs. Palliative care professionals are in a perfect position to model and mentor this team approach, but need to have access to affordable medicines controlled under the UN drug treaties in order to alleviate pain and other symptoms. This is why IAHPC and other partners work to raise awareness about global lack of availability of morphine and other opioids at CND.
The key SDG policy take-away for palliative care advocates is that Target 3.8 of Goal 3, “ensure health” relates specifically to universal health coverage (UHC) and is:
Target 3.8
“Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”
Both health and human rights experts consider palliative care to be an essential service, and morphine to be an essential palliative care medicine. IAHPC is involved in strategic advocacy planning with our national and network partners to ensure that palliative care services, both institutional and home based, are included under universal coverage, and to promote it as a basic health platform. Stay tuned for more news on this and please feel free to contact me with questions, or for more information. For more information on palliative care and the SDGs see Worldwide Hospice Palliative Care Alliance (WHPCA) report, and on the CND intercessional, see International Drug Policy Commission (IDPC) report and blog.
World Health Organization European Regional meeting – Copenhagen
The WHO European Regional meeting in Copenhagen also emphasized the SDG framework for strategic health planning, and focused on health of migrants, a life course approach, and non-communicable diseases, among other things. Although no member states mentioned palliative care in any of the official discussions I was monitoring on the floor, Dr. Julie Ling (Chief Executive of the European Association for Palliative Care) and I ensured that it is featured in every joint statement of non-governmental organizations (NGOs) given from the floor. The effective coordination between NGOs on migrant health and NCDs was inspiring and productive and gave us a good platform to build on for future meetings. (View the Statement on Refugee and Migrant Health – Final and the NGP Joint Statement – 5(c) Action Plan for NCDs).
I attended the breakfast briefing hosted by Dr. Sania Nishtar candidate for Director General of WHO. Sania has been a leader in raising awareness about NCDs and is a great supporter of palliative care, which she says will be central to her platform. She believes that improved coordination and communication across government ministries and across WHO departments will improve availability of controlled medicines, and is committed to addressing the issue if elected.
Human Rights Council – Geneva
I returned from Copenhagen to listen to the Independent Expert on the Rights of Older Persons, Ms. Rosa Kornfeld Matte, deliver her report to the Human Rights Council. The report contains several mentions of the need to ensure the delivery of palliative care services where appropriate, and I was interested to monitor member states’ responses. Most were supportive of her recommendations, and of a new convention to protect the rights of older persons, but only Iran, Colombia, and Portugal mentioned the importance of palliative care in their interventions from the floor. Even these small numbers represent progress though, and palliative care features in the resolution passed by the Human Rights Council renewing Ms. Kornfeld Matte’s mandate.
IAHPC organized and I participated, representing the organization, in a side event on “Protecting, respecting, and fulfilling the rights of older refugees,” discussing the right to health and palliative care. (See also this article).
I will also be attending the Open Ended Working Group on Ageing at UN Headquarters in December.