Katherine I. Pettus
Whirlwind May Focuses on Advocacy for Access
May was an action-packed month that began with my May 6 Atlantes lecture, in Spanish, in Pamplona, “From Bedside Care to Global Policy,” followed by a three-day “Collaborating for Global Impact Workshop” meeting in Dublin, Ireland, hosted by Global Partners in Care.
The goal of the meeting, attended by palliative care leaders from around the world, was “to create intentional space for additional high-level strategic thinking, alignment, and momentum toward unified global action.” Participants engaged in intense, professionally moderated group discussions organized around principles of “human-centered design” to create collaborative projects aimed at overcoming previously identified barriers to global palliative care development.
Part 2 of the project will take place at the African Palliative Care Congress in Botswana in September.
Our WHA statements: introducing care into the debates
May also saw the culmination of our intense months of preparation for the 78th World Health Assembly, attended by IAHPC delegates Drs. Maya Jane Bates, Kayla Wolofsky, Antonios Giannakis, Sherin Susan Paul, and myself. Time and budgetary constraints (a packed WHA agenda combined with the US withdrawal from the World Health Organization) confined all non-state actors, including IAHPC, to one-minute individual oral statements on relevant agenda items and three-minute constituency statements. We gave a constituency statement co-created with seven other non-state actor partners on WHO work in emergencies, focusing on the need to integrate palliative care into health systems before humanitarian emergencies put them under pressures, and to ensure adequate stockpiles of essential palliative care medicines. Dr. Giannakis of PallChase read our constituency statement on 16.1, which can be reviewed here with all our one-minute statements on other agenda items.
Bonus article: IAHPC delegate Kayla Wolofksy’s : "Reflections from WHA78: Championing palliative care on the global stage"
IAHPC side event on interfaith advocacy
Dr. Maya Jane Bates stressed the need for safe, affordable access at the WHO event announcing its new guideline on controlled medicines. Also pictured are Ruth Dreyfuss and Belgium Ambassador to UN Geneva Christophe Payot. Photo by Katherine Pettus used with permission.
IAHPC organized two WHA78 side events and cosponsored one other. Our unofficial (off-campus) side event “Interfaith Palliative Care Advocacy for Older Persons and Persons with Disabilities in the Current Global Funding Crisis” was cosponsored by the World Council of Churches and the International Federation on Ageing. Sarah Hess of the WHO moderated the session, which featured independent consultant Francesca Merico, Dr. Arvind Kasthuri, professor of community health at St. John’s College, and IAHPC’s Jane Bates. Francesca described the US President's Emergency Plan for AIDS Relief (PEPFAR) collaboration with multiple faith communities in Africa during the HIV/AIDS crisis, Dr. Arvind called in from Bangalore to describe his innovative elderly outreach and clinical programs, and Jane discussed her research on the economics of palliative care in the context of her work with EMMS International in Malawi. I gave a brief introduction of the IAHPC and our work, concluding with the proposal to develop an Interfaith Palliative Care Advocacy Coalition.
WHO's new guideline on controlled medicines
Our official WHO side event (on campus at the Palais de Nations) launched the new, long-awaited guideline “Balanced National Policies for Controlled Medicines to Ensure Access and Safety.” The session was chaired by Deus Mubangizi, director of the WHO Department of Health Policies and Standards.
Professor Julia Downing—executive director at the International Children's Palliative Care Network, and co-chair of the WHO guidelines group—summarized the guiding principles of the document and reported on the most important policy takeaways for governments. These include regulating the pharmaceutical industry to remove undue pressure on governments to distribute expensive opioids at the expense (literally) of generic medicines, such as morphine, and the imperative of steering clear of conflicts of interest that could trigger public health crises of nonmedical use, such as in the US.
Read the WHO news release on the guideline; access a pdf of the guideline's full text.
The WHO has launched a social media campaign to publicize the guideline, asking for help to support and amplify its campaign. Access it on LinkedIn, X, and Blue Sky.
IAHPC Board Member Dr. Bates gave a brief introduction to our work and stressed the need for safe and affordable access to controlled medicines from the perspective of her work in Malawi. She then moderated the civil society panel, which included representatives of the harm reduction community, the Union of International Cancer Control (UICC), the International Association for the Study of Pain (IASP), and the World Federation of Anesthesiologists. International Narcotics Control Board president Jallal Toufiq, former Commission on Narcotic Drugs president Ambassador Ghislain d’Hoop, and United Nations Office on Drugs and Crime staffer Dr. Elizabeth Sáenz made brief supportive interventions on behalf of the other UN treaty bodies involved in the global governance of controlled medicines. Ruth Dreifuss, former president of the Swiss Confederation/ Global Commission on Drug Policy, closed the session with strong remarks on the value of the guidelines for many communities adversely affected by unduly restrictive national drug policies.
Cosponsors of the side event were the governments of Belgium and Switzerland, the Global Commission on Drug Policy, IASP, UICC, and the Worldwide Hospice Palliative Care Alliance. Mr. Mubangizi opened with tributes to Dr. Anne Merriman, who died the week before, having just celebrated her 90th birthday, and Naomi Burke-Shyne, a friend and former executive director of Harm Reduction International. Naomi had been an integral part of the global guidelines group on balanced policies for controlled medicines. Her untimely death from cancer is a great loss to harm reduction. We honor their passing by continuing their work.
Accelerating progress on universal access to PC
The IAHPC cosponsored a side event with the Worldwide Hospice Palliative Care Alliance on “Accelerating Progress on Universal Access to Palliative Care: Learning from country experiences.”
Key messages included: successful models of integrating palliative care into primary care in the Philippines and Georgia; the need to expand and culturally adapt these models; and the fact that palliative care is essential to anyone with a serious illness.
The session featured representatives of the governments of the Philippines and the Republic of Georgia, as well as regional palliative care representatives such as Dr. Paola Ruiz, president of the Latin American Palliative Care Association, who reported on progress in Brazil, Chile, Colombia, and Panama.
Meeting with WHO to further IAHPC's PC goals
Last but not least, in line with IAHPC's strategic focus on palliative care for older persons, I met with Dr. Hyobum Jang, medical officer responsible for long-term care at WHO's Ageing and Health Unit of the Department of Maternal, Newborn, Child and Adolescent Health and Ageing, to discuss how IAHPC’s global membership might contribute to the WHO's current project of developing long-term care policy guidelines that include palliative care. We will be sending communications and organizing webinars on the topic of older persons, those with dementia, and other disabilities, per our agreement with WHO, so keep an eye on your inbox and IAHPC's social media.
Have a good summer in the north/winter in the south! I will be taking July off to spend time with my family, so look for my next report in September. Have a good summer/winter, and thank you all for your ongoing support and interest in our work.
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