Message from the Chair
&
Executive Director
Kathleen M. Foley, MD (USA)
Liliana De Lima, MHA (USA)
Dear Readers:
Welcome back to our May, 2007 edition of the IAHPC Newsletter. We have some important announcements to make:
First, as we mentioned in the previous edition of this NL, the Essential Medicines Committee of the World Health Organization (WHO) recently met in Geneva to review applications for the WHO Model List of Essential Medicines. For those who are not familiar with the WHO Essential Medicines concept, this program was established thirty years ago and has been extremely successful in improving availability and access to medications which are considered priorities within each country. The medications need to be proven safe, efficacious and cost effective in order to be added to the Model List - countries may copy, or adapt it, when developing their own lists.
As many of you know, IAHPC developed a List of Essential Medicines for Palliative Care (available free in our website at
http://www.hospicecare.com/resources/emedicine.htm), at the request of WHO. The IAHPC List was submitted to WHO, and after a discussion with the Expert Committee members, it was agreed that individual applications are needed to include medications in the List, which will be done for the next Expert Committee meeting. In addition to the comprehensive list, IAHPC had submitted two applications for addition to the WHO Model List: modified release morphine for pain relief (as a new formulation) and Fluoxetine for depression. We are happy to announce that both were accepted and included in the new version of the WHO Model List. The new version of the Model List (15th edition) can be downloaded in a pdf format from
http://www.who.int/entity/medicines/publications/EML15.pdf
Some people have expressed concerns about the addition of modified release morphine in the List and how this could have an affect on the availability of cheaper formulations, such as immediate release morphine. We are aware that there are some governments that have allowed this to happen, but we strongly believe that the slow release formulation provides several advantages for both care givers and patients and we advocate for the availability of both formulations (immediate and modified release) as essential for pain relief. Immediate release formulations are essential for dose titration during escalation of pain as rescue doses. Once a stable daily dosage provides pain relief, the patient should have access to a modified release formulation. Governments, health care providers and organizations, should ensure access for patients who are unable to afford them in developing countries.
Additionally, the first draft of a WHO Model List of Essential Medicines for Children is now available on the WHO website – please see below under Anouncements - a call for applications and comments.
Second, IAHPC is collaborating with the European Association for Palliative Care (EAPC) and the Worldwide Palliative Care Alliance (WPCA) to support the development of national palliative care associations throughout the world. The EAPC has created a Task Force to work on this objective, which will be chaired by Mr. David Praill, who also co-chairs the WPCA with Dr. Cynthia Goh from the Asia Pacific Hospice and Palliative Care Network (APHN). The EAPC has a designated space in the next EAPC Congress, in Budapest in June 2007, to work on this project and help support this initiative. Individuals representing national/regional associations or organizations will be invited to propose three commitments to work on in order to help develop and move palliative care forward in their countries. These commitments will be presented at the closing of the EAPC Congress as the Budapest Commitments. Invitations are being sent to representatives of National, Pan National and Regional Organizations, with a background document. We hope that many of you will be able to join us in this collaborative effort. Additional information about the EAPC Congress can be found in http://www.eapcnet.org/budapest2007/
Third: We are glad to able to announce the beneficiaries of IAHPC grants this month:
- Dr. Andrew Ang, Coordinator of Supportive, Palliative and Hospice Care section at the Department of Family and Community Medicine in the Philippine General Hospital in Manila, received a Traveling Scholarship to travel to Singapore in order to attend the Asia Pacific Hospice Network Diploma in Palliative Care/Graduate Certificate in Health (Palliative Care) given by Flinders University, Australia.
- Dr. Jessica Masterson, from Massachusetts General Hospital in Cambridge, USA received a Traveling Fellowship to travel to Holy Cross Hospice in Gaborone, Botswana. Dr. Masterson will spend one month teaching nurses and physicians in Botswana on symptom management and will do home visits with the team to teach and learn about palliative care delivery in their country.
We hope these grants will help establish strong ties and build networks of support in addition to the educational opportunities that both parties will experience. We look forward to their reports after they return.
This edition of the Newsletter now includes two new sections, which we hope you will find useful. One includes articles on Public Policy which may have an impact on the provision of palliative care in countries around the world, and another includes a list of resources, grants and funding opportunities in palliative care.
Last month, our Executive Director participated in the 4th Latin American Forum on HIV/AIDS, in Buenos Aires, Argentina. The Forum was sponsored by UNAIDS, the World Health Organization, Pan American Health Organization and the Ministry of Health of Argentina, among others. Dr. Jorge Eisenchlas, director of the Latin American Association (ALCP) Task Force on Research in Palliative Care, was invited to chair a panel on home care in HIV/AIDS. Dr. Eisenchlas was able to secure a presentation for Liliana on Palliative Care in HIV/AIDS. In addition to Dr. Eisenchlas, Ms. Carolina Monti, the general manager of the ALCP, also attended the Forum. During the presentations it became evident that there is some interest in palliative care and that additional work is needed to improve access to symptom relief for people living with HIV/AIDS. We hope this initial participation will increase the chances to include palliative care and symptom relief in the Global AIDS Meeting in Mexico City in 2008.
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| ONU SIDA – Ms Carolina Monti, manager of the Latin American Association for Palliative Care (ALCP) and Dr. Jorge Eisenchlas, Director of the Research Task Force of the ALCP. |
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| Panel – Lilliana De Lima giving a presentation on palliative care on HIV/AIDS during the Session on Home Care in HIV/AIDS in the IV Forum on HIV/AIDS for Latin America and the Caribbean. |
Until next month,
Kathy Foley, MD
Chair, Board of Directors
Liliana De Lima, MHA
Executive Director
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