Travel date: May 18, 2017
Name of Meeting/Event/Activity: 15th European Association Palliative Care Conference
Origin: Cairo, Egypt / Destination: Madrid, Spain
This year, the scientific program of the EAPC Congress was rich and diverse. The stories of successful palliative care development in the face of barriers were inspiring. I had meetings with international palliative care experts from around the world. We had discussions about how to promote palliative care and cancer pain control in Egypt through education and advocacy. It was also an opportunity to communicate with palliative care professionals from my region (e.g. from Kuwait, Lebanon, Saudi Arabia and Sudan). I attended the launching of the APCA Atlas of Palliative Care in Africa and the launching of the Atlas of Palliative Care in the Eastern Mediterranean Region. My country Egypt is included in both atlases which provide valuable information for palliative care professionals and policy makers in our region. With the help of the IAHPC team, I recorded a video about the morphine shortage in Egypt.
Some activities and discussions added to my knowledge about advocacy for palliative care and cancer pain control. I discussed with colleagues from our region research opportunities addressing the palliative care needs in our culture. The morphine shortage video may be helpful in making cheap oral morphine available for patients in Egypt and may be in other countries with similar problems.
Faced by many barriers, palliative care is in an early stage of development in Egypt with relatively few services providing palliative care for cancer patients. One of the major barriers is the unavailability of oral morphine which is necessary to relieve the suffering of advanced cancer patient. Morphine is the drug of choice for moderate/severe cancer pain control and is considered an essential medicine by the World Health Organization. However, there is an ongoing oral morphine shortage in Egypt since 2014. Since the 1990s, only one company has supplied Egypt with only one form of oral morphine, the 30 mg slow-release morphine (SRM-30mg) tablets. This form of oral morphine has not been available in Egypt for more than 2 years, since late 2014 except for a short period when a limited amount was made available in early 2016. As a consequence, the morphine consumption in Egypt decreased from 23 kilograms in 2013 to only TWO kilograms in 2014. It is frustrating to see terminal cancer patients dying in suffering because of the unavailability of a cheap medicine like oral morphine. On the other hand expensive unaffordable alternatives like fentanyl, hydromorphone and oxycodone are marketed in Egypt. With the support of the IAHPC, I was fortunate to attend the EAPC 2017 Congress. During the congress, I discussed the morphine shortage problem with experts from around the world. In addition, with the help of the IAHPC team, I recorded a video about the morphine shortage in Egypt. The morphine shortage video may be helpful in making cheap oral morphine available for patients in Egypt and may be in other countries with similar problems. In general, palliative care is in an early stage of development in Arab countries. To date, there is no project dedicated to mapping the level of palliative care development in Arab countries. However, during the EAPC 2017 Congress, I had the opportunity to attend the launching of two important atlases published by the IAHPC, the “APCA Atlas of Palliative Care in Africa” and the “Atlas of Palliative Care in the Eastern Mediterranean Region (EMRO)”. These two atlases included almost all Arab countries except those with conflict. The atlases described the available palliative care services as well as the progress in palliative care development indicators; education, drug availability and government policy. The atlases showed that palliative care is underdeveloped in Arab countries and represent an important updated guide for those concerned with the development of palliative care in these countries.