Katherine Pettus, International Association for Hospice and Palliative Care Association (IAHPC) Advocacy Officer, reveals some of our key advocacy moments of the past two months.IAHPC stand with Liliana De Lima and Katherine Pettus
January and February were extremely active IAHPC advocacy months. We started the year with the Chinese proposal at the Commission on Narcotic Drugs (CND) to place ketamine, a widely used anesthetic medication, under international control. I collaborated with controlled medicines expert, Dr. Willem Scholten, PharmD, in preparing a basic fact sheet to circulate to CND member states and other influential parties to prevent the Chinese proposal from succeeding. The statement has garnered endorsements from more than 40 civil society organizations around the world. Stay tuned for the outcome of this critical policy issue, which will affect the lives and health of millions of people.
In late January, I went to India. First to work in Trivandrum with Dr. Rajagopal, Chairman of Pallium India, for a week, then to Kochi, to collaborate with Dr. Chitra Venkateswaran of the Mehac Foundation, which provides palliative care to mentally ill persons, and finally to the Indian Palliative Care Conference in Hyderabad.
Dr. Raj asked me to help him edit his draft of what has become the Kerala Declaration, which stipulates the right of all the people of Kerala to access palliative care and pain medicines as a human right. Dr. Raj and I first presented the Declaration at a meeting hosted by the Trivandrum Rotary and Freemasons’ Clubs, where I also gave a talk on palliative care within the human rights framework. The clubs adopted the Declaration unanimously. Dr. Radbruch, Chair of the IAHPC Board, presented the Kerala Declaration at a meeting of the Indian Medical Association, which also endorsed it.
Visiting patients and families is always a highlight of my visits to India. I was privileged to do this both with Dr. Raj’s team in Trivandrum, and Dr. Chitra’s mental health team in the rural areas around Kochi. I’m always amazed by the deep community involvement with palliative care and the numerous volunteers who identify and care for their neighbors in need of support. South India has a deeply rooted social model of palliative care, which also delivers excellent clinical services.
The Indian Association for Palliative Care Conference in Hyderabad was a four-day feast of workshops, plenaries, parallel sessions and networking with colleagues from around the world. IAHPC board members and staff were very active: Liliana and Lukas co-facilitated a pre-conference workshop on Leadership in Palliative Care with Drs. Mhoira Leng and Gayatri Palat. I participated in an opioid availability workshop with Dr. Sushma Bhatnagar which focused on how the Indian states could implement the reformed NDPS (Narcotic Drugs and Psychoactive Substances Act). This law, the product of intense lobbying by palliative care organizations and industry stakeholders, applies uniform procurement regulations and other rational provisions to a previously chaotic system that made medical opioids practically unavailable to most of the population. The challenge is now to implement it and train providers.
Then on to Geneva to attend the Human Rights Council Social Forum, which focused on improving global access to medicines in the framework of the right to the highest attainable standard of health. IAHPC held a side event in the Social Forum, with expert panelists Drs. Willem Scholten (consultant in internationally controlled substances), Gilles Forte (Coordinator WHO Medicines Program), and Jannicke Mellin-Olsen (Deputy Secretary of the World Federation of Societies of Anesthesiologists). Dr. Scholten presented the final report of the ATOME (Access to Opioid Medication in Europe) project; Dr. Forte discussed the World Health Organization’s work on essential medicines and Dr. Mellin-Olsen presented on the need to keep ketamine, an essential anaesthetic, out of any international schedules. The Social Forum report will be presented to the Human Rights Council in September and will include IAHPC and UICC recommendations on the need to improve global access to essential controlled medicines for pain, palliative care, and dependence treatment.
Stay tuned for the next IAHPC policy piece in May when I’ll report on the Commission on Narcotic Drugs 58th Session in Vienna, which will focus on improving access to essential controlled medicines.