Policy and Advocacy

2017; Volume 18, No 12, December

Policy and Advocacy

Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Palliative Care Medicines, with her latest roundup of advocacy news.

From Latin America to New York to Geneva

Latin America

Following the October Global Conference on Non-Communicable Diseases in Montevideo (see last month’s newsletter report), I traveled to Lima, Peru, to visit with the palliative care teams of Dra. Luz Villafuerte and Dra. Elizabeth Diaz, who both run services in large hospitals with little official support. The lack of publicly funded palliative care services for patients in the home places enormous pressure on Peru’s hospitals and palliative care providers.


In San Salvador: Katherine Pettus, center, with Dr. José Mario López Saca, Internal Medicine and Palliative Care,
Hospital Nacional "Dr. Juan José Fernández” Zacamil in El Salvador, and ALCP president Tania Pastrana.

The next stop was San Salvador, as Paliamed El Salvador had invited Dr. Tania Pastrana (president of the Latin American Palliative Care Association [ALCP]) and me to speak at the I Congreso Internacaional de Cuidados Paliativos (First International Palliative Care Congress), which had the theme ‘Medicina Paliativa, un Trabajo en Equipo’ (‘Palliative Medicine, A Team Effort’). Together with the leaders of the national associations, Tania and I participated in a stimulating week of seminars, press interviews, workshops, and hospice visits, followed by an exciting, four-country IAHPC advocacy training workshop in Guatemala.

Bringing together representatives of the regional, national, and international palliative care associations at the country level generates powerful political synergies. Providers learn about progress at the international level, and policymakers are alerted to the supportive global framework, which requires improving access to internationally controlled medicines, more professional training, and increasing the availability of palliative care services.


New York

After Central America, I traveled to New York to meet with members of UN missions, colleagues with the Stakeholder Group on Ageing, and UN staff preparing for two big events in 2018. These include the Ninth Open-Ended Working Group on Ageing, which will focus on long-term and palliative care needs of older persons around the world, and the High-Level Political Forum, which will discuss progress toward defined sustainable development goals. Forty-eight UN member states will be reporting on their progress toward the goals, one of which (Goal 3) includes Universal Health Coverage (UHC) and access to essential medicines (Target 3.8). Palliative care is part of the WHO definition of UHC, and requires the use of internationally controlled essential medicines, such as morphine, that are on the WHO Model List.


Geneva
Chairman Dr. Assad Hafeez presides over the UN meeting of the executive board in Geneva.

As IAHPC is a ‘non-state actor’ in ‘official relations’ with the World Health Organization, I flew to Geneva for the WHO executive board’s ‘Special session on the draft thirteenth general program of work’ for 2019 through 2023. Since several items in the draft program, namely Universal Health Coverage and non-communicable diseases, implicate the development of palliative care, IAHPC submitted a statement for the online consultation, requesting that WHO develop a palliative care indicator to measure progress in service development. This submission can also be found in Spanish on our new Advocacy Page. Several Latin American countries, particularly Panama and Ecuador, echoed our call for a palliative care indicator during the plenary session, showing the success of our recent regional advocacy! The work is now to develop this indicator with partners and WHO staff in preparation for the WHO executive board meeting in January of 2018.

Stay tuned for developments from Geneva!

Links

Editor’s note: You may also be interested in Dr. Pettus’s recent blog of her trip to South America, where she visited three hospices and was reminded of how Latin American liberation theology influenced her 30 years ago. Below is a brief excerpt.


Palliative Care: Medicine of the poor in wealth, but also those poor in spirit

I just returned to the U.S. from an all too brief work trip to Peru, El Salvador, and Guatemala. I had the tremendous privilege of accompanying palliative care physicians, nurses, and volunteers who provide services to the poorest of the poor in their countries, patients who would otherwise die terribly, in squalid conditions with no pain relief and little family support...

It dawned on me that palliative care, like the gospels, is the medicine of the poor. Providing palliative care in resource-challenged countries demonstrates a ‘preferential option for the poor.’ It serves those who are both poor in material wealth, and those who are poor in spirit...

As the costs of medicines and treatments for life-limiting illnesses cripple both individual households, and public health systems, it will be key, as the Lancet Commission on Palliative Care Report emphasizes, to ensure the inclusion of palliative care services under Universal Health Coverage...




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