Policy and Advocacy

2018; Volume 19, No 1, January

Policy and Advocacy

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

Making Palliative Care Change Happen in Austria

December was a relatively quiet advocacy month, with duty travel to only one country — Austria! I was in Vienna, for the Reconvened Session of the Commission on Narcotic Drugs (CND), and then took a train to Salzburg for a weeklong workshop on global palliative care advocacy, titled ‘Making Change Happen.’ The workshop was sponsored by the Open Society Foundations and moderated by consultants Martin Clark of the Advocacy Hub, and Melanie Judge, an HIV/AIDS and LGBTQ activist from South Africa.

Salzburg was one of two stops in Austria. The first was Vienna.

The proceedings of the CND reconvened session covered mostly technical, administrative, and budget matters. Of special interest to IAHPC was the Report from the World Health Organisation Expert Committee on Drug Dependence (ECDD), which has responded to the US and Canadian ‘opioid overdose epidemic’ by recommending that CND put Carfentanyl under the strictest international control possible. Find the details here, Annex 1, p. 1. IAHPC was concerned to learn that the ECDD also recommended that Tramadol proceed to a ‘critical review at a subsequent meeting.’ Read more here. The WHO presentation at CND can be found here.

The Commission hosted a special event on ‘Drug statistics: Practices and challenges in relation to data quality and the national capacity to produce drug statistics,’ chaired by Norway Ambassador Bente Angell Hansen, who called on member states to collect better data on barriers to availability of internationally controlled medicines. Although the International Narcotics Control Board collects this data as part of its mandate, and issues regular reports for member states on the need to improve availability, I had the opportunity to discuss why the United Nations Office on Drugs and Crime (UNODC) should also collect data on actual ‘abuse and diversion’ of prescribed medicines. UNODC could do this through its through its Annual Reporting Questionnaire (ARQ), which has never contained any questions on the topic. It is important to track diversion and abuse accurately, as every official recommendation to improve availability of internationally controlled medicines adds the phrase ‘while preventing diversion and abuse.’ The lack of evidence behind these ubiquitous throwaway words reinforces the unproven assumption that availability of prescribed medicines goes hand in hand with abuse and diversion.

It is also important to track availability of controlled medicines for the purposes of CND reports to the United Nations on progress towards the Sustainable Development Goals (SDGs). Regular readers of my column will know by now that SDG Target 3.8 includes access to essential medicines, many of which are internationally controlled and many of which are the cornerstones of palliative care.

The ‘Making Change Happen’ workshop was well attended and lively.
Making Change Happen

This workshop, organized by the Open Society Foundations and the Open Medical Institute at Schloss Arenburg in Salzburg, was an exciting opportunity to share challenges and successes with colleagues and partners working to provide palliative care and develop palliative care policies around the world. We worked and had fun envisioning, discerning, and (literally) drawing advocacy strategies in global and regional groups. Together we built problem and solution trees; did role playing of encounters, with participants acting the part of indifferent health and finance ministers; and plotted power maps for our various issues.

It was a week to recharge our advocacy batteries, meet new friends, and connect with old ones. Above all, it was an opportunity to stoke our collective, constructive hope for a productive 2018 as we continue to meet the needs of patients and families in need. We are grateful to the Open Society Foundations for their faith in IAHPC and ongoing support of our work. Colleagues came from Ukraine, Moldova, Georgia, Kyrgyzstan, Uganda, Kenya, Rwanda, South Africa, Ireland, the UK, Argentina, Colombia, Egypt, India, and the USA.

The next report will cover the World Health Organisation Executive Board meeting in Geneva, where IAHPC will be advocating with partners for a palliative care indicator as part of the WHO General Program of Work.

Stay tuned!


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