Policy and Advocacy

2018; Volume 19, No 10, October

Policy and Advocacy

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

European Meetings on Global Health, Primary Health Care & Access to Controlled Medicines


In September, I left my sister holding her own through chemo in Baltimore, and flew to London, where I took a train to Liverpool to visit my mentor, Dr. Anne Merriman. The Founder of Hospice Africa Uganda, a regional center dedicated to practicing and teaching the art of palliative care and use of controlled medicines, was about to undergo major surgery. After leaving Anne in the capable hands of good friends, and taking some personal retreat time in Hereford, I flew to Rome to participate in the weeklong 68th Regional Committee meeting of WHO Europe. Rome was followed by Heraklion, Crete, for the European Forum for Primary Care (EFPC) conference, and Vienna, Austria, for a meeting of the UN’s Commission on Narcotic Drugs.

At Hospice Africa Uganda, Tuesday is patients’ day for those suffering from life-limiting illnesses, especially HIV/Aids and cancer. (Photo: Hospice Africa Uganda)

Fortunately, Dr. Anne, at 83 years young, came through the surgery well, and recovered sufficiently to attend Hospice Africa Uganda’s Silver Jubilee celebrations in Liverpool organized by her supportive community in that great city. Dr. Anne was excited that two of her original Ugandan nurses, Rose Kiwanuka (Executive Director of the Palliative Care Association of Uganda) and Martha Rabwoni, came to Liverpool to take a leading role in both the Jubilee and other fundraising efforts.


Go here for my report on the WHO Euro RC68 meeting.


The EFPC conference was titled, ‘Vulnerability and Compassion: The role of Primary Care in Europe’ How to overcome the austerity period? Plenary and workshop presentations focused on the public health impacts of economic and social inequality, which can be offset by a primary care workforce organized around principles of compassion and solidarity. Social inequality, coupled with professional trends toward specialization and privatization of health care, leave increasingly vulnerable marginalized populations to bear the full brunt of austerity in their bodies, minds, and spirits, as the harsh statistics on the social and economic determinants of health presented at the conference showed.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus has made development of primary health care a policy priority for his term of office. The World Health Organization has just published three new guides, including Integrating palliative care and symptom relief into primary health care, authored by IAHPC Board Member and Lancet Commissioner Dr. Eric Krakauer of Harvard Medical School (see Announcements). These support lawmakers and administrators wish to include palliative care training and services in order to begin relieving the severe-health related suffering exposed in the 2018 Lancet Commission Report on palliative care and pain relief. It is helpful for advocates to present this information either in person or by video link at national, regional, and international primary care venues such as EFPC and the upcoming global conference in Astana, Kazakhstan. IAHPC will be developing a corps of experts to operationalize the DeclarAction on health-related suffering all over the world, throughout the next year. Stay tuned!

I participated in several breakout workshops on multidisciplinary teams and on the value of compassion in primary care, reminding participants that these are also the core values of best practice palliative care.

The UN Commission on Narcotic Drugs meeting in Vienna was a follow-up to UNGASS.

The Commission on Narcotic Drugs meeting was one of a series of follow-up sessions to the 2016 UN General Assembly Special Session (UNGASS) and in preparation for the 2019 High-Level Meeting. The purpose is for member states to report on progress toward, and challenges implementing, the recommendations of the UNGASS. As civil society (non-member) representatives are entitled to participate, the Civil Society Task Force selected five speakers from non-governmental organizations working to improve access to controlled medicines for pain and palliative care. IAHPC Board Chair Lukas Radbruch gave a compelling presentation highlighting the findings and recommendations of the Lancet Commission Report, following the presentations of Stefano Berterame of the International Narcotics Control Board, and Gilberto Gerra of the UN Office of Drugs and Crime.

Dr. Rumana Dowla

Dr. Tammam Aloudat, Deputy Medical Director of Medecins Sans Frontières, presented harrowing cases from the front lines of humanitarian crises and rural clinics where medicines are unavailable, or where doctors suffering from ‘opioidphobia’ are unwilling to prescribe those that are available. Other speakers, who came to Vienna at their own expense (thank you Rumana and Lauren!) included Dr. Rumana Dowla from Bangladesh, and Ms. Lauren Deluca of CIAAG (Chronic Illness Advocacy & Awareness Group). Mr. Mark Mwesiga, of the Palliative Care Association of Uganda, and Dr. João Batista Garcia, MD, PhD, (Brazil) President of the Latin American Federation of Associations for the Study of Pain, gave video presentations discussing the situations in their countries, and the difficulties of providing adequate pain control for patents. These are posted here (Presentations and Statements: Thematic debate) and here (Intersessional Meetings) on the UNODC website.

Stay tuned next month for the report from Astana, and the Global Conference on Primary Care cohosted by WHO, Unicef, and the Government of Kazakhstan.


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