Policy and Advocacy

2019; Volume 20, No 5, May

Policy and Advocacy

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

The Right of Older Persons to Palliative Care

April’s advocacy highlight was our participation in the 10th Open-ended Working Group on Ageing, held at UN Headquarters in New York. The four-day meeting convened older activists, as well as advocates for older persons, many of whom are young. The lack of palliative care for rapidly ageing populations internationally, including persons confined to nursing homes, makes involvement in ageing and health policy an imperative for the palliative care and human rights movement around the world. The meeting was attended by representatives of UN member states interested in the issue of ageing, national human rights organizations, and expert representatives of international bodies such as the World Health Organization (WHO) and the Organization of American States (OAS).

Side event panelists (L-R): Grace Vasquez, Katherine Pettus, Bethany Brown, Simon Cernesi, Marvin Mutch, Karen Gomez-Dumpit, Sheila Payne, Rose Gahire, and Karin Mansell.
IAHPC side event outlines normative gaps

IAHPC hosted a side event on ‘Normative Elements of a Right to Palliative Care for Older Persons.’ [See our flyer.] Our panelists, who attended from the UK, Italy, and Rwanda, among other far-flung locations, described how their work fulfills the right of older persons to palliative care, and outlined the gaps that remain to be filled in order to ensure universal enjoyment of the right.

We were fortunate to have Dr. Shelia Payne, a leader of the PACE Project and professor emeritus at Lancaster University; Dr. Simone Cernesi, of the Movimento Giotto in Modena; Ms. Rose Gahire, Palliative Care Association of Rwanda and Nsindagiza; Karin Mansell of the Human Rights Commission of the OAS; Marvin Mutch of Humane Prison Hospice Project; and Bethany Brown of Human Rights Watch. Karen Gomez-Dumpitt, representing the Philippines and the Philippines Human Rights Commission, moderated the event, while Grace Vasquez, Technical Director of the National Council for Intergenerational Equity for the Government of Ecuador made opening remarks. Ms. Mansell reviewed how civil society organizations and individuals can file complaints with the Inter-American Human Rights Commission regarding absence of palliative care and controlled medicines for the control of pain and dyspnea. [For more information write to [email protected].]

The full 78-minute soundtrack of this remarkable collection of international expertise can be found here, along with slide sets of presenters who used visuals.

PC is integral to
rights of older persons

On the final day of the Open-ended Working Group, Ms. Gahire, RN, founder and President of the Palliative Care Association of Rwanda, whose trip to the UN was sponsored by the Global Alliance of Older Persons, gave this statement. I think it is safe to say that palliative care is now firmly on the radar of any future outcome document or convention on the rights of older persons. We need to continue mentioning how palliative care teams ideally support patients, families, and caregivers, with all the attendant preventive and promotive side benefits of public health.

OAS has blazed a legal trail

The Organization of American States has blazed the international legal trail, promulgating the only multilateral convention that explicitly stipulates the right of older persons to palliative care and pain relief.

Ecuador is the latest OAS member state to ratify the multilateral convention, committing itself to ensuring that its older population has access to palliative care as needed. Implementation is a big challenge that requires the participation of all civil society organizations actively involved in the development of palliative care at the national and regional levels. These may be professional associations that provide clinical, social, and psychological support, as well as faith-based organizations.

Most recently, the Pontifical Academy for Life has been very supportive of palliative care, contrasting its ethics to those of consumer cultures that perpetuate a throwaway culture (including throwaway persons) that normalizes ‘medically assisted dying’ and euthanasia. [See the IAHPC Position Paper here.]

Meetings on ‘drugs’ in Washington

This month I also had the pleasure of meeting Ms. Marya Hynes, chief of the data department of the Comisión Interamericana para el Control del Abuso de Drogas, or CICAD (Inter-American Drug Abuse Control Commission), at its Washington headquarters. An entire section of CICAD’s most recent strategic publication — the Hemispheric Plan of Action on Drugs 2016-2020 (in English and Spanish) — urges countries to attend to the need to improve access to internationally controlled essential medicines (called ‘drugs’ in the international control system; Dr. Willem Scholten addresses the importance of such descriptors in Language Matters).

Focus should turn to access, affordability

CICAD’s MEM (Multilateral Evaluation Mechanism) holds governments and civil society organizations accountable for their commitments in the Hemispheric Plan. Palliative care organizations should establish working relationships with CICAD focal points in each country’s office that controls illicit ‘drugs.’ These relationships will allow them to advocate for more visibility of the issues concerning access to, and affordability of, essential palliative care medicines as a key public health domain of regional and national drug policy. As of our last meeting, Ms. Hynes suggested hosting a webinar for CICAD staff on the topic. She also mentioned that CICAD, as a member state organization, needs to hear from countries other than Mexico in order to make the topic of controlled medicines a specific focus area. For more information, please contact me or Dr. Tania Pastrana, president of the Latin American Palliative Care Association.

IAHPC side event at the
72nd World Health Assembly

May’s big advocacy events will be the WHA72 in Geneva and the European Association of Palliative Care’s Congress in Berlin.

IAHPC will host a side event on May 21 at 7 p.m. in Geneva at the Palais de Nations, Room IX, to present the findings of the Lancet Commission on Pain and Palliative Care. The side event is cosponsored by Malaysia and Panama, and we are looking forward to the participation of Panama Health Minister Dr. Miguel Mayo and an official of the Malaysia Ministry of Health. Thanks to all in the palliative care associations of those countries that made this possible

Lancet Commission Chair Dr. Felicia Knaul will present the report, and Dr. Stephen Watiti from Uganda will attend as a direct stakeholder from the African Palliative Care Association and the Worldwide Hospice Palliative Care Alliance. The event is also supported, thus far, by the Union of International Cancer Control and the International Federation on Ageing.

At the EAPC Congress in Berlin, I will be presenting at a parallel event on ‘End of Life and Prison: Inequalities and Vulnerability — Normative and Legal Framework About End of Life for Inmates in Europe,’ with our EAPC Task Force on Palliative Care in Prison, chaired by Dr. Mary Turner.

Live updates on Twitter

Stay tuned for those reports next month, and follow us @IAHPC on Twitter for live updates from Geneva and Berlin.


Do you have any comments or questions about this piece or our advocacy program?

Contact Dr. Katherine Pettus

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