By Katherine Pettus, PhD
IAHPC Advocacy Officer
In late May, IAHPC surveyed our membership to find out how the COVID-19 pandemic was affecting their practice. Many readers of this column participated. A total of 79 members from 41 countries responded, representing 14% to 22% of the countries in each income category. Participants came mostly from high-income countries (34.2%), followed by low- and middle-income countries (32.9%).
I was particularly interested in answers to the question on how the IAHPC could assist in addressing challenges that respondents flagged in the survey. I picked a few responses that may be of interest to members with similar concerns. A full report on the survey will be available later this year.
One member asked for general help improving access to essential medicines and education. Here is our answer:
IAHPC can teach you how to advocate for improved access to medicines in your country and we can also share advocacy success stories. We advocate at the international level, where all your governments have adopted resolutions stipulating that this is a priority. Please view our introductory educational webinar on advocacy, which discusses improving access to internationally controlled essential medicines among other topics. IAHPC will offer a series of advocacy webinars this fall on improving access to controlled medicines and can always help with education resources.
Several members asked us to advise their governments on integration of palliative care into the national COVID response.
Our answer: US law applying to tax-exempt entities such as IAHPC prohibits us from lobbying or interacting directly with lawmakers. This includes foreign governments, unless they specifically request our help. The national associations are the appropriate “agents” for this work, and we can assist them, also upon their request. We can provide the tools you will need to begin this work, including a list of the international agreements your government has adopted that include provision of adequate access to population-level palliative care.
Another education-related suggestion was for IAHPC to provide “continuous education for health care professionals from different specialties and to engage their national associations, because many health care professionals themselves are not aware of the importance of palliative care needs of patients.”
Our answer: This is an excellent suggestion, but beyond our scope of work as a U.S. tax-exempt organization. IAHPC can attempt to engage the international associations of those non-palliative-care-specific specialties in our organizational capacity, but our individual members who belong to professionals associations themselves, or academic institutions, must approach the national associations of other specialties. Colombian PC advocates recently held urgent consultations with the critical care and anesthesiologist associations regarding looming shortages of controlled medicines. There will be a full report on this next month.
Another member, responding to the question about how IAHPC can assist in capacity building, asked IAHPC to help “create capacity for our organization in training and provision of documents on the subject that can update our knowledge. We need funding to continue the integration of palliative care in the National Health Service, as well as continue to provide post-discharge monitoring to patients in palliative care and in COVID-19 at the community level. We need standards at the district and community level for patient follow-up, as well as individual protection material for those who deal directly with patients.”
Our answer: IAHPC is providing continuing education (non-certified) for our members (see our advocacy course); we just produced a series of webinars and briefing notes on COVID-19 and palliative care, and our monthly newsletters are full of advocacy information. IAHPC’s mission is to serve as a platform for information on palliative care. If national associations that are members would like to schedule an advocacy training session with me, we can certainly do that. For instance, we can talk about the request for funding: how to advocate for integrating palliative care into primary health care. This must come with a budget. Your government has approved international agreements that require this integration.
These are clearly very challenging times for palliative care, palliative care patients and their caregivers, and public health as a whole. It is also an opportunity to raise palliative care’s profile everywhere by highlighting its essential role in interdisciplinary symptom relief and communication regarding goals of care.
We have our advocacy work cut out for us as the World Health Organization is finalizing a set of indicators to help member states implement palliative care service delivery per their commitments in the Astana Declaration and Political Declaration on Universal Health Coverage, as well as WHA 73/1, COVID-19 Response and the 2014 WHA 67/19 resolution on strengthening palliative care. During the indicator testing phase, the WHO will need health ministries in selected countries to have a palliative care focal point to collect data on the indicators for reporting purposes, an ask that will require focused advocacy on the part of national palliative care associations.
Stand by for next month’s newsletter announcement on upcoming advocacy educational opportunities. Have a good vacation if that is in your stars, and please care for yourself and your team!