By Dr. Katherine I. Pettus, PhD
IAHPC Advocacy Officer for Palliative Care Medicines
My first February highlight was participating in the annual Kazakhstan palliative care conference, organized by IAHPC Board Member Gulnara Kunirova. The conference theme was: Palliative Care: World Trends and Kazakhstan Realities. I presented on “Global Palliative Care Advocacy for Patients and Families in Kazakhstan,” covering key definitions, the function of IAHPC, potential partners, challenges, and opportunities for action. My presentation, translated into Russian, was delivered with the help of a Russian interpreter for the hundreds of assembled providers. Dr. Galina Khemlina, an IAHPC member and palliative care physician in San Diego, also participated, teaching in Russian on “Palliative Care for people with dementia and delirium. Experience from USA”. Dr. Galina reported that teaching “in” Kazakhstan from San Diego was a wonderful experience for her. We at IAHPC hope to have inspired palliative care workers in Kazakhstan to advocate with their government for better integration of palliative care into primary health care, per the Astana Declaration of 2018.
The following week I participated in an advocacy workshop convened by a new regional network, the Western Pacific Palliative Care Advocacy Network (WPPCAN). The workshop was virtually hosted by the Australian and New Zealand Society of Palliative Medicine (ANZSPM) and included participants from both those countries, as well as Fiji, Hong Kong, Papua New Guinea, the Philippines, Samoa, and the US. My presentation, on “Making Advocacy Happen,” gave a brief history of global palliative care advocacy (professional advocacy is only six years young!) in the complex ecosystem of over half a century of palliative care and hospice service delivery development and drug control. The presentation contained practical information for the fledgling network, and basic tips I have learned in my journey through the UN organizations.
My talk closed with a discussion of the newly approved World Health Organization resolution on the rights of persons with disabilities to the highest attainable standard of physical and mental health. We then held moderated, role-playing workshops, where participants were charged with presenting the resolution—with its commitment to provide palliative care for persons with disabilities—to their ministry officials. Covering it all with a health minister in five minutes was a challenge! Groups then reported back to plenary and discussed lessons learned.
WPPCAN leadership have since participated in its first regional meeting hosted by the Vienna NGO Committee on Drugs, which issued a call for regional organizations to draft a Western Pacific Common Position. There is wide agreement amongst IAHPC colleagues in the region that any Common Position on Drugs should include a strong statement on improving access to palliative care medicines, controlled under the international drug conventions. We will report back on developments. For more information on WPPCAN, if you live in the region or just want to join, please contact Dr. Odette Sprujit.
IAHPC collaborated with the Worldwide Hospice Palliative Care Alliance and the Union for International Cancer Control to propose text including palliative care in the resolution currently being negotiated by WHO member states in preparation for the World Health Assembly in May. We were pleasantly surprised that that the EU hosted a civil society forum requesting input on the text, although, predictably, the “zero draft” included no reference to palliative care in its recommendations for preparedness planning. Stay tuned for further updates.
We are happy to report that the United Nations Office on Drugs and Crime (UNODC) accepted our proposal for a side event at the 64th Session of the UN Commission on Narcotic Drugs taking place in April. On Monday, April 12, 2021, 14:10-15:00 Central European time. IAHPC will provide the Zoom platform and registration link closer to the event. The 64th Session is cosponsored by the governments of Belgium and Australia and will feature an address by Dr. Kees De Joncheere, President of the International Narcotics Control Board. Other sponsors include the UN High Commission on Human Rights, Harm Reduction International, DeJusticia, Hospice Africa Uganda, the Vienna NGO Committee on Drugs, Asociación salvadoreña para el estudio y tratamiento del dolor y cuidados paliativos (ASEDP) and Paliamed El Salvador. Panelists include Dr. Eddie Mwebesa, who heads Hospice Africa Uganda; Dr. Christophe Rerat, a WHO expert on pharmaceutical supply chains; Zaved Mahood, Office of the UN High Commissioner for Human Rights; and a representative of the national competent authority of El Salvador.
The COVID-19 pandemic has revealed catastrophic weaknesses in global supply chains for pharmaceutical products, and inefficient procurement and administration mechanisms for essential medications regulated under the three international drug control conventions. As the Joint Statement on Access to Medicines issued by the INCB, WHO, and UNODC in August 2020 addressed this problem, the side event will take up the request of the president of INCB to use this challenging time “as an opportunity to strengthen our cooperation with a view to ensuring availability of controlled substances for medical and scientific purposes while preventing diversion.” Panelists will showcase leadership in ensuring balance in access to controlled medicines during the pandemic: specifically, sharing lessons learned in treatment for pain and drug dependence.
We are preparing a written statement for an upcoming session by the Open-Ended Working Group on Ageing, and will submit an application for a side event. Please stay tuned and follow us on social media for developments. The Eleventh Session of the Working Group will be held from March 29 to April 1, 2021 at United Nations Headquarters in New York. Substantive issues to be discussed include the right to work, access to the labour market, and access to justice. Palliative care, integrated into primary health care, can support both the right to work and access to the labor market for patients and caregivers. IAHPC is particularly interested in supporting stipends and paid leave for family caregivers providing services to seriously ill loved ones. I have heard multiple stories from colleagues around the world about how palliative care has helped patients return to work, family life, social and political participation, and their faith communities. Health systems that fail to integrate palliative care for older persons, or discriminate against them because of age, deny them these basic human rights and inhibit the development of healthy communities for persons of all ages. Please stay tuned on social media for more information about how you can join the side event once we have the details and a Zoom link.
To learn more about Australian and New Zealand Society of Palliative Medicine, the Worldwide Hospice Palliative Care Alliance, and the Hospice Africa Uganda visit the IAHPC Global Directory of Palliative Care Institutions and Organizations.