A Timeline of Those at the Helm

1997-1999 Roger Woodruff, MD, Australia
2000-2004 Eduardo Bruera, MD, USA
2005-2007 Kathleen Foley, MD, USA
2008-2013 Roberto Wenk, MD, Argentina
2014-present Lukas Radbruch, MD, Germany

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Eduardo Bruera, Chair, 2000-2004

From the very beginning of my career in palliative care I became very concerned about international programs, especially those in developing countries. I had witnessed the suffering of patients and families who had no access to essential medications for the relief of suffering, and who were also subject to the lack of skills by health care professionals to communicate and care at this stage of life.

During my 15 years in Edmonton, Canada, I became involved in multiple initiatives to bring opioids and education to multiple countries in Latin America as well as other regions of the developing world. I also collaborated with efforts of the World Health Organization to increase the awareness of palliative care as part of the cancer program. In these activities I learned that WHO was very limited by the nature of its inter-governmental structure and has very limited independence to promote new initiatives. I also became aware that my isolated efforts were of limited value, since they were not accompanied by the credibility of a major organization.

After my relocation to MD Anderson Cancer Center, I was offered the position of Chair of IAHPC and the job of bringing it back to Houston. The timing was far from perfect: at the same time I had to start a completely new program in the largest cancer center in the world. Therefore, my only request was that I be allowed to select the organization’s executive director.

My smartest move was to hire Liliana De Lima and to collaborate with her for the four years of my mandate as IAHPC Chair.

Being global extended our reach,
but limited fundraising success

There were multiple administrative and financial challenges we were able to address initially with a support grant from MD Anderson. We recruited a wonderful, truly global board of directors who helped us establish IAHPC’s vision, mission, and strategic plan. The organization focused on the development of clinical and academic programs, mainly in developing nations. We also learned how hard it is to obtain funding for organizations with a global mandate.

The IAHPC name allowed us access to government and international agency officials, and we were able to establish collaborations in many regions of the world.

We travelled a lot on our own funds and, whenever possible, we timed board meetings to coincide with congresses so as to minimize costs to our board members and use every dollar for programs.

I watched with pride as IAHPC
influenced PC development

I remember very fondly the multiple programs we established with a total of only one staff member (Liliana!). I have watched, over the years after my departure, as IAHPC has become a major partner in the development of palliative care and hospice worldwide. These actions have relieved suffering to millions of patients and family members worldwide.

I am grateful for my years with IAHPC and for the wonderful job done by those who followed, volunteering their time and talent to make our organization what it is today

I am delighted to wish a very happy 25th anniversary to IAHPC. Although I will not be there for the 50^th, I am sure the celebrations will be even bigger!

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Dr. Kathleen Foley, Chair, 2005-2007

Over the last 25 years, the field of palliative care has grown exponentially and IAHPC has played a pivotal role in educating and advocating for the full integration of palliative care into international and national health care policies. Since its evolution from the International Hospice Institute under the leadership of pioneer leaders like Drs. Josephina Magno, Derek Doyle, Roger Woodruff, and Eduardo Bruera, IAHPC has created an impressive legacy as a leading nongovernmental organization advocating for the care of those with life-limiting illnesses and their families.

IAHPC adopted the WHO Model for Palliative Care, advocating for major expansion in the education and training of health care professionals, access to essential palliative care medicines, and health care policy reform to integrate palliative care into universal health care coverage. IAHPC has led the way working collaboratively with other stakeholders including national and international NGOS, national governments and international regulatory agencies to reform drug policies and to inform governmental healthcare policy. The progress IAHPC has helped advance in each of these domains is stunning.

Leadership and members
are relentless advocates

Its leadership and membership have been selfless in claiming attribution and relentless in advocating for palliative care for all. As a Board Member, then as Chair for three years in 2005 to 2007, I have witnessed firsthand how change happened under the leadership of Liliana De Lima, whose guiding hand has been apparent to the Chairs who have had the great fortune to work with her. We all owe her a debt of gratitude for her leadership, her resilience, and her determination to improve the care of patients and their families experiencing serious life-limiting illnesses.

All policy challenges that the field of palliative care has faced—and continues to advocate for—have IAHPC’s mark of engagement. During my tenure, IAHPC developed its Essential List of Palliative Care Medicines that WHO adopted: just one example among many successful policy reforms. In drug policy, IAHPC has been a respected advisor to the WHO and other international drug policies agencies as they have worked to formulate balanced policies to assure access to essential medicines, especially analgesics.

Major achievements

More recently, IAHPC played a critical role in the WHO resolution for the integration of palliative care into health care systems, a major policy win. It led the efforts to develop and publish a Consensus-Based Definition of Palliative Care that represents the forward-looking perspective of the need for palliative care for all, and has collaborated extensively with the Lancet Commission on Palliative Care and Pain Relief, helping to create a measure of “health-related suffering” that can be used to assess a country’s need for palliative care services, the first step in developing a national health care budget to pay for such services. The list of accomplishments continues in their many newer collaborations, including supporting the Pontifical Academy of Life and engaging religions of the world to embrace palliative care for their constituents.

Join me in acknowledging our sincere thanks and appreciation to all the IAHPC staff and members who, over these 25 years, have worked (many as volunteers) enthusiastically and tirelessly to make palliative care a public health and human rights issue.

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Dr. Roberto Wenk, Chair, 2008-2013

I was delighted to accept the invitation to comment on IAHPC’s 25th anniversary. When I thought about what I would write I decided to tell newsletter readers the reasons why I am happy, proud, and satisfied to be a member of this institution. This pleasant feeling of belonging has four origins:

• To be part of a group that originated and was led by many of my palliative care teachers and counselors.
• To have the opportunity to meet exquisite people, and to live with them during unforgettable moments of my life.
• To know and admire the quality of selflessness, which has such enormous impact in the palliative community, that is an integral part of so many small teams with limited resources.
• To have guidance and modeling, which strengthened my values.

This last one may be the most important issue for me. In my 40+ years in palliative care, I participated in the creation and operation of various national and international institutions. The two negative characteristics of most of them were that big projects remained just on paper, and I found myself working alone. But for IAHPC projects, I learned to work as part of a team with people who share an interest in, and dedication to, institutional development.

At this moment, looking back, I am sure that IAHPC has been the most nurturing experience in my professional life. Thanks to all of you, for being there.

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IAHPC emeritus, in old newsletter photos

(L-R): IAHPC founding member and longtime adviser Dr. Derek Doyle; founding newsletter editor Dr. William Farr; and Dr. Roger Woodruff, the first Chair and longtime newsletter book reviewer.

Taking a stand

When the newsletter reports on any IAHPC official statement or position on palliative care issues, readership spikes. The community trusts IAHPC to deliver timely, knowledgeable, useful, and, often, consensus-driven information.

Snapshot The Global Consensus-Based Definition of Palliative Care published in early 2019 was—by far—the most-read item in the newsletter in recent years. The definition has been endorsed by 1,000 individuals and 200 organizations around the world.