By Dr. Katherine I. Pettus, PhD
IAHPC Senior Advocacy Director
On October 7, 2021, the United Nations Human Rights Council (HRC) adopted Resolution 48/3, titled simply “Human Rights of Older Persons.” I was thrilled to see “palliative care,” usually absent from high-level UN documents, referenced four times in the text, twice in the preambular paragraphs—acknowledging the challenge of accessing services—and twice in the operational paragraphs, calling upon member states to “adopt and implement non-discriminatory policies, national strategies, action plans, legislation and regulations” to help people access services.
The background report on the resolution, prepared by the Office of the United Nations High Commissioner for Human Rights (OHCHR) for member states to consider as they prepared for the discussions, has an extensive chapter on the issue of older persons’ lack of access to palliative care, including for those who are incarcerated. I have been working on this issue for years with colleagues from Human Rights Watch, the Worldwide Hospice Palliative Care Alliance (WHPCA), and older persons’ rights groups, such as the NGO Committee on Rights of Older Persons in Geneva, the International Federation on Ageing, Help Age, and the Global Alliance for the Rights of Older People (GAROP). It is exciting to see these collaborations bear fruit.
IAHPC will respond to OHCHR’s call for inputs, and will share our submission in a future issue of this newsletter. For more background on the resolution and discussion of palliative care, see this recent article I published in Ehospice.
Palliative care advocates can now reference this resolution when they work with their governments to propose and develop palliative care services for older adults. IAHPC will include a module on advocating for palliative care for older persons in the IAHPC Advocacy Course. The module will be released in 2022.
As a civil society organization in official relations with the Organization of American States (OAS), IAHPC is invited to meetings of the Inter-American Drug Abuse Control Commission, or CICAD, which describes itself as “the consultative and advisory body of the OAS on the drug issue.” As many readers know, “the drug issue” includes ensuring adequate access to essential palliative care medicines, many of which, such as morphine, have been controlled by international drug conventions since 1961. Indeed, the fourth objective of the Hemispheric Strategy and Plan of Action on Drugs (2021-2025) commits OAS member states to “ensure adequate availability and accessibility of internationally controlled substances for medical and scientific purposes, while preventing their diversion to illicit purposes, in accordance with the international drug control treaties.”
Our statement, delivered at the 70th regular session of CICAD, was prepared by myself and Advocacy Focal Points Victoria Diehl of Costa Rica and María Adelaida Córdoba of Colombia. It can be read here. Advocacy for access to palliative care medicines is the topic of Modules 3 and 3 of the IAHPC Advocacy Course now underway, freely available to members. (Watch the Introduction and modules, as they arrive, here. Module 2 has been recently added.)
The World Health Organization has released two new technical guidances for health systems policymakers on quality palliative care and indicators to evaluate palliative care development. The documents were presented in an excellent webinar.
The guidances are:
Speakers at the webinar on this these timely documents stated that “as countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centeredness, timeliness, equity, integration and efficiency.” IAHPC agrees with Dr. Marie-Charlotte Bouësseau, World Health Organization technical officer and IAHPC Focal Point at the WHO, who said, “Providing compassionate, dignified and people-centered palliative care is an ethical responsibility of health systems.” Use of essential medicines, education and training are just two of the indicators that Dr. Carlos Centeno of ATLANTES presented in the recorded webinar.
Dr. Bouësseau’s department will run pilots to test these indicators in several member states, yet to be selected, in 2022.
IAHPC participated in the World Health Assembly Special Session from November 29 to December 1, fielding a delegation from Argentina, Australia, Bangladesh, Canada, Colombia, and the USA. All IAHPC registered delegates, who are also Advocacy Focal Points, sent our full statement—endorsed by the Worldwide Hospice Palliative Care Alliance, with a cover letter from their organizations—to their government representatives at the WHA.
During the session, member states considered the benefits of “developing a WHO convention, agreement, or other international instrument on pandemic preparedness and response with a view towards the establishment of an intergovernmental process to draft and negotiate such a convention.” In our one-minute oral statement, IAHPC and WHPCA requested that member states include palliative care, along with therapeutics and diagnostics, in any proposed pandemic framework treaty. We were delighted that the Canadian Hospice Palliative Care Association sent a letter of support for our statement to its federal Health Minister, Dr. Jean-Yves Duclos.