Policy & Advocacy

Volume 23, Number 9: September 2022

Health Ministries in Africa Affirm Need for Palliative Care
As Part of Pandemic Preparedness & Response

By Katherine I. Pettus, PhD
IAHPC Senior Advocacy and Partnerships Director

The 7th International African Palliative Care Conference, held in Kampala, began with a pre-conference session with representatives from 13 African countries signing a powerful declaration affirming the importance of integrating palliative care as part of pandemic preparedness and response.

IAHPC Board Member Mary Callaway chairing a plenary session. Photo by Katherine Pettus. Used with permission.

IAHPC member Emilia da Felicidade Venturas Pinto Miquidade spoke on behalf of the Mozambique Ministry of Health and IAHPC Board Member Nahla Gafer for the Sudan Minister of Health. Their statements depicted the challenging health system issues in their countries, the progress made in implementing palliative care integration against all odds, to improve access to controlled medicines, and to educate health care workers. Dr. Miquidade reported that there was NO morphine in Maputo’s largest public hospital. Dr. Gafer told me several months ago that the situation in the Sudan was the same. Fortunately, it has since been remedied.

Lack of morphine, common in low- and middle-income countries, is unimaginable in high-income countries. It represents the stark global inequity in access to even this generic, gold standard pain medicine, which it is unprofitable for the pharmaceutical industry to produce and market. The African Palliative Care Association (APCA) is piloting a program with the University of Kinshasa Teaching Hospital that will serve as the morphine production unit for the province. More must be done to ensure that medicines reach rural areas, since the Democratic Republic of the Congo is such a huge country.

I was particularly impressed by Dr. Maya Jane Bates’ presentation on making a business case for palliative care [the topic of this video]. Dr. Bates also showed excellent short videos on how palliative care provision can promote household health and well-being.

Cristina Montanez from Hospice of the North Coast; Samuel Kabota, Clinical Officer Nkhoma Mission Hospital, and IAHPC Board Member Nahla Gafer. Photo by Paolo Zizzo. Used with permission.

IAHPC was honored to help plan, provide scholarships for, and participate in this conference. We were well represented by three board members: Mary Callaway, Eve Namisango, and Dr. Gafer. A pair of institutional members twinned by Partners in Care, California-based Hospice of the North Coast and Nkhoma Hospital Malawi, were IAHPC delegates. Many IAHPC members presented posters and addressed side sessions, including Zambia Advocacy Focal Points Mwate Joseph Chaila and Abidan Chansa.

Since budget constraints prevented travelling to Kampala, I gave my plenary presentation, IAHPC Advocacy for Access to Controlled Medicines, online.

Comparative models in palliative care:
Africa, Asia & the Americas

The topic of a Global Palliative Care and Pain Relief Research Hub webinar in August was “Comparative Models in Palliative Care, Perspectives from Africa, Asia, and the Americas.” This free webinar was co-organized by the IAHPC, Memorial Sloan Kettering Cancer Center, and the University of Miami. It featured Pallium India Chair M.R. Rajagopal; Gulnara Kunirova, IAHPC board member and cofounder/president of the Kazakhstan Association for Palliative Care; two members of the African Palliative Care Association, its president Emmanuel Luyirika and IAHPC Board Member Eve Namisango; and University of Swansea PhD candidate Heloisa Broggiato.

Some of their comments:

Gulnara Kunirova: “I loved the incredible atmosphere of the webinar, both professional and friendly! I am grateful to everyone, there’s always something to learn from you and be inspired by.”

Co-organizer Felicia Knaul: “One of the best webinars I have ever participated in or listened to. Encourage all who care about caring and reducing health-related suffering to watch the recording.”

Many thanks to IAHPC member Billy Rosa and the Sloan Kettering team for their hard work in producing this terrific webinar series. Register to watch this and other webinars in the series on demand.

WHO’s upcoming European session

As a non-state actor in official relations with the World Health Organization, IAHPC was invited to participate in the 72nd European Regional Session in Tel Aviv. Our delegations have attended these meetings—in person, then virtually due to COVID—for years. This year’s meeting will be a hybrid, and we are delighted that Dr. Victoria Hewitt, from Newcastle University, will attend in person to represent IAHPC. Together we have been drafting our statements on relevant agenda items and will be participating in some joint statements prepared and approved by other non-state actors in attendance. Our statements on the need to include appropriate palliative care in all health system programs are garnering more endorsements than ever. Dr. Hewitt will report on the session in the October newsletter.

Human Rights Council meeting

One of my few trips this year was to Geneva to attend a two-day conference organized by the Office of the United Nations High Commissioner for Human Rights (OHCHR). The multi-stakeholder meeting followed up on Human Rights Council (HRC) Resolution 48/3 and discussed the recent report of the High Commissioner [see more information]. Thanks to years of concerted advocacy in New York and Geneva, these high-level documents now encourage all UN member states to provide palliative care and pain relief for older persons in need. I gave a joint statement with Pallium India, represented remotely by IAHPC Advocacy Focal Point Smriti Rana.

The deadline for the WHO stakeholder survey on “Assessing barriers, enablers, and priority actions for improving access to morphine for medical use” has been extended to 11:59 p.m. Central European Time on September 11, 2022. A high number of responses from a variety of stakeholders will improve the survey’s ability to present different contexts. I urge participation, especially those in the African, East Mediterranean, and Southeast Asia WHO regions. Participants are not compelled to answer all questions. The survey is available in Arabic, Chinese, English, French, Russian, and Spanish, accessible via a language “switch” at the top of each webpage. Have a question about the survey? Inquire here.


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

Contact Dr. Katherine Pettus


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