By Katherine I. Pettus, PhD
IAHPC Senior Advocacy and Partnerships Director
As we reach the end of another year of palliative care advocacy, I would like to extend my deepest thanks to each and every one of our readers, IAHPC members, and the millions of patients and caregivers who we represent. Although the changes we want to see in health systems are happening more slowly than we would like, and though we are still far from achieving IAHPC’s vision of a world free from health-related suffering, we are on our way, and our relentless advocacy and partnership building will continue until it is so.
This year’s #NoPatientLeftBehind campaign and Joint Call to Action on access and availability of controlled medicines spearheaded by Ambassador Ghislain D’Hoop of Belgium, Chair of the 65th Commission on Narcotic Drugs (CND), is one example of how more than a decade of systematic work at CND by physician advocates and scores of palliative care colleagues is paying off. A series of United Nations events in Geneva, Vienna, and New York, all of which included World Health Organization Director General Tedros Ghebreyesus, IAHPC board members, and our Advocacy Focal Points, showcased best practices and new evidence on the need for workforce development and training, more proximate and resilient supply chains, and balanced regulatory frameworks to improve global access to controlled medicines. These high-level convenings with ambassadors as well as technical staff from the secretariats brought unprecedented attention to the issue of global lack of access to essential palliative care medicines, such as opioids, in more than 80% of the world.
Our delegation at the December reconvened session of the 65th Commission on Narcotic Drugs consists of myself, Advocacy Focal Points Dr. Victoria Hewitt from the UK, Dr. Dingle Spence from Jamaica, and Dr. María Adelaida Córdoba from Colombia. I will report on the session, held while this issue of the newsletter was being published, in the January issue. Our statements and submissions can be found on the Advocacy page of the IAHPC website.
November’s global Climate Change Conference, COP27, saw significant participation of health care workers, not just highlighting the public health price paid by patients, families, and communities due to extreme weather events, but also networking about how to reduce the health care industry’s carbon footprint. More research is needed to provide evidence about how integration of palliative care into health systems can help governments reach more goals and targets of the UN’s 2030 Agenda for Sustainable Development.
A 2016 study of the US health system showed that its major contributors to greenhouse gas emissions are: hospital care (36%), physician and clinical services (12%), and prescription drugs (10%). Regulators can shorten supply chains for essential medicines, hospitals can reduce waste and pollution, and environmentally friendly primary palliative care provided in compassionate cities and communities can replace most futile tertiary treatments.
IAHPC advocates for the development of pooled regional procurement mechanisms for inexpensive generic medications such as oral morphine, which consumes fewer resources to deliver and provide in the public sector than brand name medicines. Hospice Africa Uganda and Pallium India are best practice examples among low- and middle-income countries that demonstrate safety and success at the community level.
We are delighted to welcome Dr. Victoria Hewitt (UK), Dr. Neil Nijhawan (UAE), Dr. Justin Woods (USA), Dr. Kristin Forner (USA), and Dr. Ruth Mae Corvera (Philippines) to the 2023 IAHPC Advocacy Focal Point cohort.
As a nonstate actor in official relations with the World Health Organization, the IAHPC is invited to participate in consultations and multilateral meetings of member states. We have been attending meetings of the Intergovernmental Negotiating Body, or INB, which is charged with drafting a binding convention on pandemic preparedness and response to ensure that any such instrument includes palliative care services, resilient supply chains for controlled palliative care medicines, and workforce training. Palliative care was explicitly included in the first draft, but subsequent drafts have subsumed it into primary health care and universal coverage. We will continue to monitor these deliberations to see if there is any other way to specify the need for palliative care. Our delegation, including Dr. Kristin Forner, Dr. Victoria Hewitt, Dr. Justin Woods, and Monica do Coutto Monni, will attend the third INB (hybrid) session in December. Our official submission can be found here.
Last but not least, I want to remind our readers about all the palliative care guidelines and publications that the WHO Secretariat has developed in partnership with collaborating centers around the world, many of which are IAHPC members. Their webpage has excellent tools to aid in your advocacy with government, and to spread the message among your association members and on social media. Bring them to the attention of your health ministry contacts!
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