By Katherine I. Pettus, PhD
IAHPC Senior Advocacy & Partnerships Director
The International Narcotics Control Board marked Human Rights Day, December 10, 2022, with a press release focusing on the right to health and the issue of availability of internationally controlled essential medicines, lacking in more than 80% of the world.
The press release states that, “Tying in with the initiative of the chair of the 65th session of the Commission on Narcotic Drugs to scale up the implementation of international drug policy commitments on improving availability of and access to controlled substances for medical and scientific purposes, the board is issuing in early 2023 a supplement to its 2022 annual report, titled ‘No Patient Left Behind: Progress in Ensuring Adequate Access to Internationally Controlled Substances for Medical and Scientific Purposes.’” We look forward to seeing the report in March.
The last event my team and I attended in 2022 was the third meeting of the Intergovernmental Negotiating Body (INB) for a World Health Organization binding treaty on pandemic prevention, preparedness, and response. IAHPC has been contributing to INB inputs since the first open call in December 2021, requesting that palliative care services and medicines be included. We were gratified to see that “palliative care” was included in an early draft of the treaty, but disappointed that it was absent in the following Conceptual Zero Draft.
We are now focusing our advocacy on draft Articles of the treaty that refer to supply chain resilience for essential medicines, and on the text of the paragraphs below.
Article 10, 2(b) Strengthen public health capacities to ensure availability of quality routine health services, including immunization, during pandemics, and continuity of essential health service provision during the response, notably with a focus on primary health care and community level interventions, to mitigate the shocks caused by emergencies and prevent the health system from becoming overwhelmed, by means that include:
(i) measures to ensure continuity of primary health care and universal health coverage by maintaining the availability of, and timely access to, efficacious, quality, safe, effective, affordable and equitable health services, including clinical and mental health care.
(ii) measures to address the backlog in the diagnosis and treatment of, and interventions for, other illnesses […]
Since palliative care has been removed from the body of the text, we want to ensure that the definitions section explicitly includes “palliative care” as part of the spectrum of services included in both primary health care and universal health coverage. It is customary for treaties to open with an Article that defines all key terms, to ensure that signatories are agreeing to the same set of commitments.
The United Nations includes palliative care in the spectrum of services of both primary health care and universal health coverage that begins with health promotion and prevention, thanks to concerted advocacy with our global, regional, and national partners throughout the past decade.
The fourth INB meeting begins on February 27. The INB Bureau is comprised of six delegates, one from each of the six WHO regions, including the co-chairs, Roland Driece, the Netherlands’ director of International Affairs of the Ministry of Health, and Precious Matsoso, South Africa’s director general of the National Department of Health. If you would like to join the IAHPC delegation, please contact me.
The IAHPC will field a largely virtual delegation and submit written statements at the 152rd meeting of the World Health Organization Executive Board in Geneva, January 30 to February 2. Topics relevant to palliative care include: universal health coverage, health emergencies, noncommunicable diseases, and health rights of persons with disabilities.
The IAHPC will field a delegation at the in-person 66th session of the Commission on Narcotic Drugs in Vienna, March 13-17. We have applied to host a side event on rational governance of internationally controlled essential medicines, to address the twin crises of access and excess afflicting populations in different parts of the world.
If approved, the side event will highlight examples of good opioid governance in different regions, including the Eastern Mediterranean and Latin America, and suggest ways forward based on recommendations of the Lancet Commission on Palliative Care and Pain Relief and the Stanford-Lancet Commission on the North American Opioid Crisis.
Please contact me to apply for a spot in the IAHPC delegation, or to submit a short video on availability of controlled medicines governance in your country. His Excellency Ambassador Miguel Ruiz Blanco from Colombia will chair the 66th session. The 2022 CND newsletter highlights the former chair’s campaign to raise awareness about the crisis of availability in more than 80% of the world.
The IAHPC will also field a delegation and organize a side event at 13th Open-Ended Working Group on Aging (OEWGA) at the United Nations headquarters in New York, April 3-6.
The delegation will be led by Dr. Kristin Forner, our new Advocacy Focal Point for the USA. We hope that she will be accompanied by Dr. Irena Laska from Albania, one of our LEAD grantees, and Dr. Mataa Moses Mataa, our Advocacy Focal Point from Zambia, who is a palliative care physician who recently founded Alzheimer’s Disease and Related Dementias in Zambia (ADDIZ). The OEWGA session themes are the right to health and access to health services, which includes a right to palliative care. If you are a geriatrician and/or work with older persons and want to apply to join the IAHPC delegation, please contact me.
Stay tuned for information on how to participate and communicate with your government to support integration of palliative care services for older persons.
IAHPC will field an in-person delegation to the 76th World Health Assembly in Geneva, May 21-30. Please contact me to join the IAHPC delegation; although we have no funding for delegate travel or per diem, we welcome your participation if you can cover your expenses.
Check out this recording of the excellent European Association for Palliative Care/WHO webinar aired on Universal Health Coverage Day on the “Economics of Palliative Care.” It features the work of new IAHPC Board Member Dr. Maya Jane Bates and others (Drs. Liz Gwyther, Eric Krakauer, Richard Harding, Eleanor Reid), providing invaluable evidence on the economic benefits that can be used to further palliative care advocacy nationally regionally, and globally.
On a related note: I have proposed that the WHO palliative care technical officers co-sponsor a series of webinars with IAHPC and partners on how integrating palliative care into health systems can help governments achieve more than six goals and targets (including Goal 1: No Poverty) of the 2030 Agenda for Sustainable Development. (See the draft concept.) Alternatively, we can plan a side event on the topic at the 2024 World Health Assembly, which marks the 10th Anniversary of the approval of WHA 67/19 on “Strengthening of palliative care as a component of comprehensive care throughout the life course.”
We look forward to a fruitful 2023 and appreciate all the help you can give us as members, supporters, and readers. Remember, your feedback and questions are always welcome!
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