By Katherine I. Pettus, PhD
IAHPC Senior Advocacy & Partnerships Director
IAHPC’s in-person delegation for the 76th Session of the World Health Assembly, taking place this month, includes three board members: Dr. Hanan Hazboun, from Bethlehem, Dr. Natalie Greaves from Barbados, and Dr. Victoria Hewitt from the UK, who is also an IAHPC Advocacy Focal Point. Dr. Kristin Forner, Advocacy Focal Point for the USA, also joined the delegation. The delegation will meet its national representatives and deliver statements on agenda items relevant to palliative care, including health promotion, health rights of persons with disabilities, noncommunicable diseases, health in the Palestinian territories, and pandemic preparedness. IAHPC is also participating in constituency statements (joint statements prepared by groups of nonstate actors on a particular agenda item) led by Help Age International, WONCA (World Association of Family Doctors), and the NCD (noncommunicable disease) Alliance. Delegates will report on their experiences at WHA76 in the June issue of the newsletter.
IAHPC has been attending and reporting on the United Nations Open-Ended Working Group on Ageing (OEWGA) since its inception to ensure that any binding international convention on the rights of older persons includes palliative care. This year, IAHPC delegate Dr. Kristin Forner gave a three-minute statement describing her work with frail patients that ended with a question to high-level panelists: “How do we fully integrate palliative care for older persons into health care systems around the world such that it is treated as a human right and not as a privilege?”
Unfortunately, no answer was forthcoming. The IAHPC will continue to advocate for palliative care for people of all ages at all UN fora. You can read our written submission, which goes into more detail on the human rights-based approach to palliative care, and watch the recording of our official side event, which was attended by more than 100 people.
Due to the popularity of our OEGWA side event, a webinar, IAHPC has decided to launch a series of similar webinars highlighting the work of our Advocacy Focal Points and LEAD grantees. The series will begin with a virtual side event on the margins of the 76th World Health Assembly featuring Dr. Joseph Mwate Chaila’s work with the Zambia Medical Association to establish a national palliative care association, Dr. María Adelaida Córdoba’s project to bring essential palliative care medicines to a remote area of Colombia, Dr. Hanan Hazboun’s palliative care service for the Palestinian population in Bethlehem, and Dr. Danielle Soler’s experience developing palliative care in Brazil. Stay tuned to our social media channels for more information on this side event.
Australian IAHPC board member Dr. Maria Cigolini, along with Health Professionals Say No, published a full-page advertisement in The Australian newspaper challenging proposed changes to state laws that would allow telemedicine approvals for voluntary assisted dying (VAD).
The ad was accompanied by an article describing the health professionals’ objections. It quotes one signatory, New South Wales geriatric care specialist Dr. John Obeid, who said the changes would effectively force regional patients into VAD, due to the lack of geriatric and palliative services in their areas. “The most vulnerable, who have the least resources, who are desperate and may need proper health care but can’t access it, would then feel like that [VAD] is the only option to them…It’s cheap—only a phone call and postage of the medication—whereas it’s really, really expensive to provide proper geriatric and palliative services. There would be no driver for government health care providers to actually provide services to these people, because VAD would be so affordable and easily accessible.”
The Australian ad summarized an open letter sent to the Commonwealth and state attorneys general urging them to retain the current prohibition on the use of electronic communications, including phone, email, and video conferencing, for access to VAD due to "the great hazards and injustice that would result.” The 1,000 signatories claimed that, “Further relaxation of criminal codes to facilitate telehealth for VAD assisted suicide would remove protections owed those vulnerable to suicide under duress and in need of palliative care, aged care and mental health services, especially so in regional and remote Australia. This is counterintuitive to the National Suicide Prevention initiatives as also supported by evidence on the need for suicide prevention in rural Australia and amongst First Nations people.”
Negotiations of the World Health Organization intergovernmental negotiating body on the Zero Draft of the proposed Pandemic Preparedness and Response (PPR) Treaty will resume in June. If your organization has not already endorsed IAHPC’s Advocacy Note requesting inclusion of palliative care as an essential element of PPR, and sent the information to your health ministry, please do so as soon as possible. A template guidance letter is included on the web page along with a list of 62 signatories of global, regional, and national palliative care and allied professional associations. Please ensure that any contacts you have who are involved in the negotiations have a copy of our note.
Last but not least, tune into one of my favorite podcasts, End of Life University, to hear an interview with Dr. Libby Sallnow, palliative medicine expert and co-chair of the Lancet Commission Report on the Value of Death: Bringing Death Back Into Life. The interview discusses the creation of the Lancet report and its key takeaways, which can form a road map for reform and rebalancing of death and dying in our societies. Libby’s PhD explored the translation of a model of compassionate communities from Kerala, India, to London. Happy listening!
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