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Direct stakeholders demand palliative care as WHO chief calls for Universal Health Coverage

Author: Kate Jackson, WHPCA
23 January 2018
  • Palliative care delegation at the WHO Executive Board meeting. From left: Dr Katherine Pettus, IAHPC, Dr Ioseb Abesadze, IAHPC, Dr Jim Cleary, WHPCA and Dr Tania Pastrana, IAHPC.

A delegation representing palliative care direct stakeholders and professionals is attending the World Health Organization Executive Board meeting, where Dr Tedros, WHO Director General has called strongly for all member states to adopt Universal Health Coverage.

Addressing the Executive Board, Dr Tedros said: “At least half the world’s population still lacks access to essential health services. And almost 100 million people are pushed into extreme poverty every year because of out-of-pocket health spending. This must end.”

Palliative care is an essential, defining part of Universal Health Coverage, and can contribute to all aspects of this target.

National and regional palliative care organisations around the world asked their governments to make sure that palliative care is included in the WHO General Programme of Work. Thanks to the commitment of member states, this has been achieved, and we look forward to its inclusion in the SDG impact framework and dedicated budget to do the work.

Dr Katherine Pettus, Dr Tania Pastrana and Dr Ioseb Abesadze represented the International Association for Hospice and Palliative Care, and delivered statements on the WHO General Programme of Work, the importance of the Lancet Commission on Access to Palliative Care and Pain Relief, and access to medications. 

Lucy Watts, MBE, and Huyaam Samuels, both direct palliative care stakeholders, sent statements to be read by Dr Jim Cleary and Dr Stephen Connor, who represented The Worldwide Hospice Palliative Care Alliance at the meeting.

On the discussion of the inclusion of palliative care in the General Programme of Work, Ms Samuels said: “I am sorry I cannot be there with you. Recently, I experienced severe pain and was hospitalised from Christmas Eve for nearly a month including receiving urgent medical care within the Intensive Care Unit…

“I heard about the new General Programme of Work language and the possible palliative care target while in hospital. I was so happy. But palliative care must be included in the budget for change to happen. I hope one day to be at the World Health Organization to give you the chance to see not only the importance of the patient’s voice but that it is because of palliative care that I can live well.”

Ms Samuels referenced the need for ongoing education of health care workers in palliative care, as well as the importance of access to appropriate pain medication for those living with a life limiting illness.

In the discussion around the upcoming UN High Level Meeting on NCDs, the palliative care community requests that the WHO member states:

  1. ensure palliative care is included in the preparations for the High Level Meeting,
  2. note that palliative care is not only for adults and children living with cancer but for those living with other NCDs including cardiovascular disease, lung conditions and organ failure, and
  3. listen to those who access palliative care or may in the future.

Ms Watts sent the following statement to contribute to the discussion: “I’m a 24 year old from the UK living with a rare non-communicable disease that means that my life span will be limited. Despite my health challenges including overcoming sepsis 12 times, palliative care has enabled me to lead a fulfilling life including receiving an MBE for my services to young people with disabilities.

“Sadly, I am unable to travel, however, I would like to pass on a message to you today. Palliative care and access to pain treatment enables me to survive and live well. I have a Fentanyl patch which provides a constant stream of pain relief, as well as sublingual Fentanyl which absorbs under my tongue when my pain breaks through; essential since I cannot take medication orally that absorb in the digestive tract, due to Intestinal Failure. I cannot imagine where there are no opioid analgesics to manage pain for people like me.

“We must work to prevent NCDs and address the social determinants of health, but we must also ensure that people like me access the palliative care that I need. For people like me, a shortened life is an inevitability that we live with. Whilst we cannot change the end result, we can greatly improve the journey through managing distressing symptoms such as pain."

These statements by Ms Samuels and Ms Watts remind WHO member states of the importance of their decisions to the people accessing palliative care. They help to ground the high level policy discussions in the reality of living with a life limiting illness.

For more information on palliative care at this year’s WHO Executive Board meeting, you can download the information sheet on palliative care the draft letter sent to governments ahead of the meeting, from the WHPCA website. 

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