Lukas Radbruch, Incoming Chair of the International Association for Palliative Care
The 66th World Health Assembly was held at the Palais des Nations in Geneva, Switzerland, just two weeks ago. I went there for the day on 22 May and had some time to listen to the plenaries, where the health ministers of one country after the other explained in about five minutes what their country’s healthcare system had managed to achieve, and what were the major barriers and problems it was facing. All of them talked about prevention and cure; I did not hear anything about palliative care.
So why did I go there?
Actually, for a very good reason. On 22 May a side event was sponsored by the permanent missions of Panama, Uganda and the United States, together with the International Association for Hospice and Palliative Care (IAHPC), the Union for International Cancer Control (UICC), the Worldwide Palliative Care Alliance (WPCA), the World Medical Association, the African Palliative Care Association (APCA), the Asociación Latinoamericana de Cuidados Paliativos (ALCP), Hospice Africa Uganda, Kenya Hospice and Palliative Care Association, Open Society Foundations and Human Rights Watch.
This side event was on strengthening palliative care as a component of integrated treatment throughout the life course. It started out with Dr Javier Diaz, the Minister of Health of the Republic of Panama, explaining about the role and responsibility of the World Health Organization and the World Health Assembly in promoting palliative care. He explained that worldwide about 50 million people require palliative care every year, but that in 100 countries no palliative care is available at all. He also stated that this problem could be resolved, as access to palliative care should be established for every patient who needs it.
Prof Onyebuchi Chukwu, the Minister of Health of the Federal Republic of Nigeria, described how palliative care is being developed in Africa’s most populous nation, with huge needs and scarce resources. He talked about the barriers that have to be faced, for example misconceptions about opioid analgesics that have to be overcome.
Ms Kathy Greenlee, the Assistant Secretary of Health for Ageing of the United States of America, discussed the importance of palliative care in a time of ageing populations. Public awareness is all about active ageing, and nobody is talking directly about death, as it is felt to be just too depressing. People want to die peacefully in their sleep, but not many will. A change is necessary, discussing preferences for the end of life. She also stated clearly that the new framework on noncommunicable diseases (NCD) would not be complete without considering palliative care. John Beard, representing the WHO Department of Ageing and Life- course, emphasized this position and explained WHO’s efforts to promote a public health approach to palliative care.
Other speakers included Dr Mary Cardosa, President of the Malaysian Medical Association, and Prof Claude Moreira, head of pediatric oncology at Hôpital Aristide le Dantec in Senegal.
The meeting had an interested audience, which participated very actively in the discussion, and it may well have raised awareness in a number of participants. However, the main goal of the side event was not only to discuss successful palliative care models from different regions of the world, but also to initiate a discussion about a potential resolution to promote access to palliative care for those in need at the next World Health Assembly in 2014.
We hope that this side event will be the first step towards putting palliative care on the political agenda of a major global healthcare organisation!
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