Dawn of a new era – or a false dawn?

Richard A Powell, a Global Health Researcher based in Nairobi, Kenya, and former Director of Learning and Research, African Palliative Care Association, Kampala, Uganda.

Richard A Powell

Richard A Powell

The profile of palliative care has increased thanks to commendable global advocacy work – the high point being the landmark resolution passed by the World Health Assembly in May 2014. And yet, the Sustainable Development Goals (SDG) agenda has been comparatively overlooked. Sustainable Development Goals are a set of 17 international development goals and 164 targets that address a diverse range of sustainable development issues, from health to the protection of oceans and forests.

The importance of palliative care in the Sustainable Development Goals agenda was recently outlined in a commentary written by 12 recognised palliative care experts in the February edition of The Lancet Oncology.1 The paper, acknowledging the relative absence of palliative care from the global health dialogue, urges that the discipline should be incorporated into the SDG agenda.

The authors argue that the SDG health goal (to “Ensure healthy lives and promote wellbeing for all at all ages”) should include reference to palliative care, especially in two specific sub-targets. These sub-targets are 3.8, concerning the achievement of universal health coverage, and 3.9b, which aims to “support research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, [and] provide access to affordable essential medicines and vaccines …”

logo The Sustainable Development Goals agenda originated at the 2012 United Nations’ Conference on Sustainable Development held in Rio de Janeiro (Rio+20), and the goals have now succeeded the Millennium Development Goals. Not only will the specific deliverables forge the political agenda for world health for the next 15 years, but crucially they will also guide national governments in the prioritisation of their domestic agendas to meet internationally agreed expectations. And that prioritisation is vital because potentially it will lead to the allocation of funds to achieve the goals.

While proposing an indicator that is relevant to the above sub-targets – i.e., morphine-equivalent consumption per capita – the authors readily acknowledge that it does not in any way capture the holistic nature of palliative care. However, it does ensure that, as an essential aspect of a functioning health system, palliative care is represented, providing a leverage point for advocates to advance the fuller agenda: integration of palliative care within public health systems.

The SDGs are hugely important and will underpin the global dialogue. Palliative care must become an integral part of that conversation, with internationally coordinated advocacy among policy makers and global health and development agencies. In this way, we can ensure that the sun on our collective horizon is truly the dawn of a new era and not a false dawn.


  1. Powell RA, Mwangi-Powell FN, Radbruch L, Yamey G, Krakauer EL, Spence D, Ali Z, Baxter S, De Lima L, Xhixha A, Rajagopal MR, Knaul F. Putting palliative care on the global health agenda. Lancet Oncol 2015 Feb;16 (2):131-133.  

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