In yesterday’s post, representatives from the International Association for Hospice and Palliative Care (IAHPC) and the Worldwide Hospice Palliative Care Alliance (WHPCA), explained how they worked hard, together with other organisations, to ensure that palliative care had a strong voice at the recent World Health Organization European Regional Meeting in Budapest.
Today, Dr Katherine Pettus, Advocacy Officer of the IAHPC, explains the impact of the side events at the meeting and the need for more research and collaborative advocacy.
Several stimulating Technical Briefings and side events at RC67, with bearing on access to palliative care, included the following:
‘Ensuring positive outcomes for health at the country level’, a discussion of the benefits of Universal Health Coverage in resource-limited countries; ‘Responding to antimicrobial resistance (AMR): lessons learned from multidrug-resistant tuberculosis; ‘Technical Briefing on the Investment case for Sustainable Development Goals (SDGs)’, and ‘Investment for health and well-being: Strategies and practical examples.’ 1
Although the links between AMR, TB, and palliative care are not immediately obvious to health policymakers at the moment, the health system need for palliative care will spike astronomically if health systems don’t solve the growing problem of AMR. With regard to TB, the World Health Organization is updating its guidance and guidelines for palliative care in TB. The briefing on the investment case for the SDGs presented evidence that governments could realize a 14/1 return on public health investments. Although policymakers see most of this funding going to prevention, advocates for palliative care as an essential service under UHC must also present evidence for the return on investment (ROI) for palliative care. One attractive approach, which was beautifully expounded at the Investment for Health and Wellbeing Side event, was the Social Return on Investment (SROI) model.
This public health approach studies health and wellbeing investments that produce returns in dimensions other than profit margins. It emphasises value-driven investments that are socially just and inclusive. In the words of report author, Christoph Hamelmann, “Optimizing social returns brings governments closer to realising the right to health, the highest attainable standard of health – attainable in the sense of global and local solidarity. Investments that benefit those who need them most.
What we need – research and collaborative advocacy
Advocates need research to make the case that policymakers can apply the Social Return on Investment (SROI) model to support publicly funded palliative care under UHC. The current model: private funding by financially strapped charities and faith-based organisations, is unsustainable in the face of the epidemic of non-communicable diseases, including the dementias, and the demographics of ageing, which are also affecting resource-challenged countries. One SROI palliative care research project is ‘Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program)’.
What I heard in Budapest was that policymakers need the evidence for what providers already know: that the clinical, psycho-social, and spiritual support they give patients and caregivers through life-limiting illness, improves family, community, and ultimately national health outcomes in multiple domains. Collaborative advocacy is also required to ensure that palliative care is included in the spectrum of primary care and public health in the revised Alma-Ata Declaration to be unveiled at next year’s 40th anniversary celebrations.
EAPC researchers could contribute by providing the preliminary evidence to present at the next WHO Regional meetings next year in Rome, and 2019 in Copenhagen.
- Health Evidence Network Synthesis Report 51 ‘Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020.’
- If you missed the first part of this post, click here.
- For more posts from Katherine Pettus, follow her regular Policy and Advocacy page in the IAHPC Newsletter.
- You can read more posts on policy and advocacy on the EAPC Blog.