Continuing the Salzburg Questions series that encourages a global discussion about the key issues affecting palliative care.
Today, ahead of World Hospice and Palliative Care Day tomorrow (14 October 2017), Dr Stephen Connor, Executive Director Worldwide Hospice Palliative Care Alliance (WHPCA), explores the eighth question in the Salzburg Questions that asks Do you know how to access #palliativecare when you need it?
The data suggest not. The World Health Organization and WHPCA Global Atlas of Palliative Care at the End of Life reports that while 40 million people need palliative care annually, including 20 million at the end of life, only 14 per cent of that need is being met at the end of life, and less than 10 per cent overall. Less than one per cent of children who need it are receiving palliative care.
A report released today by The Lancet Commission on Global Access to Palliative Care and Pain Relief suggests that these numbers are as high as 61 million people needing palliative care annually, including 25.5 million at the end of life.
In only 20 countries is palliative care well integrated into the healthcare system, while 78 per cent of those needing palliative care live in low- and middle-income countries with weak health systems.
This draws attention to the fact that palliative care is an essential and needed service and a defining feature of Universal Health Coverage It is impossible to have Universal Health Coverage (UHC) without universal coverage of palliative care.
So what exactly does UHC entail? Universal Health Coverage means that: ALL people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Central to UHC is a focus on equity: ALL people must be able to access these services. Equally important is the provision that seeking these services must not expose people and families to financial hardship or force them into poverty through paying for expensive treatments, travel to services or through loss of income by the person who is ill or their carers.
The sub-themes of World Hospice and Palliative Care Day are: Count, Care and Cost. These speak to the three dimensions that must be taken into account to realise UHC including palliative care: Political and population (count) – Who needs palliative care and who is covered?; Health services (care) – Which services are covered?; and Economics and financial protection (cost) – Who will pay for palliative care as part of UHC and how will they do this?
UHC is a target under Sustainable Development Goal (SDG) #3: Good Health and Wellbeing. There is currently great political momentum around the SDGs.
It is essential to keep palliative care at the forefront of these discussions so that as UHC is realised, anyone who needs palliative care will know what it is, how it could help, and how they or their loved ones could access it if they need it.
- Temel JS, Greer JA, Muzikansky MA, et al. Early palliative care for patients with metastatic non-small cell lung cancer. N Engl J Med 2010; 363:733-742.
More about World Hospice and Palliative Care Day . . .
- Download the Toolkit, posters and other materials
- Register your World Hospice and Palliative Care Day event on the interactive map, and feel free to donate to the World Day campaign through Just Giving.
More about the Salzburg Questions series . . .
- Follow the global dialogue on Twitter. Using the hashtag #allmylifeQs, the nine Salzburg Questions are being debated throughout 2017.
- Follow the EAPC Blog for more posts in the Salzburg Questions series.
- Professor Irene Higginson will be discussing the ninth Salzburg Question on the EAPC Blog on Friday 10 November …