A call to action for regional and national palliative care organisations …

Put Palliative Care into the Political Declaration for the 3rd High-level Meeting on NCDs!

In this advocacy backgrounder, Katherine Pettus, PhD, International Association for Hospice & Palliative Care (IAHPC) Advocacy Officer, explains how global organisations are working together to ensure that palliative care language is included in the Political Declaration, where it is currently absent. And to help you play a vital advocacy role, there are several resources to use.

Katherine Pettus

Brief background

Before a high-level meeting such as the one coming up at the United Nations on non-communicable diseases (NCDs) in September, two leading member states produce a ‘zero draft’ of text that all other member states, advised by civil society organisations, negotiate, contribute to, and polish over subsequent months. The zero draft is the first draft of what usually ends up as a consensus Political Declaration and General Assembly Resolution that expresses what is called “the will of the parties”.

Uruguay and Italy are leading this process for the 3rd High-level NCDs meeting, and in June released the zero draft of what will be the final Political Declaration. That zero draft does not mention palliative care at all!

This is not surprising: Foreign Affairs Ministry (MoFA), not Health! (MoH) staff, are leading the drafting and negotiations process on the Political Declaration in most countries. This is because the main focus of the document is to recommend trade and fiscal policies that “prevent and control” NCDs, rather than health policies to care for the millions of people suffering from NCDs that are not prevented and controlled. This is precisely where and why palliative care must enter the narrative.

MoFA staff negotiating the text don’t usually know much about health policy, let alone about palliative care for NCDs. Although they consult with their MoH counterparts, the impact of those consultations varies from country to country, according to palliative care literacy levels of MoH staff. This is where national and regional palliative care organisations can serve as essential ‘connective tissue’ between communities and governments. Governments must know about your work, and be shown precedents!

Good advocacy ensured the inclusion of palliative care in the 2017 Montevideo Roadmap.

Precedent is all in United Nations’ negotiations over text!

The 2012 Political Declaration and the 2013 follow-up report include palliative care language, although the 2014 Political Declaration contains none! BUT, good advocacy ensured the inclusion of palliative care in the 2017 Montevideo Roadmap, which originally ignored it.

It is much easier for advocates to make the case for national palliative care policies when high-level declarations contain explicit language recommending that UN member states develop services. A vacuum in language provides an excuse for policy vacuums, which have existed for too long with regard to palliative care education and implementation.

IAHPC, the Worldwide Hospice Palliative Care Alliance (WHPCA), the Union for International Cancer Control (UICC), and the NCDA (Non-communicable Diseases Alliance) are all submitting comments on the zero draft requesting the inclusion of palliative care at different places in the text. IAHPC endorses all these submissions. We believe that it is good for member states and ministries to see that four different global organisations, with different constituencies, are concerned about this issue and advocating to ensure inclusion of palliative care language.

Please take some time to do some advocacy with your government!

There is no policy without evidence-based advocacy. IAHPC cannot advocate directly with governments. Only citizens can. Your governments will be negotiating the text and (with your help!) considering our submissions in the next few months.    

Introduce yourself and your organization to NCD staff in your ministries of health. Let them know that you support inclusion of palliative care language in the Political Declaration under construction.

The text of the zero draft and the IAHPC submission are posted on the IAHPC website. The NCDA submission is posted on their website.

The next phase of negotiation on the text will take place today, 11 July, and 18 July, so please make sure your country negotiators are informed of our position.

Please direct any very welcome questions, comments or feedback to me, Katherine Pettus.

Links and resources

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