Board Position Should Improve Access for Patients with Life-Threatening Illness
(Geneva) –The Executive Board of the World Health Organization (WHO) on January 23, 2014, adopted a groundbreaking resolution urging countries to ensure access to pain medicines and palliative care for people with life-threatening illnesses.
The resolution addresses the health needs of the 20 million people who die each year suffering from moderate or severe pain and other symptoms due to cancer, HIV, and other conditions, and the 40 million each year who require palliative care for relief of pain and other symptoms. More than 6.5 million people are estimated to die each year without any access to pain medicines, almost all in low- and middle-income countries.
“The WHO resolution on palliative care is a real breakthrough,” said Diederik Lohman, senior health researcher at Human Rights Watch. “It clearly and unambiguously recognizes the obligation of all countries to make sure no one needlessly suffers from pain and other debilitating symptoms.”
Most moderate and severe pain can be treated with inexpensive, generic medicines such as morphine. More broadly, palliative care both provides pain relief and seeks to improve the quality of life of patients with life-threatening illnesses and their families. The need for palliative care is projected to grow due to the aging of populations in many countries and the increasing prevalence of non-communicable diseases, such as heart disease, diabetes, dementia, and cancer.
Yet the availability of palliative care is very limited in much of the world. A 2011 study by the Worldwide Palliative Care Alliance found that 74 percent of countries have no palliative care services, or services that reach only a small percentage of the population.
As a result, millions of people suffer unnecessarily from severe symptoms, such as pain or shortness of breath, without access to treatment. Human Rights Watch research in countries like India, Kenya, Mexico, Senegal, and Ukraine has found that for many patients the suffering is so severe that they become suicidal or attempt suicide.
In a report to the Executive Board, WHO said that the increasing need for palliative care demands a sustainable response. It encouraged countries to integrate palliative care into their national health systems, observing that this would not only improve the quality of life of patients but also benefit health systems by reducing unnecessary hospital admissions and use of healthcare services.
The discussion on January 23 was the first by the WHO Executive Board about the importance of integrating palliative care into health systems. Previous discussions have focused on the provision of palliative care for specific diseases such as cancer or HIV. Yet, as WHO notes in its report, palliative care services are required for people with a vast range of health conditions, ranging from cancer, heart disease, and Alzheimer’s to multiple sclerosis, HIV, and tuberculosis.
The resolution urges countries to integrate palliative care into healthcare systems, to improve training for healthcare workers, and to ensure that relevant medicines, including strong pain medicines, are available to patients. It also urges WHO to increase its technical assistance to member countries on the development of palliative care services.
The resolution was drafted under the leadership of Panama by Australia, Chile, Ghana, Libya, Malaysia, Panama, South Africa, Spain, Switzerland, and the US. More than a dozen additional countries co-sponsored the resolution.
The resolution must still be confirmed at the World Health Assembly in May, the annual meeting of health ministers, before it becomes final.
“This resolution offers a roadmap for improving palliative care services,” Lohman said. “If governments follow up, as they should, millions of people will be lifted out of unnecessary suffering.”
Please follow the link to view the resolution: http://apps.who.int/gb/ebwha/pdf_files/EB134/B134_R7-en.pdf