The meeting consisted of a half-day session as part of a broader meeting for national non-communicable diseases (NCDs) programme managers from 24 Francophone Member States in the WHO African Region.
This consultation, directly linked to the palliative care resolution adopted at the 67th World Health Assembly, had two main objectives:
- to sensitise NCD programme managers to the principles and the scope of palliative care through international experience sharing; and
- to seek participants’ feedback about the Palliative Care Programme Manual under development.
This manual is part of a set of tools that WHO Headquarters has been developing in 2015, with input from the WHO ad-hoc technical advisory group on palliative care and long-term care.
Its aim is to support Member States in establishing palliative care services in a very practical way, from planning to implementation, with an emphasis on primary care, community care and home-based care.
Dr Marie-Charlotte Bouësseau, Advisor at WHO Headquarters (Service Delivery & Safety), said: “What matters most is that the Programme Manual remains relevant and appropriate in various national contexts, with different health systems.
“This is the reason why we wanted it to be reviewed by the representatives from Ministries of Health, and WHO Country Offices in the African Region”.
Before discussing the draft Manual, representatives from Senegal, Cameroon and Niger outlined the main barriers, challenges and priority actions for the development of palliative care in their countries.
“As a result of epidemiological transition, NCDs are responsible for a large amount of premature deaths in the WHO African Region, said Professor Jean-Marie Dangou, regional advisor for NCDs at WHO African Regional Office.
“They also lead to physical, psychological, and spiritual suffering. Therefore, it is important to incorporate palliative care in NCD programmes, because people want more equity, respect for their basic human rights, and for their dignity”.
The first step in strengthening palliative care in health systems is to tackle the issue of opioid availability in Francophone African countries.
“There is really a cluster of barriers that together impede the use of opioid medications in most of the countries in the region,” explained Diederik Lohman, Associate Director with the Health and Human Rights Division at Human Rights Watch.
“There is a lack of training of healthcare providers, a lack of availability of oral opioids, often even in major hospitals; and restrictive regulatory requirements that complicate medical use, such as limits on the number of days a prescription can cover… In order to ensure people can access palliative care and pain management, these barriers have to be addressed simultaneously.”
Further consultation meetings are planned in the Eastern Mediterranean, South-East Asia and Western Pacific WHO Regions during the next months, with the same agenda: raise awareness and involve key actors in the dynamics of the WHO Palliative Care Resolution.
Dr Sébastien Moine is a General practitioner and PhD candidate in Public Health at Laboratoire Educations et Pratiques de Santé, EA 3412, Université Paris 13. He is a member of the scientific council of the French Society for Palliative Care (SFAP).