On World AIDS Day we celebrate the achievements towards universal availability of comprehensive HIV services, including palliative care in Africa. We celebrate the spirit of partnership between civil society, NGOs and governments in Africa, Europe and the United States with people living with HIV and AIDS and their families.
We also celebrate the researchers who have contributed to the body of new knowledge that has improved the quality of life for people living with HIV and their carers. Increased access to antiretroviral drugs, symptom control medications including oral morphine is also a notable achievement in many countries.
Despite these achievements, there are over a million HIV-related deaths occurring annually in Africa with many of them never having access to ART and to palliative care. In many African countries, the availability of morphine for management of severe pain remains a big challenge.
As we work towards reducing suffering, the palliative care fraternity is challenged to further advocate for integrated, affordable, accessible and sustainable services for patients in all African health care systems. Special effort needs to be asserted into availing services in rural areas where the majority of Africans live. We also need to remain diligent in our inclusion of children and other vulnerable groups in our efforts and plans.
The disproportionate distribution of palliative care skilled health workers between urban and rural areas and the lack of aggressive and proactive staff retention plans in health systems is causing untold suffering to patients, even where medications and physical facilities exist.
The view that the provision of ART alone will address all patients’ needs is slowly being entertained by some due to the pressure of declining resources.
As we face the future in a context of limited resources in the traditional donor communities, prioritisation should not in any way mean limited access to HIV services, including palliative care.
As the palliative care fraternity strives to generate evidence that will inform progressive palliative care policy development and programming, patients will directly benefit from improved services.
Let us not grow weary in embracing the comprehensive palliative care approach which addresses the vital physical, spiritual, emotional and social needs of patients and their families.
With a vision to see HIV patients in Africa benefit from the holistic care that palliative care provides, allow me to wish you a fruitful World AIDS Day.
Dr Emmanuel Luyirika
African Palliative Care Association