World Cancer Day Issue; Regional approach to increase access and availability of controlled medicines in French-speaking countries on the African continent

The management of pain is a critical component in the care of people with life-threatening and life-limiting illnesses. In many cases, inadequate pain management measures lead to untold suffering, at times prolonged, that could be avoided. We highlight this today, in commemoration of World Cancer Day, since this issue affects a large percentage of patients living with different types of cancer, and impacts the quality of life for the patient and those who care for them.

One of the major barriers to effective pain management is that many of the medications fall under the category of “controlled substances.” This makes their accessibility quite difficult, despite the key role that they play in palliative and chronic care. Meanwhile, the global debate on drug control policies and access to these pain management opioids has spanned decades. Unfortunately, the obligation to prevent the illicit use of opioids has received far more attention than the obligation to ensure their availability for medical care and pain relief. There continues to be a need to further engage policymakers across the continent to ensure that efforts to improve access to these essential drugs result in safe implementation for those in need.

To further contribute to this cause, the African Palliative Care Association (APCA) has entered into a unique partnership with the United Nations, represented by its Office on Drugs and Crime (UNODC), in a 1-year pilot project whose aim is; To strengthen the capacity of health care professionals in French-speaking African countries to fully understand the importance of medically controlled drugs, to order, prescribe, monitor patients within the health care system, and report on use. It has further components that seek to increase community awareness and advocacy efforts regarding pain management and palliative care in the target countries.

The project brings together the global perspectives of the UNODC with the unique experience and competencies of APCA on the African continent to form a partnership that will engage Ministries of Health, academic institutions, schools of health sciences, health facilities, civil society organisations, and other key stakeholders at national levels.

The project will involve analysis of existing policies to identify gaps and opportunities to support increased access to essential medicines under control, particularly in the implementation and maintenance of a quality palliative care program. Further, the project will support the application of the basic knowledge and skills needed to help health care workers provide adequate pain management and palliative care to patients in need.

With the Democratic Republic of Congo as the pilot site, key project activities will comprise;

Examining the legal and policy frameworks, data and information collection systems specific to the identified French-speaking countries,
Mapping capacity-building needs and intersections where capacity building is essential as part of the targeted geographic strategic approach.
Reproduction and dissemination of existing materials associated with access to controlled medicines and palliative care in French;
Training for physicians, nurses, and pharmacists, establishing a solid knowledge base to build on to increase the capacity of health professionals in four identified provinces in the DRC, including Kisantu General Hospital, Kisangani General Hospital, Mosango General Reference Hospital, and Bwamanda General Hospital
Establishing a cascading training system, reminder/refresher sessions, and professional mentoring to maintain the knowledge and skills developed during the training sessions.

The project launch is set for early 2021 with key stakeholder meetings and is envisaged to transform access to essential pain management medications for patients during its lifespan. The African Palliative Care Association worked to ensure that significant components of the project such as training, stakeholder meetings, material reviews, etc. can be implemented remotely and online, and some materials delivered digitally, in order to accommodate the prevailing travel restrictions and limited physical interactions due to the prevailing COVID-19 control measures in most countries.