Access to medications: Lessons learned from the ATOME project

Categories: Research.

The event was co-sponsored by Latvia, Hungary, Panama, Romania, World Health Organization, European Association for Palliative Care, Harm Reduction International, Help the Hospices, Human Rights Watch and the Worldwide Palliative Care Alliance.

Access to opioid medicines is a major problem in most countries around the world. They are necessary for the treatment of moderate and severe pain, for treatment of opioid dependence and for the prevention of blood borne disease, such as HIV and hepatitis C.  Although these medicines are considered essential medicines by WHO, these medicines are beyond reach for some 5.6 billion people due to over-emphasis on drug control. In palliative care, access to opioid medicines is the first major problem almost everywhere.

The Access to Opioid Medications in Europe (ATOME) Project addresses the inadequate consumption of opioid medicines in 12 eastern European countries by analysing policies and legislation and promoting awareness of the problem among policy makers, health care professionals and the general public. As part of the programme, WHO developed its policy guidelines Ensuring Balance in National Policies on Controlled Substances, Guidance for Availability and Accessibility of Controlled Medicines, which is available in 15 languages.

Speakers at the event included: Professor Dr Lukas Radbruch, President of the International Association for Hospice and Palliative Care (IAHPC), Chair of Palliative Medicine at the University Hospital Bonn, Germany and Chair of the  ATOME Programme Management Team; Willem Scholten, PharmD., MPA, Consultant in Medicines and Controlled Substances; Former Team Leader of Access to Controlled Medicines, WHO; Dr Bogdan Gheorghe, National Anti-drug Agency, Ministry of Internal Affairs, Romania; Professor Dr Marie-Helène Schutjens, Chair of Pharmaceutical Law at the Department of Pharmaceutical Sciences of Utrecht University; Dr Joan Marston, Chief Executive Officer of the International Children’s Palliative Care Network (ICPCN), Cape Town, South Africa; and Dr Kees de Joncheere, Director of Essential Medicines and Health Products, WHO.

Panellists spoke about the vital importance of access to opioid medications for palliative care and pain relief. They addressed the importance of balance in policy between control of illicit substances and access to essential medications, noting that the implementation of drug control measures should not hamper public health. 

Harm Reduction International joined the meeting via Skype to remind the meeting attendees of the importance of bringing together people who are working on pain control and harm reduction groups. The ATOME project encouraged these different groups to talk to each other, allowing suggestions for coordinated action to be tabled that may not have been possible had each group been working alone.

Stephen Connor, co-author of the Global Atlas of Palliative Care at the End of Life reminded delegates that across the world, over one million people die per week, and that over 80% of these do not have access to adequate pain relief.

Dr Connor commended the project, saying that the findings could be used to propel the implementation of the resolution on palliative care to be considered later this week by the WHA.

Dr de Joncheeres presented the lessons learned from the study, noting that Universal Health Coverage (UHC) will be a leading strategy for the World Health Organization for years to come and identified palliative care as one of the core elements of UHC.

He went on to note that it is: “Extraordinarily important” to have multisectoral discussions in this area, saying that “the ATOME project has helped in building a critical mass of interested parties in countries and fostered an approach of common understanding.” Dr de Joncheeres concluded by saying that the awareness raising of these issues has propelled the discussion at the national level.

Dr Joan Marston, Chief Executive of the International Children’s Palliative Care Network closed the meeting with inspirational words. She said: “This project really has the potential to make a great change to all the 5 million people who do not have access to opioids. It shows us that change can happen when people with a common goal come together, adopt a strategy and work together.”

Dr Marston commented on the “respectful” approach taken by the project, where the researchers collaborated with the resources and expertise within the countries, instead of simply importing an approach. She noted: “Going forward, unless we approach this research as a collaborative, it will not work as effectively as it has here.”

Dr Marston concluded: “There are people out there who are suffering, if we don’t do anything about it, who is going to do it? And if we don’t do it soon, when will it happen?”

Find out more about the ATOME project online.

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