“Most palliative care organizations have a communications strategy. The real opportunity lies in sustaining its discipline when the stakes are high, and the policy environment is complex.” Communications in global health is about how organizations understand and navigate power, influence policy, and position themselves responsibly within society.
For palliative care specifically, this function has become indispensable. We are advocating in politically dynamic health systems, institutionally uneven across regions, and increasingly shaped by public expectation in an interconnected world. Palliative care organizations are no longer judged only by the services they deliver, but by how they engage ministries of health, how they show up in national UHC conversations, and whether they are seen as aligned with rather than peripheral to broader development priorities.
Communications, therefore, is a leadership responsibility, not a support function. It is not simply about explaining what a palliative care organization does; it is about helping leaders read the policy terrain, anticipate shifts in funding or political attention, build coalitions across health and human rights actors, and ensure that palliative care is not just present in the global health ecosystem but contributing meaningfully to how it is shaped. This has always translated into engagement and narrative that drive both policy influence and social impact, the two outcomes that matter most in a field still fighting for a seat at the UHC table.
The Gap Is Rarely the Strategy
Nearly every serious palliative care organization has an advocacy or public affairs strategy. The gap is rarely in the design. It is in execution, particularly when the pressure is real: a funding cycle closes, a ministry reshuffles, a competing health priority crowds out attention. What we consistently see across national and multi-country coordination is that execution breaks down not because teams are unclear on the strategy, but because the organization has not built the conditions required to deliver it.
One of the most persistent structural issues in this sector is that public affairs and communications are lumped together and then collectively undervalued. They are treated as dissemination functions, writing the newsletter, updating the website rather than strategic ones, and as a result, they are excluded from the leadership conversations where direction and decisions are actually made.
By the time communications is brought in, the critical policy choices have already been taken, often without a full understanding of their reputational or advocacy implications. Messaging is then left to catch up to decisions it never had the chance to shape. In a field where policy windows for palliative care integration into national health plans can open and close quickly, that lag is costly.
Execution also breaks where leadership alignment falls away under pressure. In steady state, organizations largely agree on positioning: palliative care as an essential, cost-effective component of UHC. But when risk emerges as a contested budget line, a politically sensitive end-of-life debate, or a donor pulling back, functions retreat into silos. Legal becomes cautious, programme leadership becomes reactive, and communications is either sidelined or pushed into purely defensive mode. In those moments, the strategy fractures precisely when it is needed most.
There is also a tendency, even among well-intentioned organizations, to underestimate what execution actually requires. Strong advocacy delivery is not just about clarity of message. It depends on systems, decision-making discipline, clear accountability, and empowered teams who can move without waiting for every position to be re-approved.
It reflects how an organization is structured to make decisions, how much it genuinely values communications, and whether it treats public affairs as central to strategy or peripheral to it.
Influence is Built Through Relationships and Held to a Standard
In global health contexts, palliative care is no exception; influence is built less through formal processes alone and more through relationships: access, credibility, and trust. That does not mean those relationships should be informal in a way that compromises integrity. Ethical engagement is both possible and necessary, and it is arguably more important in palliative care, where advocacy sits close to sensitive questions of dying, dignity, and resource allocation.
Building trust starts with consistency. Organizations often approach ministries of health or regulators only when they need approval or are under pressure around a policy deadline, a funding gap, or a crisis. That is not relationship-building; it is transactional engagement, and health officials recognize it as such. Trust is built over time, through sustained presence: contribution to sector conversations, evidence-sharing even when nothing is being asked for, and visible alignment with national health priorities rather than only organizational ones.
Access should not be based on proximity alone, but on the value an organization brings. In palliative care, that value is often data on unmet need, programme insights from service delivery, technical expertise on integration models, or the ability to convene stakeholders, clinicians, policymakers, and patient voices meaningfully in one room. The most effective partnerships in this space are grounded in shared outcomes, not short-term interests.
It is critical to anchor these relationships institutionally, not personally. Political leadership changes, sometimes rapidly, and palliative care is still a relatively young priority in many health systems, and is especially vulnerable to losing ground when a single champion moves on. Organizations that build relationships around individuals often lose continuity when transitions happen. Those that invest in broader institutional engagement across technical teams, administrative levels, and policy structures, including engagement with bodies like WHO working groups shaping palliative care guidance, are far better positioned to maintain trust even as the political landscape shifts.
From Messaging to Meaning
Too often, communications in palliative care is reduced to a tactical function: awareness days, campaign toolkits, media statements. These have their place. But there is a persistent underinvestment in communications as a leadership discipline for the field as a whole. Where communications is seen primarily as dissemination or media relations, it is unlikely to be leveraged for the kind of strategic influence that shifts national health budgets or reframes palliative care as essential rather than optional.
Palliative care organizations need to move from messaging to meaning, defining clearly what they stand for and how they want to shape the conversation, not just within the sector, but within the broader UHC and human rights discourse. That requires intentional narrative development: framing palliative care in evidence-based, impact-driven terms, cost-effectiveness, coverage gaps, and quality of life outcomes rather than leaning solely on the language of compassion and responsibility, which, while true, rarely moves a finance ministry on its own.
It requires sustained storytelling across multiple countries and health systems, and a willingness to lead on the harder conversations: access inequity, opioid availability, workforce shortages, rather than wait to respond to them once they become crises.
The organizations that will shape the next decade of palliative care policy will not be those with the most polished campaign materials. They will be the ones who treated communications as a leadership discipline from the start, built into how decisions are made, not brought in after they are taken.
Howard Kinyua
Communications Manager
The Worldwide Hospice Palliative Care Alliance (WHPCA)
Deeply insightful.
Sure, we need to move from ‘messaging to meaning.’
TREATING COMMUNICATION AS A LEADERSHIP DISCIPLINE