On this Universal Health Coverage Day, the hope and optimism for the inclusion of an essential package of palliative care within Universal Health Coverage (UHC) remains high.
Promises have been made, both nationally and internationally, that people with palliative care needs will not, and cannot, be left behind as countries move forward with their UHC commitments by 2030.
The theme for UHC Day is ‘Keep the promise’ and we are hopeful. Will countries include an essential package of palliative care in UHC? Will adults and children with palliative care needs get the care they need through the Kenyan UHC pilots and roll out? Will South Africa include an essential package of palliative care within their version of UHC? Will access to palliative care be included in any kind of accountability mechanism following the UN High Level Meeting? What will the Global Action Plan on SDG 3 deliver for the 61.5 million with serious health related suffering from cancer, dementia, HIV and other serious conditions? Time will tell.
Yet, the harsh reality is that time is a luxury that most do not have. Every single day we wait for UHC promises to be kept, we estimate that 60,000 people will die without the palliative care that they need.
Every day, millions of people will live another day with unbearable pain and suffering. Every day, millions of families will face the emotional trauma of watching their loved ones suffer. And every day, households will struggle as out of pocket expenditure on health relating to serious illness will rise.
Lucy Watts MBE, a young woman who accesses palliative care in the UK says “Life without palliative care would be painful and lonely, a horrendous struggle, living with constant, relentless, unbearable suffering. I’d be bed bound and have no life or quality of life. I would not have the amazing life I have now. I also think I would have died long ago without palliative care. I wholeheartedly believe – as do my team – that palliative care is the reason I’m still here, years after I was expected to have died. Palliative care is essential to my life, as well as my survival.”
It is clear that palliative care is part of the solution to ensure quality of life for all people with serious illness. It is person-centred, cost effective and the right thing to do. It alleviates expenditure on medical interventions which do not help, and may even make things worse. It helps people stay at home, if that is where they want to be. It supports family and communities. It provides the psychological and social support that is so crucial but so often neglected. Many countries have shown how it can be done so what are we waiting for?
The UN High Level Meeting Political Declaration was clear on the need to reach the most vulnerable and marginalised. Now is the time to hold our governments to account and make sure these promises are kept. High level events have their place, yet accountability should be focussed on the human impact of these promises being kept in every single community worldwide, every single day.