This week is an important week for the NCDs agenda. The consultations taking place in Geneva are to enable member states to provide input and feedback on the Zero Draft on the WHO Global Action Plan on NCDs 2013-2020 and the draft of the Monitoring and Evaluation Framework on NCDs. Both of these documents will be fundamental in directing the response to NCDs of UN agencies, including WHO and governments, in the next 8 years.
As was highlighted in the United Nations General Assembly Political Declaration on NCDs, palliative care is a fundamental component in the response to non-communicable diseases. Evidence has shown how palliative care relieves pain and suffering, supports family members and carers, is cost effective and can be integrated into existing health systems in low and high resource settings. Despite this, 42% of the world’s countries have no identified hospice and palliative care services and the availability of medications for palliative care are extremely inequitable. 99% of deaths with untreated pain from cancer and HIV occur in the developing world.
The Political Declaration strongly committed to the development of palliative care services and this must be reflected in the Global Action Plan on Non-Communicable Diseases and the Global Monitoring and Evaluation Framework on NCDs.
Organisations working in palliative care worldwide have therefore developed documents supporting specific and general requests to improve the inclusion of palliative care within both documents. National and pan-national organisations are requested to engage the NCDs leads in their governments to raise the following points.
1. Global Action Plan on Non-Communicable Diseases – 1-2 November 2012
The need to reduce suffering associated with NCDS needs to be specifically identified within the context and scope of the WHO Global Action Plan
Actions to improve access to palliative care must be much more strongly referenced within the Global Action Plan, particularly in relation to Objective 5
Palliative care is a core part of comprehensive primary care. The Global Action Plan should clearly identify the need to integrate palliative care into primary care as the latter is scaled up
The term “Prevention and Control” must be clearly defined as including management of pain and symptoms and palliation as a core part of control
The comprehensive nature of the political declaration covering promotion, prevention, treatment, rehabilitation and palliative care should be fully reflected across the vision, goal, objectives, targets, outcomes and actions of the Global Action Plan
All references to essential medicines should refer to the WHO Essential Medicines List to ensure that palliative medications, included controlled medications, are included.
2. Global Monitoring and Evaluation Framework on Non-Communicable Diseases – 5-7 November 2012
Inclusion of the treatment target aligned with the WHO essential medicines list
The retention of an ‘Access to palliative care indicator’
The most appropriate, effective and applicable measure of access to palliative care is selected. The current preferred indicator is “per capita morphine equivalent consumption of strong opioid analgesics (excluding methadone)”.
This is a prime opportunity to reduce the unnecessary pain and suffering of millions of people in this country and around the world. We thank you for consideration and your support to date.