Palliative care features in the country reports of Armenia, Russia, India and Mexico.
The World Report 2015 does not mention a change in the state of palliative care in Armenia,since the publication of teh last World Report in 2014. According to the Report, tight police controls and policies restricting access to essential opioid medications “continue to obstruct the delivery of adequate palliative care, condemning most terminally ill patients to unnecessary suffering” (HRW 2015).
Although local press has reported on Armenian government plans to launch a palliative care system “in the coming couple of years,” the results of these efforts have not yet been observed.
The publication reports some positive developments in Russia. These include the introduction of clinical guidelines on pain treatment for children, and the acquittal of two women charged with drug trafficking for helping a patient in severe pain obtain essential pain relieving medications.
HRW reported on the amendment of the Narcotic Drugs and Psychotropic Substances act in India in February 2014. This positive development shows a change from last year’s World Report in which HRW noted that progress in palliative care had “slowed considerably” in that reporting year (HRW 2014).
HRW commended this change, noting in the World Report 2015 that: “More than 7 million people in India require palliative care every year and the new revisions to the law will help spare them the indignity of suffering needlessly from severe pain” (HRW 2015).
Human Rights Watch has been working to improve access to palliative care in Mexico and, as part of this work, has produced the report, ‘Care When There Is No Cure: Ensuring the Right to Palliative Care in Mexico’.
In their World Report 2014, HRW reported that although legally, patients and their families had a right to palliative care, these rights were not claimed.
Structural barriers such as inadequate coverage by health insurance schemes, obstructive drug control regulations and insufficient training of palliative care workers made it too difficult to do so.
This year’s World Report reflects the progress that has been made in that country, while still recognising that access to palliative care is far from universal in Mexico.
The government has announced efforts to draft a national palliative care strategy, as well as work on a government health insurance scheme for the poor. Drug control regulations are being reviewed to make access to essential medicines easier for those who need them.
However, researchers point to the great unmet need remaining, and the work that still needs to be done. The report states that as of the beginning of this year: “Tens of thousands of patients require end of life care in Mexico every year but only a small minority can access it in practice” (HRW 2015).
Access to pain relief and palliative care remains a global human rights issue. For example, a proposal has been submitted to the Commission on Narcotic Drugs to schedule ketamine, a painkiller commonly used in surgery in low and middle-income countries.
Human Rights advocates are joining medical professionals in advising against this move.
Read the full Human Rights Watch World Report 2015 online.