A meeting forming the association was held last July, but approval from the Ministry of Justice can take a long time or not be granted at all.
There is growing suspicion and restrictions on non-governmental organizations in Russia and many of the former Soviet republics.
However, palliative care is now included in the national strategy for health care in the Republic of Tajikistan and there is growing support for palliative care as the country continues to reform its health care system.
The TNPCA can now be the focus of palliative care development in the country.
The new director is Dr Furkat Batirov, a traumatologist who, in recent years, has focussed his efforts on palliative care and has been doing training throughout the country with support from the Open Society Institute Assistance Foundation, Tajikistan (OSIAFT).
OSIAFT is part of the Open Society Foundations network and has been supported in palliative care work through OSF’s International Palliative Care Initiative, based in New York.
In the past few years, palliative care has been growing in the country.
In addition to inclusion of palliative care in the national health plan, courses for undergraduate nursing and medical students and post-graduates have been developed and hundreds are now being trained in the basics of palliative care.
Plans are being developed for university courses for social workers and psychologists in palliative care and there are efforts to educate the religious community and even the police.
There are three OSIAFT funded pilot sites, one at the national cancer centre, one at the nursing hospital in Dushanbe, and one at the regional cancer centre in the GBAO autonomous region (see previous ehospice article on palliative care development in The Republic of Tajikistan).
Agreement has been reached to register oral morphine and an effort is underway to acquire a humanitarian supply in the near future for the pilot sites.
Currently only injectable morphine is available and is not frequently used outside the pilot sites.
Last July, an international training program was held for TB physicians on palliative care for Drug Resistant TB and work is planned to organise training on children’s palliative care in the near future.
A national needs assessment has been completed and palliative care standards and clinical protocols for pain and dyspnea have been developed and are awaiting government approval.
The Republic of Tajikistan was in category II of the Global Atlas of Palliative Care at the End of Life – meaning that there was interest in palliative care but no service delivery – a short while ago, but now it is clear that Tajikistan has made some remarkable progress on palliative care in a relatively short time.