Research essential for universal health and palliative care

Categories: Policy.

Universal health coverage means that everyone has access to quality health services that they need without risking financial hardship from paying for them.

Earlier this year WHO amended its definition of ‘universal health coverage’ to include palliative care. A report by the secretariat cites palliative care as part of the ‘minimum set of health care services’, alongside prevention, promotion, treatment and rehabilitation.

Palliative care can benefit people with a wide range of conditions, at all stages of a disease, from diagnosis onwards, and as Dr Liz Gwyther, CEO of the Hospice Palliative Care Association of South Africa, said in an interview with ehospice last year: “We can’t ignore people who are dying because they don’t fit into our concept of having a healthy community.”

WHO highlighted the importance of research in developing and sustaining a system of universal health coverage at the launch of the report ‘World health report 2013: Research for universal health coverage‘ last week. The report shows how countries can use research to determine what health issues should be addressed, how a system should be structured and how to measure progress according to their specific health situation.

Case studies in the report demonstrate the importance of local and global research for improving health and emphasize the critical need for research to be carried out locally, where researchers can consider specific factors critical to individual countries. 

Launching the report, Dr Margaret Chan, Director-General of WHO, said: “Universal coverage is the best way to cement the health gains made during the previous decade. It is a powerful social equalizer and the ultimate expression of fairness.”

The importance of palliative care research

“The modern palliative care movement was built on research evidence,” says Dr Richard Harding from the Cicely Saunders Institute, King’s College London. “Cicely Saunders was clear that the needs of advanced cancer patients and their families could be best understood and managed through clinical research. Since then, the field of palliative care has moved from a few high income countries to be a global response to need, and has expanded to be applicable earlier in the disease trajectory, across conditions and for older people,” he adds.

On the subject of universal health, Dr Harding says: “To truly achieve the right to universal health, research is essential so that funders, policy makers, clinicians and patients can advocate and choose care options that are effective, meet preferences and are appropriate to setting. This requires us to generate high quality evidence to determine needs, preferences and effectiveness across many conditions, care settings, and national boundaries. Universal health coverage can then be provided that meets public health need at population level, meets choices at the individual level, and is demonstrably effective in improving patient outcomes while being cost effective within health systems.”

In the UK, the national charity Help the Hospices established a Commission into the Future of Hospice Care to help hospices prepare for the challenges of the future. Emerging findings from the Commission point to the need for local hospices to engage in palliative care research. 

Laura Hamblin, the Commission’s project manager, commented: “In order to thrive in the future, it is clear that hospices cannot solely rely on a reputation as excellent providers of care. They must engage in rigorous research and provide serious data to underpin their claims of effectiveness and cost effectiveness. Hospices must develop their capacity to research and collect data in all settings – potentially working with academic institutions to achieve this.”