Richard Smith, in the BMJ, has warned us of concerns with the UN summit but with 32 days to go (according to my twitter in-basket), the heat is rising in the kitchen. There is real fear that palliative care may not feature as a priority in this “Document/Declaration/manifesto” that is being crafted by UN member states at present.
So I was delighted to see the Briefing paper from NCD Alliance on “NCDs and the Rights-based movement,” delighted because surely this would be the most important argument for palliative care. This is particularly true with the very strong focus that Human Rights Watch, under the guidance of Diederik Lohman, has been placing on the under treatment of pain with a number of recent reports that have added greatly to PPSG’s resources.
- Global State of Pain Treatment
- Unbearable Pain; India’s Obligation to Ensure palliative care
- Uncontrolled Pain: Ukraine’s Obligation to Ensure Evidence-based Palliative Care
- Needless Pain: Government Failure to provide Palliative Care for Children in Kenya.
And around Pain and Human Rights, there has been the work of the International Association for the Study of Pain (IASP) that hosted The First International Pain Summit last year that produced the Declaration of Montreal. This Declaration went onto say……
And, recognizing the intrinsic dignity of all persons and that withholding of pain treatment is profoundly wrong, leading to unnecessary suffering which is harmful; we declare that the following human rights must be recognized throughout the world:
Article 1. The right of all people to have access to pain management without discrimination .
Article 2. The right of people in pain to acknowledgment of their pain and to be informed about how it can be assessed and managed (Footnote 5).
Article 3. The right of all people with pain to have access to appropriate assessment and treatment of the pain by adequately trained health care professionals
I know that briefing papers need to be short to capture our short attention spans and there are competing interests but where is “access to pain relief” in the NCD Alliance Briefing Paper. Morphine gets a mention under “THE RIGHT TO ESSENTIAL MEDICINES AND TECHNOLOGIES”
To comply with the right to health, countries must ensure that health policies address the needs of patients who can no longer be cured, many of whom are victims of NCDs. Quality assured essential medicines and technologies, including but not limited to, opioids such as morphine, insulin, anti-asthmatic inhalers, and various core medications for cardiovascular diseases must be made available to all who need them.
One specific mention!!!
I hope this is not a reflection of the actual document that comes out of New York in just over 4 weeks. In these 32 days, we need to ensure that the care, including palliative care, of those who currently suffer with NCDs does not get lost in the push for prevention strategies.
This is highlighted in today’s editorial from the Bulletin of the WHO by Dermot Maher and Nathan Ford. Their final paragraph reads:
Especially in the current climate of economic crisis, hard-headed policy-makers and decision-makers need effective persuasion when deciding on resource allocation. In articulating the arguments for investment in disease prevention and management, the case has to be made in terms of promoting health as a human right and as a means of contributing to poverty reduction and economic stability. The economic case was made successfully in the past for tuberculosis12 and more recently for HIV,13 and now needs to be developed for investment in a two-pronged approach to the global problem of NCDs: the upstream multisectoral actions for prevention, and the complementary downstream health sector actions for care. The United Nations high-level meeting must balance the priorities for multisectoral and health sector actions so that it will be recorded as a turning point for NCDs.
Let’s make this Summit a turning point for pain relief and palliative care!
After all, it is a human right!