As we move forward (or is it backward) towards the UN Summit for Non Communicable Disease, it is essential that we consider both treatment and prevention strategies for NCDs. As Diederik Lohman, of Human Rights Watch, reminds us we should not just be preventing “avoidable deaths,” a common mantra around global health but also preventing “avoidable suffering.”
The Kenyan Cancer Control Strategy provides us with an excellent example of this. The Director of the Kenyan Hospices and Palliative Care Association (KEHPCA), Dr Zipporah (Zippy) Ali, proudly announced the release of that plan with the incorporation of palliative care last week. According to the Worldwide Palliative Care Alliance, they are the 11th Nation to include palliative care in their national cancer control plan and our colleagues at Pallium India, have summarized the palliative care components in a blog this week. We join with Pallium India and the global palliative care community in congratulating Zippy, KEHPCA and the Kenyan government for taking this bold step on behalf of the people of Kenya.
But given it is less than 30 days to the Summit, we can’t stop and celebrate for too long. How do we use the Kenyan example and the language of other leaders to ensure palliative care is available for all? And it is important
The Worldwide Palliative Care Alliance was raised a number of items that we should be looking for in the Document from New York.
- Commit by 2015 to achieve universal access to palliative care, including pain treatment, for those living with non-communicable conditions. Palliative care should be provided from the point of diagnosis throughout the course of the illness regardless of access to disease modifying treatment.
- Ensure access to controlled medications including opioid analgesics for pain treatment for all those living with non-communicable conditions through the removal of excessive legal and regulatory barriers
- Ensure a comprehensive and holistic approach to care and support, including palliative care, for people with non-communicable conditions and their caregivers, including physical, psychosocial, nutritional, socio-economic and legal and human rights.
- Commit to the integration of palliative care into training curriculum of all health professionals
- Recognise the contribution of community carers, particularly women and girls, and ensure that they are adequately trained, supported, equipped and recompensed for their care work to ensure quality care
- Commit to the inclusion of palliative care for non-communicable conditions in all national strategies and budgets related to non-communicable diseases
It may seem a pipe dream to have these included at the late stage of negotiations, but Kenya has made huge strides in including palliative care in its National Cancer Control Strategy, an approach for which the Union for International Cancer Control strongly advocates. And the African Palliative Care Association in a document, Who Cares? Palliative Care: A Special Report, released last week in Africa Health with the support of the Diana Fund suggests ways that palliative care can work throughout the disease trajectory.
- Communication skills
- Dealing with uncertainty
- Management of distressing symptoms
- Psychosocial and spiritual support
- Prevention messages
Yes, prevention messages. Palliative care providers should not be working in isolation. It can be during the unique opportunities that they have in the care of people with NCDs, that palliative care personnel can talk to the family and community members about healthy lifestyle, prevention of illness and early detection of possible illness, encouraging people to seek medical care if symptoms of disease are present.