Engaging Health Ministers to Integrate Palliative Care Into National Health Systems in Africa

Abstract

Background and context: The African Palliative Care Association (APCA) is a pan-African entity aiming to strengthen health systems in Africa by integrating palliative care for life threatening illnesses. Africa has 54 states and 1.2 billion people with high burdens of cancer, HIV and other infectious and NDCs for which palliative care is needed. Most of them lack national palliative care policies, palliative care delivery system, access to controlled medicines and radiotherapy for treatment or palliation of cancer. Aim: The aim was for APCA to gather ministers of health from Africa to be informed about palliative care and have them support the setting up of sustainable palliative care models in their countries. Strategy/Tactics: The strategies involved contacting individual ministers by country and specifically sharing with them the evidence in terms of palliative care need, making them aware of national, regional and international frameworks that commit them to support palliative care integration into health systems, improving access to controlled medicines, radiotherapy and other palliative care interventions. These frameworks include their own national laws and policies, the 2012 African Common Position on access to controlled substances for pain control, the WHA resolutions related to palliative care and cancer and the international frameworks calling for balancing control and access to controlled medicines for medical and scientific use. APCA working with host ministers of health at the international triennial palliative care conference, organizes a preconference African ministers of health session on palliative care. Program/Policy process: The process involves engaging APCA partners to fund the ministers´ palliative care session. APCA then works with the minister of the host country to invite African ministers to a one-day session where selected ministers share their best practices and challenges. International agencies such as WHO, IAEA, INCB and UICC have a chance to update the ministers too. The host country provides security and protocol requirements while APCA and partners work on the technical input into the day´s program and the preparation of the declaration which is passed at the end of the session. Outcomes: Two ministers of health sessions on palliative care have been held. The first was cohosted with the Minister of Health of South Africa in 2013, attracted 92 delegates from 23 countries. It resulted into the Johannesburg Declaration with ministers committed to supporting palliative care and working together on a consensus before the 2014 WHA Palliative Care Resolution. The 2016 meeting was held in Kampala attracted 163 delegates from 48 countries who signed on the Kampala Declaration committing to implementing the WHA PC Resolution and availing essential technologies. What was learned: Ministers in Africa are open to engaging with civil society to improve the health system and access to cancer and palliative care.