Palliative Care Program Network Public Health Program Open Society Institute New York

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Palliative Care ProgramNetwork Public Health
Program Open Society InstituteNew York

• Mary Callaway, Director
• Kathleen Foley, M.D., Medical Director
• Sept. 5, 2005

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Open Society InstituteNetwork Public Health
Program

• HIV/AIDS
• Salzburg Seminars
• OSI Seminar Series
• Policy Fellows
• Global Fund
• Media

• Harm Reduction
• Palliative Care
• Public Health Watch
• TB Prevention Control
• Sexual Health Rights
• Roma
• Tobacco Control

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1982 WHO Definition of Palliative Care The
active total care of patients whose disease is
not responsive to curative treatment. Control of
pain, of other symptoms, and of psychological,
social, and spiritual problems is paramount. The
goal of palliative care is the achievement of the
best quality of life for patients and families.
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• 2002 WHO Definition of Palliative Care
• "Palliative care is an approach which improves
  quality of life of patients and their families
  facing life-threatening illness, through the
  prevention and relief of suffering by means of
  early identification and impeccable assessment
  and treatment of pain and other problems,
  physical, psychosocial and spiritual"

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WHO Monographs

• 1986 Cancer Pain Relief
• translated into 22 languages
• 1990 Cancer Pain Relief and Palliative Care
• translated into 10 languages
• 1996 Cancer Pain Relief with a Guide to Opioid
  Availability translated into 16 languages

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WHO Monographs

• 1998 Cancer Pain Relief and Palliative Care in
  Children translated into 6 languages
• 1998 Symptom Relief in Terminal Illness
• translated into 8 languages
• 2002 National Cancer Control Programmes
• Policies and Management Guidelines
• translated into 3 languages

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World Health Organization
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Palliative Care in Eastern Europe and Central
AsiaHistorical Perspective

• 1998 Poznan Declaration
• 1999 ECEPT organized
• 2000 OSI developed palliative care initiative.
• EAPC-E- Center for palliative care in
  Eastern Europe

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Palliative Care Program

• The overall goal of this initiative is to serve
  as a catalyst to create palliative care as an
  essential aspect of health care policy and health
  care systems and to build capacity for palliative
  care services, education, and advocacy within the
  region.

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Palliative Care Program

• Central Eastern Europe Former Soviet Union
• Began 2000
• Collaboration between Project on Death in America
  and Network Public Health Program
• 500,000 a year for three years
• South Africa
• Began 2002
• 330,000 a year for three years
• International Expansion
• Began 2005
• CEE FSU, SubSaharan Africa, Middle East,
  Southeast Asia, Turkey

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Goals

• Professional Public Education
• Drug Availability
• Policy
• Advocacy

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Professional Public Education

• Integrate palliative care into the medical,
  nursing, social work undergraduate and graduate
  school curriculums
• Health system managers, policy makers, community
  caregivers,
• Enhance the workforce capacity to provide
  palliative care services through
  institutionalization of sustainable training
  programs

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Drug Availability

• Examine and recommend the necessaryt changes in
  national drug control laws and regulations in
  order to guarantee the availability of opioid
  analgesics for pain and symptom management in
  patients with cancer and/or AIDS

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Policy

• Integrate palliative care throughout the
  healthcare system
• Change laws governing the registration and
  licensing of delivery systems
• Integrate palliative care in national cancer
  control and AIDS programs
• Develop national standards and guidelines for
  palliative care

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Advocacy

• Financing for palliative care services from
  government health budget
• Financing for international donors and
  development agencies
• Expand and enhance the capacity of existing
  professional medical associations and
  organizations to support and sustain palliative
  care development

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Programs Supported

• Albania
• Armenia
• Bosnia-Herzegovenia
• Bulgaria
• Croatia
• Czech Republic
• Estonia
• Georgia
• Hungary
• Kazakhstan
• Latvia

• Lithuania
• Macedonia
• Moldova
• Mongolia
• Poland
• Romania
• Russia
• Serbia
• Slovakia
• Tajikistan
• Ukraine
• Uzbekistan

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2000-2005

• grants made to
• National foundations
• NGOs
• Policy Centers
• National and international professional
  associations
• WHO-Geneva, WHO-Euro, WHO Collaborating Center,
  Wisconsin

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Programs Supported

• Palliative Care Resource Training Centers in
  Croatia, Hungary, Mongolia, Poland, Romania,
  Russia, Slovenia
• National Regional Palliative Care Courses
• Meetings with Policy Makers
• Translation of Educational Materials
• Policy Fellows in Croatia and Slovenia
• CEE FSU Newsletter
• Collaborations with WHO, ESMO, IASP, EFIC,
  IAHPC, HtH, EAPC-E, ECEPT

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WHO Cancer Pain Relief and Palliative Care

• Bulgarian
• Georgian
• Hungarian
• Lithuanian
• Moldovan
• Mongolian
• Romanian
• Russian
• Serbian
• Slovenia
• Turkish

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Transitions in End of Life Care
Mapping hospice and palliative care programs
and services in CEE FSU Published by Open
University Press in their Facing Death
Series Distributed to health care policy
makers www.eolc-observatory.net
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Program Supported

• WHO PublicationsSolid Facts, Better Care of the
  Elderly
• WHOCC Romanian Beacon Center Drug Availability
• International Observatory on End of Life Care
• European Association for Palliative Care
• Country Palliative Care Needs Assessments
• Salzburg Medical Seminars
• OSI Seminar Series

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• www.eolc-observatory.net

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WHO/EDM/QSM/2000.4 DISTRIBUTION GENERAL 
Bulgarian--done Georgian--pending Hungarian--pendi
ng Lithuanian--done Moldovan--done Mongolian--done
Romanian--done Russian--done Serbian--pending Slo
venian--pending Turkish--pending
NARCOTIC PSYCHOTROPIC DRUGS  ACHIEVING BALANCE
IN NATIONAL OPIOIDS CONTROL POLICY    GUIDELINES
FOR ASSESSMENT
World Health Organization
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Leverage Other Donors

• Private foundations and donors
• International development funds
• EU funds
• Industry partnerships
• -pharmaceutical companies
• -medical device companies
• -insurance companies
• Government partnerships

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Goals of the Meeting

• To bring together national cancer, pain, and
  palliative care leaders to discuss cancer, pain,
  and palliative care in their countries
• To identify which countries have National Cancer
  Control Programs and whether they include
  palliative care
• To discuss how palliative care can be integrated
  into NCCP

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Goals of the Meeting

• To discuss the challenges of integrating
  palliative care into cancer care
• To discuss an OSI RFP for the development of
  palliative care programs in cancer programs in
  these eleven countries
• To develop action plans for further collaborative
  work together

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The health care system we develop today will be
the system that takes care of our loved ones
tomorrow.