A new paradigm for public health: implementing a palliative care resolution

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Dr Marie-Charlotte Bouësseau is Adviser at the Department of Service Delivery and Safety at the World Health Organization in Geneva. Dr Bouësseau spoke to ehospice about the implementation of the WHA resolution: ‘Strengthening palliative care as a component of integrated care throughout the life course’, how local services can use this document, and the potential of palliative care to model a new paradigm for public health.

A physician and an ethicist by training, Dr Bouësseau has been tasked with coordinating the implementation of the Resolution at WHO headquarters in Geneva.

Strengthening palliative care as a component of integrated care throughout the life course

The Resolution represents a global commitment from the 194 member states of the World Health Organization to put in place and implement policies in palliative care, and a move from fragmented efforts towards worldwide collaboration.

“With the resolution we have something quite new at a global level,” says Dr Bouësseau, speaking to me at the World Congress of the European Association for Palliative Care. “We have a great opportunity to benefit from this commitment and to strengthen programmes all around the globe.”

A transversal approach

Implementing the Resolution will not be achieved by working in silos, argues Dr Bouësseau, but rather calls for “a transversal approach,” which requires a commitment to effective partnership by many different groups, such as policy makers, Non-governmental Organisations and healthcare professionals.

Patient and family caregivers must be included in this discussion. Dr Bouësseau says: “the voice of patients and the family caregivers is extremely important if we really want to integrate the different aspects of palliative care, including social care.”

Palliative care as part of Universal Health Coverage

Palliative care is included in the WHO definition of Universal Health Coverage (UHC), a priority of the Organization’s work. According to Dr Bouësseau, an important function of the Resolution is to ensure that the palliative care component of UHC is achieved. “One of the most important components of this global commitment is to ensure that palliative care is provided to everybody,” she says.

Dr Bouësseau noted that legal barriers, such as lack of access to opioid medication, impeded access to palliative care. Lack of trained human resources and poor public education also stop people accessing these vital services.

Palliative care is applicable throughout the life course, and can improve the quality of life and death for people with any life-limiting disease. Dr Bouësseau noted that: “a strong message of the Resolution is that palliation should be a concern at an early stage, not only when people are at the very end of their life,” saying that palliative care should be integrated into other forms of care; and not only for cancer, but also for people affected by communicable diseases such as HIV and TB .

“That is why the department where I work, Service Delivery and Safety, is involved,” she said. “Palliative care is not a need for some specific diseases, but it is really for all patients suffering from life-threatening illnesses through their life course and as such it is a responsibility of health services.”

Dr Bouësseau specifically recognised the need for quality palliative care for children, saying “(this) is a particular concern because we know that there is a very big lack of access for children…read more

From ehospice