African health ministers call for palliative care

KIGALI, Rwanda

African health ministers called on their governments at an international conference on Tuesday to include palliative care in their roadmaps towards universal healthcare.

Speaking at the 6th International Palliative Care Conference in Rwandan capital Kigali, the ministers and other health experts urged African countries to prioritize health in national budgets -- as an investment, not as an expenditure -- in order to achieve universal health coverage that includes palliative care.

Health experts said that without government funding it would be difficult to move the palliative care agenda forward -- yet it is a core component of universal health coverage.

Out of pocket expenditure for some patients and families with palliative care needs is so high and leads some people to fall into poverty every year by using household income for health services, said Dr. Jean-Marie Dangou, representative of the World Health Organization (WHO) regional office for Africa.

"This is not acceptable," he said.

Rwanda’s Primary Health Care Minister Dr. Patrick Ndimubanzi said the country has made significant progress in integrating palliative care as part of universal health coverage out of compassion and humanity as well as to ensure patients dignity.

In Rwanda, palliative care services are defined at all levels from the community to university hospitals, he added.

These services, approved the health ministry, are covered by existing health insurances, where insurance holders has a 10% to 15% co-payment.

Sarah Opendi, Uganda’s Health Minister in charge of general duties, said her country remains committed to ensuring universal health coverage by 2030 which includes palliative care.

She underlined the need for collective role in meeting the moral and legal obligation of ensuring universal access to essential health services, including palliative care and pain relief for adults and children with serious illnesses.

The conference is co-hosted by the African Palliative Care Association and Rwanda’s Health Ministry, and held on Sept.17-20 under the theme Palliative Care and Universal Health Coverage.

The conference served as both an advocacy and reporting opportunity with focus on understanding the trends, lessons and best practices as well as evidence on cost-effective interventions that can enable nations to ensure universal access to palliative care and pain relief as an integral component of universal health care, according to Emmanuel Luyirika, the head of the African Palliative Care Association.

According to Githinji Gitahi, the chief executive of Amref Health Africa -- formerly the African Medical and Research Foundation -- achieving universal health coverage requires countries to find mechanisms to identify the most vulnerable people to start with, and then adding more sections of the populations as socioeconomic conditions improve.

Claire Morris, advocacy director at the Worldwide Hospice Palliative Care Alliance, a global action network focusing on hospice and palliative care development, stressed the need for political will to ensure that palliative care is included in universal health coverage.

According to the WHO, universal health coverage means that all people have access to full spectrum of essential, quality health services they need, including health promotion, prevention, treatment, rehabilitation and palliative care without the risk of financial hardship.

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses, through the prevention and relief of suffering by means of early identification and thorough assessment and treatment of pain and other problems, including physical, psychosocial and spiritual, says the WHO.

In May 2014, the World Health Assembly Resolution called on WHO member states to improve access to palliative care as a core component of health systems, with an emphasis on primary health care and community or home-based care.