The topic of this year’s World Hospice and Palliative care Day was “Leave no one behind: Equity in access to palliative care”. This is an urgent and important message as the provision of palliative care in most countries lags far behind the need for these essential services. Each year, it is estimated over 56.8 million people, including 25.7 million in the last year of life, are in need of palliative care, of whom 78% live in low- and middle-income countries. However, it is estimated that only about 12% of people needing palliative care receive this care.
WHO continues to work to support countries in the implementation of the 2014 World Health Assembly (WHA) Resolution 67.19 on Palliative Care which states the provision of palliative care is a moral imperative of health systems and it should be integrated into all levels of health care. On 5 October 2021, ahead of the opening of the world congress on palliative care hosted by the European Association of Palliative care, WHO hosted an online workshop exploring the implementation of the WHA resolution to date. Palliative care specialists from different countries described the successes and challenges of expanding access to quality palliative care, thinking through key elements relating to children, essential medicines, and communities.
New WHO resources on palliative care
As WHO continues to support Member States in the implementation of the WHA resolution, two new technical resources have been released which focus on expanding access to quality palliative care. The first of these is a report on Assessing the development of palliative care worldwide: a set of actionable indicators. To date, monitoring the existence and maturity of palliative care services has most often been done by assessing the consumption of opioid analgesics. Although opioids are vital for pain relief in palliative care, they are only one component required for the development of robust palliative care systems. This new WHO resource provides a globally applicable and robust set of palliative care indicators to Member States that can be used to assess and monitor the provision of palliative care services in countries worldwide. Reliable data derived from these indicators can support decision-making by informing health priorities, resource allocation and ongoing palliative care strengthening activities.
The second resource released by WHO on 5 October 2021 supports policy makers through to practitioners to take action to strengthen the quality of palliative care services delivered to patients. Quality health services and Palliative Care supports action across all domains of quality, i.e., effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system.
Quality and palliative care are both embedded at the heart of Universal Health Coverage (UHC), and without concerted action on quality palliative care, the achievement of UHC is at risk. These two new WHO resources will support countries in their journey of providing quality palliative care as part of UHC, alongside other important WHO resources such as the UHC compendium. The compendium now contains a detailed package of palliative care services which can be utilized at country level to develop an essential package of services required to meet palliative care needs. Throughout the UHC compendium, users will also find palliative care linked to multiple other disease programmes to support an integrated approach to palliative care service delivery, including through primary healthcare services.
As described above, currently only about 12% of palliative care need is being met worldwide. WHO will continue to work tirelessly with member states to address this gap in provision and ensure concerted action is taken on expanding access to quality palliative care to ensure no one is left behind.