Worried by the soaring cases of people presenting to health facilities with diseases that cause excruciating pain such cancers and HIV/AIDS, medical practitioners in sub-Saharan Africa now want palliative care given the prominence it deserves.

They are pushing for a comprehensive policy on Palliative Care to reduce the disease burden, particularly on the poor.

Speaking at the recently concluded international conference on palliative health care in Windhoek Namibia, speaker after speaker rallied stakeholders to advocate and pressure their governments to put in place such policies.

Their concern is informed by the fact that in most of the African countries, palliative care, especially for terminal illness, is not part of the national health policy.

Those who suffer from this terminal illness have to use their own resources to buy expensive medicines. But the biggest sufferers are the poor who cannot afford them because of abject poverty.

According to World Health Organization, palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with 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, psychological, and spiritual.

Studies show that of the 45 million people who die annually in developing countries, particularly in Africa, at least 60 percent will have a prolonged advanced illness that requires palliative care.

According to Dr Henry Ddungu, an Advocacy Manager with African Palliative Care Association, over 90 percent of patients with advanced cancer and HIV/AIDS experience severe pain that need palliative acre. But he warns that funding antiretroviral treatment should be used an excuse to deny funds to palliative care.

With at least two family members involved in the management of patients with terminal illness, doctors believe the burden would be reduced by over 70 percent if palliative care is embraced.

Addressing participants at the Namibia conference, Dr Ddungu added that pain severity decreases the quality of life for any patient, and access to strong painkillers should be seen as a right for patients with cancer and HIV/AIDS, among others.

Indeed, the 2002 Cape Town declaration on Palliative care states that palliative care is a right to every adult and child and should be made accessible and affordable.

During the Namibia conference that brought together nurses and community based workers from 18 African countries, health experts called for an urgent measure to ensure those affected with terminal illness, particularly the poor, access the essential drugs.

Even though Kenya is among African countries where palliative care is well established, there is no comprehensive policy to guide the delivery of services in this area.

Speaking at the Windhoek conference, the Namibian Minister for Health Dr Richard Nahabi Kamwi decried the reluctance of African governments to scale up palliative care therapy, saying it is leaving those who desperately need this service worse-off.

He said his government has already changed the laws to ensure there is increased access to Opioid drugs needed in palliative care.

 “We have included palliative care in HIV/AIDS policy because we believe it has to be used in the management of AIDS,” says Dr Kamwi.

Opioid drugs also called narcotics are one of the strongest painkillers used in the treatment of cancer pain.

Access to such drugs has been a source of debate with one group arguing for increased access Opioid for patients with cancer or terminally illness, while another warning of the associated side-effects.

There are also those who argue that chances of addiction to Opioids are high among those who use them on a regular basis. The high cost of the drugs, restrictive laws and poorly developed health systems in many African countries are also an area of concern.

Dr Julia Dawning, Deputy Director, African Palliative Care Association (APCA) stressed that this issues must be addressed if comprehensive care for patients whose disease are not responding to curative treatment, is to be ensured.

“We do not need to wait until someone is about to die to control pain. Dying needs to be part of normal life, therefore, we need to look at a patient in totality,” she said.

Dr Dawning beseeched African governments to implement a palliative care policy which can offer support system that guarantee patients with terminal illness a productive life until they die.

“A palliative care is a philosophy that is applicable from diagnosis until death and then into bereavement care of the family, she added.

But proponents of palliative care argue that people with terminal illness will only enjoy what is being proposed by Dr Dawning and others if a comprehensive palliative care policy is put in place.

Says Dr Faith Mwangi-Powell, Executive Director of APCA: “There is need to put in place such a policy and to improve the knowledge of healthcare practitioners on policies, tools and infrastructure necessary to make Opioids available in their own settings.”

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